Posts tagged swaziland

Photo by Sven Torfinn
Swaziland is in the middle of a medical crisis. The highest HIV prevalence in the world and the emergence of drug-resistant TB threaten to have a disastrous effect on the social and economic situation there. 
Millions of people in developing countries are still waiting for the AIDS revolution. Join us for a Twitter chat on how millions of people are still waiting for the AIDS revolution: Friday, Dec. 6, 11am EST/5pm CET @MSF_SouthAfrica

Photo by Sven Torfinn

Swaziland is in the middle of a medical crisis. The highest HIV prevalence in the world and the emergence of drug-resistant TB threaten to have a disastrous effect on the social and economic situation there.

Millions of people in developing countries are still waiting for the AIDS revolution. Join us for a Twitter chat on how millions of people are still waiting for the AIDS revolution: Friday, Dec. 6, 11am EST/5pm CET @MSF_SouthAfrica

Multidrug-resistant TB (MDR-TB) as a Child

Senzo is seven years old and lives alone with his grandmother in Mgazini, Matsanjeni Health Zone in Swaziland. He is HIV-positive and has been on treatment for MDR-TB for just over five months.

We need better treatment for MDR-TB now! Show your support by signing the TB Manifesto.

Photo: Blood is drawn for an HIV test at the MSF Dipping Tank community testing campaign at Nhletsheni, in Shiselweleni region. Swaziland 2012 © Giorgos Moutafis
Trying Out New Approaches to HIV Treatment
Thirty years into the HIV/AIDS epidemic and more than a decade since the introduction of antiretroviral treatment (ART) in developing countries, the latest scientific evidence shows that the treatment keeps people healthy and prevents the virus from spreading. MSF is now treating more than 222,000 people for HIV/AIDS in 23 countries and introducing new approaches to treatment including earlier provision of ART to pregnant women living with HIV, expanded testing and treatment programs, and using improving technological monitoring techniques to track patient progress. Here, Micaela Serafini, MSF medical referent, discusses MSF’s efforts to treat HIV/AIDS in Swaziland.
Why is it important to provide antiretroviral treatment to people living with HIV while their immune system is still strong?
Today, we measure the level of an HIV-positive person’s white blood cells [CD4 cells] to determine when to start them on treatment, because this is an indicator of how strong their immune system is. Right now, the World Health Organization recommends starting people on ART when their CD4 cell count drops to 350 cells per mm3 of blood, but asks countries to consider earlier ART for pregnant women and HIV-positive partners in couples where one person is HIV-positive and the other is not, or “sero-discordant” couples. A healthy person’s CD4 count ranges from 800 to 1,200 cells per mm3—the lower the count, the more prone a person is to becoming ill from opportunistic infections like tuberculosis.
In Swaziland, MSF is studying the feasibility and acceptance of the “Test and Treat” (T&T) model, the most radical option of Treatment as Prevention (TasP). It involves providing all HIV-positive people with treatment, regardless of their CD4 count. This approach would allow us to have a maximum impact on reducing illness, as well as transmission of HIV in the community.
We are currently paving the way for TasP in Swaziland with the implementation of a greatly improved treatment protocol for pregnant women in order to better prevent mother-to-child transmission of HIV, or PMTCT, and help keep mothers healthy. The protocol is referred to as “Option B+.” In a nutshell, PMTCT Option B+ is T&T for pregnant women—we aim to start all HIV-positive pregnant women on life-long treatment, regardless of their CD4 count.
This new pilot project is just starting in the south of the country, in the Shiselweni region, which has a population of 208,000 people. We hope to start PMTCT B+ this month and from there put 3,000 pregnant women on ARV treatment every year. In 2013, we will expand this approach to other vulnerable groups and eventually to all HIV-positive adults in the region.

Photo: Blood is drawn for an HIV test at the MSF Dipping Tank community testing campaign at Nhletsheni, in Shiselweleni region. Swaziland 2012 © Giorgos Moutafis

Trying Out New Approaches to HIV Treatment


Thirty years into the HIV/AIDS epidemic and more than a decade since the introduction of antiretroviral treatment (ART) in developing countries, the latest scientific evidence shows that the treatment keeps people healthy and prevents the virus from spreading. MSF is now treating more than 222,000 people for HIV/AIDS in 23 countries and introducing new approaches to treatment including earlier provision of ART to pregnant women living with HIV, expanded testing and treatment programs, and using improving technological monitoring techniques to track patient progress. Here, Micaela Serafini, MSF medical referent, discusses MSF’s efforts to treat HIV/AIDS in Swaziland.

Why is it important to provide antiretroviral treatment to people living with HIV while their immune system is still strong?

Today, we measure the level of an HIV-positive person’s white blood cells [CD4 cells] to determine when to start them on treatment, because this is an indicator of how strong their immune system is. Right now, the World Health Organization recommends starting people on ART when their CD4 cell count drops to 350 cells per mm3 of blood, but asks countries to consider earlier ART for pregnant women and HIV-positive partners in couples where one person is HIV-positive and the other is not, or “sero-discordant” couples. A healthy person’s CD4 count ranges from 800 to 1,200 cells per mm3—the lower the count, the more prone a person is to becoming ill from opportunistic infections like tuberculosis.

In Swaziland, MSF is studying the feasibility and acceptance of the “Test and Treat” (T&T) model, the most radical option of Treatment as Prevention (TasP). It involves providing all HIV-positive people with treatment, regardless of their CD4 count. This approach would allow us to have a maximum impact on reducing illness, as well as transmission of HIV in the community.

We are currently paving the way for TasP in Swaziland with the implementation of a greatly improved treatment protocol for pregnant women in order to better prevent mother-to-child transmission of HIV, or PMTCT, and help keep mothers healthy. The protocol is referred to as “Option B+.” In a nutshell, PMTCT Option B+ is T&T for pregnant women—we aim to start all HIV-positive pregnant women on life-long treatment, regardless of their CD4 count.

This new pilot project is just starting in the south of the country, in the Shiselweni region, which has a population of 208,000 people. We hope to start PMTCT B+ this month and from there put 3,000 pregnant women on ARV treatment every year. In 2013, we will expand this approach to other vulnerable groups and eventually to all HIV-positive adults in the region.

"I’m Going to Tell The Whole World": An HIV "Expert Patient," In Her Own Words


In 2001, I tested positive for HIV. At that time, I was 25 years old and in a terrible state. I had lost a lot of weight, I was vomiting, had cold and hot rashes and was saying weird things. My whole body was covered with sores and I was confined to a wheelchair. Literally, I was more dead than alive.
In 2004, I started volunteering for an organization that helped people living with HIV/AIDS in Nhlangano, the capital of Shiselweni region. They asked me to share my experiences, and I told people about antiretroviral treatment and what it had done for me.

When I started seeing MSF cars in Nhlangano in 2009, I became curious and asked around. Someone told me what MSF was doing, and immediately I wrote my application letter and was hired as an “expert patient.” My role is to do pre and post-test counseling and to be there for the patients when they need support.

I really like the work with the patients. I know I give them hope by telling my story. Today I am fine. I have a healthy four-year-old boy who is HIV negative. Before I had him, five children I brought to this world had died, each after six months. My older son is 17, and he is well, too. I know what the patients are going through, and telling them my story and how important it is to stick to the treatment encourages them. The other day a young girl even told me I was her role model. That made me very happy.Photo: Thembi (right) with her two sons
Swaziland 2012 © Irene Jancsy/MSF

"I’m Going to Tell The Whole World": An HIV "Expert Patient," In Her Own Words

In 2001, I tested positive for HIV. At that time, I was 25 years old and in a terrible state. I had lost a lot of weight, I was vomiting, had cold and hot rashes and was saying weird things. My whole body was covered with sores and I was confined to a wheelchair. Literally, I was more dead than alive.

In 2004, I started volunteering for an organization that helped people living with HIV/AIDS in Nhlangano, the capital of Shiselweni region. They asked me to share my experiences, and I told people about antiretroviral treatment and what it had done for me.

When I started seeing MSF cars in Nhlangano in 2009, I became curious and asked around. Someone told me what MSF was doing, and immediately I wrote my application letter and was hired as an “expert patient.” My role is to do pre and post-test counseling and to be there for the patients when they need support.

I really like the work with the patients. I know I give them hope by telling my story. Today I am fine. I have a healthy four-year-old boy who is HIV negative. Before I had him, five children I brought to this world had died, each after six months. My older son is 17, and he is well, too. I know what the patients are going through, and telling them my story and how important it is to stick to the treatment encourages them. The other day a young girl even told me I was her role model. That made me very happy.

Photo: Thembi (right) with her two sons
Swaziland 2012 © Irene Jancsy/MSF

Senzo is seven years old and lives with his grandmother in Mgazini, in the Shiselweni region of southwestern Swaziland. He is HIV-positive and has been on treatment for multidrug-resistant tuberculosis (MDR-TB) at Our Lady of Sorrows clinic in the Matsanjeni Health Zone for just over five months.

Read more about Senzo’s story and treating children with drug-resistant TB in Swaziland

Photo: Swaziland 2011 © Sifiso Sibandze

Senzo is seven years old and lives with his grandmother in Mgazini, in the Shiselweni region of southwestern Swaziland. He is HIV-positive and has been on treatment for multidrug-resistant tuberculosis (MDR-TB) at Our Lady of Sorrows clinic in the Matsanjeni Health Zone for just over five months.

Read more about Senzo’s story and treating children with drug-resistant TB in Swaziland

Photo: Swaziland 2011 © Sifiso Sibandze

I do get a lot of emotional support from my family, but financially we are struggling.
Colisile Lushaba, A TB patient from Swaziland. Read more about Colisile in her blog part of our TB&ME blogging project.

Happiness Dlamini is an MSF patient on treatment for multi drug-resistant tuberculosis (MDR-TB) in Swaziland. The treatment for MDR-TB requires taking less effective drugs with terrible side effects for up to two years. Happiness has 21 months of treatment remaining.

Today is World Tuberculosis Day, learn more here.

Swaziland has the highest HIV prevalence in the world among adults. Disturbingly, more than 80 percent of TB patients are also co-infected with HIV. Life expectancy has halved within two decades, plummeting from 60 to just 31 years. People are dying in large numbers and tuberculosis is currently the main cause of mortality among adults. As a result, many children are being made orphans and the adult workforce is declining.
Aymeric Péguillan, MSF’s head of mission in Swaziland
Read More.