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Mildred Mudany

Mildred Mudany

Jhpiego, an affiliate of Johns Hopkins University, Kenya office.

Title: Kenya’s race towards elimination of pediatric HIV

Biography

Dr. Mildred Mudany completed her Masters Degree in Paediatrics from the University of Nairobi and her PhD in Tropical Medicine in 2004 from Tokyo Women’s Medical University She is the Country Director of Jhpiego, an affiliate of Johns Hopkins University, Kenya. Prior to this she worked for Centers for Disease Control and Prevention (CDC) as a Senior Technical advisor in PMTCT and Chair for USG Inter-agency Technical Team on Maternal, Newborn and Child Health. She has published more than 15 papers in reputed journals and made significant contributions to Guidelines in PMTCT, Infant Nutrition and Early Infant Diagnosis of HIV. (Up to 100 words)

Abstract

According to Kenya AIDS Indicator Survey (KAIS) 2012, 1.2 million (5.6%) people live with HIV/AIDS. Globally Kenya ranks among 22 priority countries targeted to reduce new HIV infections in children. Approximately101, 000 (0.9%) children between 18mo-14 years are HIV-infected, majority due to mother to child transmission. In 2013 WHO recommended use of HAART for all HIV positive pregnant and lactating women; guideline adopted by Kenya in October 2013.

Methods:

Dissemination of national guidelines done. Nationwide rollout of option B plus starting with large volume facilities offering ART and facilities with integrated HAART within MCH. APHIAPLUS  Kamili   scaled up Option B plus to 134 high volume facilities in Eastern and Central Kenya. Service providers trained on new guidelines. Regular supervision, mentorship, chart reviews and HIV-exposed infant cohort analysis established.  HIV positive mentor mothers placed in  high volume facilities, to support adherence and retention in care of HIV positive pregnant mothers.  HAART integrated into MCH for easy access.  Exclusive breastfeeding for 6 months encouraged. National EID website monitored for PCR results.

Results:

Between October 2013 to September 2014, 1,320,664 pregnant women were tested for HIV of whom 66,258 (5%) HIV positive. Of positives, 56,137 (85%) put on ARV prophylaxis. Of these, 64.2% were on HAART for life (Option B plus). For KAMILI supported zone, EID positivity reduced between APR 2013 and 2014 as follows: @2mo from 5.9% to 4.8%; @9mo from 7.5% to 6.2%; @12mo from 7.8% to 6.7%; @ 18mo from 8.7% to 7.5%.

Nationally 6 weeks PCR positivity has dropped as follows: 12% (2010); 10% (2011) ; 6% (2012) ; 5% (2013);  4% (2014)..

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