Female genital mutilation and parent to child transmission of HIV: A case report of a possible double tragedy

Abstract

Most cases of human immunodeficiency virus (HIV) infection in children result from mother to child transmission. Other risk factors for transmission include transfusion of infected blood and use of contaminated instruments. We report the case of a five-month-old female infant who presented with a history of cough and weight loss of a month's duration. Her mother was diagnosed HIV positive in the first trimester of pregnancy but defaulted from prevention of mother to child transmission services. After delivery, the child was circumcised on the eighth day and severe bleeding complicated the procedure. She was then taken to a private hospital were she was transfused with her father's blood without screening. Both parents were subsequently confirmed HIV positive. The child was also confirmed HIV positive by DNA polymerase chain reaction and had features of HIV encephalopathy and severe immunosuppression (CD4 9.3%). Exposure of this infant to HIV through the mother only carries a transmission risk of 30%. Female genital mutilation and transfusion with her father's blood that was probably already infected constituted increased or additional risks. There is need for health education against transfusion of unscreened blood even when the parents are the donors. Female genital mutilation should also be discouraged by health education and appropriate legislation.

Keywords

Female - genital - mutilation - HIV - blood transfusion