After last year’s shocking finding that 5.6% of South African children between the ages of two and 14 were HIV positive, the Human Sciences Research Council (HSRC) has announced that it will conduct further research.
The finding , which if correct means some 670 000 children are HIV positive , was part of the groundbreaking Nelson Mandela/HSRC study of HIV/AIDS published last December.
We were surprised by this finding so we have developed a proposal to validate the findings of HIV/AIDS in children and also to investigate infections in healthcare services, said principal investigator, the HSRC’s Dr Olive Shisana, this week.
The HSRC’s new study, to be conducted on 4 000 Free State children, will investigate the role of the healthcare system, sexual abuse and other non-healthcare related events, for instance traditional circumcision ceremonies, said
Shisana. Dr Mark Colvin, an epidemiologist of the Medical Research Council (MRC) who participated in the study, said further research was necessary as it was unclear as to how these children could have been infected.
Most children get HIV from their mothers while in the womb, during birth or from breastfeeding. However, the HSRC study found there was evidence of significant non-vertical (other than mother-to-child) transmission.
Some 11% of white children tested positive, for example, while the overall HIV rate for white adults was only 5.7%.
In addition, in the case of 20 HIV positive children who could be linked with their parents’ HIV results, only five of these children had HIV positive parents.
This is a small sample size and also biased, said Colvin. Hence the data is not really interpretable in terms of what it says about the proportion of children infected from their mothers.
While the rate of sexual abuse of children is high in South Africa, a recent study showed that it only accounted for around 1% of HIV transmission. This is borne out by the experience of Dr Kimesh Naidoo of Greys Hospital in Pietermaritzburg, who says that of the 300 patients seen at the hospital’s child abuse clinic last year, only three were infected as a result of the abuse.
Commenting on the Mandela/ HSRC study, an article in the latest edition of the British Journal of Obstetrics and Gynaecology says that the HIV infection of children in the South African sample through non-sterile medical procedures is a more reasonable hypothesis than the sexual one.
Dr Shisana believes that unsterile hospital procedures, particularly involving immunisations, could be responsible for the high rate of children’s infection. However, this has been disputed by the Department of Health.
Meanwhile, Professor Rob Dorrington of the Centre for Actuarial Research at the University of Cape Town, says the entire HSRC/ Mandela study has obvious shortcomings. In addition, KwaZulu-Natal’s chief virologist Professor Alan Smith said the study appeared to have been shabbily done
Both men were quoted in the latest SA Medical Journal and said that Shisana had refused their requests to review the study’s raw data to address their misgivings. However, Shisana says that the research belongs to the Nelson Mandela Foundation. (Source: Health-e,21-05-2003)