Missed opportunities of inclusion in a cohort of HIV-infected children to initiate antiretroviral treatment before the age of two in West Africa, 2011 to 2013
| Autor: | Désiré L, Dahourou, Madeleine, Amorissani-Folquet, Malik, Coulibaly, Divine, Avit-Edi, Nicolas, Meda, Marguerite, Timite-Konan, Vic, Arendt, Diarra, Ye, Clarisse, Amani-Bosse, Roger, Salamon, Philippe, Lepage, Valériane, Leroy, Claire, Rekacewicz |
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| Přispěvatelé: | Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées |
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Male Pediatrics Time Factors HIV Infections Logistic regression Santé publique Cohort Studies 0302 clinical medicine Acceptability Linkage to care [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Medicine 030212 general & internal medicine Pathologie maladies infectieuses Children access to care Age Factors Lopinavir Infectious Diseases Cohort [SDV.IMM]Life Sciences [q-bio]/Immunology Female Cohort study medicine.drug Research Article medicine.medical_specialty Anti-HIV Agents Access to care 03 medical and health sciences Acquired immunodeficiency syndrome (AIDS) children acceptability Legal guardian West Africa Humans linkage to care business.industry Public Health Environmental and Occupational Health Infant Newborn Infant HIV Odds ratio medicine.disease 030112 virology Confidence interval Logistic Models Early antiretroviral therapy early antiretroviral therapy business |
| Zdroj: | Journal of the International AIDS Society Journal of the International AIDS Society, 19 (1 Journal of the International AIDS Society, BioMed Central (2008-2012) ; International Aids Society (2008-) ; Wiley (2017-), 2016, 19 (1), pp.20601 |
| ISSN: | 1758-2652 |
| Popis: | Introduction: The World Health Organization (WHO) 2010 guidelines recommended to treat all HIV-infected children less than two years of age. We described the inclusion process and its correlates of HIV-infected children initiated on early antiretroviral therapy (EART) at less than two years of age in Abidjan, Côte d'Ivoire, and Ouagadougou, Burkina Faso. Methods: All children with HIV-1 infection confirmed with a DNA PCR test of a blood sample, aged less than two years, living at a distance less than two hours from the centres and whose parents (or mother if she was the only legal guardian or the legal caregiver if parents were not alive) agreed to participate in the MONOD ANRS 12206 project were included in a cohort to receive EART based on lopinavir/r. We used logistic regression to identify correlates of inclusion. Results: Among the 217 children screened and referred to the MONOD centres, 161 (74%) were included and initiated on EART. The main reasons of non-inclusion were fear of father's refusal (48%), mortality (24%), false-positive HIV infection test (16%) and other ineligibility reasons (12%). Having previously disclosed the child's and mother's HIV status to the father (adjusted odds ratio (aOR):3.20; 95% confidence interval (95% CI):1.55 to 6.69) and being older than 12 months (aOR: 2.05; 95% CI: 1.02 to 4.12) were correlates of EART initiation. At EART initiation, the median age was 13.5 months, 70% had reached WHO Stage 3/4 and 57% had a severe immune deficiency. Conclusions: Fear of stigmatization by the father and early competing mortality were the major reasons for missed opportunities of EART initiation. There is an urgent need to involve fathers in the care of their HIV-exposed children and to promote early infant diagnosis to improve their future access to EART and survival. Copyright: - 2016 Dahourou DL et al;. SCOPUS: ar.j info:eu-repo/semantics/published |
| Databáze: | OpenAIRE |
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