Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis
<p>Abstract</p> <p>Background</p> <p>Successful antiretroviral treatment programs in rural sub-Saharan Africa may face different challenges than programs in urban areas. The objective of this study was to identify patient characteristics, barriers to care, and treatment...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-10-01
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| Series: | BMC Infectious Diseases |
| Online Access: | http://www.biomedcentral.com/1471-2334/9/169 |
| _version_ | 1818471279570714624 |
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| author | Hamangaba Francis Munsanje Bornface Sutcliffe Catherine G van Dijk Janneke H Thuma Philip E Moss William J |
| author_facet | Hamangaba Francis Munsanje Bornface Sutcliffe Catherine G van Dijk Janneke H Thuma Philip E Moss William J |
| author_sort | Hamangaba Francis |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Successful antiretroviral treatment programs in rural sub-Saharan Africa may face different challenges than programs in urban areas. The objective of this study was to identify patient characteristics, barriers to care, and treatment responses of HIV-infected children seeking care in rural Zambia.</p> <p>Methods</p> <p>Cross-sectional analysis of HIV-infected children seeking care at Macha Hospital in rural southern Zambia. Information was collected from caretakers and medical records.</p> <p>Results</p> <p>192 HIV-infected children were enrolled from September 2007 through September 2008, 28% of whom were receiving antiretroviral therapy (ART) at enrollment. The median age was 3.3 years for children not receiving ART (IQR 1.8, 6.7) and 4.5 years for children receiving ART (IQR 2.7, 8.6). 91% travelled more than one hour to the clinic and 26% travelled more than 5 hours. Most participants (73%) reported difficulties accessing the clinic, including insufficient money (60%), lack of transportation (54%) and roads in poor condition (32%). The 54 children who were receiving ART at study enrollment had been on ART a median of 8.6 months (IQR: 2.7, 19.5). The median percentage of CD4<sup>+ </sup>T cells was 12.4 (IQR: 9.2, 18.6) at the start of ART, and increased to 28.6 (IQR: 23.5, 36.1) at the initial study visit. However, the proportion of children who were underweight decreased only slightly, from 70% at initiation of ART to 61% at the initial study visit.</p> <p>Conclusion</p> <p>HIV-infected children in rural southern Zambia have long travel times to access care and may have poorer weight gain on ART than children in urban areas. Despite these barriers, these children had a substantial rise in CD4<sup>+ </sup>T cell counts in the first year of ART although longer follow-up may indicate these gains are not sustained.</p> |
| first_indexed | 2024-04-14T03:49:08Z |
| format | Article |
| id | doaj.art-ca1b7820058145ff90effc53c9107843 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-14T03:49:08Z |
| publishDate | 2009-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ca1b7820058145ff90effc53c91078432022-12-22T02:14:08ZengBMCBMC Infectious Diseases1471-23342009-10-019116910.1186/1471-2334-9-169Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysisHamangaba FrancisMunsanje BornfaceSutcliffe Catherine Gvan Dijk Janneke HThuma Philip EMoss William J<p>Abstract</p> <p>Background</p> <p>Successful antiretroviral treatment programs in rural sub-Saharan Africa may face different challenges than programs in urban areas. The objective of this study was to identify patient characteristics, barriers to care, and treatment responses of HIV-infected children seeking care in rural Zambia.</p> <p>Methods</p> <p>Cross-sectional analysis of HIV-infected children seeking care at Macha Hospital in rural southern Zambia. Information was collected from caretakers and medical records.</p> <p>Results</p> <p>192 HIV-infected children were enrolled from September 2007 through September 2008, 28% of whom were receiving antiretroviral therapy (ART) at enrollment. The median age was 3.3 years for children not receiving ART (IQR 1.8, 6.7) and 4.5 years for children receiving ART (IQR 2.7, 8.6). 91% travelled more than one hour to the clinic and 26% travelled more than 5 hours. Most participants (73%) reported difficulties accessing the clinic, including insufficient money (60%), lack of transportation (54%) and roads in poor condition (32%). The 54 children who were receiving ART at study enrollment had been on ART a median of 8.6 months (IQR: 2.7, 19.5). The median percentage of CD4<sup>+ </sup>T cells was 12.4 (IQR: 9.2, 18.6) at the start of ART, and increased to 28.6 (IQR: 23.5, 36.1) at the initial study visit. However, the proportion of children who were underweight decreased only slightly, from 70% at initiation of ART to 61% at the initial study visit.</p> <p>Conclusion</p> <p>HIV-infected children in rural southern Zambia have long travel times to access care and may have poorer weight gain on ART than children in urban areas. Despite these barriers, these children had a substantial rise in CD4<sup>+ </sup>T cell counts in the first year of ART although longer follow-up may indicate these gains are not sustained.</p>http://www.biomedcentral.com/1471-2334/9/169 |
| spellingShingle | Hamangaba Francis Munsanje Bornface Sutcliffe Catherine G van Dijk Janneke H Thuma Philip E Moss William J Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis BMC Infectious Diseases |
| title | Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis |
| title_full | Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis |
| title_fullStr | Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis |
| title_full_unstemmed | Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis |
| title_short | Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis |
| title_sort | barriers to the care of hiv infected children in rural zambia a cross sectional analysis |
| url | http://www.biomedcentral.com/1471-2334/9/169 |
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