HIV testing crucial in TB vaccine programme

New research showing that the tuberculosis vaccine Bacille Calmette Guerin (BCG) can be deadly to HIV-positive infants means Kenya's health ministry will have to redouble its efforts to test pregnant mothers and their infants for HIV, senior health officials say.



The South African study found that HIV-positive babies who receive the BCG vaccine were three times more likely to contract TB from the vaccine than previously thought. The authors recommended delaying vaccination until an infant's HIV status is known.



"The new revelations will be challenging to us in regards to the treatment of children, especially given that diagnosis of both HIV and TB in children is not easy and takes a long time to determine," Joseph Sitienei, the director of the National Leprosy and TB Programme at the Ministry of Health, told IRIN/PlusNews.



An estimated 80 percent of children born in Kenya's health facilities receive the TB vaccine, whether or not they have been tested for HIV.



"We must strengthen prevention of mother to child transmission [and] encourage mothers to embrace delivery in health facilities for adequate antenatal and post-natal care to save infants," Sitienei said.



Just 40 percent of Kenyan mothers have their babies in health facilities, with most rural women and up to one in four women in the slums of the capital, Nairobi, opting to have their babies at home with traditional birth attendants.



The government now plans to incorporate traditional birth attendants into the national drive to bring women to antenatal clinics and boost immunization.



"The government will use them as a link between the community and health facilities... this will have the double benefit for the mothers and the children in terms of both vaccination against TB and prevention of mother to child transmission in the case of HIV," Sitienei added.



To encourage women to come to antenatal clinics, it would also be important to reduce the costs associated with obtaining maternity services, including medical fees and expensive transportation.



"The biggest challenge, however, will be to ensure that our healthcare system is strengthened to deal with these new findings on the dangers and efficacy of the BCG vaccine vis-à-vis children born infected with HIV," he said.



According to the National Leprosy and TB Programme, children account for about 11 percent of new TB infections per year. Kenya is ranked 13 out of the 22 high burden countries worldwide and had 140,000 new TB cases in 2008.



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