| Autor: |
Neary J; Departments of Global Health, University of Washington, Seattle, WA, USA., Njuguna IN; Departments of Epidemiology, University of Washington, Seattle, WA, USA.; Research and Programs, Kenyatta National Hospital, Nairobi, Kenya., Cranmer LM; Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA., Otieno VO; Kenya Medical Research Institute, Kisumu, Kenya., Mugo C; Departments of Global Health, University of Washington, Seattle, WA, USA.; Research and Programs, Kenyatta National Hospital, Nairobi, Kenya., Okinyi HM; Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya., Benki-Nugent S; Departments of Global Health, University of Washington, Seattle, WA, USA., Richardson BA; Departments of Global Health, University of Washington, Seattle, WA, USA.; Departments of Biostatistics, University of Washington, Seattle, WA, USA., Stern J; Departments of Biostatistics, University of Washington, Seattle, WA, USA., Maleche-Obimbo E; Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya., Wamalwa DC; Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya., John-Stewart GC; Departments of Global Health, University of Washington, Seattle, WA, USA.; Departments of Epidemiology, University of Washington, Seattle, WA, USA.; Departments of Medicine, University of Washington, Seattle, WA, USA.; Departments of Pediatrics, University of Washington, Seattle, WA, USA., Wagner AD; Departments of Global Health, University of Washington, Seattle, WA, USA. |
| Abstrakt: |
Newly diagnosed HIV positive children may be unique index cases to identify undiagnosed parents. Data was used from the Pediatric Urgent Start of HAART (NCT02063880) trial, which enrolled hospitalized, ART-naïve, HIV positive children ages 0-12 years in Kenya. Exact McNemar's tests were used to compare proportions of mothers and fathers tested for HIV, linked to care, and on ART at baseline and 6 months. This analysis included 87 newly diagnosed children with HIV who completed 6 months of follow-up. Among 83 children with living mothers, there were improvements in maternal linkage to care and treatment comparing baseline to 6 months (36% vs. 78%; p < 0.0001 and 22% vs. 52%; p < 0.0001). Among 80 children with living fathers, there were increases from baseline to 6 months in the number of fathers who knew the child's HIV status (34% vs. 78%; p < 0.0001), fathers ever tested for HIV (43% vs. 65%; p < 0.0001), fathers ever tested HIV positive (21% vs. 43%; p < 0.0001), fathers ever linked to care (15% vs. 35%; p < 0.0001), and fathers ever initiated on ART (11% vs. 23%; p = 0.0039). Newly diagnosed HIV positive children can be important index cases to identify parents with undiagnosed HIV or poor engagement in care. |
