Olanrewaju Lawal, Birnin Kebbi
Kebbi State has its fair share of People Living With HIV/AIDs (PLWHA). Out of an estimated population of 4,781,074, 23,834 of them are believed to be living with the virus.
Statistics recently released by the International Research and Exchange Board (IREB), also revealed that about 30 new born and a 100 children under the age of five die daily as a result of the virus or because of complications related to it.
It is largely against this backdrop that health stakeholders from United State of America and medical doctors as well as nurses in the North West zone converged to first brainstorm and subsequently seek ways of improving on maternal, neo-natal and child health indices in the state.
The convener of the meeting, Dr Obinna Orjingene, said the programme was initiated by Reciprocal Exchange Project and implemented by Professor Patricia Whitley Williams, a Division Chief, Allergy, Immunology and Infectious Disease Department at the Robert Johnson Wood Medical School, New Jersey, USA.
Orjingene, a maternal, new born, child health and nutrition consultant, said the purpose of meeting was to, “develop an advocacy document validated by healthcare providers and managers that can be widely shared for improved healthcare system funding, both from government at all levels and partners agencies.
“It is also designed to address the barriers affecting the health building blocks with the aim of providing sustainable solutions, leveraging on available resources and integrating maternal and child health programming for better results.”
Director of Public Health, Ministry of Health, Mohammed Abdullahi Bubuche, identified the factors undermining the efforts aimed at preventing the disease in the state to include weak prevention intervention, weak TB/HIV collaboration, lack of ownership and sustainability of the response, low uptake of services by the general public and also a low dispensation of paediatric viral suppression among others:
“Due to these challenges, the rate of HIV/AIDS in Kebbi State cannot be suppressed. We have prevalence of 0.6 per cent, 23,834 people living with the virus. About 10, 000 are PLWHAs are placed on ART. The disease is caused by high risk of multiple sexual partners, low risk of perception, drugs misuses and abuse, early marriage, seasonal migrations of infected persons to neighbouring countries, which prevents the necessary follow up as well as risky traditional harmful practices.”
He acknowledged the support of government and traditional rulers towards stabilising the primary health sector of the state and urged all of these institutions to redouble their efforts to rid the state of these health issues. He sought increased domestic funding in the fight against the disease.
He stressed the need to strengthen HIV coordination structures at the wards, local government councils and state levels. He also tasked stakeholders to ensure that HIV service delivery is in line with the global trend of 90-90-90 targets.
Dr Aisha Nana Adamu, Head, Department of OBGYN, Federal Medical Centre (FMC), Birnin-Kebbi, said: “Prevention of Mother to Child Transmission of HIV or PMTCT is a package of care consisting of strategies whose goal is to prevent the transmission of HIV infection from the infected mother to her unborn child during pregnancy, labour, delivery, and breastfeeding.
“Pregnancy is an absolute indication for ARV Use. ARVs are recommended for use in pregnancy regardless of disease stage or CD4 count. Proper use in pregnancy for at least 4 weeks in the index pregnancy significantly reduces the risk of ante and intrapartum transmission of infection to infants. ARVs are continued for life, even after delivery.
“PMTCT is a package of care whose goal is to reduce new paediatric HIV infection and give the mother a longer good quality life. So far, it has led to significant reduction in the paediatric infection rate in countries with proper implementation.” She, however, regretted that in Nigeria, “ARV use among pregnant women is still low, ss a result of this paediatric HIV is still high in the country.”
Dr Teslim Lawal, Head, Clinical Services, FMC, spoke on HIV/AIDS and Pediatric Care in the Tropics: “HIV is major global health emergency and affects all parts of the world. South Saharan African accounts for over 70 per cent of cases, compounded by poverty, social inequity and armed conflict.
“Complex social, medical, psychological, cultural, individual and family factors surround paediatric HIV/AIDS cases. The affected children have the same needs as other children – love and affection, good nutrition, exercise, education, security etc. Development is dependent on all these needs, Legal support may be required.”
Williams said the health challenges in the region are surmountable, if all stakeholders continuously worked as a team to confront and tame the challenge: “Cumulatively, 81,437 cases of HIV/ AIDS have been reported in New Jersey. As of 12/31/17, 37,411 individuals are living in New Jersey. In 2015, there were 1,170 new diagnoses with HIV/ AIDS in New Jersey with the three most affected subpopulations. New Jersey was ranked 8th nationally in the rate of adults and adolescent female living with HIV/AIDS infection through 2016.”
Despite all these, the Professor of Immunology and Infectious Disease noted that they were able to curb the prevalence of the disease through consistent outreach activities in various communities, provision of support groups to patients, youth advisory board, provisions of division of child protection and screening, provision of adult patient HIV clinical programmes and provisions of HIV testing and pre- exposure prophylaxis among others.
She advised states in Nigeria to continue to ensure adequate provisions and create conducive environment for health workers, asking researchers to discharge their services as expected while insisting that they must continue to awake the public attention to the benefits of yielding to the health workers counselling.”