Early infant diagnosis of HIV facing challenges in Malawi district hospitals- Kalondolondo
Quality of Early Infant Diagnosis (EID) of HIV exposed infants and DNA services remains a challenge in the fight of Prevention of Mother to Child Transmission in the districts of Mwanza and Chiradzulu due to unavailability of a DNA at the district hospital, Kalondolondo established.
During a Kalondolondo presentation on PMTCT at Mwanza Hotel which was presented by the project manager of Women’s Legal Resources Centre (WOLREC) Gift Mauluka, said diagnosis of exposed children is offered in all the health centres in the district but the problem lies in sending dry blood samples (DBS) to QECH for DNA-CPR services.
“Dry Blood Samples which are taken are sent to Blantyre through the Mwanza District Hospital as they do not have the machine in the district. As such results can take close to three weeks, and sometimesgo missing,” said Mauluka in his report.
Mauluka said even when the results are out there is a process for the exposed infants mothers to be notified.
“After tests are done by experts results are disseminated through a text message on their mobile for each exposed child as a health centre, however, this is upon registration of the facility by particular personnel and network challenges are always a problem in some health centers such as Kunenekude and Thambani,”said a report
from WOLREC.
Mauluka emphasasized that the issue of sending DBS to QECH for DNA Services is an advocacy issue which needs to be pursued further if cases of lost misplaced and unconfirmed cases of exposed children is
to be resolved.
However, the same problem was established in Chiradzulu district as well following a PMTCT presentation which was done by the Association of Early Childhood Development in Malawi.
In her presentation report on Friday at Chiradzulu District Council Hall, the organization’s project officer Ruth Makwakwa said exposed children are being tested in all health centres of the district and samples being sent to the Malawi College of Medicine where tests are conducted before results are sent back through SMS’s.
“Results take time before being known by the mothers to the infants, as a results service users are lobbying for a DNA PRC machine so that such tests should be conducted on a district level,” she said.
Mwanza District Medical Officer Godwin Ulaya said they do not have the machine because it is expensive.
“We do not have this machine because it is expensive. But all in all we are trying our best because once the dry blood samples are sent to QUECH it takes only about three weeks to get the results through a text message which is sent to each and every mother of the infant whose blood samples were taken,” said Ulaya.
Achievements
However, Mwanza district and Chiradzulu emerged shining examples in achieving PMTCT basing on the Kalondolondo reports which were conducted by WORLEC and Association of Early Childhood Development in
Malawi.
For instance, in Mwanza district the assessment exercise which was covered in 20 facilities with a total of 377 participants; 124 male and 253 females it revealed that Over 70% of the participants expressed satisfaction over the availability of the test kits and reagents in their health centers including ARVs for the positive pregnant mothers.
Another notable achievement is that Chiefs in the areas are very supportive of PMTCT and all HIV related activities.
Their involvement includes dissemination of PMTCT and HIV messages encouraging couples to go for HTC, advising the youth to get tested before marriage, encouraging guardians to take sick persons to hospital for treatment as soon as they fall ill.
Encouraging
To sum up, Kalondolondo Programme manager Jephter Mwanza said it was encouraging to note that Mwanza district achieved 98 per cent in PMTCT with Chiradzulu district on 97 per cent.
Mwanza said that means there is a great improvement but he was quick to comment on the issue of DNA PRC Services.
He described the unavailability of DNA PRC machines in the two districts as unfortunate and lobbied for government intervention because it showed how serious the problem is affecting PMTCT.
“Nobody has come out openly from the ministry of health to mention how expensive this machine is. We will table the matter during our stakeholders meeting because as Kalondolondo we feel we need such machines in our district hospitals,” said Mwanza.
According to the recommendations of the World Health Organization (WHO), infants known to have been exposed to HIV should undergo a virological test for infection at 4 to 6 weeks of age.Antiretroviral therapy (ART) should be initiated upon diagnosis of HIV infection in children aged less than 24 months.
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