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Mother to Child HIV and Syphilis

A team of local doctors, healthcare workers and policy makers is presently in the process of verifying and documenting the elimination of mother to child transmission (MTCT) of HIV and congenital syphilis in the Cayman Islands.

The group is working to prepare a report that will be submitted to the Pan American Health Organisation/World Health Organisation (PAHO/WHO) for certification.

Medical Officer of Health Dr. Kiran Kumar explained that countries need to document the process by which elimination is verified according to WHO guidelines.

“We have achieved this goal due to the quality of our antiretroviral programme over the years. In order to receive certification, we need to document the verification process that we have undertaken, to ensure that there has been no MTCT for the past three years.’’ he added.

Members of the MTCT of HIV and Syphilis Elimination Initiative team include:

• Dr. Karina Palmer- Chair, Obstetrician and Gynaecologist , HSA

• Mrs. Laura Elniski, HIV Programme Coordinator

• Dr. A. K Kumar, Medical Officer of Health

• Dr. Samuel Williams Clinical Head of General Practice Department, HSA

• Ms Janett Flynn, Senior Policy Advisor, Ministry of Health

• Dr. Chela Lamsee Ebanks , Peadiatrician , HSA

• Mr. Timothy McLaughlin, PH Surveillance Officer , HSA

• Mrs. Marcella Greaves, Midwife, HSA

• Mrs. Judith Clarke, Laboratory Manager, HSA

• Mrs. Lavern Swaby, Peadiatrician, HSA

• Mrs. Hamerika Black-Walters, Midwife Maternity Ward, HSA

• Dr. James Robertson, Peadiatrician (private sector)

• Dr. Rommel El-Madany, Obstetrician and Gynaecologist (private sector)

Minister of Health, Hon. Osbourne Bodden, praised the Cayman Islands healthcare community, especially gynaecologists, paediatricians and midwives for maintaining zero levels of MTCT of HIV and congenital syphilis since 2004.

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Editors’ Note:

At the end of 2012, 35.5 million people were living with HIV globally.

With Governments scaling up their efforts for better treatment, care and support, new infection rates have been showing a decline. In addition, advancements made in the use of antiretroviral therapy have led to a reduction in MTCT.

The World Health Organization (WHO) notes that in the absence of any interventions, transmission rates range from 15-45% globally. This rate can be reduced to levels below 5% with effective interventions.

The global community has committed itself to accelerate progress for the prevention of mother-to-child HIV transmission (PMTCT) through an initiative that aims to eliminate new paediatric HIV infections by 2015 and improve maternal, new-born and child survival and health in the context of HIV.

Regional initiatives have since been adopted following the endorsement and approval of a strategy and plan of action for the elimination of MTCT at the 50th Directing Council meeting of the Pan American Health Organization (PAHO) in 2010.

Regional targets to be reached by the end of 2015 are:-

• Reduction of MTCT of HIV transmission to 2% or less

• Reduction of the incidence of MTCT of HIV to 0.3 cases or less per 1000 live births

• Reduction of the incidence of congenital syphilis to 0.5 cases or less per 1000 live births.

Side Bar: Facts on MTCT of HIV

• All pregnant women should be screened for HIV as early as possible during each pregnancy.

• Women with HIV who take antiretroviral medication during pregnancy as recommended can reduce the risk of transmitting HIV to their babies to less than 1%. Globally, only 35% of infants born to mothers living with HIV in low- and middle-income countries received an HIV test within the first two months of life.

• Only 28% of children under 15 living with HIV in low- and middle- income countries received antiretroviral treatment for the virus, as compared with 54% for adults.

• In the Cayman Islands pregnant women over 25 years are routinely tested for HIV and Syphilis

• The last reported case of an HIV positive mother in the Cayman Islands was in 2004.

• The last reported case of mother to child transmission (MTCT) in the Cayman Islands was in 2004.