Zimbabwe’s ambitious HIV/Aids target

Dr. Mushavi

Zimbabwe is closely following in the footsteps of Cuba which eliminated the mother to child transmission of HIV in 2015.

Less than five percent of babies in Zimbabwe are now born HIV positive. The country strives to have no baby born HIV infected.

“It is possible to give birth to an HIV negative baby even if the mother is HIV positive,” said Dr Angela Mushavi, the Prevention from mother to child co-ordinator in the Ministry of Health and Child Care. She told journalists and parliamentarians in Kariba attending a workshop jointly hosted by the National Aids Council, Elisabeth Glaser Paediatric Aids Foundation and the Ministry of Health and Child Care.

Dr Mushavi said the way to overcome this was to have parents, both mother and father getting tested together. This was an effective way as challenges faced by women to disclose to the partners would be minimised. This barrier could only be overcome if husbands accompanied their wives to ante natal clinics and get tested together. Dr Mushavi said a baby born by an HIV positive mother was at risk of getting infected.

“A baby born by an HIV positive mother is at risk of getting infected when in the womb, at birth and during breastfeeding,” said Dr Mushavi.

Dr Mushavi assured pregnant mothers that they were assured of giving birth to HIV negative babies if the registered early when pregnant. Thanks to highly effective anti HIV medication now available.

“We put the mother on Highly Active Antiretroviral Therapy (HAART) to cut off infection risk. So pregnant mothers are advised to book for ante-natal clinic early so that they are tested for HIV and other infections. It is possible to give birth to an HIV negative baby,” said Dr Mushavi.

In 2013 Zimbabwe incorporated Option B+ programme. This saw all pregnant mothers who tested HIV positive placed on medication irrespective of the DC4 count. This ensured that vertical transmission was stopped.

“In 2013, the country incorporated Option B+ and all pregnant mothers who tested HIV positive were commenced on medication. This resulted in less babies getting infected,” said Dr Mushavi.

Testing for HIV in infants is done at six weeks and results come out after about 10 weeks. However the time could be longer in remote areas where there are transport challenges. Some parents do not follow-up on the results too.

It is now possible to get early results in infant diagnosis as the country unveiled state-of-the-art Point of Care Machines, used in viral load testing and Early Infant Diagnosis (EID) of HIV.

Known as SAMBA 1 and 2, the machines will see results given out before a mother leaves a health centre after delivery.

The current centralised system saw results taking long to be released that the ministry of health had to urgently act. The National Aids Council (NAC) also weighed in with $1 million worth of machines.

The director of the TB and Aids unit in the Ministry of Health and Child Care Dr Owen Mugurungi said the machines were distributed to 25 selected sites nationally.

Dr Mugurungi said by reducing the turnaround time between diagnosis and intervention, the machines helped reduce loss-to-follow-up, where patients get tested, but do not come back to collect their results.With these machines, results are not sent anywhere, but are processed at the collection point.

“Ideally these machines have been identified for the Early Infant Diagnosis (EID) programme, where we have prioritised exposed babies. Exposed babies are those at risk and are that are born of HIV positive mothers,” Dr Mugurungi said.

“We want to ensure that HIV positive mothers get results early after delivery. They get the results before leaving the hospitals. If there was transmission, then the baby would be put on treatment immediately.”

In the past a baby had a dry blood sample (DBS) taken.  The DBS was then sent to a central hospital laboratory and the results sent back after the test.

At times samples got lost. There was also a delay in the mother getting the results and when a baby was ill this resulted in death.

This is however, going to be a thing of the past with the EID point of care machines.

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