Poor infection control at dental, maternity and paediatric facilities is possibly contributing to the spread of HIV/Aids, statistics showed on Tuesday.
The findings were in a study commissioned by the Nelson Mandela Foundation, conducted by the Human Sciences Research Council and released at an international Aids conference in Cape Town.
Findings included that 24,6% of dental instruments ready to be used in patients’ mouths, and 24% of instruments to be used for maternity and paediatric patients were contaminated with invisible blood, and 17,5% had visible blood on them.
”Results show that there is very poor cleaning of the environment in the labour and maternity areas and in dental facilities; the same is true for the baby and neo-natal areas,” read a section of the report.
A lack of infection control may play a role in HIV transmission, the report said.
One of the worst findings showed that only 1,65% of health professionals at hospitals and clinics surveyed knew that expressed mother’s milk, pooled in many cases, had to be pasteurised before being fed to a baby.
”We went to brief the Department of Health, nationally, with regard to this particular study, so that they could be able to take up some of the recommendations. Indeed they were very sympathetic when we met with them… [and felt] something has to be done,” said Dr Olive Shisana, co-principal investigator.
Shisana, who was addressing a media conference, said the buck stopped everywhere when dealing with the recommendations.
”It doesn’t just stop with the national Department of Health. It stops at the provincial departments of health, it stops with the public for not being very knowledgeable about what to expect from our own health workers.”
The study identified all possible sources of HIV transmission, besides that of mother-to-child, among children aged two to nine in the Free State public health sector.
Four thousand mother-and-child pairs in 25 public hospitals, three community health centres and 54 health care clinics were studied.
Breastfeeding of babies by a non-biological caregiver with HIV was the single most important cause of HIV infection in children, besides mother-to-child transmission.
Shisana said prolonged breastfeeding by HIV-positive mothers also increased the risk of infection, with 92,3% of positive mothers breastfeeding, and 60% of them for over a year.
”This suggests that even if children are born HIV-negative, they are likely to contract HIV due to breastfeeding.”
Shisana urged government to help inform the public about the risks of HIV.
Catherine Hawkins, a chief scientific adviser to UNAids, a United Nations body, said that it was worrying that in a country which could apply universal precautionary measures, such as gloves, this was not being done.
”It’s [infection control] not being done… maybe because of personal attitudes and behaviour. In some countries this would be considered negligent, when you know what to do and don’t do it, not because of a lack of resources,” she said.
Earlier, John Samuel of the Nelson Mandela Foundation said the critical question was how to translate the recommendations into reality.
”Children do not have to die, it can be avoided…it’s high time we acted on this.”
Calling the study ”very valuable”, Free State health spokesperson Elke de Witt said the province discouraged shared breastfeeding and counselled mothers about the risks.
The department would have to decide how to approach the issue of HIV-positive mothers breastfeeding, as poor women found feeding formula a very expensive alternative.
The province applied the national Department of Health’s policy that breastfeeding was best.
The province discouraged ”mixed feeding” and preferred HIV-positive mothers either to breast feed or to formula feed, but not to do both.
A programme on infection control was being rolled out in the province’s health facilities. — Sapa