Anthony Bugembe and Elvis Basuude
23 August 2008
Kampala — After years of using a single dose of nevirapine to prevent HIV+ mothers from passing on the virus to their babies during delivery, scientific evidence is showing that is not good enough. "The country has been implementing PMTCT since 2000 but the regiments that we are using in Uganda don't reduce mother-to-child transmission (MTCT) markedly," said Dr. Justine Nankinga, the national Anti-Reviral Therapy coordinator in the ministry of health.
Now health experts want the strategy changed. Instead of giving just a single dose of nevirapine, they argue that pregnant women should get the full combination of antiretroviral drugs (ARVs).
The methods used nationally since 2000 involved administering a single tablet of nevirapine to the mother at the onset of labour. The baby is given syrup of the same drug within 72 hours after birth. This approach reduces the risk of mother-to-child HIV transmission by half.
However, using a full ARV combination, the risk could be reduced much more dramatically. "Today, research has shown us that if all HIV+ pregnant mothers are given a triple combination of ARVs, we can reduce MTCT to almost 1%," Nankinga said during the second national HIV paedriatric conference in Kampala.
Dr. Victor Musiime, a pediatrician at Joint Clinical Research Centre, said "Now that more resources are available we are advocating for a triple combination. This is being done in developing countries."
However, this is still far from being achieved. "Adopting the new intervention requires the health ministry to revise the current ARV policy guidelines," said Nankinga, adding, "This would also mean increasing our ARV requirement."
According to health ministry estimates, over 20,000 children are born with HIV in Uganda annually. However, using the triple therapy, this could be reduced to just 200 if it becomes available to every HIV positive women.
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