Mozambique: cases and investigations
Unexpected HIV infections in children, 2015: A random sample national survey in 2015 tested children and adults for HIV. The study found 30 HIV-positive children aged 6-23 months (2.0% of 1,497 children) — 20 with mothers who were HIV-positive and 10 with mothers who were HIV-negative. Thus a low estimate is that 33% (= 10/30) of the HIV-positive children in the survey got HIV from healthcare. However, because most children 6-23 months old are breastfeeding, it’s also necessary to consider that many breastfeeding children who get HIV from healthcare infect their mothers. How many? In Russia and Libya, where hundreds of children got HIV from healthcare, children who were breastfeeding infected 40%-60% of their mothers (see Little et al). If 50% of breastfeeding children who got HIV from healthcare in Mozambique infected their mothers, then the number of children in the 2015 survey who got HIV from healthcare would be 20 (not 10), and 10 of those children infected their mothers. Is it so? Rather than wonder about such risks, it is easy to investigate — government of Mozambique could do what governments of Libya, Russia, Kyrgyzstan, Romania, and other countries have done. Finding out how children with HIV-negative mothers got HIV protects not only children but also breastfeeding mothers. Sources:
- Little KM, Kilmarx PH, Taylor AW, et al. A review A review of evidence for transmission of HIV from children to breastfeeding women and implications for prevention. Pediatr Infect Dis J 2012; 31: 938-942. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565150/ (accessed 8 November 2018).
- page 231 in: Ministério da Saúde (MISAU), Instituto Nacional de Estatística (INE), e ICF, 2015. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique 2015. Rockville, Maryland: ICF, 2018. Available at: https://dhsprogram.com/pubs/pdf/AIS12/AIS12.pdf (accessed 8 November 2018).
Unexpected HIV infections in children, 2009: A random sample national survey in 2009 tested children as well as adults for HIV. The study found 63 HIV-positive children aged 0-11 years old, of which 18 (29%) had mothers who tested HIV-negative. Five mothers were not tested. Among children with tested mothers, 18 (31%) of 58 had HIV-negative mothers. Sources:
- pp. 177-181 in: INS, INE, and ICF Macro. Inquérito Nacional de Prevalência, Riscos Comportamentais e Informação sobre o HIV e SIDA em Moçambique 2009. Calverton, Maryland: ICF Macro, 2010. Available at: http://measuredhs.com/pubs/pdf/AIS8/AIS8.pdf (accessed 19 January 2012).
- Brewer D. Scarification and male circumcision associated with HIV infection in Mozambican children and youth. Webmedcentral 2011, Article ID WMC002206. Available at: http://www.webmedcentral.com/article_view/2206 (accessed 19 January 2012).