Protecting newborns from HIV


“In Africa the World Health Organization (WHO) estimates that more than 90 percent of 430,000 new cases of AIDS in 2008 were attributable to mother-to-child transmission,” said Carolina Gamache , program coordinator in senior researcher Robert Malkin’s Developing World Healthcare Technology Laboratory at Duke’s Pratt School of Engineering. “A single dose of Nevirapine right after birth has been shown to be effective in protecting the baby from the virus, but it has been difficult for many reasons to make this option available to women who give birth at home.”

Africa in particular has unique challenges to the distribution and application of medication. People are rural and spread out far away from clinics or hospitals; the weather is dry and very hot reducing the shelf life of medication; and many times people are nomadic and difficult to find for follow up care.

This new packaging addresses these issues head on. The medication is sealed in what looks like a fast food ketchup packet, is not as vulnerable to evaporation, is portable and oral so it’s very easy to administer to a new born.

In the past, healthcare workers tried distributing single doses to expectant mothers by other means, like syringes and screw top containers. They were vulnerable to the weather and the ability of the mother to use a syringe.

Sad but true, manufacturers have not been encouraged to solve the problem because there is no broader market for this type of drug distribution. It is unique to a poor and mobile community. Development costs and limited marketing potential do not make it an attractive or lucrative problem to solve. The new pouch was fabricated at Duke and is being field tested by their research teams.

“In our system, the pharmacist can fill an individual pouch for women early in their pregnancy, and they can take it home with them,” Gamache said. “When the baby is born, the mother can then easily rip off the corner of the pouch and empty the drug into the newborn’s mouth.”

WHO estimates that only 32 percent of infants born to HIV-positive mothers receive any kind of prophylactic antiretroviral drug. If field tests support the distribution of this product, it could change Africa. “This could be accomplished at little additional cost and could be a significant step in creating a generation of child free of HIV,” concluded Gamache.

Source: Duke University, Science Daily


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