KENYA: New PMTCT guidelines to save moms and babies

Photo: Julius Mwelu/IRIN

A new triple-therapy drug regimen replaces single-dose nevirapine

NAIROBI, 28 August 2009 (PlusNews) - A more effective antiretroviral (ARV) regimen for pregnant HIV-positive Kenyan women lies at the heart of new national guidelines for the prevention of mother-to-child HIV transmission {PMTCT).

Now, a combination of three ARVs - zidovudine (AZT), nevirapine and lamivudine (3TC) - will be used for mother and baby, rather than the single dose of nevirapine administered previously, which led to some women and children developing resistance to the drug.

"With these guidelines we intend to move into more efficacious regimens," Dr Martin Sirengo, the PMTCT programme manger at the National AIDS and STD Control Programme (NASCOP), told IRIN/PlusNews.

Although the government intended phasing out single-dose nevirapine in PMTCT altogether, the new drug regimen will take some time to implement as it involves additional costs and training for health workers.

The guidelines, issued in the capital, Nairobi, on 26 August, also state that HIV-positive mothers should exclusively breastfeed their infants for six months, with replacement feeding recommended only when it was affordable, feasible, accessible, safe and sustainable. Earlier prevention guidelines were less specific about feeding options.

The strategy is also aimed at men. "Male involvement is key to our success in rolling out an effective programme for prevention of mother-to-child transmission of HIV," said Beth Mugo, Kenya's Minister for Public Health.

According to the Ministry of Health, 90 percent of women attending antenatal clinics agree to be tested for HIV, but only 10 percent of their male partners accompany them and are also tested. Couples counselling and incentives like delivery vouchers for those who attend together are being implemented to encourage male participation.

NASCOP's Sirengo noted that female-specific HIV-prevention activities were crucial to reducing the number of infants born with the virus - three out of every five HIV-positive Kenyans are women.

"Because a majority of infants get infected through the mother, it is important to reduce the HIV burden among women if we are to succeed in eradicating paediatric HIV and preventing new infections involving children," he said.

Every year more than 114,000 babies are exposed to HIV, and at least 45,640 are born HIV-positive. Kenya has more than 4,000 health facilities offering PMTCT services, but more than half of all pregnant women opt for home births.

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