Success Stories: Early Infant Testing Showing Success in Botswana

December 2006

FRANCISTOWN - A pilot program for early testing of HIV-exposed infants in Botswana has found that less than 7 percent of the 1,917 infants enrolled were infected with HIV.

The results offer new evidence about the effectiveness of the PMTCT program, giving HIV infected mothers hope that their babies might be able to live a life free of HIV.

The data were collected by BOTUSA during a pilot program from June to December 2005. The pilot was conducted in Francistown and Gaborone.

BOTUSA, with support from the U.S. President's Emergency Plan for AIDS Relief, launched the pilot program to determine the feasibility of rolling out early infant testing across the country. Due to the program's success, the rollout began in October 2006 and has now reached all of the districts in Botswana.

Early infant testing allows babies infected with HIV to be identified soon after birth and placed on life-saving treatment. Using the early infant testing method, health care providers can diagnose infants with HIV by collecting dried blood spots as early as six weeks after birth and sending them to Gaborone for testing. These dried blood samples are stable, do not require refrigeration, and can be transported whenever practical.

Previously, infants were tested using an ELISA (Enzyme-Linked Immunoabsorbent Assay) or rapid test. While these tests produce accurate results, the approach was inadequate for program monitoring and clinical purposes since health care workers had to wait until the infant was 18 months old to be tested. By this time, many infants had been moved from the areas where they were delivered and were lost to follow-up, or already had advanced AIDS.

"The benefits in the short term are of course medical - less sick infants," said Dr. Molly Smit of the BOTUSA team in Francistown.

She added that the social benefits to families are even greater. "The relief of knowing that they have negative infants should give mothers hope for the future and to raise their babies with motivation," she said.

Balekanye Mosweu, a 25-year-old HIV-positive mother in Francistown, worried her twins would be born HIV positive. However, because of early infant testing, she learned her babies were HIV negative six weeks after giving birth to them.

"It was a miracle," Mosweu said. "At the end of the day, the results came so fast that it was so much easier to relax and enjoy bringing up my children."