HIV/AIDS reversing gains made in Africa's mortality rates

By Henry Neondo, Rio de Janeiro

The high prevalence of HIV infection among pregnant women in Africa is leading to a reversal of progress on maternal, infant and child mortality, Dr. Marie-Louise Newell, Professor of Paediatric Epidemiology at the Centre for Paediatric Epidemiology and Biostatistics at the Institute of Child Health at University College London, United Kingdom said.

Addressing a plenary session at the 3rd international AIDS conference on Pathogenesis and Treatment held in Rio de Janeiro from July 24-27, Dr Newell said prevention-of-mother-to-child-transmission (PMTCT) programs depend on the identification of HIV positive pregnant women.

Dr Newell’s work agree with earlier work done by the economic commission for Africa.
According to ECA, whereas the risk of mother to child transmission of HIV (MTCT) has dropped to as low as 2 per cent among the limited number of HIV-infected women in developed countries, the figures in developing nations, however, particularly Sub-Saharan African countries where the vast majority of HIV-infected women of childbearing age live, MTCT rates remain high.

Such high rates persist mostly because of the lack of access to existing prevention interventions, including HIV voluntary counseling and testing (VCT), replacement feeding, selective caesarian section, and antiretroviral drugs.

Current UNAIDS estimates suggest that 25.4 million adults live with HIV/AIDS in Sub-Saharan Africa.

Well over half of these are thought to be women. In the absence of appropriate interventions, about a third of children born to HIV-positive women are likely to also be infected.

Presently, around 2 000 000 children are estimated to live with HIV in Sub-Saharan Africa.

Close to 700 000 children were infected in 2003 alone. Almost all of these were infected through vertical or mother-to-child transmission (MTCT).

UNAIDS say that about half of the children who are infected with the HIV through vertical transmission develop AIDS symptoms and die within 2 years.

ECA says that the child infected through MTCT also runs a very high risk of being orphaned, as the mother, and probably also the father will be infected.

In the absence of efficient life-prolonging interventions, the likelihood of the parent(s) dying within 8-10 years after infection is high.

Recent estimates suggest that there are nearly 14 million orphans in Africa, and this number is projected to rise to a staggering 25 million by 2010.
She pointed out a variety of barriers to expanded HIV testing in this population, including the reluctance of some women to learn their test results, and lack of approval from some husbands for their wives to seek HIV testing.

Newell noted that additional research is needed to overcome challenges to treating HIV/AIDS in children, including paediatric drug formulations and studies to follow up on emerging evidence of adverse events of ART that are unique to children.


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