30,000 Nigerian Children Die from HIV/AIDS

Posted on: Thu 18-02-2016

• There is low coverage of PMTCT treatment- NACA

• Train private hospitals to assist- GMD

• We need to adopt Option B+ -HIV Specialist

Nigeria’s effort to achieve elimination of Mother-To-Child-Transmission (eMTCT) of HIV/AIDS in Nigeria by 2030 seems an uphill task, as 30,000 innocent children infected with the disease, dies from AIDS related infections while about 60,000 new child infections occurred through Mother-To-Child- Transmission (MTCT) in 2014, according to the latest statistic from the National Agency for Control of AIDS (NACA). From the report, Nigeria’s contribution to global burden of mother to child transmission of HIV is estimated at over 30 per cent, with only a 2 per cent decline in number of new infections in children since 2009.

The main reason for this high MTCT burden is low coverage of PMTCT services (Only about 27 per cent of HIV positive pregnant women access the PMTCT care). According to the Director General of NACA, Prof. John Idoko, several challenges are responsible for the low coverage of PMTCT services. Chiefly among them is poor utilization of antenatal care (ANC) services, “facility delivery and Skilled Birth Attendants remain very low. While over 14,000 health facilities offer ANC services, only a small fraction of these facilities, less than 5 per cent offer PMTCT services. At the end of 2011 only 17% of pregnant women received HIV test, the entry point to PMTCT services”, he said. However, this problem can be improved, if most private hospitals are trained to offer PMTCT services. This is because private hospital takes care of 70 per cent of health care burden in Nigeria, The President Guild of Medical Directors (GMD), Dr. Tony Philips, told National Mirror. Meanwhile, some experts claim that private hospitals and Traditional Birth Attendant (TBA’s) do not refer their patients to PMTCT sites for fear of losing them. According to a HIV Specialist, Dr. Anslem Audu, some private hospitals despite knowing the HIV positive status of their antenatal clients, still refuse to refer them to PMTCT sites for treatment.

“sometimes, the pregnant women do not even get tested, maybe because the test kits are out of stock at these facilities and this can result in MTCT”, he said. A recent survey carried out by Journalist Against AIDS (JAAIDS) and Positive life Organization of Nigeria (PLON)-a HIV support group, for Lagos State AIDS Control Agency (LSACA) confirmed this report. From the field report made available to National Mirror, it was gathered that many of the private hospitals go ahead to give antenatal services to HIV positive pregnant women, despite their status. The monitoring and Evaluation officer for the survey, Mabel Nwachukwu, who spoke with National Mirror, narrated these findings.

She said, “Many of the private hospitals do not even care if the pregnant woman is HIV positive or not. They will rather treat her and collect the money, instead of referring her to the center where she can access treatment. It is only when there is complication that they will refer the patient, by that time, the patient’s situation would have gotten worse. She also said that some private hospitals and TBA’s do not even bother to do HIV testing. “During our visit to some private hospitals, where we carried out HIV testing on pregnant women, we discovered that many doctors did not even know the status of the pregnant women in their clinic.

Some doctors requested us to test the women in labour to find out their status”, she said. According to her, private hospitals cannot give PMTCT treatment because they are not among the comprehensive sites and some of them do not know how to administer antiretroviral prophylaxis (drug for PMTCT) on children. In reaction to the issue of referral, GMD, the body representing private practioners in Nigeria denied this accusation. Dr. Philips, told National Mirror that it is the churches, not the private hospitals that should be blamed for lack of referral. “Most churches teach their members to believe in faith and ignore treatment”, he said. He however mentioned the unavailability of test kits at private hospitals “sometimes we have to buy these test kits.

Government should realize that private sector takes care of 70 per cent of health care burden in Nigeria, so they should learn to carry us along if they want to make progress in health” Dr. Philips however, advised government to train private hospitals on how to administer PMTCT treatment to avoid loss to follow up. On why more positive women patronize faith base clinics and TBA’s, one member of PLON HIV support group, who simply identified herself as Uloma, told National Mirror, that some of the HIV positive pregnant women in her group choose to patronize faith owned clinics and TBA’s so that their status will not be questioned and they can have access to maternal services without stigmatization. “Although Lagos state has developed a program where pregnant women seen by Traditional Birth Attendants (TBA’s) are visited by health personnel so they can be tested for HIV, after testing positive, some of them still refuse to access the PMTCT service and will prefer to go back to the TBA’s for delivery, she said.

Incomplete referral is also another huddle to PMTCT in Nigeria, Dr. Anslem, mentioned. “In this situation, a pregnant positive woman who is referred from the primary level of care (from the community or Primary Health Centre), to the secondary (General or Teaching hospital), for PMTCT, refuses to attend for reasons such as lack of transport fare to facility”, he said. In September 2015, the WHO released new guidelines, Option B+, for elimination of Mother-To-Child-Transmission (eMTCT) of HIV. The guideline recommends lifelong ART to be provided to all pregnant and breastfeeding women living with HIV regardless of their CD4 count. But this guideline is not yet practiced in Nigeria.

On the option B+, Dr Anslem said some states are already piloting it but it is not yet adopted nationally. Adopting this guideline is one way that MTCT of HIV can be eliminated, he said. During a two days meeting by The Journalists Alliance for Prevention of Mother-To-Child Transmission of HIV in Nigeria (JAPiN), at Bayview Hotel in Enugu, HIV Specialist, Abiola Davies, said that Nigeria still has the highest new HIV infections among children. Considering the slow MTCT decline, she said there was a need for an urgent action towards eliminating MTCT in the country. The group identified reasons for the persistent of MTCT. Some of the reasons noted were; inadequate domestic funding in the face of declining support from donors; insufficient capacity (human resource and infrastructure) to effectively provide prevention, treatment and care programmes; poor health seeking habit among the rural population, particularly Ante Natal Care (ANC) attendance, stigmatization and reluctance of pregnant women to deliver in health facilities.

In a communiqué signed by its national president, Sola Ogundipe, the group appealed to the Federal government to be guided by the new UNAIDS target of 90:90:90, which ensures that 90 per cent of the global population are tested for HIV, with 90 per cent of those who test positive having access to treatment and 90 per cent of those tested having their viral load suppressed.

Source: National Mirror News

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