mardi 18 octobre 2011

Free and voluntary screening for children 3 – 15 years in Yaoundé -Cameroon


Who could have imagined such, children between the ages of 3 to 15 years tested on HIV?
HIV has always been an “ADULT THING’’, most of our public health policies on free and voluntary screening are adult oriented. However, KidAIDS thought it otherwise; this is the reason why more than 100 children have already been tested at the Etoug-Ebe Baptist School at the beginning of a program which targets 1000 children.
Wonders shall never end imagine those nursery kids, one will ask why test children? After all they are not yet sexually active and as we all know 90% of HIV transmission is by unprotected sexual intercourse with an infected person we ignore. Besides they may be playing with sharp objects but the chances of transmission here are slim, so why bother about children, they are not yet ripe to know their HIV status, a false assumption. This explains why children have long been relegated.

KidAIDS says no, we must consider the kids, more of them are victims of Pedophilia in all forms, cases of rape, incest and homosexuality are fast plaguing the society. Worse still Child trafficking and pornography among others, turn to fuel irresponsible and premature sexuality, because children learn and practice by imitation.

It is worth noting that, children between 0-14 years have lower accessibility ARV treatment as oppose to adults. Statistics of 2010 estimate that only 13% (4195 Children out of 32000  are eligible to treatment). Comparatively speaking in relation to the past years, there is an increase but which is still below the National Strategic Plan’s (NSP) objective on the level of acceptability fixed at 100% access to therapeutic treatment.

To appreciate the opinion of the Head teacher of the Etoug-Ebe Baptist school vis-à-vis our activity, KidAIDS Benevolent worker Marie Enanga spoke with her in a brief:       

INTERVIEW WITH HEADMISTRESS Mme. Doris EMBOLLO YETTAH ETOUG- EBE BAPTIST NURSERY AND PRIMARY SCHOOL YAOUNDE         

Thank you for granting us this golden opportunity to speak with you.

I have quite a busy schedule; I hope you won’t be long?

Of course no, we’re going to be snappy, so what are your impressions concerning our activities in your school? What about the reactions of parents?

Mme. Doris EMBOLLO YETTAH: In the beginning I was skeptical because of the reaction of some parents, I was just wondering aloud if most parents were to be aggressive as the few that personally came to warn me not to involve their child. But to my greatest dismay many more parents replied favorably. This silver lining was so conspicuous that no one perceived the dark cloud expressed by the few aggressive parents.

Mme. do you think as the aggressive parents or else what reasons can you advance for testing children?

Well in my opinion, I see this activity of capital importance to children because many people consider “HIV AN ADULT THING” which is far from the truth because I know a case of a girl who was transformed by her own very father to a wife, right from her very tender age and the pedophilia incest scenario went on and on. Let’s say the father was seropositive what could have become of this girl? Conclude for yourself, though her mother was tested negative during pregnancy.

I have also noticed with regrets that most parents go to hospital for tests or medical checkup but will hardly ever take their children for such except when they fall ill.

I equally believe that the pre and post test counseling goes a long way to create awareness of the modes of transmission as well as the prevention, which is a plus to health education.

Besides little children are fond of playing with sharp objects, in which process they risk wounding themselves and torching blood but with modes of transmission being emphasized to these children it will certainly avoid the danger of transmission by blood stained objects.

For the bigger pupils that’s from classes 4 -6  the pre and post test counseling will give them a solid foundation to stabilize their sexuality given that they are preadolescent and soon getting in to active sexual life, it will be good to hold firmly on abstinence as they grow in to  adolescence.

Our comments : Well certainly the aggressive parents had their reasons and some of which as related the Headmistress to us were their dislike for general tests results, they said such results are not always reliable because there is likely going to be a mixed up as the medical team rush to produce results. Others said they have sent their children to school for education not for health care and that if they want to do anything in the health domain they will take their children to the hospital. The school has not become a hospital. Again a parent said while the mother is pregnant she does the HIV and it is negative, why should the child be troubled with testing. That notwithstanding surprisingly enough, many more parents saw the need and expressed their motion of support by signing our parental accord, and the headmistress marveled. What a mood swing from skepticism to certainty.                       

                                                                                             Marie Enanga L.
                                                                    Psychologist/Senior Social welfare officer

lundi 3 octobre 2011

MISE EN OEUVRE DES NOUVELLES DIRECTIVES OMS SUR LA PTME : DIFFICULTÉS D’APPROPRIATION OU RETICENCES CHEZ LES FEMMES ENCEINTES SÉROPOSITIVES AU CAMEROUN ?


Le Cameroun, avec une prévalence de 5,1% au VIH se trouve dans un contexte d’épidémie généralisée. En 2010, la séropositivité des femmes aussi bien en consultation prénatale qu’en salle d’accouchement tournait autour de 7%.
Depuis 2009, le pays a adopté les nouvelles directives sur la PTME suite aux recommandations de l’OMS. Trois importantes recommandations entre autres avaient été faite sur, d’une part la systématisation  de la prophylaxie ARV dès la 14ème semaine de grossesse, la gratuité du comptage des CD4 et d’autre part l’allaitement maternel exclusif protégé pendant les 06 premiers mois de vie. De Janvier 2010 à Juin 2011, KidAIDS-Cameroun a accompagné 198 femmes séropositives indigentes suivies dans trois CTA (Centres de Traitement Agrées) à Yaoundé. Dans ce groupe, nous avons observé le niveau d’appropriation des directives nationales.

En collaboration avec l’équipe de soins des  services PTME des CTA partenaires, des conseillers psychosociaux identifiaient les femmes en consultation prénatale. Celles recrutées dans la cohorte bénéficiaient entre autre de : écoute et conseils, participation aux groupes de paroles, éducation nutritionnelle, visites à domicile, soutien social à travers le financement des ordonnances médicales, des examens biologiques (charge virale et sérologie torch), des moustiquaires imprégnées et du lait artificiel pour celles en situation d’urgence.
En entretien individuel, nos conseillers vérifiaient le degré d’appropriation des nouvelles directives PTME à travers 04 indicateurs : le démarrage de la prophylaxie dès la 14ème semaine de grossesse, le bilan biologique, le démarrage de la prophylaxie chez les bébés exposés, le choix éclairé pour l’allaitement protégé.

Sur 198 bénéficiaires,  les résultats suivants ont été enregistrés :
-       Prophylaxie 14ème semaine : aucune femme enceinte ne déclarait avoir commencé la prophylaxie à 14 semaines,
-       Gratuité des bilans biologiques : aucune femme enceinte ne déclarait avoir reçu un bilan gratuit,
-       Prophylaxie chez les bébés exposés : l’ensemble des bébés nés pendant la durée du projet ont effectivement reçus les ARV à la naissance,
-       Allaitement : seulement 5 bébés sur 105 nés pendant la durée du projet ont été allaité par leurs mamans et les mamans en attente d’accouchement sont réticentes à plus de 90% à l’allaitement protégé.

En outre, la quasi-totalité des femmes expriment l’absence de cohésion des messages dans les formations sanitaires.

Une vulgarisation des nouvelles recommandations est nécessaire tant au niveau hospitalier que communautaire pour une harmonisation des pratiques.
Communication et mobilisation au niveau des interventions communautaires pour améliorer le niveau d’appropriation des recommandations.

M.J. ATANGANA-NDZIE