Efforts to end HIV infections in children hit a snag
The gains Kenya has made towards reducing transmission of HIV from positive mothers to their children are being eroded.
A new study has shown that mothers who are either expectant or breastfeeding fail to religiously take their antiretroviral drugs (ARVs).
As a result, the number of children getting infected with the virus has more than doubled over the last two years, seeing 22 children acquiring HIV and 12 dying every day across the country, the study by the Ministry of Health notes.
According to the first national integrated stock taking report on elimination of mother to child transmission of HIV and syphilis (eMTCT), children accounted for 15 per cent of all new infections, with 4,312 dying from HIV last year.
“Currently, 22 new HIV infections occur daily through mother to child transmissions, and one in every three pregnant women attending antenatal care is an adolescent. This is unacceptable,” said Dr Catherine Ngugi, National Aids and STIs Control Programme (NASCOP) STI Programme Manager.
NEW INFECTIONS
Some of the children were infected during breastfeeding after their mothers stopped taking ARVs, while others stopped taking the drugs during pregnancy.
Others did not get their ARVs during their pregnancy. The report does not state why this happened. These gaps mean there were 1,073 HIV-infected infants who were not put on treatment in 2018, the report said.
As a result, the number of mothers who were not on any antiretroviral treatment doubled from 6.7 per cent in 2016 to 12.4 per cent. “The high transmission rate is unacceptable and must be reversed,” Health Principal Secretary Susan Mochache said at the meeting last week.
Over half (or 4,108) of these new infections occurred in eight counties: Homa Bay, Nairobi, Siaya, Kisumu, Kakamega, Migori, Nakuru and Busia.
VALIDATION
Wajir, Tana River, Lamu, Marsabit, Mandera, Isiolo, and Samburu were among counties with the lowest infection rates.
“I am aware that several countries have already been validated for eMTCT of HIV, and I am keen to see our renewed commitment to this agenda. I would particularly want us to be the first country in this region to be validated,” Ms Mochache said.
According to World Health Organisation (WHO) guidelines, for a country to be validated (recognition for eliminating mother to child transmission), it must have administered HIV and syphilis testing to 95 per cent of pregnant women accessing antenatal care and put those diagnosed with the diseases on treatment. So far, only 11 countries have been validated.
Statistics also indicate that last year, 52,800 Kenyans were newly-infected, including 8,000 children and adolescents under the age of 14.
SHORTAGE
Some of the challenges that could be reversing these gains also include shortage of ARVs, especially those given to the 69,000 children born to HIV-positive mothers.
In June, medical personnel in public hospitals lamented the shortage of the drugs given as prophylaxis in syrup form to newborns to prevent them from contracting the virus. The drugs, nevirapine and zidovudine, also reduce the viral load.
According to the 2018 guidelines on using ARVs for treatment and prevention of HIV, all HIV-exposed babies should receive infant ARV prophylaxis, consisting of six weeks of zidovudine and nevirapine, and thereafter continued doses of nevirapine until six weeks after complete termination of breastfeeding.
TARGETS
To reverse the trend, Dr Ngugi urged pregnant women to give birth at hospitals, where their health and that of the baby can be monitored.
“We are encouraging all expectant women to give birth at health facilities where they can be tested. And if found to be HIV positive, they can be put on medication so that the country achieves a target of less than five per cent of mother to child transmission,” she said.
The United Nations Programme on HIV and Aids (UNAIDS) notes that though there has been steady progress in the reduction of HIV and Aids-related deaths over the last decade, the gains are getting smaller year after year. In Kenya, 1.6 million people are infected.
“Efforts to reduce HIV infections are clearly off track. And while reductions in HIV and Aids-related deaths are stronger, mortality-reduction targets could also be missed,” the report says.
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