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A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)

We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 yea...

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Autores principales: Mutisya, Immaculate, Muthoni, Evelyn, Ondondo, Raphael O., Muthusi, Jacques, Omoto, Lennah, Pahe, Charlotte, Katana, Abraham, Ngugi, Evelyn, Masamaro, Kenneth, Kingwara, Leonard, Dobbs, Trudy, Bronson, Megan, Patel, Hetal K., Sewe, Nicholas, Naitore, Doris, De Cock, Kevin, Ngugi, Catherine, Nganga, Lucy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683548/
https://www.ncbi.nlm.nih.gov/pubmed/36417391
http://dx.doi.org/10.1371/journal.pone.0277613
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author Mutisya, Immaculate
Muthoni, Evelyn
Ondondo, Raphael O.
Muthusi, Jacques
Omoto, Lennah
Pahe, Charlotte
Katana, Abraham
Ngugi, Evelyn
Masamaro, Kenneth
Kingwara, Leonard
Dobbs, Trudy
Bronson, Megan
Patel, Hetal K.
Sewe, Nicholas
Naitore, Doris
De Cock, Kevin
Ngugi, Catherine
Nganga, Lucy
author_facet Mutisya, Immaculate
Muthoni, Evelyn
Ondondo, Raphael O.
Muthusi, Jacques
Omoto, Lennah
Pahe, Charlotte
Katana, Abraham
Ngugi, Evelyn
Masamaro, Kenneth
Kingwara, Leonard
Dobbs, Trudy
Bronson, Megan
Patel, Hetal K.
Sewe, Nicholas
Naitore, Doris
De Cock, Kevin
Ngugi, Catherine
Nganga, Lucy
author_sort Mutisya, Immaculate
collection PubMed
description We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from caregivers or guardians on child’s demographics, HIV testing, and treatment history. Blood specimens were collected for HIV serology and if HIV-positive, the samples were tested for viral load and antiretrovirals (ARV). For participants <18 months TNA PCR is performed. We computed weighted proportions with 95% confidence intervals (CI), accounting for the complex survey design. We used bivariable and multivariable logistic regression to assess factors associated with HIV prevalence. Separate survey weights were developed for interview responses and for biomarker testing to account for the survey design and non-response. HIV burden was estimated by multiplying HIV prevalence by the national population projection by age for 2018. Of 9072 survey participants (< 15 years), 87% (7865) had blood drawn with valid HIV test results. KENPHIA identified 57 HIV-positive children, translating to an HIV prevalence of 0.7%, (95% CI: 0.4%–1.0%) and an estimated 138,900 (95% CI: 84,000–193,800) of HIV among children in Kenya. Specifically, children who were orphaned had about 2 times higher odds of HIV-infection compared to those not orphaned, adjusted Odds Ratio (aOR) 2.2 (95% CI:1.0–4.8). Additionally, children whose caregivers had no knowledge of their HIV status also had 2 times higher odds of HIV-infection compared to whose caregivers had knowledge of their HIV status, aOR 2.4 (95% CI: 1.1–5.4)”. From the unconditional analysis; population level estimates, 78.9% of HIV-positive children had known HIV status (95% CI: 67.1%–90.2%), 73.6% (95% CI: 60.9%–86.2%) were receiving ART, and 49% (95% CI: 32.1%–66.7%) were virally suppressed. However, in the clinical cascade for HIV infected children, 92% (95% CI: 84.4%–100%) were receiving ART, and of these, 67.1% (95% CI: 45.1%–89.2%) were virally suppressed. The KENPHIA survey confirms a substantial HIV burden among children in Kenya, especially among orphans.
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spelling pubmed-96835482022-11-24 A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018) Mutisya, Immaculate Muthoni, Evelyn Ondondo, Raphael O. Muthusi, Jacques Omoto, Lennah Pahe, Charlotte Katana, Abraham Ngugi, Evelyn Masamaro, Kenneth Kingwara, Leonard Dobbs, Trudy Bronson, Megan Patel, Hetal K. Sewe, Nicholas Naitore, Doris De Cock, Kevin Ngugi, Catherine Nganga, Lucy PLoS One Research Article We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from caregivers or guardians on child’s demographics, HIV testing, and treatment history. Blood specimens were collected for HIV serology and if HIV-positive, the samples were tested for viral load and antiretrovirals (ARV). For participants <18 months TNA PCR is performed. We computed weighted proportions with 95% confidence intervals (CI), accounting for the complex survey design. We used bivariable and multivariable logistic regression to assess factors associated with HIV prevalence. Separate survey weights were developed for interview responses and for biomarker testing to account for the survey design and non-response. HIV burden was estimated by multiplying HIV prevalence by the national population projection by age for 2018. Of 9072 survey participants (< 15 years), 87% (7865) had blood drawn with valid HIV test results. KENPHIA identified 57 HIV-positive children, translating to an HIV prevalence of 0.7%, (95% CI: 0.4%–1.0%) and an estimated 138,900 (95% CI: 84,000–193,800) of HIV among children in Kenya. Specifically, children who were orphaned had about 2 times higher odds of HIV-infection compared to those not orphaned, adjusted Odds Ratio (aOR) 2.2 (95% CI:1.0–4.8). Additionally, children whose caregivers had no knowledge of their HIV status also had 2 times higher odds of HIV-infection compared to whose caregivers had knowledge of their HIV status, aOR 2.4 (95% CI: 1.1–5.4)”. From the unconditional analysis; population level estimates, 78.9% of HIV-positive children had known HIV status (95% CI: 67.1%–90.2%), 73.6% (95% CI: 60.9%–86.2%) were receiving ART, and 49% (95% CI: 32.1%–66.7%) were virally suppressed. However, in the clinical cascade for HIV infected children, 92% (95% CI: 84.4%–100%) were receiving ART, and of these, 67.1% (95% CI: 45.1%–89.2%) were virally suppressed. The KENPHIA survey confirms a substantial HIV burden among children in Kenya, especially among orphans. Public Library of Science 2022-11-23 /pmc/articles/PMC9683548/ /pubmed/36417391 http://dx.doi.org/10.1371/journal.pone.0277613 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Mutisya, Immaculate
Muthoni, Evelyn
Ondondo, Raphael O.
Muthusi, Jacques
Omoto, Lennah
Pahe, Charlotte
Katana, Abraham
Ngugi, Evelyn
Masamaro, Kenneth
Kingwara, Leonard
Dobbs, Trudy
Bronson, Megan
Patel, Hetal K.
Sewe, Nicholas
Naitore, Doris
De Cock, Kevin
Ngugi, Catherine
Nganga, Lucy
A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title_full A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title_fullStr A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title_full_unstemmed A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title_short A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)
title_sort national household survey on hiv prevalence and clinical cascade among children aged ≤15 years in kenya (2018)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683548/
https://www.ncbi.nlm.nih.gov/pubmed/36417391
http://dx.doi.org/10.1371/journal.pone.0277613
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