23 March 2018

Uganda Making Strides With HIV-Free Babies

Baby Rahumah, now seven months old, is among hundreds of babies born by HIV-positive mothers in the country but are declared HIV-negative at their second birthday.

Her mother, 28-year-old Sarah has been under Mildmay Uganda's care since 2016. It is at this hospital that she was recruited into a version of the ongoing national Elimination of Mother to Child Transmission (EMTCT) programme also being administered here. As in public hospitals around the country, Mildmay is helping save lives through EMTCT.

She says when she learnt of her pregnancy yet she was HIV-positive, she expected her baby to contract the virus. But after several counselling sessions at Mildmay, she gained hope.

"I had a boy but I also wanted a girl, to have at least two children. When I got pregnant, the doctors and counsellors assured me of giving birth to an HIV-free baby when I follow their instructions of caring for myself and the baby, especially during the first six months of breastfeeding," Sarah said.

The doctors told her to attend antenatal care monthly, remain on her antiretroviral therapy and also gave her folic acid tablets to prevent maternal anaemia.

"At seven months of pregnancy, they gave me the nevirapine syrup to keep it at home as an emergency and be able to give it to my child immediately after birth at any hospital that I can easily access before I breastfeed her," Sarah said.

According to Dr Violet Nabatte, the pediatrician at Mildmay, nevirapine syrup is safe for a baby from birth to the age of six months, but if the child is not progressing, administration can continue for one year. Sarah gave birth normally at Kawempe General hospital in August last year.

"Immediately after giving birth, I told the doctors and nurses that I was under Mildmay-Uganda care and I gave them the nevirapine syrup which they gave my child instantly. They also told me to exclusively breastfeed my child up to six months, without giving her anything else, not even a drop of water or any prescribed drugs by non-professional doctors," she said.

"Even when Rahumah was sick, and doctors gave me tablets, I could crush them into powder and give her with breast milk. They prevent the baby from taking anything like food, water because she might get infections yet her intestines are still young," she says.

At seven months now, Rahumah is now on septrin tablets, which she takes daily and is allowed to consume food, water and juice.

"They told me septrin prevents the baby from contracting any virus that might be in the breast milk," Sarah says.

Sarah says when Rahumah is one year and a half, they will do her final test. If confirmed HIV-negative, she will stop taking septrin and graduate at two years as an HIV-free baby.

How they do it

She said the successful results are due to following all their pregnant mothers and making sure they are virally suppressed by monitoring their adherence to ART.

"When they follow our advice, and have safe deliveries, their babies are not exposed to risks of acquiring HIV/Aids. However, we also follow up these mothers after giving birth and advise them on exclusive breastfeeding, avoiding mixed feeding and giving babies medicine that is prescribed by any health practitioner," she said.

"This helps us to do away with herbal medications that can be given to these babies or any liquids such as water and juice which might cause infections to them when they are below six months of age".

Mildmay says they operate a 24-hour open phone policy through which mothers can contact them whenever the need arises.

"When they call in the morning, we advise them to come to hospital and give the child to a specialist to examine her and also provide a suitable recommendation. We also have a peer- led team of mothers and fathers who speak to them and also sometimes do home visits to make sure mothers are adhering to the programme," she said.

Spouses are encouraged to come.

"When they don't come, we write an invitation letter to the spouses and they come. However, some of the challenges we are still facing is that some others don't want to disclose. Issues of adherence and coming to the antenatal for several times, bringing children for checkup and transport finances are still a big problem," she said.

zurah@observer.ug

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