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NANASI 9: December 2002

NANASI 9: December 2002

In this issue of NANASI:
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  • Q & A: Nevirapine for pregnant women who refuse HIV testing
  • Good news! Anti-Retroviral drugs now under Kshs 4000
  • Spotlight on SWAK: Post-test clubs for women — and more
  • Book review: Palliative Medicine, adapted by Dr. Anne Merriam in Uganda

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QUESTION AND ANSWER

Question from a PMTCT nurse-counselor:

Many of the women coming to our ante-natal clinic refuse an HIV test. Yet, they are willing to take a nevirapine tablet. What should I do?

Answer from Dr. Colina of Kijabe Hospital:
At Kijabe we offer all ante-natal women an HIV test. It is true that some women refuse to be tested. If they refuse, we offer these women a nevirapine tablet anyway, even though the HIV sero-status is not known. We explain that, if the mother happens to be infected with HIV, nevirapine can help prevent the baby from getting infected. On the other hand, if the mother is NOT infected with HIV, one nevirapine tablet will not harm the mother or the baby. It is better to give nevirapine without a test than to withold nevirapine from women who need it and refuse the test.

REMEMBER- you can give the mother a nevirapine tablet to take home with her as early as the 30th  week of pregnancy (because she may not return to the clinic before she begins labor pains).  At home, she should swallow the nevirapine tablet at the beginning of her first labor pains.

If a woman in labor comes for delivery, and she has not been counseled or tested, we offer her nevirapine immediately. The tablet will do no harm, and it might prevent HIV infection of her baby. After delivery, when the mother can intelligently receive counseling, we do counsel her and offer her an HIV test. By this procedure, we save many babies from getting HIV, even if their mothers have not had ante-natal care and HIV testing before going into labor.


GOOD NEWS!

MEDS has received a shipment of generic Anti-Retroviral (ARV) drugs at low prices.  MEDS is making these drugs available to its associated church medical facilities so that the patient cost of an approved, adult, three-drug ARV regimen now can be less than KSh 4,000 per month. The three lowest-cost regimens from MEDS:

Regimen A

weight <60 kg.
stavudine 30 mg. bid KSh 310
lamivudine 150 mg. bid KSh 944
nevirapine 200 mg. bid KSh 1,551
total cost per month = KSh 2,805

weight >60 kg.
stavudine 40 mg. bid KSh 351
lamivudine 150 mg. bid KSh 944
nevirapine  200 mg. bid KSh 1,551
total cost per month = KSh 2,846

Regimen B
weight <60 kg.
stavudine 30 mg. bid KSh 310
didanosine 125mg. bid KSh 1,650
nevirapine 200 mg. bid KSh 1,551
total cost per month = KSh 3,511

weight >60 kg.
stavudine 40 mg. bid KSh 351
didanosine 200 mg. bid KSh 2,130
nevirapine 200 mg. bid KSh 1,551
total cost per month = KSh 4,032

Regimen K
all adult weights
zidovudine+lamivudine (300/150mg.)  1 tab bid. KSh 2,228          
nevirapine 200 mg. bid KSh 1,551
total cost per month = KSh 3,779

Note: didanosine should be given on an empty stomach
 
Note: nevirapine should be started at one 200 mg. tablet daily for the first 14 days; then give nevirapine 200 mg. bid. thereafter.

Note: to avoid liver problems, do not give nevirapine during the first two months of tuberculosis treatment with Rifater

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Contact Information

Health Action International (HAI) Africa Office
4th Floor, Top Plaza off Kindaruma Road Suite 4-2
P.O Box Nairobi - Kenya
Tel: +254 20 2692973 ext 108, Cell phone: + 254 0733 398654.
E-mail:info@haiafrica.org, Web:http:// www.haiafrica.org