Low ART uptake during pregnancy in Manicaland

MANICALAND should vigorously promote the uptake of anti-retroviral therapy (ART) during pregnancy to achieve and maintain HIV viral suppression to undetectable levels, reduce the risk of perinatal transmission and maximise pregnant women’s health.

The use of ART is a core strategy proposed by the World Health Organisation to prevent mother-to-child-transmission of HIV.

This came up during a recent National Aids Council media training workshop in Chinhoyi, when the Ministry of Health and Child Care’s national PMTC and paediatric HIV care and treatment coordinator, Dr Angela Mushavi said the province is lagging behind alongside the Midlands.

“Maternal ART coverage in ANC in 2023 saw Manicaland Province being the least covered province, with a coverage of only 92.6 percent. Only 92.6 percent of women who were tested HIV positive while pregnant in Manicaland last year were successfully put on ART, leaving a total of 7.4 percent at risk of transmitting the virus to their unborn babies or during breastfeeding.

“Midlands Province also had 93.8 percent coverage. Both provinces failed to meet their targets at a time where the ministry is fighting to improve coverage to at least 95 percent in all provinces,” she said.

Dr Mushavi, however, commented the province for managing to cover a total of 99.1 percent pregnant women in HIV testing in 2023.

“HIV testing coverage for all provinces was above 95 percent in 2023, including in Manicaland and Midlands, which recorded 99.1 percent and 98.7 percent, respectively, which is quite commendable.

However, there is need to improve to 100 percent if we need to control and eliminate the HIV and AIDS virus, and there is also need to make follow-ups and put such mothers on ART to reduce the risk of mother-to-child-transmission,” she said.

Dr Mushavi emphasised the importance of eradicating the transmission of HIV, syphilis, and hepatitis B from pregnant and breastfeeding women to children by the Year 2026.

To achieve this goal, the country initiated the implementation of the Zimbabwe Triple EMTCT Plan, stretching from 2023 to 2026.

This comprehensive plan mandates all expecting mothers to undergo testing for HIV and AIDS and syphilis during their antenatal care visits.

Consequently, this initiative facilitates the collection of essential statistical data.

“The plan, which was launched in 2023 has a vision to attain the gold tier on the path to elimination by 2026. What we are striving for is for the MTCT rate to be below five percent by 2026. There should be a reduction of new paediatric HIV and congenital syphilis cases and a reduction of Hepatitis B prevalence among children,” she said.

In testing for syphilis, Manicaland covered at least 97.4 percent of all pregnant mothers in 2023, leaving a gap of 2.6 percent.

The province remains in danger in syphilis treatment coverage in antenatal care as only 88.8 percent of pregnant mothers were treated.

The rest remained untreated, despite being diagnosed. This left them at risk of transmitting the disease to their unborn children.

“Syphilis can also be passed on to an unborn baby during pregnancy. Congenital syphilis is the disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. Babies born to women with untreated syphilis may be stillborn or die from the infection as a new born. Syphilis treatment coverage in the country remains very low, with only two provinces, Mashonaland East and Matabeleland South attaining coverage of more than 95 percent. As a result, more babies remains at risk of getting congenital syphilis from their mothers,” she said.

Dr Mushayi highlighted the ministry’s concerted efforts to ensure the successful execution of the Triple EMTCT Plan.

Specifically, the ministry is actively engaged in training healthcare professionals from high-volume central hospitals like Victoria Chitepo Provincial Hospital and all district referral hospitals in the province on Triple EMTCT protocols.

This training aims to ensure that all pregnant woman receive comprehensive care, thereby significantly reducing the risk of transmission and paving the way for the emergence of a generation free from the diseases.