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By Vision Reporter

Added 19th June 2007 03:00 AM

Is the PSI kit for everyone?
Dear doctor,
Recently, I received a basic care kit from my health unit given by Population Services International (PSI). It contained two mosquito nets, a packet of condoms and a safe water vessel with two bottles of water guard. It has, however, become a

Is the PSI kit for everyone?
Dear doctor,
Recently, I received a basic care kit from my health unit given by Population Services International (PSI). It contained two mosquito nets, a packet of condoms and a safe water vessel with two bottles of water guard. It has, however, become a source of trouble for me, because nobody at home wants to drink water from the water vessel treated with water guard. They say it smells and is meant for only us with HIV. Is this true or can people without HIV also drink of the same water at home?
Esther

Dear Esther,
The problem you are facing is from stigma due to ignorance about HIV. Safe water for drinking and hygiene at home is good for all people. The safe water vessel and water guard, just like insecticide-treated mosquito nets are for the whole family. It is only that people who are HIV-positive are more vulnerable to water-borne diseases and since we have limited resources, they have been targeted with this intervention. This intervention was put in place because it was found that the incidence of diarrhoea among HIV-infected individuals using the safe water vessels is much lower than in the general population.
The message that PSI is passing on is good for the whole community. The smell in the water is because of the chlorine, the active chemical in water guard. Chlorine is used in purifying water and all of us using piped water know how it smells, especially when it has just been pumped. This should not deter people from using Water Guard.
I know of patients at our centre who remove the mosquito nets and leave the rest of the contents of the package provided by PSI, for fear of being stigmatised. Maybe we need to promote water guard along side insecticide-treated nets in order to remove the misconception that water guard is only for HIV-positive people. Healthcentres providing the Basic Care Package should take it upon themselves to educate communities about these issues in a bid to eliminate stigma.
What should never be shared are ARVs and other drugs prescribed for people living with HIV/AIDS.
Lastly, encourage all members of your family to go for HIV testing so that they know their HIV status. People who have undergone an HIV test with proper pre and post-test counselling usually have a positive attitude towards others with HIV, even when they are HIV-negative.

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Will my son get permanent teeth?
Dear Doctor,
My son has just been tested HIV-positive. Even before this, he had bad teeth and rampant painful sores which make eating a real ordeal for him. Does HIV also affect teeth and will he ever develop good permanent teeth as he grows?
Juliet

Dear Juliet,
HIV-related immune suppression can cause candidiasis, a fungal infection. Other manifestations of HIV in the mouth can be due to a cancer called Kaposi’s sarcoma, which often manifests as painful purplish nodules.

Because of lowered immunity, the gums are inflamed, resulting in a condition known as gingivitis.

Another common condition in the mouth is the decay of teeth (caries). Caries or holes in the teeth make it difficult for anyone to eat and can, therefore, lead to malnutrition in both children and adults. Caries are often caused by poor oral hygiene or eating of sweets, which are often given to children. Frequent use of drugs in form of syrups which have a lot of sugar, also contributes to this.

You should encourage your son to observe strict oral hygiene, including brushing his teeth with fluoride containing toothpaste after meals and before going to sleep.

He should also avoid eating sweet foods or taking sweet, fizzy drinks which are not good for teeth.
He should be fed on a balanced diet and the food needs to be prepared in such a way that he does not need to chew a lot, since his teeth are affected. This should help him to improve and be able to develop strong permanent teeth as he grows.

A dentist should also examine him to identify conditions like oral candidiasis or oral Kaposi’s sarcoma, which need definitive treatment. These occur in advanced stages of immune-suppression.

Lastly, your son should be assessed for antiretroviral therapy (ART). When someone starts having so many opportunistic infections, it means they are severely immune-suppressed and should have already started taking ARVs to stop and even reverse the process.

I hope that you have done an HIV test because as you may know, most children with HIV/AIDS means they got it through mother to child transmission route.

Send your question on HIV to Health Editor,
The New Vision. P. O. Box 9815, Kampala or health&beauty@newvision.co.ug

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