AIDS and Child Health (3)
-------------------------
I have only recently discovered the note from Geoff Foster (no relation) in
Zimbabwe regarding the impact of HIV/AIDS on child health. In his summary
he names three measures to support children, namely reduce the number of
children developing HIV infection, prolonging HIV-positive mothers' life
expectancy, and developing low cost community support to orphans.
I would like to suggest yet another key intervention to protect children:
that of HIV screening of blood for transfusions. In a paper I published in
the Lancet in 1995 entitled "Benefits of HIV screening of blood transfu-
sions in Zambia", we showed that in a district hospital in Zambia where se-
roprevalence among donors was about 16%, the blood screening programme pre-
vented 150 cases of transfusion-related AIDS, of which 59% were in children
under 6 and 31% in women -- and this is net of existing infections among
hospital patients. It was very cost-effective, with a benefit/cost ratio
of 2.7 to 3.5 depending on the assumptions chosen, and the cost per year of
life saved was $1.32.
In this district, the transfusion screening prevented approximately 6% of
the expected number of HIV infections -- but in children past the perinatal
period, prior to beginning sexual activity, the major source of infection
would be expected to be blood transfusion -- and thus nearly 100% of such
infections were thus prevented. We concluded that blood screening for HIV
was essential, and that it was key to find financial and political support
for HIV screening. Of course at the same time, all efforts must be made to
ensure that transfusions are only used when ABSOLUTELY NECESSARY -- despite
the screening programme, approximately 11 infected units (of 1073) were
transfused, thus causing HIV infection despite screening.Those who are in-
terested in following up can look at the article in Lancet 1995, vol. 346,
July 22 1995, pp. 225-7.
Regards,
Susie Foster
--
Susan Foster, MA, PhD
Distance Learning Coordinator
London School of Hygiene & Tropical Medicine
Keppel Street
London WC1E 7HT, UK
Tel +44-171-927-2359
Fax +44-171-637-5391
mailto:s.foster@lshtm.ac.uk
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