Delayed Result: Agony Of HIV Positive Mothers

The plight of HIV Positive Mothers after being delivered of their babies has been near endemic, to say the least. It came to the fore recently again. This time, it came through Alice, 34.

After being abandoned by her husband shortly after she was diagnosed of HIV early in her pregnancy, she now faces the agony of waiting for about seven months to ascertain the fate of her little boy in terms of ascertaining his HIV status.

Six weeks after she delivered her baby boy, in accordance with procedures intended to ascertain the HIV status of the baby, Dry Blood Spot of the baby was taken for testing in neighbouring Akwa Ibom State.

The reason was that Rivers State does not have the Polymerase Chain Reaction (PCR) machine used for the screening.

In addition to detecting diseases in a sample, PCR enables the monitoring of the amount of a virus present in or viral load, in a person’s body.

In diseases such as Hepatitis C or HIV infections, viral load is a good indication of how sick a person may be or how well a person’s medicine and treatment is working.

Armed with this information, physicians may determine when to commence treatment, and a person’s response to treatment, making treatment personalized to each individual.

Currently, Alice’s baby is about seven months old, and she is still expecting the results from Dry Blood Spot taken from her child.

According to her, over the past five months, she had been restless and the restlessness has developed into an agonizing trauma because as the days go by, she suspects every sign of illness in her baby to be HIV. The thought of her child being infected with HIV is thus too much for her to bear, and it has gradually taken its toll on her health.

“Since six months ago that they took sample from my baby, I’ve been waiting for the result. They initially told me to come after one month. But since that first time, I’ve been coming almost every month and the nurses are still expecting the result from where they sent the sample.

“Now, anything I see on my baby’s skin, I feel it is the result of HIV. Each time I go to ask them (Health Workers) they tell me to go home and wait for the result,” she said.

Fortunately, for Alice, at seven months her baby is not likely to come down with AIDS, according to Dr Chimezie Okeh, the Executive Director of the Rivers State Agency for the Control of AIDS (RIVSACA).

In an exclusive interview, Dr Okeh explained that as long as the child is on exclusive breast-feeding and is given Post Exposure Prophylasis, the child will still be protected from coming down with AIDS.

Explaining the implications of sending DBS samples to other states, Dr Okeh said a lot of things could happen to the samples that may make it unreliable.

“Sample storage is a problem, it can grow mold, it can go bad, so, it could give you a false result. If it gets to a laboratory where there are so many samples from different states, the samples can be mishandled, there could be confusion, mistakes on how the various samples are handled.

The implications of Dr Okeh’s explanation is that a lot could happen to a given sample, or samples. The Tide’s investigations revealed that sometimes there had been need to take another sample after the first got missing in transit.

In the case of Alice, waiting for about seven months for the result of her baby’s sample has put her in a state of uncertainty, one that had been traumatic to her and likely to put her in a state of delusion.

What may have put her in such state may not be far from ignorance, especially, given the fact that health workers did not deem it expedient to explain to her the real situation regarding the possible effect of the availability of the sample result. This may not have been the situation if the PCR machine was available in the state.

Explaining the importance of PCR machine in a somewhat lay man’s perspective, the coordinator, HIV/AIDS and STI, Rivers State Ministry of Health (RSMoH), Dr Golden Owhonda, said the PCR screening is different from the conventional test.

“When we carry out the conventional or rapid test, we are testing for the antibody. With this test, you can have false positive and false negative.

“But the PCR looks for the virus itself, not what the virus produces. So, the PCR is more accurate and predictive. As far as the PCR is concerned, if it (the virus) is there, it is there.

“We use the PCR when we want an exact diagnosis, such as in case of Mother-To-Child Transmission,” he said.

Dr Owhonda stated further that at six weeks when the baby’s blood sample is taken for test, the baby does not have its own antibodies, and that if it has any, it would be from its mother.

“So, for you to know that the baby has the virus, you must test for the presence of the virus itself. This is where we use the PCR machine. It is also how we find out if the baby has HIV acquired from its mother,” he said.

While the HIV status of the baby is important, the emphasis of this piece is the state of the mother, who is HIV positive.

Going by the fact that whatever happens to a lactating mother medically is likely to affect her baby, the state of Alice, which may be one in so many, becomes very important.

If her delusionment prompted by her imagination that her baby is suffering out of no fault of hers, as a result of which she becomes so incapacitated that it affects her already fragile health condition, one can only imagine how this condition can affect the baby.

In essence, when one reasons that there could be more women in the shoes of Alice, one can only imagine how many of such children can be found in Rivers State and other states in Nigeria that do not have the PCR machine.

It is in this context that it is most expedient for the Rivers State Government to ensure that the state gets at least one PCR machine.

As can be deciphered from the fore-going beyond fulfilling part of its social obligations to its citizenry, provision of the PCR machine will no doubt alleviate the suffering of not only the HIV positive mothers, but also that of health care providers, who carry out the sample logging and have to offer explanations regarding the delay in availability of results.

It will also eliminate problems associated with taking the samples to Uyo, such as misplacement, molding, and delay in the availability of results.

Most of all, the status of such children can be known faster and relevant precautions taken earlier when necessary, all of which will be to the development of the state and society at large.

Dokubo