Scaling the frontier – should traditional birth attendants also be used to provide nevirapine for PMTCT in Uganda?.

Samson Kironde , John Lukwago , Richard Ssenyonga
Sandown, Sandton 2196, South Africa
Axios International Consultants Ltd, P.O.Box 6924, Kampala, Uganda
Department of Community Medicine, Makerere University, P.O.Box 7072, Kampala, Uganda
Corresponding Address:
Dr Samson Kironde
88 Stella Street, Sandown Mews East
P.O.Box 652767, Benmore 2010, South Africa
Phone: +27 (0)82 883 5450,
Fax: +27 (0)11 506 9009
E-mail: skironde@hotmail.com

Despite considerable progress in stemming the tide of the epidemic in Uganda over recent years, HIV prevalence still remains high in the general population. With a current estimated HIV seroprevalence of under 10% in many sentinel surveillance antenatal clinics in Uganda, a vertical transmission rate of 27%, and a crude birth rate of 52 per 1000 in a country of 23 million; almost 30 000 of the 1.2 million babies born each year will acquire HIV from their mothers if no preventive interventions are put in place.

In January 2000, the Ugandan Government with assistance from UNICEF, UNAIDS and other partners, embarked on a programme to provide Prevention of Mother-toChild HIV Transmission (PMTCT) and Voluntary Counselling and HIV Testing (VCT) interventions with the aim of reducing the risk of transmission  of HIV from mother to the newly born and to promote awareness and responsible living with AIDS.

The programme involves the administration of anti-retroviral drugs to the mother in the peripartum period and to the baby within the first week post-partum. Nevirapine (200mg) given orally as a single dose to the mother at the onset of labour and to the baby (syrup of 2mg/Kg) within 24 hours of delivery, is one of the drugs that is used in the PMTCT programme in Uganda.