Know Your Child's Health Problems

Perhaps your child does not seem to be gaining weight and is staying small and thin? Perhaps your baby is not trying to sit up and crawl, not trying to talk, not even smiling as young babies usually do? Perhaps your child has a cold, a runny nose and a cough, that last for weeks and weeks, with ear problems too? Perhaps your child seems to catch every illness going round the neighbourhood?

Any child who is often sick and does not grow well has a health problem. It might be TB, or diabetes, or other illnesses. But it might be that the child is HIV-positive. If you are worried about your child’s health, take your child for a health check-up at the clinic. Explain your worries to the medical staff and ask that the child be examined for any major illness, including HIV.

Before the HIV test on your child, you will be counselled, and you will have a chance to talk about your worries and fears for the child, and for yourself and your family. The counsellor will help you to help yourself, and to find your own answers to problems that might come into your life if the test is positive for HIV.

Explain to your child: before you go to the clinic, tell the child about the test in words that he or she can understand, so that s/he won’t feel too frightened. Perhaps you can say that there might be “baddies” making him or her feel unwell, and that the test will show them up, so that he or she can have medicines to help make their bodies stronger. Check which test the clinic will give the child – the nurse might either take blood, or prick a finger, or take saliva (spit) from the child’s mouth for testing.

Tell the child about it calmly and quietly, and that it will be only a quick sting, and soon it will be over. Let the small child pretend to be the nurse, and pretend to take blood or spit from you or from a doll. Make sure that children know that they are loved and safe, that you will stay with them, and that no-one blames them for anything that might be “wrong” with them.

Testing for HIV:
Then the child will be tested using one of these HIV tests:

1. Testing for signs of the HI Virus (Anti-bodies)
Some of the tests for HIV look to see if there are signs of HIV in the blood. These signs are called “anti-bodies”. They are like an ID, or recognisable mark, that the HI Virus leaves in the blood. There are two forms of anti-body tests:
ELISA Test: A little blood is taken in a tube. Two tests are done using this blood to see if it has HIV anti-bodies.
•If both show up negative, this proves that the child does not have signs of HIV or anti-bodies in the blood at this time. But, because the blood takes a while to make enough of these signs to be clearly shown in a test, it could be that the test results could be inaccurate. To make sure that the negative result is not false, one has to wait for the window period to pass – and take more tests, usually after one month and then again three months later.
•If both tests show up positive, then the child is HIV-infected, and you should ask for more counselling, at that time – or any time later when you feel you need support and advice.
•If one test shows up positive and the other one negative, then the test result is not clear. You will be advised to bring the child for a second test a month later.
It can take some days to get the results of this test.

RAPID RESULTS TESTS: these are other tests that are not as slow as the ELIZA Test. The nurse takes either a drop of blood, or the saliva (spit) and a result can be given within about 15 minutes. But these are not always accurate, and so if the Rapid Test comes up as HIV-positive, a second test is always taken to confirm this result.

Question: my baby has HIV anti-bodies – is it really infected?
In children under 12 months old, HIV-positive anti-body results do not always mean that a child is infected. A mother who is HIV-positive passes the anti-bodies (or signs of the virus) on to her baby, so these babies will test positive in an anti-body test until they are about a year old. If they are re-tested at 18 months, and there are still anti-bodies present, it means that they are definitely HIV-positive. Not all babies born to HIV-positive mothers will have HIV themselves.

2. Testing for the HI VIRUS itself = PCR
These tests do not look for the markers made by the blood once the virus is present, but for the actual virus formations. The test used in South Africa for this purpose is the Polymerase Chain Reaction (PCR) test. As long as the baby is over six weeks old and is not being breast-fed, this test is accurate.
The PCR test is more expensive than the anti-body tests, but it is better for children, because caregivers need to know if a child is infected so that he or she can get special care and treatment as soon as possible. The PCR test is also the best one to use for children who are to be adopted or given foster homes, as the adoptive or foster parents have a right to know the child’s status.

Question: why should I take the child for voluntary counselling and testing?
There are good reasons for a parent or caregiver to knowif a child is HIV-positive or not:

•You can give the child special care to help him or her stay as healthy as possible.
• You can get extra help and support for yourself in this work.
• An HIV-positive child or adult can get very sick because the HIV makes them weak and open to sicknesses and infections. These illnesses are called opportunistic infections (OIs) because they have a chance to attack the body when it has no strength no fight them. If you know that the child is HIV-positive, you can watch for early signs of illness and you will be able to get treatment for the child before he or she becomes very sick.
• You will be able to apply for anti-retroviral (ARV) drugs for the child to keep him or her healthy for longer.

Question: what does an HIV test cost?
You can get free voluntary counselling and testing (VCT), for you and your child, at local government clinics or hospitals.

(Source: KZN HIV/AIDS Civil Society Network – Tel: 031 307 6075)

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