I've been doing a lot of work lately on prevention of mother-to-child transmission of HIV/AIDS. About 20,000 children are infected each year in Uganda during pregnancy, childbirth, or breastfeeding - about 10% of the children of HIV+ mothers. If the right drugs are taken at each stage (anti-retrovirals are used in prevention here) and protocols are followed (exclusive breastfeeding for the first 6 months is recommended in Uganda because very few women can access formula and clean water and not be stigmatized when using infant formula), this percentage can go down to 1-5%.
Uganda recently switched to a more effective method of PMTCT and trained over 600 health facilities in this new method. However, a large number (>1/3) of those sites are not ordering the drugs they need for PMTCT, so they still are not able to promote effective prevention. I've been working on figuring out which sites are not ordering, which sites are ordering wrong, and how many mothers the sites treat in order to do a one time drug "push" to ensure that all sites are stocked with these drugs and begin ordering drugs themselves.
It's been interesting (if frustrating) and honestly a bit scary -- if I make a mistake in sending drugs to facilities, there could be infants infected with HIV who would not otherwise have been infected because they could have accessed the right drugs. If we don't do it at all, most likely a large number more infants would be infected, and 50% of infected infants die before age 2. Prevention obviously has many parts of which I am one very very tiny one, but it's strange and exciting to do work about whose outcome I care so much.
The maternity ward at a health facility an hour and a half from Kampala
Uganda recently switched to a more effective method of PMTCT and trained over 600 health facilities in this new method. However, a large number (>1/3) of those sites are not ordering the drugs they need for PMTCT, so they still are not able to promote effective prevention. I've been working on figuring out which sites are not ordering, which sites are ordering wrong, and how many mothers the sites treat in order to do a one time drug "push" to ensure that all sites are stocked with these drugs and begin ordering drugs themselves.
It's been interesting (if frustrating) and honestly a bit scary -- if I make a mistake in sending drugs to facilities, there could be infants infected with HIV who would not otherwise have been infected because they could have accessed the right drugs. If we don't do it at all, most likely a large number more infants would be infected, and 50% of infected infants die before age 2. Prevention obviously has many parts of which I am one very very tiny one, but it's strange and exciting to do work about whose outcome I care so much.
The maternity ward at a health facility an hour and a half from Kampala
No comments:
Post a Comment