A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa-the International epidemiologic Databases to Evaluate AIDS (IeDEA)
| Autor: | Ung Vibol, Rawiwan Hansudewechakul, Karina Razali, Sam Phiri, Didier K. Ekouevi, Antoine Jaquet, Charlotte Lewden, C. V. Do, Harry Moultrie, Huu Khanh Truong, Matthew Law, Brian Eley, Serge Eholié, Vonthanak Saphonn, Man Charurat, Annette H. Sohn, Pagakrong Lumbiganon, Kulkanya Chokephaibulkit, Daniele Garone, François Dabis, M. Y. Maiga, Hans Prozesky, Siew Moy Fong, Robin Wood, Nik Khairulddin Nik Yusoff, Cleophas Chimbetete, Haby Signaté Sy, Nagalingeswaran Kumarasamy, Jintanat Ananworanich, Paula Vaz, Nia Kurniati, Virat Sirisanthana, Revathy Nallusamy, Kevin Peterson, Lorna Renner, Janet Giddy, Joseph Drabo, Marcel D. Zannou, Emmanuel Bissagnene, A. H. Sohn, Karl Technau, Bui Vu Huy, Valériane Leroy |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Asia Sub saharan Adolescent Pediatric hiv Child Health Services Short Report computer.software_genre 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Pregnancy Surveys and Questionnaires East africa Humans Medicine observational 030212 general & internal medicine Child Africa South of the Sahara Health Services Administration Management practices Acquired Immunodeficiency Syndrome 0303 health sciences Database 030306 microbiology business.industry Infant Newborn Public Health Environmental and Occupational Health Infant Central africa paediatric HIV cohort medicine.disease 3. Good health Infectious Diseases Child Preschool Africa Cohort Female Observational study Health Services Research business computer |
| Zdroj: | Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| DOI: | 10.7448/ias.16.1.17998 |
| Popis: | Introduction There are limited data on paediatric HIV care and treatment programmes in low-resource settings. Methods A standardized survey was completed by International epidemiologic Databases to Evaluate AIDS paediatric cohort sites in the regions of Asia-Pacific (AP), Central Africa (CA), East Africa (EA), Southern Africa (SA) and West Africa (WA) to understand operational resource availability and paediatric management practices. Data were collected through January 2010 using a secure, web-based software program (REDCap). Results A total of 64,552 children were under care at 63 clinics (AP, N=10; CA, N=4; EA, N=29; SA, N=10; WA, N=10). Most were in urban settings (N=41, 65%) and received funding from governments (N=51, 81%), PEPFAR (N=34, 54%), and/or the Global Fund (N=15, 24%). The majority were combined adult–paediatric clinics (N=36, 57%). Prevention of mother-to-child transmission was integrated at 35 (56%) sites; 89% (N=56) had access to DNA PCR for infant diagnosis. African (N=40/53) but not Asian sites recommended exclusive breastfeeding up until 4–6 months. Regular laboratory monitoring included CD4 (N=60, 95%), and viral load (N=24, 38%). Although 42 (67%) sites had the ability to conduct acid-fast bacilli (AFB) smears, 23 (37%) sites could conduct AFB cultures and 18 (29%) sites could conduct tuberculosis drug susceptibility testing. Loss to follow-up was defined as >3 months of lost contact for 25 (40%) sites, >6 months for 27 sites (43%) and >12 months for 6 sites (10%). Telephone calls (N=52, 83%) and outreach worker home visits to trace children lost to follow-up (N=45, 71%) were common. Conclusions In general, there was a high level of patient and laboratory monitoring within this multiregional paediatric cohort consortium that will facilitate detailed observational research studies. Practices will continue to be monitored as the WHO/UNAIDS Treatment 2.0 framework is implemented. |
| Databáze: | OpenAIRE |
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