Health
HIV/AIDS: Delayed Results And Positive Mothers
The plight of HIV Positive Mothers after being delivered of their babies has been a thing of concern for some time. It came to the fore recently again, after Joan, 32, explained her ordeal.
She was abandoned by her husband shortly after being diagnosed of HIV early in her pregnancy. Presently, she is faced with the agony of waiting for about four months to ascertain the fate of her little girl in terms of knowing the baby’s HIV status.
Six weeks after she delivered her baby, in accordance with procedures intended to ascertain the HIV status of the baby, Dry Blood Spot (DBS) of the baby was taken for testing in the Rivers State University Teaching Hospital (RSUTH), which has the only Polymerase Chain Reaction (PCR) machine in the State.
In addition to detecting diseases in a sample, PCR enables the monitoring of the amount of a virus present in blood, or viral load in a person’s body.
In diseases such as Hepatitis C or HIV infections, viral load is a good indication of how sick a person may be or how well a person’s medicine and treatment is working.
Armed with this information, physicians may determine the stage of the infection and the kind of treatment to administer, making treatment personalized to each individual.
Currently, Joan’s baby is about four months old, and she is still expecting the results from DBS taken from her child.
According to her, over the past three months, she had been restless and the restlessness has developed into an agonizing trauma because as the days go by, she suspects every sign of illness in her baby to be HIV. The thought of her child being infected with HIV is thus too much for her to bear, and it has gradually taken its toll on her health.
“Since four months ago that they took sample from my baby, I’ve been waiting for the result. They initially told me to come after two weeks. But two weeks has long elapsed, and I’ve gone to the hospital several times in the last four months. They still tell me to come later”, she said.
On investigation, it was revealed that the PCR machine at the RSUTH, which is the only one in the State, serves not just Rivers State, but also neighbouring states.
The implication is that there are so much samples being attended to, such that it now takes longer time to get to given samples, resulting in delays of up to months.
Joan continued that the waiting has become so unbearable that she suspects any form of discomfort in her child.
“Now, anything I see on my baby’s skin, I feel it is the result of HIV. Each time I go to ask them (Health Care providers) they tell me to go home and wait for the result,” she said.
Investigations have revealed that Joan’s fears arise from the possibility of samples being mixed up, or even misplaced, given the fact that there are so much of them from different states, particularly in the light of the PCR machine serving several states.
This used to be the case during the period samples from Rivers State were taken to Akwa Ibom State for screening, when the State did not have PCR machine.
The difference now is that the screening now takes place in Rivers State, but there are so much samples, which are treated on first come, first serve basis.
Joan’s fears may have been given credence by the fact that ordinarily sample storage could be a problem under the circumstance: it could grow mold, or go bad, in which case, the question becomes if it can still give the right result. Can there not be mistakes in the way the numerous samples are handled?
The Tide’s investigations revealed that in the past, before Rivers State had he PCR machine, sometimes there had been need to take another sample after the first got missing in transit, especially for those coming outside the State that had the machine.
In the case of Joan, waiting for about four months for the result of her baby’s sample has put her in a state of uncertainty, one that had been traumatic to her and likely to put her in a state of delusion.
What may have put her in such state may not be far from ignorance, more probably because health workers did not deem it expedient to have the patience to douse her fears by explaining the real situation to her.
Explaining the importance of PCR machine from a lay man’s perspective, the Director, Public Health, Rivers State Ministry of Health (RSMoH), Dr Golden Owhonda, said the PCR screening is different from the conventional test.
“When we carry out the conventional or rapid test, we are testing for the antibody. With this test, you can have false positive and false negative.
“But the PCR looks for the virus itself, not what the virus produces. So, the PCR is more accurate and predictive. As far as the PCR is concerned, if it (the virus) is there, it is there.
“We use the PCR when we want an exact diagnosis, such as in the case of Mother-To-Child Transmission,” he said.
Dr Owhonda stated further that at six weeks when the baby’s blood sample is taken for test, the baby does not have its own antibodies, and that if it has any, it would be from its mother.
“So, for you to know that the baby has the virus, you must test for the presence of the virus itself. This is where we use the PCR machine. It is also how we find out if the baby has HIV acquired from its mother,” he explained.
While the HIV status of the baby is important, the emphasis here is the state of the mother, who is HIV positive.
Given that whatever happens to a lactating mother medically is likely to affect her baby, the state of Joan, which may be one in so many, becomes very important.
If her delusionment prompted by her imagination that her baby is suffering out of no fault of hers, as a result of which she becomes so incapacitated that it affects her already fragile health condition, one can only imagine how this condition can affect the baby.
In essence, when one reasons that there could be more women in the shoes of Joan, one can only imagine how many of such children can be found in Rivers State, which has just one PCR machine, and other states in Nigeria that do not have it at all.
It is in this context that it is most expedient for the Rivers State Government to ensure that the state gets at least one PCR machine in each Local Government Area.
This is because, beyond fulfilling part of its social obligations to its citizenry, provision of more PCR machines will no doubt alleviate the suffering of not only the HIV positive mothers, especially those in the remote areas, but also that of health care providers, who carry out the sample logging and have to offer explanations regarding the delay in availability of results.
Most of all, the status of such children can be known faster and relevant precautions taken earlier when necessary, all of which will be to the development of the State and society at large.
By: Sogbeba Dokubo
Two United States scientists who unraveled the human micro RNA have won the Nobel Prize in Physiology or Medicine 2024.
Victor Ambros and Gary Ruvkun won the coveted prize for their work on microRNA as their discoveries help explain how complex life emerged on earth and how the human body is made up of a wide variety of different tissues.
MicroRNAs influence how genes – the instructions for life – are controlled inside organisms, including humans.
Every cell in the human body contains the same raw genetic information, locked in our DNA.
However, despite starting with the identical genetic information, the cells of the human body are wildly different in form and function.
The electrical impulses of nerve cells are distinct from the rhythmic beating of heart cells. The metabolic powerhouse that is a liver cell is distinct to a kidney cell, which filters urea out of the blood.
The light-sensing abilities of cells in the retina are different in skillset to white blood cells that produce antibodies to fight infection.
So much variety can arise from the same starting material because of gene expression.
The US scientists were the first to discover microRNAs and how they exerted control on how genes are expressed differently in different tissues.
The medicine and physiology prize winners are selected by the Nobel Assembly of Sweden’s Karolinska Institute.
They said: “Their groundbreaking discovery revealed a completely new principle of gene regulation that turned out to be essential for multicellular organisms, including humans.
“It is now known that the human genome codes for over 1,000 microRNAs.”
The World Health Organisation (WHO) has begun acting to curb effects of antibiotic pollution.
The new guidance on wastewater and solid waste management for antibiotic manufacturing sheds light on this important but neglected challenge ahead of the United Nations General Assembly (UNGA) High-Level Meeting on antimicrobial resistance (AMR) taking place on 26 September 2024.
The emergence and spread of AMR caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites responsible for the pollution.
Despite high antibiotic pollution levels being widely documented, the issue is largely unregulated and quality assurance criteria typically do not address environmental emissions. In addition, once distributed, there is a lack of information provided to consumers on how to dispose of antibiotics when they are not used, for example, when they expire or when a course is finished but there is still antibiotic left over.
“Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health. Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone,” said Dr Yukiko Nakatani, WHO Assistant Director-General for AMR ad interim.
Globally, there is a lack of accessible information on the environmental damage caused by manufacturing of medicines.
“The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and industry themselves to include robust antibiotic pollution control in their standards,” said Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO. “Critically, the strong focus on transparency will equip buyers, investors and the general public to make decisions that account for manufacturers’ efforts to control antibiotic pollution.”
In a concerted effort to curb brain drain, the Kebbi State Government has harmonised medical doctors’ salaries to be at par with their colleagues in the federal government’s tertiary health facilities.
Kebbi State Commissioner for Health, Musa Inusa-Isma’il, disclosed this at the handing over of ambulances to the state-owned health facilities at the Ministry of Health in Birnin Kebbi yesterday.
Inusa Isma’il, according to a statement by Ahmed Idris, the Chief Press Secretary to the governor, said the essence of the harmonisation was to retain the existing medical doctors and attract more to the services of the state.
According to him, the doctors across the state had already started enjoying the new salaries from August 2024.
He said the release of the vehicles was in fulfilment of Governor Nasir Idris’ promise to uplift health care services in the state.
“His Excellency said I should inform you, the beneficiaries of this gesture, that the vehicle should be strictly used for the intended purpose. It should not be used for anything else.
“If there is no referral case, each of the vehicles must be parked at the hospital by 6 pm. The governor said you should warn your drivers against reckless driving as well as violating the instructions.
“We should also do everything possible to reciprocate the gesture by working according to the terms and conditions attached,” he advised.
The benefiting health facilities included Sir Yahaya Memorial Hospital, Birnin Kebbi; State Teaching Hospital, Kalgo; General Hospital, Argungu; General Hospital, Yauri; General Hospital, Zuru; and General Hospital, Bunza.
In his speech, the permanent secretary of the ministry, Dr Shehu Koko, recalled that the ambulances were handed over to the ministry last Friday by the governor for the onward handover to the benefiting hospitals.
He observed that the ambulances would go a long way in improving the referral system in the state, adding that delays in reaching the secondary and tertiary facilities would be eliminated.
The permanent secretary attributed the high rate of maternal mortality in the country to delays in getting to the health facilities for proper medical care.
“We believe with the provision of these ambulances, part of the gaps we have in our referral system will be addressed, whereby patients who require secondary healthcare could be easily transported to secondary and tertiary health centres, where they can get such help,” he said.
In a goodwill message, Commissioner for Information and Culture Alhaji Yakubu Ahmed expressed gratitude to the governor for the support he has given to the ministry to excel.
While advising the beneficiaries to use the vehicles judiciously, the commissioner advised that services and maintenance of the vehicles must be prompt to derive the maximum benefits from the vehicles.
The commissioner also highlighted some achievements recorded by the government in the last year, including beautification of the state capital, completion of a multimillion-naira ultramodern state secretariat, road construction, construction and renovation of classrooms and upgrading of some health facilities, among others.
