Saving Babies From HIV Through PMTCT

As part of efforts to combat the spread of HIV/AIDS, especially to unborn babies, the National Agency for Control of AIDS (NACA) instituted a special programme for expectant mothers, tagged Prevention of Mother-to-Child Transmission (PMTCT).

The programme ensures that pregnant mothers, who are diagnosed with HIV, as so managed to deliver their babies free from the disease.

Officials explain that under the programme, expectant mothers receive free treatment, after a CD4 and WHO staging tests have been conducted on them, to determine their viral loads, so as to enable an appropriate anti-retroviral management.

Prof. John ldoko, the Director-General of NACA, says that women’s participation in the PMTCT programme is improving, as over 23 per cent of mothers infected with HIV had keyed into it.

“Our coverage has improved. By December 2009, we had only 11 per -cent coverage, but that more than doubled to 23 per cent in 2010.

“This shows that we are making some progress. We need to do more, so as to be able to hit a 60 per-cent level,” Idoko says.

Medical experts say that the drugs, Zidovudine and Nevirapine, are usually administered on expectant mothers from their 28th week of pregnancy up till the time of labour, while in some instances; referrals are made for the triple therapy called HAART.

The experts add that babies delivered by such mothers undergo treatment with Zidovudine and Nevirapine syrups within six and 72 hours after birth, while the need for any extended treatment depends on the adequacy of treatment received by the mothers before the delivery.

Such management, they note, reduces the risks of passing on HIV from mother to child during delivery.

According to Idoko, it is government’s expectation that more expectant mothers who are HIV­ positive will key into the PMTCT, which is available in government and private hospitals across the country.

He says that faith-based organisations will be involved in a renewed sensitisation campaign that will be initiated soon, so as to boost pregnant women’s participation in PMTCT.

The director-general discloses that as at date, about 23,000 children had been placed on anti­retroviral drugs under PMTCT, out of the over 100,000 children who required treatment.

On his part, Prof. Barnabas Mandong, Plateau State’s Commissioner for Health, advises that mothers diagnosed with HIV should breast-feed their babies for at least the first three months, so as to give them a head start in life.

Such an act, he says, poses no danger whatsoever to the newly born babies by reason of research findings recorded the world over.

“Breast milk not only provides all the nutrients a baby needs; mothers through it also pass on antibodies, which help to protect the little ones from diseases as diarrhea and pneumonia,” Mandong stresses.

He explains further that the treatment of pregnant women, nursing mothers and infants with triple anti-retroviral drugs drastically cuts down transmission of HI V to babies during pregnancy and delivery.

“In one study, a combination of anti-retroviral drug therapy given to pregnant and breast-feeding women in Botswana kept all but one per cent from contracting the infection during the first six months of breast-feeding,” the commissloner reveals.

Some women, who had benefited from the PMTCT, applaud the scheme and advise other expectant mothers to embrace the programme, so as to safeguard the nation’s future.

They confirm that the programme helps expectant mothers to give birth to HIV -negative children.

Mrs Comfort Musa, petty trader and mother of three, says that two out of her three children were born HIV-free, having assessed PMTCT drugs during her pregnancies.

She recalls that before the PMTCT took off, HIV – infected mothers experienced a lot of troubles with neighbours, mothers-in-law and friends, who variously advised them not to breastfeed their babies.

“The inability to breastfeed babies was a ready sign for people to identify HIV -positive mothers. “I did not breast feed my first child but he was still positive, as my status was only known after I had delivered the child.

“People who visited me after delivery tried to find out why I was not breastfeeding the child; I continued to lie until I could not lie again.

“I told them I had a breast disease and was advised by the doctor not to breast feed my baby but my mother-in-law did not believe me,” Comfort recalls.

She says that after her first child, PMTCT made it possible for her to breastfeed her other babies for six months, adding that this confused her mother-in-law, friends and neighbours, who had wondered at her earlier claim.

Hajiya Fati Usman, a housewife, who lost her first husband five years ago to AIDS, says that her last child was HIV-negative because she went through PMTCT.

Usman recalls that she was only two months’ pregnant when her husband died and was afterwards confirmed to be HIV -positive.

“It was after his death that I learnt his first wife had died of AIDS. I was advised by the family doctor to attend PMTCT programme to enable me have HIV-free baby.

“The first wife was sick when I married him. She died fourteen months later. After I had my first baby, my husband fell sick and died seven months later.

“Being just two months pregnant when he died, I was advised to go for HIV test, which I did, and I was confirmed positive. Immediately, I started the PMTCT for my baby to be born HIV­ free,” she says.

She commends the Federal Government for initiating the programme and advises pregnant HIV ­positive women to avail themselves of the opportunity to bear HIV -free babies.

Health analysts say that aside from the PMTCT, specially directed at expectant mothers, other measures put in place by the Federal Government over the years to combat HIV appear to be paying off.

For the first time since 1986 when the first case of HIV/AIDS was confirmed in a Lagos hospital, records show that there had been a steady decline in the prevalence of HIV in the country.

A report by UNAIDS in 2010 listed Nigeria as one of the 33 countries in the world, and the 22nd in Africa, where the HIV incidence had declined by more than 25 per cent between 2001 and 2009.

The report attributed the decline to HIV prevention efforts.

According to the report, data from ante-natal care centres in Nigeria show a decline in HIV infections in the rural and urban areas, as well as a decrease in the number of people who are exposed to sex by the age of 15.

While it puts HIV prevalence in Nigeria at 3.6 per cent, it also reveals that about 26 per cent of males and 24 per cent of females are aware of HIV prevention methods.

It further says that about 20 per cent of males and five per cent of females engage in high-risk sex, while about 70 per cent of males and 30 per cent of females use condom.

However, officials point out that the Round Nine of global funding for HIV, through which Nigeria will access about 320 million dollars in the next five years, represents a significant boost to the fight against HIV I AIDS in Nigeria.

An additional three million dollars, they add, had also been released to the country, to boost the PMTCT.

In a related development, the World Bank has also recently offered a credit of 225 million dollars to Nigeria for four years, with which to fill funding gaps, identified as the bane of the national response to the scourge of HIV.

Notwithstanding the UN General Assembly’s Special Session Country Progress Report, which says that HIV situation in Nigeria had improved due to greater attention by government, Idoko says that much needs to be done.

He notes that the number of adults and children, who received anti-retroviral drugs in the country stood at 400,000, although the target for 2011 is 850,000.

President Goodluck Jonathan, on his part, reiterates the need to scale up the fight against HIV/AIDS, regardless of the gains recorded so far.

He gives the assurance that his administration will create a special budget to enable all ministries to join the fight but he, nonetheless, urges Nigerians, who have yet to know their HIV status, to go for HIV tests.

Jonathan reiterates that there is an urgent need to scale up universal access to comprehensive prevention, treatment, care and support to the fight against HIV/AIDS before 2015.

“Statistics have shown that only 14 per cent of Nigerians have ever been tested for HIV. “Ideally, everybody needs to know his or her HIV status, so as to take appropriate measures on whichever way the report goes,” he says.

While many analysts applaud the PMTCT initiative, they, however, call on all expectant mothers to avail themselves of the opportunities offered by the programme to know their HIV status and ensure their delivery of HIV – free babies.

Franca Ofili