After a successful pilot programme on an integrated large-scale testing of HIV coupled with prevention of malaria and diarrheal diseases activities, Kenyan civil society organizations are now seeking to implement the same strategy to benefit 1.6 million residents of Western Kenya at a tune of US$50 million.
The pilot study which was conducted in the Lurambi division of Western Kenya by Vestergaard Fransen Ltd (a manufacturer of mosquito nets) saw over 47,000 residents undertake the HIV test in just one week, with over 50,000 residents receiving free mosquito nets for malaria control.
“Every individual who turned up for the test was given a free care pack containing a long lasting insecticide treated mosquito-net for malaria prevention, a water filter that purifies drinking water to protect them against diarrheal diseases, and an optional package of 60 pieces of condoms for HIV prevention,” said Mikkel Vestergaard, the Director Vestergaard Frandsen Ltd.
Madam Ida Odinga
Among those who took the HIV test in the Lurambi study, 1694 individuals, representing four per cent of the participants were found to be HIV positive and were put on treatment immediately.
Following the success of this study, the wife of the Kenyan Prime Minister, Madam Ida Odinga, is now leading a civil society initiative to raise $50 million to finance a similar drive to have 1.6 million people, or 80 per cent of residents in Western Kenya sleep under insecticide treated nets, and at the same time have them to know their HIV status.
“We have so far raised 10 per cent of the money, and we are sure of success because several donors have pledged to offer more support following positive results from the pilot study,” said Madam Odinga, during the official opening of a clinic donated by Vestergaard Frandsen to support people living with HIV/AIDS, treat malaria, diarrhea and other diseases affecting people of the Lurambi division, and the rest of the community members.
A survey conducted in the aftermath of the pilot study found that an integrated disease control strategy is cheaper than controlling an individual disease. The report indicates that for every 1,000 prevented cases of the three diseases (Malaria, HIV and Diarrhea), an estimated US$75,000 would be saved annually.
An evidence-based study conducted by experts from the Moi Referral and Training Hospital in conjunction with the US-based Indiana University discovered that people living with AIDS who combined nutrition with Anti Retroviral drugs recovered much faster than those who used the medication alone. As a result, the hospital prescribes nutrition alongside the drugs.
“Apart from the care pack as originally provided, we are adding another component of nutrition to control malnutrition, and to work as a comprehensive treatment especially for people on the antiretroviral therapy,” said Madam Odinga.
According to the 2007 Kenya AIDS Indicator Survey, the average national HIV prevalence in Kenya is 7.1 per cent, yet 84 per cent of those living with the disease do not know their HIV status thus emphasizing the need to expand HIV testing services. At the same time, Western Kenya has the highest prevalence of malaria episodes in the country.
During the Lurambi campaign, 96 per cent of persons infected with HIV were offered a three-month course of cotrimoxazole prophylaxis and a referral for ongoing care and treatment. An additional potential benefit from this campaign was that the HIV infected persons identified at the sites where point-of-care CD4 cell count testing was provided had relatively high CD4 counts, providing an opportunity for early interventions.
According to the experts, distribution of mosquito nets was key because malaria is one of the opportunistic diseases for people with compromised immune system. Studies have further shown that malaria is the leading cause of childhood morbidity and mortality in Kenya. Yet several trials have indicated that sleeping under an insecticide treated mosquito net is an effective way of reducing malaria incidences.
On the other hand, lack of access to safe drinking water and inadequate sanitation has been found to contribute to increased risk of diarrheal diseases and causes an estimated two million deaths per year especially in young children below the age of five years. The 2003 Kenya Demographic and Health survey indicated that 75 per cent of Nyanza province population in Western Kenya lacked access to improved water supplies and reported the third highest diarrhea rates in the country.
Evidence indicates that simple, acceptable, low-cost interventions such as water filtration offers the most consistent and effective means of improving household water, which reduces the risk of diarrheal diseases and associated deaths. The campaign rapidly increased access to a safe drinking water intervention.
The quest to implement the care pack strategy in the remaining part of Western Kenya has received backing from different people and organizations. Among them is the musician Yvonne Chakachaka, who is also the UNICEF Goodwill ambassador against malaria, and Sarah Obama, the grandmother of the US President Barrack Obama, through an organization known as Grandmothers Against Malaria Initiative.
It is expected that the implementation which begins in Western Kenya, will spread to other parts of the country.