Your daily Selection of IRIN Africa PlusNews reports, 2/10/2005

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CONTENT:

1 - UGANDA: Poverty affecting ART use among mothers

1 - UGANDA: Poverty affecting ART use among mothers

KAMPALA, 10 February (PLUSNEWS) - Poverty is preventing many Ugandan

mothers from using drugs that prevent mother-to-child transmission of HIV,

and this has put more children at risk, health researchers said.

" It is frustrating when these mothers come for a single dose of Nevirapine

to protect their unborn babies, but when they are discharged and told to

report back, they don't, " a Musoke, head of the paediatrics

department of Uganda's Makerere University medical school, told PlusNews.

" Many will tell you they did not have resources like transport to come

back, " she said.

The fact that many HIV-positive mothers cannot afford alternatives to

breast-feeding, was also affecting strategies to protect their children

from contracting the disease, Musoke added.

" We have recommended to these HIV-positive mothers that they should not

breast-feed their babies, but they find themselves at a crossroads, " she

noted. " They cannot afford the alternative foods which are very expensive

or cows milk. "

Musoke is part of a team of researchers on a programme being conducted by

Makerere University and s Hopkins University, which is assessing the

success of antiretroviral therapy (ART) in preventing mother-to-child HIV

transmission.

Musoke said that a baby's risk of contracting HIV through breast-feeding

was between 14-29 percent. She highlighted the fact that while the risks

of infection from breast-feeding were relatively low in the first three

months, underprivileged children who did not breast-feed recorded higher

incidences of acute diarrhoea and malnutrition, often leading to death.

" We have recommended that they breast feed for three months and then stop,

because it is not worth preventing babies from becoming infected at birth

only for them to die after birth from not being breastfed, " Musoke told

PlusNews.

The joint Makerere- Hopkins programme started in 2000 at Mulago

Hospital, Uganda's main referral hospital, and has since attended to more

than 90,000 mothers. Musoke stressed that the challenge was to ensure that

the 70 percent of HIV-negative babies born to HIV-positive mothers

maintained their negative status.

" At least US $300,000 will be needed every year to keep tabs on these

clients to provide intensive follow-up, provide the necessary care to

mothers, and also carry out the normal immunization of the babies, " she

noted.

Musoke noted that stigma had also affected the use of the drugs. Mothers

who were advised not to breast-feed, for example, often continued to do so

out of fear of disclosing their status, while male involvement remained

limited, with only 1 percent of women who tested positive bringing their

partners to get tested.

According to the researcher, a single dose of Nevirapine given to an

HIV-positive pregnant woman just before labour, and a few drops

administered to the newborn in the first 72 hours, halves the risk of HIV

transmission. Nevirapine is also used in combination with other drugs to

prolong the lives of people living with HIV/AIDS.

The manager of Uganda's AIDS control programme, Madra, recently

announced that about 13,000 women who gave birth in Uganda last year

received Nevirapine, or a combination of AZT and 3PC, before delivering of

their babies.

The programme, however, hit a snag when questions were raised about the

research methods used to collect and analyse the data of a US-funded study

in Uganda on Nevirapine.

Every district hospital in Uganda offers the service, but officials say

the infrastructure remains very limited and high poverty levels continue

to impede progress.

Uganda has won praise for its success in the fight against HIV/AIDS, which

has seen prevalence rates drop from over 20 percent in the 1990s to under

six percent in 2004.

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