KENYA END­ING HIV IN BA­BIES

Out of ev­ery 10 moth­ers liv­ing with the virus, at least nine de­liver HIV-neg­a­tive ba­bies, ac­cord­ing to a new re­port re­leased by the health min­istry

The Star (Kenya) - - Big Read - BY JOHN MUCHANGI @jo­munji

Most Kenyan women liv­ing with HIV can now ex­pect to de­liver healthy ba­bies who are free of the virus.

The Kenya HIV Es­ti­mates 2015 re­port re­leased last week says of the 79,000 preg­nant women with HIV last year, only about 6,000 passed the virus on to their ba­bies.

This means out of ev­ery 10 moth­ers liv­ing with the virus, at least nine de­liver HIV-neg­a­tive ba­bies.

This is a ma­jor stride for Kenya where only ten years ago HIV­pos­i­tive women dreaded preg­nancy be­cause their ba­bies would al­most cer­tainly be­come in­fected.

“Re­duc­tion of mother to child trans­mis­sion rep­re­sents the great­est im­pact we have felt,” says Na­tional Aids Con­trol Coun­cil ex­ec­u­tive di­rec­tor Dr Nduku Kilonzo.

Trans­mis­sion of HIV from mother to child is al­most en­tirely pre­ventable even if both par­ents are pos­i­tive.

The mother only needs proper screen­ing and med­i­ca­tion dur­ing preg­nancy. Proper man­age­ment dur­ing de­liv­ery also re­duces the risk of trans­mis­sion.

Dr Kilonzo says this is now pos­si­ble for most women thanks to the free ma­ter­nity pro­gramme and po­lit­i­cal sup­port by First Lady Mar­garet Keny­atta.

The World Health Or­gan­i­sa­tion nowa­days ad­vises HIV-pos­i­tive moth­ers to breast­feed ex­clu­sively for six months while en­sur­ing they re­ceive ARVs. This means that the child can ben­e­fit from breast­feed­ing with very lit­tle risk of be­com­ing in­fected.

Nduku says in 2013, about 12,940 ba­bies were born with HIV, but last year only 6,000 were pos­i­tive.

“This rep­re­sents 49 per cent re­duc­tion in mother to child trans­mis­sion of HIV,” she says.

Preven­tive treat­ment for moth­erto-child trans­mis­sion of HIV is usu­ally not 100 per cent ef­fec­tive, so the WHO de­fines elim­i­na­tion as a re­duc­tion of trans­mis­sion to a level that it no longer con­sti­tutes a pub­lic health prob­lem.

The en­cour­ag­ing re­sults mean Kenya can hope to soon join coun­tries that have elim­i­nated mother-to-child trans­mis­sion of HIV. They in­clude Cuba, Moldova, Ar­me­nia and Be­larus.

The HIV es­ti­mates re­leased last week show re­mark­able progress in com­bat­ing the po­ten­tially deadly virus across the coun­try.

“We have re­duced our new HIV in­fec­tions among adults, but more sig­nif­i­cantly among chil­dren, where we have seen a 49 per cent re­duc­tion in trans­mis­sion of HIV from moth­ers to chil­dren,” says Health Prin­ci­pal Sec­re­tary Dr Nicholas Muraguri.

In gen­eral, the es­ti­mates re­veal that na­tional HIV preva­lence stands at 5.9 per cent, with about 1.5 mil­lion Kenyans liv­ing with HIV.

The re­port also re­veals a wor­ry­ing trend where 35,000 young peo­ple aged 14 to 24 years con­tract the virus ev­ery year.

Cu­mu­la­tively, 268,588 young peo­ple in this age bracket live with the virus, which means their chance to trans­mit it is high, un­less they are given an­tiretro­vi­ral ther­apy the rest of their lives.

“This means that the shared pros­per­ity of Kenya that we all as­cribe to may not be achieved if we are un­able to turn our youth into a pro­duc­tive force due to ill-health,” says Dr Muraguri.

Teenage girls ac­count for more than half of these in­fec­tions and are now twice likely to con­tract HIV as boys.

Head of the Na­tional Aids and STIs Con­trol Pro­gramme Mar­tin Sirengo said the trend of teenagers con­tract­ing the virus is wor­ry­ing.

“The coun­ties that had low youth preva­lence in the past are now ris­ing in preva­lence,” he said.

COUNTY STA­TIS­TICS For the first time, the Kenya HIV Es­ti­mates listed HIV bur­den and con­trol progress in each county.

It shows that youth aged be­tween 15 and 24 years from Homa Bay county lead the pack with new in­fec­tions, fol­lowed by Kisumu, Si­aya, Mig­ori, Nairobi, Mom­basa, Ki­ambu and Kisii coun­ties. These seven coun­ties con­trib­uted to 66 per cent of all new in­fec­tions in 2015.

Homa Bay county led with 5,473 cases fol­lowed by Kisumu ( 4, 996 ), Si­aya ( 4, 377 ), Mig­ori ( 2, 895 ),

OF THE 79,000 PREG­NANT WOMEN WITH HIV LAST YEAR, ONLY ABOUT 6,000 PASSED THE VIRUS ON TO THEIR BA­BIES. THIS IS A MA­JOR STRIDE FOR KENYA WHERE ONLY TEN YEARS AGO, HIV-POS­I­TIVE WOMEN DREADED PREG­NANCY BE­CAUSE THEIR BA­BIES WOULD AL­MOST CER­TAINLY BE­COME IN­FECTED.

Nairobi ( 2,282 ), Mom­basa ( 1, 283 ), Ki­ambu ( 1, 199 ) and Kisii ( 1, 178 ).

“In ab­so­lute terms, a large pro­por­tion of Kenya’s pop­u­la­tion is in­fected or af­fected with HIV. The spread of the epi­demic must be halted, with zero new in­fecf­tions the prin­ci­pal tar­get,” says the re­port.

There were sev­eral key high­lights from the re­port.

PEO­PLE LIV­ING WITH HIV

The re­port es­ti­mated the to­tal num­ber of peo­ple liv­ing with HIV to be 1.5 mil­lion in 2015. Of these, 98,169 were chil­dren aged less than 15 years, ac­count­ing for six per cent of all in­fec­tions.

The num­ber of youths aged 15 to 24 years who live with HIV is 268,588 , ac­count­ing for 18 per cent of all in­fec­tions.

In to­tal, half of all adults older than 15 years liv­ing with HIV are 830,243 women.

TRENDS IN NEW HIV IN­FEC­TIONS

The re­port says that new in­fec­tions among adults aged 15 years and above de­clined from 83,000 in 2010 to 77, 648 in 2015, rep­re­sent­ing a seven per cent de­cline. Among chil­dren, the in­fec­tions de­clined from 12,358 in 2010 to 6,613 in 2015, a 46 per cent de­cline over the pe­riod.

Among young peo­ple aged 15-24 years, new in­fec­tions dropped from 37,566 in 2010 to 35,776 in 2015.

“Kenya re­mains the fourth largest epi­demic glob­ally; and even though we have man­aged to re­duce the rates of new HIV in­fec­tions to 77,647 per year, we still have ma­jor gaps in the re­source en­velop avail­able for the HIV re­sponse,” says Health Cabi­net Sec­re­tary Dr Cleopa Mailu.

TREAT­MENT

About 900,000 Kenyans are on retro­vi­ral ther­apy, up from less than 500,000 in 2010. This is partly be­cause, un­til re­cently, the coun­try pro­vided ART only for pa­tients who reached a spe­cific thresh­old in HIV dis­ease pro­gres­sion. How­ever, in late 2015, based on new sci­en­tific find­ings, the WHO rec­om­mended that ev­ery­one with HIV be of­fered ART as soon as they are di­ag­nosed. This is a strat­egy known as “treat all” or “test and treat.”

An­tiretro­vi­ral ther­apy is a com­bi­na­tion of drugs (usu­ally three) that stop the the virus from mak­ing copies of it­self in the body. While ART can­not cure HIV, it has turned HIV into a man­age­able chronic dis­ease for mil­lions of peo­ple world­wide and dra­mat­i­cally re­duced deaths from HIV.

The same drugs that keep peo­ple liv­ing with HIV from be­com­ing sick also pre­vent trans­mis­sion of the virus from preg­nant women to their in­fants. Kenya puts all preg­nant women with HIV on ART treat­ment.

The min­istry of health es­ti­mates that the scale up of ART has saved more than 423, 000 lives by avert­ing deaths from Aids-re­lated ill­nesses.

AIDS RE­LATED DEATHS

Nearly 20 years ago HIV was a death sen­tence but lat­est data show sur­vival rates are high and peo­ple liv­ing with HIV have a nor­mal life ex­pectancy if they ad­here to med­i­ca­tion and life­style. Ap­prox­i­mately 35,822 peo­ple died of Aids in 2015 com­pared to 51,314 in 2010, a 30 per cent de­cline at the na­tional level.

/ FILE

The coun­try is mak­ing sig­nif­i­cant strides in re­duc­ing trans­mis­sion of the HIV virus from mother to child

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