Tag Archives: Health Communicators Forum of Zimbabwe

Need for more STIs point of care tests

Anna Machiya, National Coordinator for STI Prevention and Condom Distribution in the Ministry of Health and Child Care

BY MUNYARADZI BLESSING DOMA

There is need for more Sexually Transmitted Illnesses (STIs) point of care tests so as to determine the exact burden of the diseases in the country.
And without reliable data, more STIs continue to spread as the majority of them are asymptomatic.
This was revealed by Anna Machiya, the National Coordinator for STI Prevention and Condom Distribution in the Ministry of Health and Child Care, at a recent Media Science Café organised by the Health Communicators Forum.
“We also need to have some surveillance that maybe gives us an indication as to how big the problem of STIs in the country is, and without data on surveillance, on the magnitude of STIs it is very very difficult to really know what is happening.
“What we see now are those that become sick and present themselves at our facilities and these are the STIs that we are able to capture.
“So these ones that are asymptomatic continue to spread, and this is one reason that also fuels the spread of STIs.
“So now there is also talk of considering to move from syndromic approach to etiological approach, where we also use the specific laboratory tests to identify these STIs but the cost of doing such tests is quite high.
“So as more cheaper point of care tests are available on the market, the better it will be for us to also be able to screen,” said Machiya.
She added: “right now we have point of care test for syphilis and we are actually providing that to clients or to people that present with an STI, so we test for HIV and we test for syphilis.”
It is said syndromic approach focuses on the diagnosis and management of a specific set of symptoms or a syndrome, without necessarily identifying the underlying cause.
As for the etiological approach, it seeks to identify the underlying cause or origin of a disease, or symptom. It focuses on understanding the root cause, mechanism or pathophysiology.
According to the World Health Organisation (WHO), more than 1 million curable STIs are acquired every day worldwide in people 15-49 years old, the majority of which are asymptomatic.
WHO further adds that in 2020 there were an estimated 374 million new infections in people 15-49 years with 1-4 curable STIs: chlamydia, gonorrhea, syphilis and trichomoniasis.
Machiya added that the main aims of STI control are to prevent the development of diseases, complications and sequelae, to interrupt the transmission of sexually acquired infections and to reduce the risk of HIV infection. She stressed that STIs are avoidable, treatable and curable hence early treatment is essential.
“For prevention, we should take note of social and cultural determinants, promote safer sexual behaviour (abstinence, delayed sexual debut and promote use of condoms for penetrative sexual acts,” added Machiya.

Getting an HIV vaccine remains necessary

Dr Muchaneta Bhondai-Mhuri

BY MUNYARADZI BLESSING DOMA

While other biomedical prevention methods have been found to be effective, an HIV vaccine remains necessary as it offers long lasting protection and eliminates the stigma associated with treatment, among other benefits, a recent media science café has heard.

During the media science café organised by the Health Communicators Forum of Zimbabwe, Dr Muchaneta Bhondai-Mhuri, Investigator of Record at the University of Zimbabwe Clinical Trials Research Centre (UZ-CTRC), said while past trials have seen an HIV vaccine remain elusive, every study has provided new information necessary for this endeavor.

According to the National Institute of Health, “a preventative HIV vaccine is given to people who do not have HIV, with the goal of preventing HIV infection in the future.”

Dr Bhondai-Mhuri revealed that the first HIV vaccine trials in Zimbabwe were conducted in 2016 and currently the country is on its fifth trial and several lessons have been learned as the search continues for an efficacious vaccine.  

“We know that more than 24 percent of people in the world who have HIV experience problems with accessing HIV treatment. We also know that all HIV prevention modalities have their own challenges that include adherence and just access.

“We know that a vaccine itself can stay in someone’s immune system for a very long time so it entails long term prevention.

“With every HIV vaccine study that is being done, we are learning something new, even if the vaccine does not show us that it is efficacious, we learn something new.

“For example, whilst the HVTN 705 study did not help us to have an efficacious vaccine, it showed us that the vaccine candidate was able to elicit an immune response which means it is possible to have a vaccine that works.

“So that is new information that will lead to the development of a better vaccine, what it means is that what one candidate needs to go back to the lab and to be tweaked for it to improve the effectiveness but we have already learnt something new,” said Dr Bhondai-Mhuri.

She added that though five HIV vaccine studies have been conducted without an effective one, they (trials) are not losses.

“So every study is not a loss, each study that we do teaches us something new and it will help us, yes the road is going to be long but we will get there,” she said.

Dr Bhondai-Mhuri also revealed that currently the country was on the HIV Vaccine Trials Network 140 (HVTN 140) which has 15 participants, showing that these are strides being taken to find a vaccine.

“We have a couple of HIV prevention modalities which have been approved by four authorities and this already includes the long-acting injectable cabotegravir (CAB LA) which has reached advanced clinical trials stages and is already in implementation trials and then we also have the dapivirine vaginal ring which has been proven to be effective and which also has been approved and we now have the Pre-Exposure Prophylaxis (PrEP), the daily oral prevention pill which is broadly available and it’s available whether you go to our council clinic, or you go to your local doctor, you go to your private practitioner, they will be able to offer this prevention method,” she said.

Dr Bhondai-Mhuri added; “however an HIV vaccine is still necessary in the fight against HIV because it eliminates the stigma that is associated with going looking for an HIV prevention tool from your clinic, no one really wants to be seen going to your local clinic daily to look for an HIV prevention pill.

“An HIV vaccine is going to last in your body for longer than the pills, is going to be longer than cab injection and also an HIV vaccine is likely to be one of the best tools in the prevention of HIV compared to any other method.

“It’s likely in the long run to be more effective and more cost effective than most prevention tools because one doesn’t have to visit their clinic often, you don’t have too frequent dossing so yes as a country we will need a method that is cost effective in the prevention of HIV and in safeguarding the health of our people.”

She added that the major challenge in all these years of HIV prevention vaccine trials is that we have not yet found a vaccine that is efficacious is preventing HIV, but it (challenge) was not only unique to Zimbabwe, hence a lot of work will continue to be put to make this dream a reality.

It is estimated that a total of 1,3 million people are living with HIV in Zimbabwe.