King launches HIV test­ing de­vice

Lesotho Times - - News - Pas­cali­nah Kabi

HIS Majesty King Let­sie III is to­day ex­pected to of­fi­cially launch a new HIV test­ing de­vice for in­fants at ‘Man­thabiseng Con­ven­tion Cen­tre in Maseru as the coun­try joins the rest of the world in com­mem­o­rat­ing World Aids day.

The new point-of-care (POC) ma­chines are minia­turised de­vices that have the ca­pac­ity to per­form an early in­fant di­ag­no­sis (EID) test at the fa­cil­ity where HIV ex­posed in­fants present for care.

The de­vices pro­vide same-day re­sults and po­ten­tially fa­cil­i­tate the same-day treat­ment; re­plac­ing the con­ven­tional sys­tem where in­fants of HIV pos­i­tive moth­ers would only be tested af­ter 6 weeks.

In many African coun­tries like Le­sotho, iden­ti­fy­ing in­fants with HIV us­ing the con­ven­tional an­ti­body HIV test is a chal­lenge due to the pres­ence of ma­ter­nal HIV an­ti­bod­ies.

These ma­ter­nal HIV an­ti­bod­ies may persist for as long as 18 months af­ter de­liv­ery in a child’s blood­stream.

HIV in­fec­tion can only be defini­tively con­firmed in those in­fants us­ing a vi­ro­logic test, ac­cess to which is lim­ited in many coun- tries, es­pe­cially out­side large cities as cur­rently EID test­ing in many coun­tries is per­formed on so­phis­ti­cated ma­chines op­er­ated by highly-trained staff in cen­tralised lab­o­ra­to­ries.

In Le­sotho test­ing in­fants born of HIV in­fected moth­ers is only avail­able at the Na­tional Ref­er­ence Lab­o­ra­tory in Maseru.

With ad­di­tional de­lays at district and cen­tral lab­o­ra­to­ries, the turn­around time from sam­ple col­lec­tion to re­turn of re­sults to sites (and care-givers) can be as long as 6-8 weeks.

This can re­sult in HIV in­fected in­fants not be­ing di­ag­nosed in time, lead­ing to early mor­bid­ity and mor­tal­ity.

The new-to-mar­ket, point-of-care tech­nol­ogy en­sures that in­fants are screened on-site and re­ceive their test re­sults within two hours so that Hiv-pos­i­tive in­fants can be rapidly en­rolled on lifesaving an­tiretro­vi­ral treat­ment.

Sup­ported by the El­iz­a­beth Glaser Pe­di­atric Aids Foun­da­tion (EG­PAF) and UNI­TAID, Le­sotho is among the first nine African coun­tries to use the new life-sav­ing de­vices in rou­tine clin­i­cal set­tings.

Health Min­is­ter ‘ Molotsi Monya­mane this week toured Mafeteng Gov­ern­ment Hos­pi­tal on Mon­day to in­spect the new machin­ery ahead of to­day’s launch by His Majesty.

Dur­ing the inspection tour, Mafeteng Hos­pi­tal Di­rec­tor Sech­aba Mak­iti said due to the con­ven­tional meth­ods of test­ing, “the hos­pi­tal wasted 60.7 days from the time the in­fant was tested up un­til they re­ceived their re­sults and put on treat­ment”.

EG­PAF act­ing coun­try di­rec­tor Tšepang Mohlomi said with the new test­ing meth­ods, her or­gan­i­sa­tion and gov­ern­ment would fast-track the turn-around time as they had noted how “lengthy that turn-around time was (for the con­ven­tional test­ing meth­ods) and we know that it has com­pro­mised care for the in­fant in many cases”.

“We are ben­e­fit­ting as Le­sotho through a global award which sup­ports a num­ber of coun­tries in­clud­ing Le­sotho.

“This is a four-year pro­ject which is worth US$3.2 mil­lion ex­pensed through Le­sotho and that ex­cludes the 29 point of care early in­fant di­ag­no­sis de­vices that will be de­liv­ered in 30 sites in the coun­try,” Ms Mohlomi said.

UNI­TAID Coun­try Im­ple­men­ta­tion Tech­ni­cal Ad­vi­sor Anafi Mata- ka said early di­ag­no­sis was crit­i­cal to early treat­ment “be­cause af­ter one year we would have lost one of those cute ba­bies, 30 per­cent of the in­fants will die if un­treated”.

“By the sec­ond year of birth 50 per­cent of them would have also passed away,” Mr Mataka said, adding ev­ery year, 1.2 mil­lion in­fants were ex­posed to HIV and Aids in the 21 most af­fected coun­tries. Le­sotho is ranked sec­ond in the world with a 25 per­cent HIV preva­lence rate

He said it was un­for­tu­nate that only half of those in­fants got a chance to be tested and out of the 600 000 tested ba­bies, only 50 per­cent got their re­sults.

He said in South Africa alone there was a ten-week de­lay in di­ag­no­sis and treat­ment whereas in Kenya about 44 per­cent of the in­fants never re­ceived their tests re­sults.

Mr Mataka said it was im­por­tant that HIV pos­i­tive in­fants were ini­ti­ated on treat­ment to en­sure that they lead a healthy life-style and live long.

He said the new de­vices had been rig­or­ously tested in lab­o­ra­tory en­vi­ron­ments and found to be ef­fi­ca­cious.

Mean­while, Min­is­ter Mon- ya­mane said the coun­try was com­mit­ted to elim­i­nat­ing HIV in Le­sotho by 2030 as per the am­bi­tious Sus­tain­able Devel­op­ment Goals (SDG) 3 which seeks to end the Aids epi­demic.

He said the new de­vices would help the coun­try achieve its plans to elim­i­nate the Aids pan­demic in 2030 by help­ing Le­sotho know the sta­tus of in­fants ex­posed to HIV and Aids with­out wast­ing any time.

“We will not shy away from the fact that since 2004 we have had prob­lems of preg­nant moth­ers who show up at the clinic for de­liv­er­ies only and these de­vices will help us save the lives of those in­fants whose moth­ers did not go through PMTCT,” Dr Monya­mane said.

“The new machin­ery makes it eas­ier to test the child and put them on med­i­ca­tion im­me­di­ately if they test pos­i­tive,” he said, adding that Le­sotho was faced with HIV cri­sis due to the in­crease of new HIV in­fec­tions which in­cluded mother to child in­fec­tions.

He said gov­ern­ment would en­sure the ma­chines were well taken care as they com­ple­mented the Test and Treat cam­paign launched in April this year.

“Due to Test and Treat, each month the num­ber of peo­ple ini­ti­ated on ART is in­creas­ing and these new de­vices will help us ini­ti­ate more peo­ple on ART as it is giving in­fected in­fants a new lease of life,” Dr Monya­mane said.

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