Rates of confirmatory HIV testing, linkage to HIV services, and rapid initiation of antiretroviral treatment among newly diagnosed children living with HIV in Ethiopia: perspectives from caregivers and healthcare workers

BMC Pediatrics

Research

Hanna Kumssa¹  Tenagnework Antefe²  Wondimu Teferi³  Jelaludin Ahmed Mohammed³  Christine Ross³  Eric J. Dziuban⁴  Susan Hrapcak⁴  Kelsey Mirkovic⁴  Zena Belay⁴  Jemal Ayalew Yimam⁵  Alemayehu Bekele⁵  Semegnew Mengistu⁵  Desta Kassa⁶  Tsegaye Tilahun⁷ 

[1] Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia;Amhara Regional Health Bureau, Amhara, Ethiopia;Centers for Disease Control and Prevention, Addis Ababa, Ethiopia;Centers for Disease Control and Prevention, Atlanta, Georgia, USA;Ethiopian Public Health Association, Addis Ababa, Ethiopia;Ethiopian Public Health Institute, Addis Ababa, Ethiopia;United States Agency for International Development, Addis Ababa, Ethiopia;

关键词: Children;    HIV;    Confirmatory testing;    Rapid ART initiation;    Enrollment;    Linkage;   

DOI  :  10.1186/s12887-022-03784-3

 received in 2022-06-11, accepted in 2022-11-30,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundSuccessful linkage to HIV services and initiation of antiretroviral treatment (ART) for children living with HIV (CLHIV) is critical to improve pediatric ART coverage. We aimed to assess confirmatory testing, linkage, and rapid ART initiation among newly diagnosed CLHIV in Ethiopia from the perspectives of caregivers and healthcare workers (HCWs).MethodsWe conducted standardized surveys with HCWs and caregivers of children 2–14 years who were diagnosed with HIV but not yet on ART who had been identified during a cross-sectional study in Ethiopia from May 2017–March 2018. Eight health facilities based on their HIV caseload and testing volume and 21 extension sites were included. Forty-one children, 34 care givers and 40 healthcare workers were included in this study. Three months after study enrollment, caregivers were surveyed about timing and experiences with HIV service enrollment, confirmatory testing, and ART initiation. Data collected from HCWs included perceptions of confirmatory testing in CLHIV before ART initiation. SPSS was used to conduct descriptive statistics.ResultsThe majority of the 41 CLHIV were enrolled to HIV services (n = 34, 83%) and initiated ART by three months (n = 32, 94%). Median time from diagnosis to ART initiation was 12 days (interquartile range 5–18). Five children died before the follow-up interview. Confirmatory HIV testing was conducted in 34 children and found no discordant results; the majority (n = 23, 68%) received it within one week of HIV diagnosis. Almost all HCWs (n = 39/40, 98%) and caregivers (n = 31/34, 91%) felt better/the same about test results after conducting confirmatory testing.ConclusionOpportunities remain to strengthen linkage for newly diagnosed CLHIV in Ethiopia through intensifying early follow-up to ensure prompt confirmatory testing and rapid ART initiation. Additional services could help caregivers with decision-making around treatment initiation for their children.

【 授权许可】

CC BY   
© The Author(s) 2022