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 Sunday 07 December 2008
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KENYA: Testing for mother and child saves lives

Photo: Allan Gichigi/IRIN
Many babies aren't tested for HIV because their mothers have never been tested
NAIROBI, 4 December 2008 (PlusNews) - Maurine Kamau* lost her first child immediately after birth but did not discover why the baby had died until she fell pregnant a second time and tested positive for HIV at the Nazareth Mission Hospital, on the outskirts of Nairobi, capital of Kenya.

She received counselling at the hospital's prevention of mother-to-child HIV transmission (PMTCT) unit and her second child tested negative for HIV. Now four months old, the baby is doing well and has regular check ups at the hospital.

"I also joined the mother-to-mother mentoring programme, where we are encouraged and advised on how to care for our children, and even our partners," Kamau told IRIN/PlusNews.

The Nazareth Mission Hospital is run jointly by the government and the Catholic Church, but is given considerable support for its PMTCT and paediatric services by Catholic Relief Services, a US-based international development NGO, and the Clinton Foundation, which works to promote health and economic empowerment.

Without such support, most government health facilities would not have the resources to perform the polymerase chain reaction (PCR) testing for HIV DNA that is used to diagnose HIV in infants younger than 18 months, the only way to diagnose HIV in babies.

A lack of HIV testing for pregnant women and early diagnosis for infants means that many babies in Kenya and other poor countries do not make it to their second birthday. A UN report released on World AIDS Day on December 1, found that only 18 percent of pregnant women in low- and middle-income countries were tested in 2007.

Despite evidence that children under the age of one year are the most vulnerable to HIV and AIDS, and that early diagnosis and ARV treatment can improve their chances of survival by 76 percent, the report noted that only eight percent of children with HIV-positive mothers were tested before they were two months old.

Paediatric services lagging

Kenya has made impressive strides in providing PMTCT services - in 2007 an estimated 69 percent of HIV-positive pregnant women received ARV (antiretroviral) drugs to prevent mother-to-child transmission, compared to 34 percent in neighbouring Uganda and 57 percent in South Africa.

However, paediatric HIV services have lagged behind; of an estimated 130,000 HIV-infected Kenyan children, only about 15,000 were receiving ARV therapy in 2007. But the picture is changing.

"We are now doing early testing and we are using PMTCT as the entry point in reaching out to the mothers and the young children who need ARV therapy," said Dr Michael Njau, a paediatric expert at Nazareth Mission Hospital. "I know this will see a decrease in mortality rates amongst infants and young children."

''I only realised recently that I am positive. When I fell sick and was taken to hospital...I realised I have been losing my children to HIV''
The government-run Kenya Medical Research Institute in Nairobi runs an Early Infant Diagnosis (EID) centre that assists health facilities in five of the country's eight provinces to test newborns for HIV, with support from the Clinton Foundation and the US Centres for Disease Control.

The demand for these services, however, far outstrips the need. Dr Samuel Khamadi, head of the EID centre, estimates that they can only conduct PCR tests on about 10 percent of the infants who need them. "There is still a lot of work to be done," he said.

Uneven access

Many women cannot afford transport to hospitals where PMTCT and paediatric HIV services are available. Lillian Musau*, 30, has lost two children to HIV-related complications. Both babies were delivered with the help of a birth attendant at her home in Mathare, Nairobi's second-largest slum.

"I only realised recently that I am positive. When I fell sick and was taken to hospital ... I realised I have been losing my children to HIV. You know, in the slums the best we can do for ourselves is to use birth attendants, who charge us cheaply because it is what we can afford," she told IRIN/PlusNews.

"Most women just visit [private] health facilities in the slums ... and some visit the birth attendants, and no tests are done at all. I know many mothers who have lost their children, but they think they are just dying of malaria, or they are bewitched."

Read more:
 We can save more babies, say researchers
 PMTCT services not reaching rural women
 Paediatric care still facing major drawbacks
 Home births hamper PMTCT programme
John Murungu* runs a private maternity facility in Mathare and admits that none of the women who come him are tested for HIV. "I receive up to 25 mothers a week who come here for checks or to deliver, but I cannot lie that I test them for HIV," he said.

"I offer cheap services, and you know the economic status of the people who live here; they just give birth and they come back later to report to you that, 'Daktari [doctor], you know, the child died.'"

*Not their real names


Theme(s): (PLUSNEWS) Care/Treatment - PlusNews, (PLUSNEWS) Children, (PLUSNEWS) HIV/AIDS (PlusNews), (PLUSNEWS) Prevention - PlusNews


[This report does not necessarily reflect the views of the United Nations]
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This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States. Republication is subject to terms and conditions as set out in the IRIN copyright page.