Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Ubesie, Agozie C

doi:10.4314/ahs.v12i3.8

Cited by 23 publications

(20 citation statements)

References 38 publications

(46 reference statements)

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“…In Sub-Saharan Africa, delayed infant testing is emerging as one of the challenging complex issues facing children infected with and affected by HIV. Similar to the other Sub-Saharan African coutries, studies from Ethiopia also showed that timely infant testing for HIV is very low [6][7][8][9].…”

Section: Introductionmentioning

confidence: 89%

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

2020

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Background: Timely infant testing for HIV is critical to ensure optimal treatment outcomes among exposed infants. While world health organization recommends HIV exposed infants to be tested between 4 to 6 weeks of age, in developing countries like Ethiopia, access to timely infant testing is still very limited. The study is intended to assess timely infant testing, testing for HIV at the 18th month, test results and factors influencing HIV positivity among infants born to HIV positive mothers in public hospitals of Mekelle, Ethiopia. Methods:A cross-sectional study design was employed on 558 HIV exposed infants, using consecutive sampling technique. A checklist was used to extract 4 years (Data were analyzed using SPSS version 20, and binary logistic regression model was used to examine the association of independent variables with the outcome variables. Results: Timely infant testing for HIV accounted for 346(62.0%). Mothers who attended antenatal care (AOR: 2.77; 95% CI: 1.17, 6.55) and who were counselled on feeding options (AOR: 2.01; 95% CI: 1.11, 3.65) were strongly associated with timely infant testing. Poor maternal adherence status was associated with infants' HIV positivity at the 18th month of antibody test (AOR: 15.93; 95% CI: 2.21, 94.66). Being rural resident (AOR: 4.0; 95% CI: 1.23, 13.04), being low birth weight (AOR: 5.64; 95% CI: 2.00, 16.71) and not receiving ARV prophylaxis (AOR: 4.70; 95% CI: 1.15, 19.11) were positively associated with the overall HIV positivity. Conclusions: A considerable proportion of exposed infants did not undergo timely testing for HIV. Antenatal care follow-up and counselling on feeding options were associated with timely infant testing. Mother's poor adherence status was associated with infant's HIV positivity at the 18th month of antibody testing. Being rural resident, being low birth weight, and not receiving ARV prophylaxis were the factors that enhance the overall HIV positivity. Timely infant testing, counselling on feeding options and adherence should be intensified, and prevention of mother-tochild transmission program in rural settings need to be strengthened.

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Section: Introductionmentioning

confidence: 89%

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

2020

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“…Like other countries in Southern Africa, children living with HIV in Swaziland tend to initiate treatment at advanced stages of HIV disease (Boender, et al, 2012; Davies, et al, 2009; Davies, et al, 2013; Kabue, et al, 2012; KIDS-ART-LINC Collaboration., 2008; Lahuerta, et al, 2013; Sauvageot, Schaefer, Olson, Pujades-Rodriguez, & O’Brien, 2010; Ubesie, 2012). However, early initiation of antiretroviral therapy (ART) has been shown to significantly reduce early infant mortality by 76% and HIV disease progression by 75% (Violari, et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland

Ahmed

Jolly

Padilla

et al. 2017

African Journal of AIDS Research

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HIV/AIDS remains one of the leading causes of death among children under 5 years in Swaziland. Although it has been shown that early initiation of infants and children diagnosed with HIV on antiretroviral therapy (ART) significantly reduces mortality, many children do not initiate ART until at the later stages of disease. This study was designed to collect qualitative data from mothers and caregivers of HIV-positive children to identify the barriers to ART initiation. Focus group discussion (FGD) sessions were conducted in siSwati between July and September 2014 among caregivers of children 2–18 months in Swaziland who did or did-not initiate ART between January 2011 and December 2012 after HIV DNA PCR-positive diagnosis of the infants. Denial, guilt, lack of knowledge, TB/HIV co-infection, HIV-related stigma, lack of money, and distance to clinics were reported by the participants as barriers to ART initiation. The findings further revealed that non-initiation on ART was not linked to a negative perception of the treatment. Findings suggest a need to improve sensitivity among health care workers as well as education and counselling services that will facilitate the ART initiation process.

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“…This is an ecological study, which correlated country-level data on paediatric ART coverage (outcome variable) that were obtained from 2014 UNAIDS progress report on global AIDS epidemic plan (9) with a range of critical enablers for strategic investment of HIV response. A framework was developed by conceptualizing social determinants of paediatric ART coverage from programmatic experiences of the authors, published literature (2)(3)(4)8) and reviewing the proposed critical enablers and developmental synergies from UNAIDS (11) (Fig. 1).…”

Section: Study Design and Data Sourcesmentioning

confidence: 99%

“…The causes of poor ART coverage among children are multiple, ranging from health system to programmatic level factors. These include fewer facilities providing early infant diagnosis (EID), paediatric antiretroviral (ARV) shortages especially fixed-dose combination, inadequate integration and linkages to health facilities and community structures, limited number of health care workers providing paediatric ART services, low retention in care, and stigma and discrimination (7,8). Poor implementation of provider initiated testing and counselling (PITC) and weak decentralization of paediatric ART services also play a part (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Understanding the Influence of Socioeconomic Environment on Paediatric Antiretroviral Treatment Coverage: Towards Closing Treatment Gaps in Sub-Saharan Africa

Adeyinka¹,

Evans²,

Ozigbu³

et al. 2017

Cent Eur J Public Health

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Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Abstract: Background: Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent.

Cited by 23 publications

References 38 publications

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland

Understanding the Influence of Socioeconomic Environment on Paediatric Antiretroviral Treatment Coverage: Towards Closing Treatment Gaps in Sub-Saharan Africa

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