Cargando…

A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)

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...

Descripción completa

Detalles Bibliográficos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International AIDS Society 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547123/
https://www.ncbi.nlm.nih.gov/pubmed/23336728
http://dx.doi.org/10.7448/IAS.16.1.17998
_version_ 1782256172530663424
collection PubMed
description 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.
format Online
Article
Text
id pubmed-3547123
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher International AIDS Society
record_format MEDLINE/PubMed
spelling pubmed-35471232013-01-17 A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA) J Int AIDS Soc Short Report 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. International AIDS Society 2013-01-15 /pmc/articles/PMC3547123/ /pubmed/23336728 http://dx.doi.org/10.7448/IAS.16.1.17998 Text en © 2013 IeDEA Pediatric Working Group; licensee International AIDS Society http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Report
A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title_full A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title_fullStr A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title_full_unstemmed A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title_short A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA)
title_sort survey of paediatric hiv programmatic and clinical management practices in asia and sub-saharan africa—the international epidemiologic databases to evaluate aids (iedea)
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547123/
https://www.ncbi.nlm.nih.gov/pubmed/23336728
http://dx.doi.org/10.7448/IAS.16.1.17998
work_keys_str_mv AT asurveyofpaediatrichivprogrammaticandclinicalmanagementpracticesinasiaandsubsaharanafricatheinternationalepidemiologicdatabasestoevaluateaidsiedea
AT surveyofpaediatrichivprogrammaticandclinicalmanagementpracticesinasiaandsubsaharanafricatheinternationalepidemiologicdatabasestoevaluateaidsiedea