Uganda facing challenges with its efforts to prevent mother-to-child HIV transmission

Aug 29 2008

Mother-to-child HIV transmission rates remain high in Uganda, despite services made available by the government to prevent MTCT, IRIN/PlusNews reports. Government figures estimate 20,000 children contract the virus annually, accounting for 42% of all new cases in the country, according to IRIN/PlusNews.

"The large and growing unmet need for pediatric HIV/AIDS (services) demonstrates that failure of our PMTCT programs to avert parent-to-child-transmission of HIV," Keith McKenzie, country representative for UNICEF, said. Of the approximately 100,000 people with antiretroviral drug access in Uganda, 10,000 are children, according to the Ministry of Health. An additional 40,000 children are believed to be in need of treatment access, and slightly more than half of the country's 310 antiretroviral clinics provide pediatric drugs. "If we prevent HIV infection in children, then we do not need to take care of them when they are infected," Phillipa Musoke, chair of the health department's pediatric committee, said.

According to IRIN/PlusNews, most pregnant women in Uganda have access to PMTCT services but 60% to 70% of them deliver at home, making it "impossible" to administer antiretrovirals that can prevent MTCT, according to IRIN/PlusNews. In addition, awareness of available services and infant feeding options still is low, according to IRIN/PlusNews. Deogratius Mugisa of the health ministry in central Uganda's Kayunga district said, "Cultural beliefs, social stigma, ignorance and economic status influenced the mother's attitudes and preference for the different (feeding) alternatives."

Dennis Tindyebwa, technical director of the Elizabeth Glaser Pediatric AIDS Foundation, said that 98% of pregnant women in Uganda agreed to HIV testing and counseling but that only 67% returned for their results. Of those who tested HIV-positive, very few came to health centers to give birth, Tindyebwa said, adding that distances to health centers, a lack of infrastructure, and inadequate services and personnel contribute to the low return rate. He also said that male involvement in PMTCT is low and that men "deny their spouses the opportunity to participate in the program." Head of the Uganda AIDS Commission David Apuuli Kihumuro said that fewer pediatric HIV/AIDS cases would occur if rates of the disease among adults were controlled, adding, "We have a moral obligation to ensure that our children and grandchildren are born and remain free from HIV/AIDS" (IRIN/PlusNews, 8/26).