Children Risk HIV Infection Through Contaminated Instruments, Breastmilk at Hospitals in South African Province, Study Says
Blood-stained medical instruments and "mix-ups" with breastmilk in some public hospitals in South Africa's Free State province are increasing the risk that children might contract HIV in the health care setting, according to a study presented at a press conference on Tuesday, Reuters reports (Apps, Reuters, 4/5). Researchers from Stellenbosch University, the Human Sciences Research Council of South Africa, the Medical Research Council and the Centre for AIDS, Development Research and Evaluation studied 4,000 women and their children at 25 Free State public hospitals, three community health centers and 54 primary health care clinics from April 2004 to July 2004. According to the study, 17.5% of the instruments used for maternity and pediatric patients had visible blood on them and 24% of the instruments were contaminated with blood not visible to the human eye, the SAPA/Cape Times reports. In addition, 24.6% of dental instruments were contaminated with blood. The study also reported that 92% of HIV-positive women at the clinics breastfed their children -- 60% of them for more than a year. HIV can be transmitted through breastmilk. Bottles of breastmilk in the hospitals also were labeled by cot numbers, not the name of the infant, which allowed milk to be fed to the wrong infant if the cot was moved, according to the study. "Results show there is very poor cleaning of the environment in the labor and maternity areas and in dental facilities -- and the same is true for the baby and neonatal areas," the study says. The Free State Department of Health and the Nelson Mandela Foundation provided funding for the study, according to the SAPA/Times.
The study's authors recommended that clinics discourage "prolonged" breastfeeding by HIV-positive women, implement methods to better track breastmilk and begin education campaigns to demand better hygiene practices by health care workers, the SAPA/Times reports. Dr. Olive Shisana, HSRC executive director for the social aspects of HIV/AIDS and health and co-author of the study, said, "We went to brief the department of health, nationally, with regard to this particular study, so that they could take up some of the recommendations. Indeed, they were very sympathetic when we met with them ... (and felt) something has to be done. It doesn't just stop with the national Department of Health. It stops at the provincial departments of health and with the public for not being knowledgeable about what to expect from health workers" (SAPA/Cape Times, 4/6). Free State health department spokesperson Elke de Witt said the information from the report is "valuable," noting that the province's public hospitals now label milk bottles more clearly and are looking at ways to approach HIV-positive breastfeeding, as formula feeding is too expensive for many women in the province, according to Reuters (Reuters, 4/5).