Rapid and effective treatment for children living with HIV

Dr. Denis Nansera, a pediatrician, cares for Kansmi Ruth, 25, at the Mbarara Regional Referral Hospital in Mbarara district, western Uganda, on August 20, 2019. (Kansiime Ruth) and their 1- and 4-year-old daughters were diagnosed. "A lot of mothers don't go to prenatal care. Now with medical advances, the time to diagnose and treat a child has been greatly shortened," Dr. Nansenla said.

Last year, nearly 450 newborns were infected with HIV every day, most of which were vertically transmitted from mother to child at birth. These children are at great risk of dying before the age of two. Sadly, many of them go completely undiagnosed or untreated.

Lack of HIV testing and treatment for children is a widespread problem. In most regions, only 54% of children living with HIV were diagnosed and treated, although 82% of HIV-infected mothers were treated in 2019.

This gap in coverage is often due to the more complex and inefficient diagnostic process for children. Newborns require a special type of testing for HIV (virological testing), which is not currently available in most low- and middle-income countries.

Although antiretroviral medicines suitable for children are available, they are not available in many areas due to insufficient investment in testing.

This delay in testing and treatment should never have happened. UNICEF and the Ugandan Ministry of Health have recently passed several reforms to HIV treatment for children, with significant results. With the help of partners and innovative diagnostic tools, antiretroviral treatment for children is available at 553 health facilities across Uganda, up from 501 in 2017.

Kansmi's 1-year-old daughter was weighed and checked at the Mbarara Regional Referral Hospital on August 20, 2019. UNICEF has partnered with the Ugandan Ministry of Health and the Clinton Health Initiative to launch an early infant diagnosis point-of-care test. This rapid testing process uses equipment that is easy to transport, operate and maintain, allowing more health care centers to offer testing for newborns. With early diagnosis, antiretroviral therapy can be started immediately.

Enoch Turyatemba is a laboratory technician at the Mbarara Regional Referral Hospital. He was getting a blood sample for early diagnosis in babies to be screened for HIV and given a diagnosis the same day. "In the past, when we didn't have point-of-care testing machines, we would collect blood samples and send them out. It would take months to go back and forth," Enoch said. Start treatment in days. We're saving lives," Enoch added.

Enoch Turitba tests a blood sample with a point-of-care machine. In addition to rapid tests, the Ministry of Health has approved the use of oral medications to treat HIV infection in children. This medicine may be taken with food and/or breast milk so that the child does not perceive the bitter taste of the medicine. The tablets don't need to be refrigerated -- a huge improvement.

Kenyonyozi Joseline holds her baby at the point-of-care clinic at Mbarara Hospital. Adolescent girls are more vulnerable to HIV infection because their reproductive systems are not yet fully developed. In Uganda, where gender inequality and a patriarchal system make it difficult for girls and young women to have a voice on safe sex, early pregnancies and HIV infection are not news.

Kenyon Uzi carries the child on his back outside the point-of-care clinic. HIV testing services for children lag far behind those for adults and pregnant women. 82% of HIV-infected mothers have access to treatment, but only 54% of children living with HIV have access to life-saving medicines. Only 59 per cent of babies born to HIV-positive mothers were tested for HIV within the first two months of life.

Kansmi, 25, arrived at Mbarara Hospital with her daughters. All three are HIV-positive and regularly visit the clinic to get their medicines. “When I got to the hospital, I was surrounded by other women who were coming for treatment. We went to the hospital with a common purpose,” Kansmi said. “It helped me overcome the stigma and gave me the courage to face it.”

At home in western Uganda, Kansmi, 25, feeds her 1-year-old daughter medicine to treat HIV infection in children. Her daughter is now taking pills, rather than the bitter potions of the past, that can help reduce her viral load. "You can mix the pills with your food and you can feed her easily, instead of having to feed her like you used to." Kansmi said, "My advice to other mothers is this: give your child the right amount of medicine. , so that they can live longer so that they can teach others in the future."

Kabiite Ajara, 32, feeds her children medicines to treat HIV infection in her home in Isongo, Uganda. Both of them were born with HIV. "I feed my baby medicine once a day," Capitet said. "She was weak and vomited after taking the old medicine. Now she has no adverse reactions to the medicine. I crush the medicine and put it in water, so that She can drink it easily."

Capet and her daughter play outside the house. Kabite is HIV-infected, but because she takes her medicines on time, she is in good physical and mental condition. "I love playing with the kids, taking them to the banana fields, cooking together," Capet said. "My daughter loves soccer! And she's pretty good at it!"

This World AIDS Day, UNICEF is calling on governments and all partners to take urgent steps to close the testing and treatment gap for children and adolescents living with HIV; build supportive and discrimination-free communities for testing and care ; At the same time promulgated policies and further appealed for related rights to give people living with HIV a hope of life.