Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis.
PROBLEM: In 2003, the goal of the Kenyan Ministry of Health was to avail antiretroviral treatment (ART) to 50% of the estimated 250 000 eligible individuals by the end of 2005. By July 2005, 45 000 adults and more than 2000 children were on treatment. A study was conducted to determine the barriers...
| Publicado en: | Bulletin of the World Health Organization Vol. 86; no. 2; pp. 155 - 161 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
World Health Organization
Feb2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105900220&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105900220 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: Feb2008 vid: 86 iid: 2 pid: 437 pub: World Health Organization artinfo: ui: 105900220 105900220 2009853081 10.2471/blt.07.040402 NLM18297171 105900220 ppf: 155 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis. aug: au: Cherutich P Inwani I Nduati R Mbori-Ngacha D affil: National AIDS/STD Control Programme, Ministry of Health, Nairobi, Kenya. pcheru2000@yahoo.com sug: subj: Acquired Immunodeficiency Syndrome Diagnosis Child Welfare Health Policy Public Health Quality of Health Care Standards Acquired Immunodeficiency Syndrome Prevention and Control Age Factors Algorithms Child Child, Preschool Infant Infant, Newborn Kenya Pediatrics Practice Guidelines Program Evaluation Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month ab: PROBLEM: In 2003, the goal of the Kenyan Ministry of Health was to avail antiretroviral treatment (ART) to 50% of the estimated 250 000 eligible individuals by the end of 2005. By July 2005, 45 000 adults and more than 2000 children were on treatment. A study was conducted to determine the barriers to identification of HIV-infected children. APPROACH: Existing government policies were reviewed and the ART register of the Kenya National AIDS Control Programme was used to identify facilities providing ART. This paper reports the findings around diagnosis and staging of HIV infection in children. LOCAL SETTING: At the time of the study, 58 health facilities were providing ART to children. Only one institution had achieved universal HIV testing in the antenatal clinics. Six facilities systematically followed up HIV-exposed children. HIV antibody testing was not readily available to the children. Although four research centres were capable of carrying out diagnostic HIV polymerase chain reaction (PCR), the services were restricted to research purposes. Other constraints were inadequate physical infrastructure, inadequate systems for quality control in the laboratories and shortage of staff. LESSONS LEARNT: The policy framework to support identification of HIV-infected children had been established, albeit with narrow focus on sick children. The assessment identified the weaknesses in the structures for systematic diagnosis of HIV through laboratory or clinical-based algorithms. The researchers concluded that health staff training and implementation of a systematic standard approach to identification of HIV-infected children is urgently required. Copyright © 2008 World Health Organization pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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