THE LITTLE ANGELS BATTLING THE MONSTER OF HIV/AIDS, POINT OF CARE MACHINES TO BE THE SOLUTION

By Goodluck Musinguzi

In 52 minutes a health worker can determine a child’s diagnosis after conducting an accessible molecular HIV testing in any infant who is ever sickly using Point of Care Machine.

This simple yet smart assay provides virological HIV-1 and HIV-2 results at the point-of-care within 52 minutes. It’s perfectly suited for the challenges of virological testing in resource limited settings according to the company.

Uganda is aiming at eliminating HIV by 2030 which is ten years from now. Early Diagnosis of HIV among infants is paramount and stops the spread of the disease. Partners, like Abbott, CDC, UNICEF, CHAI and others have donated 100 machines and built capacity of health workers who will use them.

Dr Diana Atwine, Permanent Secretary Ministry of Health said that increased capacity in testing helps in timely return of results that determine the next course of action.

“This will contribute to improved outcomes and early indentification of those infected for the timely initiation onto treatment”, said Dr Diana Atwine.

She said Uganda is aiming at achieving 95:95:95 targets towards the ending of HIV/AIDS in Uganda. The 100 Point of Care Machines for Early Infant Diagnosis & Viral Load testing will enhance capacity in delivering services & progress.

Uganda continues to lead globaly in the fight against HIV/AIDS a disease that ravaged Africa in its early days. President Yoweri Kaguta Museveni came up with open policy and behavior change that became models of the world.

In Uganda, all pregnant women are required to attend at least four ANC visits during which they receive routine HIV testing with same day results, and those testing HIV-positive are supported to disclosure their sero-status.

During ANC visits, all pregnant women receive health education talks on mode and prevention of mother to child transmission of HIV among others.

The factors explained above might have accounted for the increased EID by DNA-PCR testing among HIV-positive mothers with disclosed sero-status.

However, it is surprising that attendance of four or more ANC visits did not significantly increase testing of HEIs by DNA-PCR per EID guideline, suggesting the need to continuously support HIV-positive mothers in understanding the number, schedule, and importance of EID.

This is because early testing results in most HIV-positive cases being missed because of low sensitivity of DNA-PCR test before 6 weeks. Studies indicate that HIV-DNA PCR assays identify between 20% and 55% of HIV-positivity among HEIs from birth through the first week of life, but this increases to more than 90% by 2–4 weeks of age and to 100% at 3–6 months.

So by testing early, there is a risk of missed HIV diagnosis. Contrariwise, late testing results in late HIV diagnosis, late ART initiation, and worsened HIV morbidity and mortality.

Ministry of Health has received 100 m-PIMA Point of Care Machines for Early Diagnosis and Viral Load testing for HIV/AIDS among infants, on reagent-rental model, from Abbott News.

This will enable early detection and management of HIV +ve infants in unfortunate cases of Mother to Child transmission.

The mission of the Ministry of Health of Uganda in the battle against HIV.

The machines, which are portable, can test between seven to eight samples per day and provide a short turnaround time in HIV and viral load testing among infants. These machines will be installed and utilized at 100 health facilities including Regional Referral Hospitals, General Hospitals, Health Center IVs and IIIs in Uganda.

Dr Henry Mwebesa, the General Health Services Director said that this is a cost-effective approach and I wish to emphasize that we need to explore this method further in our diagnostic interventions. This is a good innovation, which must be encouraged and supported.

Chris Kraft, the Deputy Chief of Mission at the US Embassy noted that the machines will greatly contribute to the gains sustained by Uganda in the fight against HIV/AIDS. He further said that in the last five years, the coverage of the anti-retroviral treatment among HIV pregnant women has seen a significant reduction of mother-to-child transmission of HIV from over 5% to just 2%.

 

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