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...

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Main Authors: Peter Cherutich, Irene Inwani, Ruth Nduati, Dorothy Mbori-Ngachad
Format: Article
Language:English
Published: The World Health Organization
Series:Bulletin of the World Health Organization
Online Access:http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000200018&lng=en&tlng=en
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author Peter Cherutich
Irene Inwani
Ruth Nduati
Dorothy Mbori-Ngachad
author_facet Peter Cherutich
Irene Inwani
Ruth Nduati
Dorothy Mbori-Ngachad
author_sort Peter Cherutich
collection DOAJ
description 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.
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spelling doaj.art-3b482d74d88a4618814ef8d5037e8ac22024-03-02T11:14:22ZengThe World Health OrganizationBulletin of the World Health Organization0042-968686215516010.1590/S0042-96862008000200018S0042-96862008000200018Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosisPeter Cherutich0Irene Inwani1Ruth Nduati2Dorothy Mbori-Ngachad3Ministry of HealthKenyatta National HospitalNARESACDC KenyaPROBLEM: 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.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000200018&lng=en&tlng=en
spellingShingle Peter Cherutich
Irene Inwani
Ruth Nduati
Dorothy Mbori-Ngachad
Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
Bulletin of the World Health Organization
title Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
title_full Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
title_fullStr Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
title_full_unstemmed Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
title_short Optimizing paediatric HIV care in Kenya: challenges in early infant diagnosis
title_sort optimizing paediatric hiv care in kenya challenges in early infant diagnosis
url http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000200018&lng=en&tlng=en
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