Prevent your child from HIV

Jul 22, 2012

Felista Okello, a mother of four, is finding it difficult to care for her five-year-old HIV-positive daughter, Priscilla. “My daughter keeps asking why I have to give her medicine even when she is not sick,” Okello says. “Her appetite is low. Sometimes I force her to eat so that she does not take m


By Agnes Kyotalengerire


Felista Okello, a mother of four, is finding it difficult to care for her five-year-old HIV-positive daughter, Priscilla. “My daughter keeps asking why I have to give her medicine even when she is not sick,” Okello says. “Her appetite is low. Sometimes I force her to eat so that she does not take medication on an empty stomach.”

Okello’s biggest worry, however, is how to disclose to Priscilla that she is HIV-positive.

According to the Ministry of Health stastistics, about 20,000 to 24,000 children are infected with HIV every year; 76,000 need ARVs and 24,417 are already on treatment.

Dr. Barbara Asire, the Prevention of Mother-to-child Transmission Programme manager Baylor-Uganda, says every pregnant mother is screened for HIV. “When found positive and her CD4 count is more than 350, she is started on a preventive drug (prophylaxis) at 14 weeks to reduce the amount of virus in the blood.”

If her CD4 count is less than 350 cells, she is given a combination of three drugs to be taken for the rest of her life.

During labour, a mother on prophylaxis is given two more drugs, Niverapine and lamuvedine and after delivery, she is started on combivir (Lamivudne and zidovudine) for a week. The baby is immediately started on Niverapine syrup until a week after he stops breastfeeding. The syrup helps neutralise any virus that could have crossed to the baby.

Screening and treatment


Dr. Micheal Juma, the head of clinic paediatric HIV/AIDS at Baylor-Uganda, says all babies born to HIV-positive mothers are screened at six weeks.

The baby is also put on Septrin to prevent bacterial infections. If found positive, he is started on ARVs. However, if the baby is not screened at six weeks, he is started on ARVs irrespective of the CD4 count or health status. “This is a precaution taken because there is a 50% risk of children dying before their second birthday,” explains Juma.

Children between two and five years with a CD4 count less than 750 cells are started on ARVs. Those above five years with CD4 a count below 350 are started on ARVS, Juma adds. He also emphasises the importance of monitoring the growth and development as well as nutrition and immunisation.

Care

Cissy Ssuuna, a counsellor at Baylor-Uganda, says caring for a child with HIV/AIDS requires parents and caretakers to lay strategies on how to cope.

“Usually, caretakers are prepared (through counselling) on how to administer the medicine before the baby is started on ARVS.”

Though breastfeeding is essential in the child’s first year, Juma says it can be a source of HIV infection. To minimise the risk of infection, mothers are encouraged to breastfeed up to one year. Exclusive breastfeeding (up to six months) is encouraged without giving additional foods, he says.

“The stomach and intestine lining of the new born baby is very fragile, so giving additional foods may cause damage to the lining, causing tears, which increases chances of infection with the virus,” explains Juma.

However, at one year, a mother may choose to stop or continue breastfeeding. “During the one year of breastfeeding, emphasis is put on treating conditions that make the baby vulnerable, for example, a mother’s cracked nipples.”

Aside, a child with HIV needs a balanced diet in order to grow well because their immunity is compromised. “A caretaker is taught the kind of food to give and how to prepare it,” Ssuuna notes.

Juma adds that multivitamins, as a micro nutrient supplement, are also essential. A child with HIV needs psycho-social support to adhere to treatment. The counsellors discuss with the caretakers to help them make an informed decision.

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