Health - MESHA

Study: Immunisation programs unaffected by COVID-19

May 24, 2023

by Mesha with No Comment Health

MOMBASA, May 18, 2023 – Immunisation programs in Kenya’s Kilifi county did not suffer adverse effects of the COVID-19 pandemic, a new research has revealed.

The study called Impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: a retrospective cohort study found out that despite many countries experiencing disruptions in out-patient visits and routine immunisation services during the early days of COVID-19, immunisation of children within the Kilifi County was not affected by the pandemic.

It also revealed that immunisation visits for the third dose of the Pentavalent vaccine and Measles containing vaccine were maintained during the first year and increased during the second year of the pandemic.

According to Dr Ruth Lucinde, KEMRI-Wellcome Trust Research Programme, who led the study, issuance of guidelines for continuity of essential services and exemption of healthcare workers and individuals seeking care from movement restrictions may have contributed to this scenario.

Additionally, supplying counties with extra vaccines and immunisation supplies and postponing routine weighing services for children but advising mothers to return for all their vaccination visits also contributed towards this positive report.

While making a presentation, COVID-19 Vaccination Integration into Routine Immunisation noted that currently there is still uptake as health workers implement door to door vaccination. He also said that partners have formed the County Technical Working Group which is multisector for planning and coordination; and to assess readiness.

“We know that COVID-19 is no longer an emergency, but this does not mean it is over,” he cautioned the journalists attending the 80^th Science Media café by Media for Environment, Science, Health and Agriculture (MESHA) yesterday.

Dr. Oyaro added that when COVID-19 measures were relaxed in the country there was a decline of uptake of vaccine in most counties including the Coastal region. Therefore, clear messaging and interpretation of public notice is important in managing responses to public health measures.

Naming myths and misconceptions as challenges affecting the uptake of vaccine, he advised journalists to report on the positives on how the infection prevention and control measures like wearing a mask and regular hand washing benefitted other health aspects like prevention/reduction of other respiratory and diarrheal diseases.

Anne Mweu from National Nurses Association of Kenya acknowledged the challenges that came with COVID-19 but noted that nurses are now better prepared to handle a pandemic than ever before as the shock and anxiety that at first accompanied the pandemic has been overcome by regular sensitization by the government.

Availability of resources such as personal protective equipment to protect the nurses and such resources were challenges however she noted that these are now available in the hospitals to offer protection to health workers countrywide.

Paying tribute to midwives around the world

May 8, 2023

by Mesha with One Comment Health

Liapeng Raliengoane: raliengoaneliapeng@yahoo.com

LESOTHO, Leribe – As the world commemorates the International Midwifery Day today, several interviews with midwives, village health workers and nursing mothers in the remotest areas of Leribe revealed that the midwives are instrumental in reducing maternal mortality and improving the overall health of mothers and new-borns in Lesotho.

According to the World Health Organization (WHO), quality midwifery reduces maternal, new-born mortality and still birth rates by over 80% and reduces pre-term labour and birth by 24%.

International Midwifery Day is celebrated on 5^th May every year to raise awareness of the role of midwives and to meet the growing needs of more midwives around the world. This year’s theme is “Together again: from evidence to reality.”

The Maternal Death Review Report (2015), has shown that the highest number of maternal deaths occurred in Maseru at Queen ‘Mamohato Hospital where 102 women lost their lives as a result of complications of delivery or inadequate care during pregnancy. Additional figures came from Leribe and Berea with 25 and 19 lives lost respectively.

Currently working at St. Dennis Health Centre, Nurse Midwife Tlaleng Motaba indicated that she studied towards midwifery because she loved it since childhood. She started working as a midwife in 2019.

Midwife Motaba revealed that in the beginning she was scared of delivering babies but as time went on, she got used to it.

The most challenging incident she came across while assisting a mother to deliver was when one day she came across twins, the mother did not go for ultrasound scan beforehand.

“This situation scared both me and the delivering mother as she was not anticipating twins, but all went well, there were no complications both babies and their mother lived,” she said.

She also expressed a wish for midwives to be afforded an opportunity for refresher courses often. Her words of encouragement to other midwives is that they should love their job and also groom expecting and delivering mothers to do the right thing.

From Khabo Health Centre, Nurse Midwife Lahlewe Kao said growing up, she aspired to become a nurse and her dream came true. She started working at the facility in 2022 and has delivered about 15 to 20 babies and they were all alive.

Midwife Kao expressed that seeing both the mother and baby healthy post-delivery, is satisfactory to her and brings a lot of joy in her heart. That one challenge facing them is the shortage of staff.

She said the most challenging instant in her life was when one midnight she was helping a mother to deliver and came across a complication thus had to refer her to the hospital but none of the emergency ambulances were available.

In the end she got help from a villager’s personal car and the mother was taken to the hospital and was delivered. She said this was the most frustrating event she went through as she was worried about both the mother and the baby when her efforts to get a car proved futile.

To her fellow colleagues this International Midwifery Day, midwife Kao encourages them to work tirelessly in seeing that both the delivering mothers and their babies are safe in their hands.

Although midwifery is a career perceived by society to be for women, Lesotho has beaten this odd, as there are male midwives.

A Nurse Midwife working at Matlameng Health Centre Thabo Makhakhe made known that he became a midwife because he had never seen a male midwife and he wanted to be a trailblazer in that field. He started working as a midwife in 2019 and has delivered many healthy babies. His message to fellow colleagues today, is that they should always be positive.

Another Nurse Midwife from Matlameng Health Centre Teboho Makhebesela started working as a midwife in 2021. He said he became a midwife because he wanted to become “something big” in life as in his family there were no graduates at all he wanted to defeat the odds.

He explained that he has so far delivered about 20 babies. That he has realized that festive season, is the busiest season whereby many babies are delivered.

His words of encouragement to the fellow midwives is that midwifery is a closed book, that they should update their knowledge often, they should read a lot and also meet with other midwives to discuss the challenges they come across.

To other males who want to become midwives but succumb to societal beliefs, he encouraged them to pursue midwifery and never mind what people are saying. That they should be aware that every now and then, there is a baby born thus they will have job and a well-paying one for that matter.

A Nursing Mother from Thaba Phatšoa Ha Toboleloa ‘Mampho Raleting related that she got good health services from when she was pregnant, while giving birth and post-delivery. She marvelled at the support the midwives provided and continue to provide in her journey of motherhood.

A Village Heath Worker from Ha Toboleloa ‘Makelello Pitsi expressed joy over the work and services provided by the midwives. She said their dedication goes beyond their scope of work.

“Sometimes when delivering mothers have no clothes, or no money to go to Motebang hospital when they are referred there, the midwives provide them from their own pockets. I have seen it happen many times, they are the real-life savers in every sense of the word,” Pitsi revealed.

These interviews were conducted during a field trip supported by the United Nations Population Fund Lesotho (UNFPA) for journalists to conduct interviews in hard to reach clinics so as to write informed stories that highlight the role of midwives in saving the lives of mothers and babies and focusing on the critical role of midwives in reducing maternal and child mortality in the country.

A statement by UNFPA highlights that the midwives and people with midwifery skills are the main caregivers for women and their new-borns during pregnancy, labour, childbirth and in the post-delivery period, therefore, UNFPA stands in solidarity with midwives worldwide and expresses gratitude to them for the life-saving work they do. UNFPA’s theme for this day is “Actioning Evidence: Leading the Way to Enhance Quality Midwifery Care Globally.”

In over 125 countries, UNFPA advances midwifery by strengthening quality education, regulations and workforce policies, and building strong national associations of midwives.

In Lesotho, UNFPA supports the government through the Ministry of Health in advancing the midwifery curriculum and strengthening midwifery services as a strategy of reducing maternal deaths. It also supports training of midwives, emergency obstetric and neonatal care.

How efforts to counter resistance to Covid jabs have worked

February 22, 2023

by Mesha with No Comment Health

By Omboki Monayo | omboki2725@gmail.com

Aparticipation in the Aids Vaccine Advocacy Coalition (AVAC) science symposium lands me in central Malawi’s Salima District.

The date is November 14, 2020. At the Khombedza Health Centre, Miriam Khatumba arrives for a Covid-19 jab. She is quick to reaffirm that she won’t listen to claims that the prevention measure is satanic.

Such claims spread like wildfire the moment Malawi’s Health ministry introduced COVID vaccines in 2021.

Khatumba, 68, is here for the second dose. The first was in April at this same facility that has existed since 1970s.

“I came here for my first shot after authorities asked us to get vaccinated. I ignored the rampant fear-mongering,” she tells Sayansi.

Khomebdza Health Centre serves at least 85,955 people in Salima.

According to Cosmas Phiri, the facility’s Expanded Programme on Immunisation (EPI) Coordinator, 6,838 (15 per cent) of Khombedza residents are fully vaccinated. Some came from as far as Chimphanga and Makanjira, 14km and 18km away respectively, incurring up to 6,000 Kwacha ($5.8) on transport alone in a country where the Ministry of Labor, Youth and Manpower Development data estimates the December 2022 average monthly wage at $48.77.

Khatumba, accompanied by her husband, says: “I want to protect myself and my family from severe COVID-19 infection and possible death.”

Lucia Frankie, a traditional leader, also got vaccinated, with her first dose coming in January 2022. “It was for my sake and my family’s,” she says at the health centre that started as a dispensary in 1970s before it was upgraded in the 80s.

On the way to becoming a fully-fledged health centre, the facility has been expanded through construction of a theatre, male and female wards and a maternity wing. And now the construction of office blocks and additional housing for nurses and clinical officers is underway.

Thanks to the government and development partners’ investments infrastructure and medical personnel, Khombedza Health Centre is now an established community bulwark against the spread of COVID-19 and other infectious diseases.

“We treat TB, COVID-19, malaria and other infectious diseases. In addition, we carry out deliveries as well as maternal and child health services. At least 130 deliveries are done here every month,” says Mr Phiri, adding: “We have adult and child vaccination, as well as disease surveillance in the region.”

Although infection rates have reduced globally, COVID-19 still exists, with World Health Organisation (WHO) data showing Malawi as cumulatively recording 88,123 cases and 2,685 deaths by December 16, 2022.

“We started the COVID-19 vaccination in 2021, with Astra Zeneca, Johnson & Johnson and Pfizer doses,” says Phiri, adding: “Almost 4,000 people have since been vaccinated at the facility. Roughly half of them are fully vaccinated, with Chisamba area having the highest coverage rate of 41 per cent.”

This despite the misinformation that seemed to be a hurdle in the drive to fully vaccinate locals.

Ministry of Health statistics shows only 31 per cent of Malawians have received at least one COVID-19 vaccine dose. “We have recorded a low rate partly due to vaccine hesitancy and the global reduction in infections. We are still engaging the public to get more people vaccinated,” says Maureen Luba of the Health Ministry.

The interactive symposium that included representation from the Malawi Ministry of Health, medical experts, science journalists from Malawi, Kenya (by three members of Media for Environment, Science, Health and Agriculture (MESHA)), Zimbabwe, Uganda and Tanzania, unearths a lot of hesitancy stories.

For Rashid Manganda, a Health Surveillance Assistant (HAS) based in Palombe District on the Malawi-Mozambique border, vaccine hesitancy is a major challenge. Villagers once forced the community health worker to take the HPV vaccine meant to protect girls aged 10 to 14 against development of cervical cancer in their sexually active adult years.

Rashid agreed to take the jab, which is primarily meant for young girls and boys.

“I knew that the vaccine would cause me no harm, even though it was meant for female recipients for the purpose of preventing the development of cervical cancer during their sexually active phase of life,” he said.

The move by the HSAs bore fruit. “After we took the jab, the villagers allowed us to proceed with the rest of the exercise. It is important for us to engage the community if we are to make headway against COVID-19 and other diseases,” he says.

“Many people, including clerics, claimed the jab was a satanic method to control the black population. There were rumours that the vaccinated part of the body would be magnetic,” says Phiri.

Researchers Qun Ao, Robert Egolet, Hui Yin and Fuqian Cui carried out a cross-sectional study in the country, covering 758 participants in 2021.

“Of these, 189 or 24.9 per cent were vaccinated. A further 271 or 35.8 percent were willing to be vaccinated but had not yet received the vaccine, and 298 (39.3 per cent) refused to be vaccinated,” reads the report published in the May 2022 edition of the Swiss MDPI journal.

Vaccine hesitancy is defined by WHO as “delay in acceptance or refusal of vaccines despite the availability of vaccination services”.

WHO has highlighted hesitancy as one of the 10 threats to global health.

The Health ministry has countered the misinformation, with the help of faith and opinion leaders in awareness campaigns.

The effort, says Phiri, has paid off. “We have recorded significant success in our faith-based vaccination campaigns. For instance Jehovah’s Witness faithful were the first to be vaccinated following directions from their international leadership,” he says.

The country plans to vaccinate 10.97 million people or 60 percent of the population as soon as possible, and Mr Phiri says the vaccine is still available in the facility.

Ms Luba says the ministry intensified the campaign at the grassroots by incorporating Health Surveillance Assistants (HSAs). “We brought community leaders and other stakeholders to the table to decide which policies to be implemented. Among them was the involvement of HSAs in the vaccination drive,” she said.

In Khombedza region, some 41 HSAs serve communities under Mr Phiri’s guidance and supervision. Khatumba and Frankie have both benefited from the awareness creation by the HSAs.

Clinical Officer Boniface Chisamba says the HSAs also targeted HIV positive, those with hypertension and diabetes. “People with diabetes, high blood pressure and HIV are at high risk of infection with COVID-19, so we encourage them to be vaccinated.

We did this for the people living with HIV by combining counselling and antiretroviral services with COVID-19 awareness,” says Mr Chisamba.

Among the cases he handled at the facility was a pregnant woman admitted in May 2021. “We managed her health till the infection cleared. She delivered a baby girl free of COVID-19,” he said.

The medic admits the facility lacks test kits, which are however available at the larger Salima District Hospital. “We refer suspected cases to Salima Hospital and once they are confirmed we manage them until the infection clears,” he says.

At the end of the symposium, Ms Kay Marshall of AVAC urged media to help debunk the myths and misconceptions around vaccination.

“Media should intensify efforts to dispel the rumours around the safety and efficacy of COVID-19 vaccines. This includes misinformation being peddled by social media sites that lack scientific credibility,” she said, adding that the problem was not unique to Africa.

“Vaccine hesitancy is an issue in the wealthier countries of the Global North, including the USA, due to the political and religious beliefs of many who opted not to get vaccinated,” she told Sayansi.

“Accurate, timely and easily accessible knowledge will help the public to understand the importance of vaccines and the need to take them in large numbers to rapidly achieve herd immunity,” she said.

Urgent action needed to prevent premature deaths from HIV/AIDS

February 21, 2023

by Mesha with No Comment Health

By Joyce Chimbi | j.chimbi@gmail.com

Wangari Njau remembers well the 1980s and 90s when HIV spelled doom, stigma reigned supreme and those infected with the virus were ostracised from the community, abandoned and left alone to die.

Her sister, Catherine Wairimu, was diagnosed with HIV in 1994. Wairimu and a group of friends left their village at the foot of the Aberdare Ranges in Nyeri County and travelled to Mombasa in search of greener pastures.

“There were no mobile phones and she lost touch with the family. When she came back two years later, we could not recognise her. She had to introduce herself. She was very thin, very dark and could barely walk. We learnt that she had mukingo (the long-necked disease),” Njau recalls.

She says people infected with the virus lost a lot of weight and their necks became elongated. Faced with a mysterious disease that killed people within no time, communities struggled with terminologies and used descriptive words in line with physical symptoms of HIV/AIDS to define the disease.

“We were afraid of her. We had a room in the compound that we used as a store. That became her home until the day she died a few months later. We were extremely afraid of her. It is the first time we had come face to face with the disease,” says Njau.

While the landscape is today significantly different and stigma levels have significantly decreased, it is still not yet dawn for people living with HIV.

Data released by Kenya’s National Syndemic Diseases Control under the Ministry of Health to mark the Worlds AIDS Day on December 1, 2022, painted a most worrisome picture: AIDS-related deaths increased in 2021 for the first time in a decade.

The data shows a steady progression in reducing AIDS-related deaths from 2013 to 2020. In 2013, there was a 30.1 per cent reduction in AIDS-related deaths followed by a 5.4 per cent reduction in 2015.

There was a significant leap to 19.4 per cent and 25.6 per cent reduction in AIDS-related deaths in 2017 and 2019, respectively, followed by a 7.2 per cent drop in 2020. In 2021, there is a significant increase in AIDS-related deaths by14.9 per cent.

Overall, 8,291 men aged 30 and above died of AIDS-related illnesses compared to 6,923 women in the same age group.

Nelson Otwoma, National Coordinator at the Network of People Living with HIV in Kenya (NEPHAK), says, “Most of the AIDS-related deaths in 2021 occurred among men who, compared to women, are less likely to be diagnosed. They are also less likely to start and stay on treatment and reach an undetectable viral load. We call on communities to support men’s access to testing and retention care.”

Early diagnosis and immediate entry into HIV treatment and care is critical to ending the AIDS pandemic by 2030. UNAIDS has outlined ambitious new targets to prevent an estimated 28 million new HIV infections globally and 21 million AIDS-related deaths.

To do so, research by UNAIDS shows there is an urgent need to provide additional investment and focused efforts to remove barriers to HIV diagnosis, treatment and retention in HIV care.

Speaking during the commemoration of Worlds AIDS Day in Bungoma County, Health Cabinet Secretary Nakhumicha Wafula, said, “In more than three decades, our collective efforts have restored dignity and hope to people living with HIV and affected families. We also know that along this journey, we have lost more than 2 million Kenyans; men, women, and children to AIDS-related deaths.”

Wafula said investments in the HIV response had yielded impressive results, adding that people are more knowledgeable about the disease, with many of them adopting protective behaviour and practices. There is now increased use of scientific technologies and tools and empowered communities to access HIV services.

“The initial sense of powerlessness that acquiring HIV would undoubtedly lead to untimely death experienced 38 years ago has been replaced by a movement of strong actors, including the communities of people living with HIV, represented here today,” she said.

Working together, Wafula added, “our HIV response yielded a 58 per cent decline in annual AIDS-related deaths from 52,964 in 2010 to 22,373 in 2021. This encouraging performance reflects a five-fold increase in the number of people living with HIV on life-saving antiretroviral treatment, from about 250,000 in 2010 to 1.12 million in 2021.”

It is these gains that are now at the risk of being rolled back, with HIV experts, activists and families infected or affected by HIV/AIDS calling for urgent responses to bring the fight against the pandemic on track to reach the goal to end the epidemic in the next eight years.

Inequalities in service provision hinder fight against HIV

January 4, 2023

by Mesha with No Comment Health

By Christine Ochogo I christawine@gmail.com

Inequalities in accessing HIV services remain a major setback in the fight against the epidemic, says a new report by UNAIDS.

In the report called In Danger: UNAIDS Global AIDS Update 2022, Winnie Byanyima, UNAIDS Executive Director, pointed out that the world will not defeat HIV if men continue to hold power and women are largely excluded from it.

‘This is what we call patriarchy while dealing with HIV,’ she explained.

Mrs Byanyima vouched for addressing the intersecting inequalities being faced by women, key populations and inequalities between children and adults.

Ms Adele Baleta, a media health trainer, while addressing a virtual cross border media café that brought journalists and experts from Kenya, Uganda, Zambia, Malawi and Zimbabwe together urged journalists to focus on these key populations to address the discriminatory issue they face in accessing essential HIV services.

“Why are sex workers unable to access PrEP and why is it that only 52% of children have access to Anti-Retroviral Treatment (ART)?” Adele asked the health journalists on December 9, 2022.

According to the UNAIDS report that was released during the 2022 World AIDS Day, key populations – sex workers and their clients, gay men and other men who have sex with men, people who inject drugs, transgender people and their sexual partners accounted for 70% of new HIV infections globally in 2021.

Adele reminded journalists of the importance of increasing awareness on HIV to help decrease stigma that has affected mostly adolescents, key populations and young people living with HIV as they still face stigma when they seek sexual health services.

“Stigma has added depression and isolation among people living with HIV (PLWHIV) and this has negative impact on health outcomes,” added Adele.

Catherine Mwauyakufa, a health journalist from Zimbabwe appealed to journalists to continuously highlight success stories on HIV rather than focus on challenges. This, she said will encourage PLWHIV to adhere to HIV treatment and continue living positively.

WHO ISSUES ALERT ON POSSIBLE SURGE OF COVID CASES

December 19, 2022

by Mesha with No Comment Health

BY ANYANGO OCHIENG

sciencewriter2021@gmail.com

The World Health Organization (WHO) has issued an alert on a possible surge of Covid-19 infections amid the festive season.

The alert comes following a recent report of an increase of Covid-19 cases in parts of Africa.

Speaking during a virtual media briefing, the WHO Incident Manager Africa Regional Office Dr Balde’ Thierno said that a number of countries have already reported an increasing number of cases although the rate of hospitalizations is still low.

“It is important to maintain a certain level of vigilance, because, usually all cases of the viral disease would surge amid the festive seasons, between the months of May to July and November through December to January,” said Dr Thierno.

Dr Thierno said that similar trends had been seen in 2020 characterized by end year surges of cases and deaths.

The main drivers of the surges as explained by the expert have been the emergence of other SARS-CoV-2 variants.

“The increasing cases of Covid 19 and other respiratory diseases in parts of the world should be a cause of concern, it is during this period last year that the Omicron variant was also reported although with less severe impacts,” said Dr Thierno.

According to the WHO data as of December 9,2022, South Africa, Zimbabwe, Mauritius, Botswana, Mozambique, Democratic Republic of Congo, Madagascar and Angola have recorded a total of 143 deaths due to Covid-19 within the last two weeks accounting to 85 percent of fatalities.

South Africa leads at 122 deaths followed by Zimbabwe at six while Angola closes the list with only one death.

The data also revealed that Kenya is among the countries with a higher number of hospitalizations within the past two weeks.

As of December fourth, the number of hospitalizations in Kenya remained steady at 24 patients.

“The general hospital occupancy in the Intensive Care Unit in Mauritius had risen but remained low at 5.2 percent and 1.5 percent,” said Dr Thierno adding that in South Africa, the hospital admissions had fallen steadily for the past three weeks with a backlog of deaths reported.

In DRC and Madagascar, the number of patients in hospital were nine and two respectively while Burundi and Ethiopia did not report any new hospitalizations.

The global organization is now calling for increased sensitization and awareness on the vaccines to increase the uptake while the high risk persons should also be advised to wear masks.

Dr Thierno said that apart from building one’s immunity, the vaccine also plays an important role of limiting the circulation of the virus within the community and in turn protecting the vulnerable.

He said adding that “the more the virus circulates, the more the chances of the virus mutating with fears that it may escape the available vaccines,”.

Since the onset of the pandemic, 643,875,406 cases of Covid have been reported globally with 6,630,082 while Africa has recorded 9,415,892 cases of the infection.

Health ministry sued over review of HIV and malaria tests algorithm

October 12, 2022

by Mesha with No Comment Health

By Gitonga Marete

A vicious court battle over the review of testing sequence of HIV has emerged with the Ministry of Health being accused of failing to involve stakeholders and procuring kits that have lower sensitivity.

Joseph Omwando in his case filed before the High Court claims that the ministry wants to overhaul the current HIV/Aids algorithm under the pretext of following World Health Organization (WHO) recommendations but has failed to follow to the letter the required processes.

In his case filed by lawyer Esther Odumbe, Omwando claims that the ministry is rushing through to review the algorithm for commercial interests and not public interests.

He claims that the Health Ministry is also plotting to reduce the quality of malaria testing kits by lowering the Panel Detection Score (PDS) for the kits to be used in the country from 90 per cent to 80 per cent to accommodate manufacturers whose products are less than 90 per cent.

“The whole review process is unconstitutional due to the fact that the public participation, involvement of key shareholders and sensitisation in the collection of samples was not collected,” claims Omwando.

Kenya’s HIV testing program is currently being conducted using a kit known as Determine HIV as the first-line screening kit.

According to the petitioner, the WHO recommended to its members to introduce a third kit into their national HIV testing algorithms. “This would negate the need to have samples sent to a laboratory and would provide a swift and accurate results on the condition of the person being tested,” he says, adding that the ministry instead went ahead to review the current testing algorithm.

“The defendants (Ministry of Health) opted to change the national HIV testing strategy and algorithm which requires developing a plan and identifying the optimal time for transition while ensuring all the necessary resources are in place.

“This change is being done without much preparedness and intends to introduce inferior third generation tests into the National HIV algorithm.”

According to him, other countries have already moved to fourth-generation tests. He states that what Kenya wants to move to is ‘an old’ technology.

This is a second court case casting doubts on Kenya’s HIV and Aids test results.

Last year, two women sued two government institutions after they were diagnosed and treated for HIV while they were negative.

The two women named AWM and EM sued Thika Level Five Hospital and Msambweni County Referral Hospital claiming they were misdiagnosed and treated for a disease they did not have.

According to court documents, on July 20, 2016, EM visited Diani Health Center for a routine antenatal visit and she was tested alongside other expectant mothers.

She says a nurse did the test and the result was that she was HIV positive. The nurse allegedly requested that she bring her spouse and their one-year-old child for testing. Their test results were negative but another staff did them.

She claimed that the nurse who tested her was actually a counsellor by training and who had a two-week training certificate and without known medical laboratory training background.

“The hospital relied on the HIV test result given to me to administer antiviral therapy (ARV) to my one-year-old at the time. The ARV has permanently changed the life of my entire family in all aspects,” she claims.

According to her, being declared positive led to frustration and family fights, adding that Msambweni declined to admit her when she was to give birth on account of the alleged status.

She continued: “A HIV positive tag put on me was a result of a HIV misdiagnosis, had a big toll on my entire family due to suspicion, stigma, mistrust and regular domestic quarrels that made our lives as a family appear worthless.”

She claimed that when it was known that she did not have HIV, the hospital demanded that she returns all the medical records and medicine for destruction. She says this was meant to conceal the evidence.

Meanwhile, EWM said that she went to Thika with her husband of 22 years to get tested for HIV. She argues that the hospital staff took her blood for screening and after 30 minutes, a shocker came that she was positive while her husband was cleared. This was on March 2, 2018.

She narrated that the man gave her an assurance that he would support her only for him to disappear the following morning without a word.

According to her, she got a call 14 days later from the same hospital requiring her to visit the hospital for medication. “She threatened me that in the event that I did not start of ARVs, I would be arrested and charged for being positive and not on medication and may be forced to take my medication from cells,” she claims adding that at that time, she contemplated suicide.

“I tried mixing rat poison with iodine and yoghurt to take.”

On December 10, 2018, she went for a second test and which gave a contrary verdict. Amazed by turn of result, she did another test that confirmed she was negative.

The two also want the court to compel the ministry to review HIV testing algorithm and guidelines.

Prof Walter Jaoko: How Africa can prevent the next pandemic

September 13, 2022

by Mesha with No Comment Health

African governments are not prepared to tackle the next pandemic, a professor of medical microbiology and tropical medicine at the Kenya AIDS Vaccine Initiative (KAVI) has warned.

Prof Walter Jaoko, the director of KAVI and former Department of Medical Microbiology at the University of Nairobi chairperson, said the level of epidemic preparedness in the continent is at its lowest.

Speaking during a Science Media Café in Nairobi on Friday organised by the Media for Environment Science, Health and Agriculture (MESHA), he said the Epidemic Preparedness Index paints a grim picture of disaster management in Africa.

“We know the next epidemic will come and the question is whether we are prepared. Epidemic Preparedness Index is a tool used to try and determine how prepared countries are. The tool shows that most African countries are not prepared,” said Prof Jaoko.

Read: Waning immunity alert as fully vaccinated health staff get Covid-19

Jaoko, who has over 30 years of experience in teaching and research in various aspects of infectious diseases transmission, pathology, treatment, prevention and control, noted that one of the biggest impediments is the lack of adequate funding.

“African governments need to set aside enough funds to prepare for the next pandemic. They need to set up national public health institutes that can plan and organise how to handle the next pandemic,” added Jaoko.

African Union

He added: “African governments need to work closely with the African Union (AU). The AU has a mechanism through the African Centre for Disease Control and Prevention (CDC) which will give them guidelines and tools on what needs to be done as we wait for the next pandemic.”

“We need to have health care workers that are well trained for epidemic preparedness. We also need to strengthen our public health institutes and care facilities by equipping them well with equipment and drugs,” he added.

He observed that in 2001 the Abuja Declaration called upon the African Union member countries to commit to health system preparedness by allocating at least 15 per cent of their annual budgets to the health sector.

Kenya’s 2022/2023 overall budget estimates of Sh3.31 trillion gave health its biggest allocation ever of Sh146 billion which translates to about 4.41 per cent of the total budget.

In the last financial year of 2021/2022, the health budget was allocated Sh121.1 billion.

However, this massive budgetary allocation still fell short of the Abuja declaration even as Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus reminded countries to increase their investments in the health sector.

“There is enough evidence health spending is an investment, not a cost. Health is not a luxury, but a human right; not simply an outcome of development, but the foundation of social, economic and political stability and security,” said Dr Tedros.

Read: WHO to reconvene monkeypox emergency panel on July 21

Prof Jaoko reiterated that health is a major component of any nation’s development.

“Without a healthy population, a country will record a zero development record.”

He called upon the African governments to fulfil their commitments by increasing the health sector budgets as per the Abuja Declaration signed 21 years ago.

He said, with the current harsh economic conditions in Africa, the level of funding by African governments may not easily be fulfilled.

However, he urged the African governments to collaborate with other stakeholders and form Private Public Partnerships and commit some money which is topped by the private sector.

“Private sector has a keen interest in health because they are also major stakeholders as they would like to have a healthy workforce to meet their objectives to prepare adequately to fight future epidemics,” he said.

Address corruption

Prof Jaoko called on African governments to address corruption that has led to the embezzlement of billions of shillings in the health and other sectors.

“African governments should put in place mechanisms to ensure the health sector money is safe and secure,” he added.

On African researchers, Prof Jaoko said the continent has a huge potential for research and development but the lack of funding by the African governments remains a major hindrance.

“A lot of research happening in Africa is funded by bilateral partners. It is only South Africa that has set sufficient funds to boost research in their country.”

He said the National Research Fund Kenya is grossly underfunded and is not working well.

“I urge the government to become a little bit more serious and pump in more funds for research as we have a pool of researchers in Kenya willing to conduct various types of research in the health sector,” he said.

fmureithi@ke.nationmedia.com

County of Bungoma launches 10-day campaign to upscale COVID-19
vaccination

August 17, 2022

by Mesha with No Comment Health

By Gabriel Ingubu

Kenya’s Bungoma County has launched a rapid results initiative to administer over 170,000 COVID-19 vaccine doses in 10 days.

Speaking during the launch, county Health Executive Dr Anthony Walela asked all the stakeholders in his department and the elite from the county to be good ambassadors of the vaccination programme by encouraging other residents to take the jab.

“So far our county stands at 32 per cent in vaccine uptake yet for us to be declared safe it should be 80 per cent,” said Dr Walela.

The county is listed among 24 others that are high risk areas, yet its vaccine uptake is still very low. “

Data obtained from the Health Department indicates that 577,032 people have taken the first dose and only 224,500 have taken two doses.

“I would like my health team to be pro-active enough so that we reach the 352,532 yet to receive their second dose,” said Dr Walela.

Bungoma is considered a hotspot for COVID-19 infections because of long-distance truck stopovers at all markets along Eldoret-Malaba road, which leads to Uganda with Bukembe and Kanduyi being the busiest.

The initiative comes amid calls on journalists to use all platforms available to increase awareness among pregnant women to take the jab.

Speaking during a cross-border science café organised by MESHA and AVACon July 6, 2022, Jean Nachega, Associate Professor of Medicine, Infectious Diseases, Microbiology and Epidemiology at Graduate School of Public Health, Pittsburgh University, emphasised that pregnant women reduce their immunity, especially during their last trimester, so protecting them should be given a priority.

According to Bungoma County Director of Health Services Dr Johnstone Akatu, 171 teams of three people each have been sent on an outreach mission across the county to administer the vaccine at health facilities, worship centres, and at strategic places like government offices.

“Research on COVID-19 is still ongoing. Recently we were giving the vaccine to those aged 15 years and above and now we can administer the vaccine to children from the age of 12 years upwards,” said Akatu. He also urged his staff to keep testing, saying that in the second week of July, 98 people tested positive, yet many people have relaxed their guard against the infection.

At the launch of the initiative, 16 people were vaccinated within one hour.

Among the counties enlisted to participate in the programme are Baringo, Bungoma, Busia, Elgeyo Marakwet, Embu, Homa Bay, Kituyi, Kajiado, Kericho, Kisii, Lamu, Makueni, Meru, Migori, Mombasa, Murang`a, Nandi, Nyamira, Trans nzoia, Turkana, Nyandarua, Samburu, Tharaka Nithi and Uasin Gishu.

If the counties realise their targets within the 10 days, it will be a boost for the national government to reach its target of vaccinating 25 million people by December 2022.

International Aids Society President and International Co-Chair of AIDS 2022, Dr Adeeba Kamarulzaman

Momentum builds to deliver long-acting PrEP for HIV prevention

August 15, 2022

by Mesha with No Comment Health

Photo: International Aids Society President and International Co-Chair of AIDS 2022, Dr Adeeba Kamarulzaman

By Mike Mwaniki I mikemwaniki2016@gmail.com

Oral PrEP was first approved by the US Food and Drug Administration a decade ago, but uptake and adherence have been limited, partly because some people have difficulty taking daily pills.

In recent years, studies have shown that cabotegravir-LA (CAB-LA), administered by injection once every two months, is a safe and effective alternative to oral PrEP.

CAB-LA is approved for PrEP only in the US, but its maker, ViiV Healthcare, has submitted marketing applications in additional countries.

Speaking during the 24^th International Aids Conference held in Montreal, Canada, the International Aids Society President and International Co-Chair of AIDS 2022, Dr Adeeba Kamarulzaman said, “Long-acting PrEP could play a major role in ending the HIV pandemic, but right now, very few people can get it.

“Scaling up affordable access to this game-changing prevention tool must be a top global priority.”

During the conference, researchers presented new data confirming that CAB-LA is safe and effective for PrEP in trans and cisgender women. The World Health Organisation (WHO) also released its first guidelines for CAB-LA for PrEP, and ViiV Healthcare and the Medicines Patent Pool announced that they have signed a voluntary licensing agreement for patents relating to CAB-LA for PrEP.

Finally, WHO, Unitaid, UNAIDS and The Global Fund announced the launch of a global coalition to accelerate access to long-acting PrEP with AVAC as the secretariat.

Researchers announced the first trans-specific analysis of data from the landmark HPTN 083 study confirming that CAB-LA is a safe and highly effective HIV prevention option for transgender women.

HPTN 083 is a Phase 3 study comparing CAB-LA to daily oral TDF/FTC for HIV prevention in cisgender men and trans women who have sex with men.

In 2020, researchers announced that HPTN 083 had demonstrated a 66 per cent reduced risk of HIV acquisition for CAB-LA compared to TDF/FTC.

The new analysis, which was presented at AIDS 2022 by Beatriz Grinsztejn of the Evandro Chagas National Institute of Infectious Diseases – Fiocruz (Brazil), reports on the safety, prevention efficacy and pharmacokinetics of CAB-LA in trans women during the blinded phase of HPTN 083.

Of 4,566 study participants, 570 (12.5 per cent) were trans women, 330 (57.9 per cent) of whom reported use of gender-affirming hormonal therapy.

HIV incidence among trans women was lower in the CAB-LA group (0.54 per cent) than in the TDF/FTC group (1.80 per cent).

CAB-LA was well tolerated in trans women and, importantly, initial findings suggest there is no impact of gender-affirming hormonal therapy on CAB concentrations

New data from the HPTN 084 study shows that among individuals assigned female at birth, CAB-LA continues to be superior to daily oral TDF/FTC in preventing HIV infection.

HPTN 084 is an ongoing Phase 3 randomised controlled trial of CAB-LA for PrEP in individuals assigned female at birth.

In late 2020, a planned interim review found that CAB-LA was superior to daily oral TDF/FTC for HIV prevention in this population.

The blinded portion of the trial was then stopped; participants were subsequently unblinded and continued on their original randomised study regimen pending a protocol amendment to offer open-label CAB-LA.

This update, which was presented at AIDS 2022 by Sinead Delany-Moretiwe of the University of the Witwatersrand (South Africa), reports that 23 incident infections (3 CAB-LA, 20 TDF/FTC) were detected in the 12-month unblinded period.

Of these, two (1 CAB-LA, 1 TDF/FTC) occurred during the blinded phase, and only one of the CAB-LA cases had ever received an injection.

Cumulatively, 62 incident HIV infections (6 CAB, 56 TDF/FTC) have been observed over 6,626 person-years of follow-up (HIV incidence 0.94 per cent). In addition, no new safety concerns were identified.
Also during the press conference, WHO released new guidelines for the use of CAB-LA as PrEP for HIV and called for countries to consider this safe and highly effective prevention option for people at substantial risk of HIV infection.

The guidelines will support countries as they plan for CAB-LA introduction and facilitate urgently needed operational research.

The WHO’s Director (Global HIV, Hepatitis and Sexually Transmitted Infections programme) Meg Doherty said, “Long-acting cabotegravir is a safe and highly effective HIV prevention tool, but isn’t yet available outside study settings. We hope these new guidelines will help accelerate country efforts to start to plan and deliver CAB-LA alongside other HIV prevention options, including oral PrEP and the dapivirine vaginal ring.”

At the same time, ViiV Healthcare and the Medicines Patent Pool (MPP) announced that they had signed a voluntary licensing agreement for patents relating to CAB-LA for HIV PrEP to help enable access in least developed, low-income, lower-middle-income and sub-Saharan African countries.

Through this agreement, selected generic manufacturers will have the opportunity to develop, manufacture and supply generic versions of CAB-LA for PrEP in 90 countries, subject to required regulatory approvals.

ViiV Healthcare and MPP will now work closely with stakeholders and selected generic manufacturers to enable access to generic CAB-LA for PrEP as soon as possible.

The MPP Executive Director, Charles Gore, said, “We are delighted to sign this voluntary licence with ViiV for cabotegravir LA for PrEP.

“Long-acting technologies open up a whole new dimension that facilitates medicine uptake, and this product brings a much-needed option for those at risk.

ViiV Healthcare Chief Executive Deborah Waterhouse said, “This announcement represents a potentially game-changing moment in HIV prevention. Enabling at-scale access to generic cabotegravir LA for PrEP could play a significant role in averting the transmission of HIV, particularly amongst women and adolescent girls, and help end the HIV epidemic.

During the occasion, the new Coalition to Accelerate Access to Long-Acting PrEP was launched.

Convened by WHO, Unitaid, UNAIDS and The Global Fund, and with AVAC as the secretariat, the coalition will coordinate key stakeholder activities on PrEP access, including jointly developing strategies to identify and overcome access challenges for new PrEP options in the near to medium term (especially related to ViiV’s injectable CAB, including generics) and the medium to longer term (related to future PrEP products).

“New HIV prevention options now reaching the market, such as injectable cabotegravir, hold the promise to transform HIV prevention,” said Unitaid Deputy Director Tenu Avafia.

“But we must move far more quickly than we did with oral PrEP if we are to have real impact on the epidemic. This new coalition being formed will prioritise the acceleration of affordable, equitable and widespread access to injectable long-acting cabotegravir for PrEP without delay.”

The Global CAB facilitator at Afrocab, Jacque Wambui said, Afrocab and our community partners are excited about this announcement.

“Since we began mobilising community partners around the world almost six months ago, we have been encouraged to see the responsiveness and engagement from global partners that have made this announcement possible.”

Ms Wambui added, “However, we recognise this is just the first step on this path for long-acting cabotegravir for PrEP.

“Speedy technology transfer and low-cost pricing have still not been secured. Until then, the promise of accessible, affordable CAB-LA will not be realised. Afrocab and our community partners will continue to advocate around these issues until they are resolved.”