BURUNDI: Paediatric HIV still a major challenge

Photo: Manoocher Deghati/IRIN
Children are falling through the cracks
BUJUMBURA, 28 May 2007 (PlusNews) - By the time Claude Nsabimana [not his real name] turned nine, both his parents had passed away due to AIDS-related illnesses. In and out of hospital most of his life, Claude was only tested for HIV after a teacher at his school became concerned about his stunted growth.

"When he started taking [antiretrovirals] ARVs, he looked like a four-year-old kid, but he has started to grow now," his teacher said.

Claude, who has been accessing the life-prolonging medication for less than a year, is one of the lucky ones - only just over 1,100 of the estimated 20,000 Burundian children living with HIV are receiving the drugs.

According to Dr Amelie Nijimbere, a paediatrician with the Burundi chapter of the Society for Women against AIDS in Africa (SWAA), there are very few paediatric health centres in the country, and the few that exist operate privately in the capital, Bujumbura.

"Positive children with paediatric clinical signs and in need of antiretroviral treatment escape the eye of doctors not accustomed to children," she said.

Facilities that provide services to prevent mother-to-child HIV transmission (PMTCT) are also thin on the ground. Although the number of sites offering PMTCT in the country has risen from 10 in 2005 to 28 by the end of 2006, 16 of these centres were in Bujumbura, meaning many rural women still have little access to these facilities and thousands of children continue to be born HIV-positive.

Even when mothers are able to access the drugs for their children, doctors say better education is needed to ensure they are aware of the importance of adhering to the medication and giving the child the correct dose.

"To prescribe syrup to a mother who does not read is a real risk," said Nijimbere. "The dose will either be higher or lower than prescribed, especially with overloaded nurses with no time to explain to mothers."

Dr Thiery Nahimana, coordinator of the centre for assistance to HIV-positive people at Bujumbura's Roi Khaled Hospital, said better referral procedures were necessary for mothers to be able to get the services they needed.

"After delivery, mothers are not adequately referred to other health services to continue the medical assistance," he said. "Children from positive mothers are normally given Bactrim [an antibiotic] until six months, but a number of children can escape for lack of adequate collaboration between prevention of mother-to-child services and other health structures."

Nijimbere said the government was in the process of preparing a national protocol to guide medical practitioners in handling HIV in children.

Too ashamed to seek treatment

According to Theophile Sakubu, in charge of information and advocacy at the Burundi Network of People Living with HIV, stigma is still a factor that prevents parents from seeking treatment for their HIV-positive children.

Sakubu added that some pregnant women who attended antenatal clinics were sometimes forbidden by their husbands to access PMTCT services, in order to hide their HIV status from their community.

"Parents prefer not to know, [but] they must protect themselves and must not deprive their children of the chance to get treatment early," he said.

Burundi's HIV prevalence, at 3.3 percent, remains relatively low in comparison to neighbouring countries.


Theme (s): HIV/AIDS (PlusNews),

[This report does not necessarily reflect the views of the United Nations]

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