Making a difference for Mthatha’s children

Paediatrician Dr Andrew Oyemwimina originally planned to emigrate from his hometown of Warri in Nigeria to the USA. After being accepted to practise medicine in South Africa, he found the education so good that he stayed.

Today, he’s making a difference at the Nelson Mandela Academic Hospital in Mthatha, where he’s completed his research on the prevalence of HIV infection among paediatric patients admitted to Nelson Mandela Academic Hospital in the Eastern Cape. The tertiary hospital is located in the OR Tambo District and receives referrals from Mthatha and surrounding areas.

HIV infection in children in the Eastern Cape

Dr Oyemwimina’s study is the first of its kind in the Eastern Cape that looks at the prevalence of HIV infection among paediatric patients who were admitted to hospital in 2016. Similar studies have been done at King Edward VIII Hospital in Durban in 2001 and at Chris Hani Baragwanath Hospital in Gauteng in 2012. “My research was a cross-sectional retrospective study completed between 1 July 2018 and 31 December 2018,” he says.

The ages of the patients in his study ranged between one month and 12 years old. Talking about the conclusion of his study, Dr Oyemwimina says, “The prevalence of HIV infection in the study population of 419 patients, including both HIV-infected and noninfected patients, was 7.3%. The prevalence of HIV infection in the subgroup that was exposed to HIV and received prevention of mother-to-child transmission was 11.8%, which was above the national percentage.”

“In 2016, when these patients were admitted, the prevalence of HIV infection among children exposed to HIV and who received prevention of mother-to-child transmission across provinces varied from 1.4% to 5.9% according to the 2016 National Strategic Plan. The transmission rates at Nelson Mandela Academic Hospital was higher than that at 11.8%. This high rate compared with the national rates of 1.4% to 5.9% in 2016 will form part of another study that I plan to conduct to look at the factors responsible for the high HIV prevalence rate of 11.8%, even after patients received prevention of mother-to-child transmission.”

Obstacles to prevention of mother-to-child transmission in rural settings

Dr Oyemwimina says studies in the rural Eastern Cape have shown that obstacles to accessing prevention of mother-to-child transmission services include:

• Socio-economic constraints
• Poor roads and telecommunications
• An under-developed transport system.

A lot of people in the region prefer traditional care over Western medicine, so education and awareness are important, he adds. Nelson Mandela Academic Hospital serves 13 clinics in the OR Tambo District of Mthatha, and most hospitals in the former Transkei region refer patients to them.

National prevention of mother-to-child transmission – a major success story

Prevention of mother-to-child transmission became an official National Department of Health policy in 2010. By 2016, UNAIDS estimated that more than 95% of HIV-positive pregnant South African women were receiving ARV medicine to reduce the risk of transmission. The results were impressive. Mother-to-child transmission rates nationwide fell from 3.6% to 1.5% between 2011 and 2016, achieving the 2015 target of a transmission rate below 2%. According to the SA National AIDS Council, the country is now on track to eliminate mother-to-child transmission.

Dr Oyemwimina is married to a computer scientist with an MBA, and they have three boys. “My wife and the boys live on the north coast of KwaZulu-Natal,” he says. Dr Oyemwimina was the middle child in a family of eight. After matriculating, he moved from Warri to Benin City where he studied medicine at the University of Benin before completing his internship and community service. “I worked there for a few years but then decided I wanted to specialise. I initially spent several years at the Stanger Provincial Hospital in KwaZulu-Natal before coming to Mthatha to specialise in paediatrics.” Dr Oyemwimina plans to specialise further in paediatric cardiology. In his spare time, he enjoys listening to R&B and watching Premier League football.