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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)
Authors: V. Saphonn
U. Vibol
N. Kumarasamy
N. Kurniati
S. M. Fong
N. K. Nik Yusoff
K. A. Razali
R. Nallusamy
V. Sirisanthana
R. Hansudewechakul
P. Lumbiganon
J. Ananworanich
K. Chokephaibulkit
H. K. Truong
C. V. Do
B. V. Huy
A. H. Sohn
M. G. Law
Cleophas Chimbetete
Brian Eley
Daniele Garone
Janet Giddy
Harry Moultrie
Sam Phiri
Hans Prozesky
Karl Technau
Paula Vaz
Robin Wood
François Dabis
Emmanuel Bissagnene
Marcel D. Zannou
Joseph Drabo
Serge Paul Eholie
Kevin Peterson
Lorna Renner
Moussa Maiga
Man Charurat
Haby Signaté Sy
Didier K. Ekouévi
Antoine Jaquet
Valériane Leroy
Charlotte Lewden
Annette H. Sohn
National Centre for HIV/AIDS Dermatology and STDs
National Pediatric Hospital
Gaitonde Centre for AIDS Research and Education
General Hospital
Hospital Likas
Hospital Raja Perempuan Zainab II
Kuala Lumpur Hospital
Penang Hospital
Chiang Mai University
Chiangrai Prachanukroh Hospital
Khon Kaen University
The HIV Netherlands Australia Thailand Research Collaboration
Mahidol University
Children's Hospital 1
Children's Hospital 2
National Hospital of Pediatrics Hanoi
amfAR - The Foundation for AIDS Research
University of New South Wales (UNSW) Australia
Newlands Clinic
Red Cross War Memorial Children's Hospital
Khayelitsha ART Programme and Médecins Sans Frontières
McCord Hospital
University of Witwatersrand
Lighthouse Clinic
Tygerberg Hospital
Paediatric Day Hospital
Desmond Tutu HIV Centre (Gugulethu and Masiphumelele clinics)
Centre Hospitalier Universitaire de Treichville
Foundation for AIDS Research
Keywords: Medicine
Issue Date: 15-Jan-2013
Citation: Journal of the International AIDS Society. Vol.16, (2013)
Abstract: 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. © 2013 IeDEA Pediatric Working Group; licensee International AIDS Society.
ISSN: 17582652
Appears in Collections:Scopus 2011-2015

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