Robin Muchetu recently in Macheke
AT least 6 000 children are born with HIV in Zimbabwe and 29 percent of these are not on Antiretroviral Therapy (ART), a situation that has seen the country losing 30 percent of them each year.
It is also estimated by the Ministry of Health and Child Care that Zimbabwe is sitting on 12,4 percent HIV positive pregnancy rate while countries like Cuba have less than one percent of the same. Dr Angela Mushavi, the National Prevention of Mother to Child Transmission and Pediatric HIV and Treatment Coordinator in the Minister of Health and Child Care told journalists in an engagement in Macheke last week that the figures were alarming and more work needed to be done to reduce them. Children die from the virus largely because of delays in being diagnosed with the virus and failure to access pediatric ART.
“HIV infections among children in Zimbabwe stand at 5 919 cases per 100 000 live births each year which is a lot. Our mother to child transmission rate must be less than five percent by 2022. We should reduce new pediatric HIV infections to less than 250 per 100 000 live births,” said Dr Mushavi.
She said the major cause of the alarming infections each year in newborns was women whose status change during pregnancy.
“Women come and get mandatory testing when they fall pregnant and some test negative. What has happened in the past is that women then celebrate that negative status by not protecting, but we have also realised that it is not every mother who starts off negative who gives birth still negative. There is a lot of seroconversion along the way, one then gives birth to an HIV positive baby because no prevention measure will have been taken when the status changes because the women will be in the dark as to their change in status.
“This is because they do not stop being sexually active when pregnant or breast feeding and those negatives become positive. If your partner is engaged in sexual activity elsewhere, they can get a new infection and pass it on to the pregnant mother who also passes it on to the baby,” she said.
Dr Mushavi said it was also important to note that peadiatric formulations always take time to be availed such that many children die as drugs are first availed and formulated for adults while children get them late. This has seen 29 percent of the infected children failing to be on ART.
“The Ministry is supposed to initiate ART for everyone tested, however, peadiatric ART is still very low, sitting at 71 percent. So up to 29 percent of infants who are positive are not on ART, we are missing it somewhere. If we do not put these infants on ART, 30 percent die within the first year of life, while 50 percent die in the first two years if they are not initiated on ART which is tragic,” she lamented.
The Ministry of Health said it was concerned why women register late at health institutions while exposing their unborn babies to HIV infection.
“In Zimbabwe, we require women to register their pregnancies at health institutions at three months, but the majority of women register at seven months and that is too late. Registering is helpful in the event that you are discovered to be HIV positive, you can get antiretroviral drugs (ARVs) in time and also prevent your child from being infected thus reducing the number of babies born with the virus each year,” said Dr Mushavi.
Zimbabwe has developed a plan to have an Elimination of Mother to Child Transmission (EMTCT) of HIV and Syphilis Plan running from 2018 to 2022. “The Ministry has adopted a combination prevention approach of re-testing for pregnant women, initial testing when they first fall pregnant and another test at 32 weeks of the pregnancy to see if they are still HIV negative. We further encourage that after this test, women must get tested again at six weeks after giving birth and get tested every six months thereafter especially during breastfeeding,” she said.
Dr Mushavi said male partners must also get tested too periodically with their wives in order for the initiative to be effective and that partners must not rely on one method of preventing HIV infection but encouraged multiple methods in order for babies to be born HIV negative.
“We have certain continental and regional frameworks that we work with that are assisting us. The African First Ladies Free to Shine campaign which was launched in 2018, is aiming to have an HIV free Generation and ending Aids in children by 2030. We also have the Start free, stay free aids free framework, a global framework getting to an aids free generation which is focusing on EMTCT, babies must be born without HIV.
“If they remain free from HIV, they also need further education and protection as they reach adolescence because lack of it may also result in them acquiring a new HIV infection as they start being sexually active. So, the stay free campaign is on how to keep young people HIV negative while the Aids free is on pushing for people not to die because they have HIV but to take their ARVs correctly and consistently,” she stressed. — @NyembeziMu