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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The importance of caregivers in the outcome of pediatric HIV management, Mombasa, Kenya
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 26, No. 4, Year 2014
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Description
We assessed programmatic gaps that prevent the optimal treatment of pediatric HIV infection despite free antiretroviral care in Kenya. Of 626 HIV-infected Kenyan children, the median age was five years, 54% were male and the mortality rate was 3.2 per 100 person-years. A total of 380 (61%) children initiated antiretroviral therapy (ART) during the study period. Among the 246 children who never started ART, 129 (52%) met the criteria for ART initiation. Immunologic failure occurred in 20% of children who received ART for >24 weeks. In multivariate analysis, immunological failure was associated with having nonimmediate relative or unrelated caregivers accompanying the child to clinic (AOR = 69.16, p = 0.008). Having ≥3 types of accompanying caregivers was also associated with virologic failure in multivariate analysis (AOR = 3.84, p = 0.03). The lost to follow-up rate was 8.7/100 persons-years for the entire cohort, and significantly higher (17.7/100 persons-years) among children not on ART (p < 0.001). Among children who do initiate ART, those with the best treatment outcomes were those who had a limited number of close relatives as caregivers and good adherence to ART. Focus on early ART initiation and education of the right caregiver will likely improve retention and quality of pediatric HIV care in Kenya. © 2013 Taylor & Francis.
Authors & Co-Authors
Sivapalasingam, Sumathi
United States, New York
Nyu Grossman School of Medicine
Mendillo, Megan
United States, New York
Nyu Grossman School of Medicine
Ahmed, Aabid
Kenya, Mombasa
Bomu Medical Centre
Mwamzuka, Musa
Kenya, Mombasa
Bomu Medical Centre
Said, Swaleh
Kenya, Mombasa
Bomu Medical Centre
Marshed, Fatma
Kenya, Mombasa
Bomu Medical Centre
Abdulaziz, Farhad Luhar
Kenya, Mombasa
Bomu Medical Centre
Fajans, Mark A.
United States, New York
Nyu Grossman School of Medicine
Holzman, Robert
United States, New York
Nyu Grossman School of Medicine
Statistics
Citations: 13
Authors: 9
Affiliations: 2
Identifiers
Doi:
10.1080/09540121.2013.841829
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Kenya
Participants Gender
Male