HIV/AIDS: Delayed Results And Positive Mothers

The plight of HIV Positive Mothers after being delivered of their babies has been a thing of concern for some time. It came to the fore recently again, after Joan, 32, explained her ordeal.

She was abandoned by her husband shortly after being diagnosed of HIV early in her pregnancy. Presently, she is faced with the agony of waiting for about four months to ascertain the fate of her little girl in terms of knowing the baby’s HIV status.

Six weeks after she delivered her baby, in accordance with procedures intended to ascertain the HIV status of the baby, Dry Blood Spot (DBS) of the baby was taken for testing in the Rivers State University Teaching Hospital (RSUTH), which has the only Polymerase Chain Reaction (PCR) machine in the State.

In addition to detecting diseases in a sample, PCR enables the monitoring of the amount of a virus present in blood, 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 the stage of the infection and the kind of treatment to administer, making treatment personalized to each individual.

Currently, Joan’s baby is about four months old, and she is still expecting the results from DBS taken from her child.

According to her, over the past three 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 four months ago that they took sample from my baby, I’ve been waiting for the result. They initially told me to come after two weeks. But two weeks has long elapsed, and I’ve gone to the hospital several times in the last four months. They still tell me to come later”, she said.

On investigation, it was revealed that the PCR machine at the RSUTH, which is the only one in the State, serves not just Rivers State, but also neighbouring states.

The implication is that there are so much samples being attended to, such that it now takes longer time to get to given samples, resulting in delays of up to months.

Joan continued that the waiting has become so unbearable that she suspects any form of discomfort in her child.

“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 Care providers) they tell me to go home and wait for the result,” she said.

Investigations have revealed that Joan’s fears arise from the possibility of samples being mixed up, or even misplaced, given the fact that there are so much of them from different states, particularly in the light of the PCR machine serving several states.

This used to be the case during the period samples from Rivers State were taken to Akwa Ibom State for screening, when the State did not have PCR machine.

The difference now is that the screening now takes place in Rivers State, but there are so much samples, which are treated on first come, first serve basis.

Joan’s fears may have been given credence by the fact that ordinarily sample storage could be a problem under the circumstance: it could grow mold, or go bad, in which case, the question becomes if it can still give the right result. Can there not be mistakes in the way the numerous samples are handled?

The Tide’s investigations revealed that in the past, before Rivers State had he PCR machine, sometimes there had been need to take another sample after the first got missing in transit, especially for those coming outside the State that had the machine.

In the case of Joan, waiting for about four 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, more probably because health workers did not deem it expedient to have the patience to douse her fears by explaining the real situation to her.

Explaining the importance of PCR machine from a lay man’s perspective, the Director, Public Health, 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 the 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 explained.

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

Given that whatever happens to a lactating mother medically is likely to affect her baby, the state of Joan, 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 Joan, one can only imagine how many of such children can be found in Rivers State, which has just one PCR machine, and other states in Nigeria that do not have it at all.

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 in each Local Government Area.

This is because, beyond fulfilling part of its social obligations to its citizenry, provision of more PCR machines will no doubt alleviate the suffering of not only the HIV positive mothers, especially those in the remote areas, 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.

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.

By: Sogbeba Dokubo