Benin clinic bat­tles moth­erto-child HIV trans­mis­sion

Kuwait Times - - HEALTH & SCIENCE -

Preg­nant with her fourth child in a clinic in Benin, Ro­sine is re­lieved to learn that she does not have AIDS, af­ter a free test con­sid­ered a na­tional health pri­or­ity. “I was afraid the test would be pos­i­tive. My hus­band is a driver, you know,” the woman in her 40s told AFP at the ma­ter­nity clinic in the small town of Bohicon, where she was screened.

For 15 years, au­thor­i­ties in Benin have sought to tackle mother-to-child trans­mis­sion of HIV with free care, from the ini­tial tests to an­tiretro­vi­ral (ARV) drugs if a pa­tient proves seropos­i­tive. A pro­gram that cov­ers 87 per­cent of the pub­lic and pri­vate ma­ter­nity clin­ics in the small west African coun­try has been a suc­cess, cut­ting the rate of mother-tochild trans­mis­sion al­most by half be­tween 2012 and 2016, from 14 per­cent of cases to 7.6 per­cent. “This is com­pletely in­te­grated into ma­ter­nal care, it’s rou­tine,” said Blan­dine Mekpo, who has been a mid­wife for 11 years. “All the women who come in for a pre­na­tal con­sul­ta­tion agree to the test.”

Elise cra­dles her lit­tle son in her arms. Fif­teen months ago, the young mother learned that she was infected with HIV. The clinic at once pro­vided her with a free box of ARV drugs, which worked. Her child of six months does not have the virus. “This is a great joy,” Elise says. “The treat­ment saved me, they saved my son and my hus­band. He is the only one to know. I live a nor­mal life, like all women and all moth­ers.”

Med­i­cal staff will nonethe­less con­tinue to mon­i­tor Elise’s son un­til he is 18 months old. “When a mother takes ARVs, she doesn’t trans­mit the virus to her child, nei­ther dur­ing preg­nancy nor at birth, nor while breast-feed­ing,” Mekpo points out. The risk of trans­mis­sion is less than one per­cent, com­pared with a risk of 35 per­cent in the ab­sence of pre­ven­tive treat­ment. At 1.2 per­cent across Benin, the rate of HIV-pos­i­tive peo­ple is low by African stan­dards. Of ev­ery hun­dred births recorded at the Bohicon clinic dur­ing a month, two moth­ers on av­er­age have proved seropos­i­tive. But dur­ing the en­tire year, only one child was sub­se­quently infected.

Get the men in­volved

Sev­eral fac­tors con­trib­ute to such good re­sults, with free pro­vi­sion of screen­ing and care at the top of the list. The UN Chil­dren’s Fund (UNICEF) pro­vides test kits, while the Global Fund against AIDS, TB and Malaria pro­vides ARV ther­apy.

In Bohicon, the drugs are now stored on hos­pi­tal premises. “Be­fore, there was a risk of run­ning out be­cause ev­ery­thing was stocked in Cotonou,” the eco­nomic cap­i­tal on the Gulf of Guinea, said Ni­cole Paqui, the doc­tor head­ing up UNICEF’s AIDS pro­gram. “To­day, test kits and med­i­ca­tion are avail­able in per­ma­nent fash­ion in all the pub­lic health zones,” she added.

Train­ing for nurses and care as­sis­tants has helped to make ma­ter­nity clin­ics friend­lier places to wel­come moth­ers. AIDS has be­come less of a taboo sub­ject and health work­ers no longer take fright when a new case is de­tected. But in Bohicon as else­where, dif­fi­cul­ties arise for med­i­cal and so­cial rea­sons. Some pa­tients give up on treat­ment be­cause of un­pleas­ant side-ef­fects, while oth­ers shrug off their HIV-pos­i­tive sta­tus for fear of be­ing stig­ma­tized. Money can also be a prob­lem, for in­stance when­ever a man re­fuses to pay for his wife to travel to the ma­ter­nity clinic. Fe­male me­di­a­tors help to over­come such ob­sta­cles by ac­com­pa­ny­ing women dur­ing the med­i­cal process. “When they no­tice that some women are no longer at­tend­ing, they go out to their homes to fetch them,” said the head co­or­di­na­tor of health care in the area, Blaise Guezo-Mevo.

Seventy per­cent of the women con­cerned are found. “And when we re­cover them, we don’t lose them again,” the doc­tor added. In mid-Novem­ber, the min­istry of health launched an am­bi­tious cam­paign to bring the rate of mother-to-child trans­mis­sion of HIV down be­low five per­cent in the next four years.

If this goal is to be achieved, men have to be brought into the process. “The in­volve­ment of spouses is in­dis­pens­able,” Paqui said. “When the man is in­formed and sup­port­ive of his spouse, she’ll go all the way. But if she has to hide, the pro­to­col is not ef­fec­tive.”

Elise is one of the lucky ones. Her hus­band came to take a test, which proved neg­a­tive, and he is ready to fetch drugs for her from the clinic. “Screen­ing hus­bands is still dif­fi­cult,” Mekpo says. “Yet screen­ing is a mat­ter for cou­ples.”


BOHICON, Benin: This file photo taken on Novem­ber 29, 2016 shows Blan­dine Mekpo, a mid­wife at a ma­ter­nity ward, pro­vid­ing in­for­ma­tion about AIDS to preg­nant women.

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