29 June 2010
By Pritha Chatterjee
"Children of HIV–positive mothers are a high risk category.
Since the regular enzyme–linked immunosorbent assay (ELISA) test was found to be sensitive only for a minimum age of one–and–a half, we decided to try the more advanced DNA polymerase chain reaction (PCR) tests through dried blood spot testing, and whole blood sampling methods," said Dr SS Kudalkar, president of MDACS.
Since HIV severely lowers the body’s immunity, common diseases like diarrhoea kills a lot of such babies. "Paediatricians were baffled, since no proper cause of death could be identified," said Dr Kudalkar.
Not only the paediatric Anti Retroviral Therapy (ART) Centre in the Lokmanya Tilak Municipal General Hospital in Sion, but also all seven ART centers in the city now provide this test. "Paramedics have been specially trained in collecting blood from infants and identifying dry blood spots. Paediatricians at all hospitals have also been sensitised," said Dr Swapnali Patil, in charge of MDACS’s paediatric ART department.
Samples from all centres are being sent to Kasturba Hospital’s lab for testing. All five cases identified so far are on ART.
"The delay in ELISA test reports meant that treatment also started late, leading to further loss of lives," she said.
This comes after the National AIDS Control Organisation (NACO) and MDACS initiated other measures to improve treatment of HIV–positive children.
Free drugs were rolled out through the second line of ART in March, for children who did not respond to the first line of drugs.
"About one per cent of children usually have to be shifted to second–line therapy. Earlier they had to pay for the treatment; since March, the drugs have been made free as per NACO guidelines," said Dr Mamata Manglani, head of the paediatric ART centre at LTMG Hospital.
Mumbai’s only paediatric ART unit, it has been identified as a regional centre. "We thought treatment facilities should be made available for children from not just Mumbai, but all over Maharashtra," said Dr Patil.
A counselling group, Ankur, has been started for parents of HIVpositive children. "Just as a school monitors a child’s development in parent–teacher meetings, we needed such a mechanism to chalk out the treatment progress of children," added Dr Patil.