Mother-to-Child HIV Prevention Problems

Two recent articles discuss the challenges of prevention of mother-to-child transmission (PMTCT) programs in Uganda.

1.  According to this article from IRIN/PlusNews (summarized here):

The number of Ugandan children becoming infected with HIV during pregnancy, childbirth and breastfeeding remains high despite the government’s ongoing rollout of services to prevent mother-to-child HIV transmission (PMTCT).

The provision of antiretroviral (ARV) drugs to pregnant women living with HIV can reduce transmission of the virus to below two percent, yet 20,000 children in Uganda become infected with HIV annually, accounting for an estimated 42 percent of all new infections in the country, according to government figures.

While PMTCT services are widely available in clinics, 60-70 percent of Ugandan women give birth at home: thus, they cannot get the antiretroviral drug doses that can prevent HIV transmission to the baby.

Dr Dennis Tindyebwa, technical director of the Elizabeth Glaser Paediatric AIDS Foundation, noted that 98 percent of pregnant women in Uganda agreed to HIV testing and counselling, but only 67 percent returned for their results; of those who tested HIV-positive, very few came to health facilities to have their babies.

“For some women it is the distance to the health centre, or the poor quality of services and personnel, as well as lack of infrastructure,” he said. “But there is also low male involvement in PMTCT, as the men deny their spouses the opportunity to participate in the programme.”

2.  According to this article from Ugandan paper New Vision, new mothers and babies do not get all the drugs they need to achieve high rates of PMTCT.  While the doses used in most developing countries (including Uganda) can reduce HIV transmission by about 50 precent, more advanced ARV combinations can achieve a 99 percent reduction in transmission.  Health officials and pediatricians hope that with more resources available, Uganadan clinics will be able to begin using these more effective doses.

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~ by h.e.g. on August 31, 2008.

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