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Finding Children Living With HIV in Low-prevalence Countries: HIV Prevalence and Testing Yield From 5 Entry Points in Ethiopia.
Hrapcak, Susan; Bekele, Alemayehu; Ahmed, Jelaludin; Ayalew, Jemal; Gutreuter, Steve; Kumssa, Hanna; Antefe, Tenagnework; Mengistu, Semegnew; Mirkovic, Kelsey; Dziuban, Eric J; Ross, Christine; Belay, Zena; Tilahun, Tsegaye; Kassa, Desta; Teferi, Wondimu.
Afiliação
  • Hrapcak S; Centers for Disease Control and Prevention, Atlanta, GA.
  • Bekele A; Ethiopia Public Health Association, Addis Ababa.
  • Ahmed J; Centers for Disease Control and Prevention, Addis Ababa, ET.
  • Ayalew J; Ethiopia Public Health Association, Addis Ababa.
  • Gutreuter S; Centers for Disease Control and Prevention, Atlanta, GA.
  • Kumssa H; Addis Ababa City Administration Health Bureau, ET.
  • Antefe T; Amhara Regional Health Bureau, ET.
  • Mengistu S; Ethiopia Public Health Association, Addis Ababa.
  • Mirkovic K; Centers for Disease Control and Prevention, Atlanta, GA.
  • Dziuban EJ; Centers for Disease Control and Prevention, Atlanta, GA.
  • Ross C; Centers for Disease Control and Prevention, Addis Ababa, ET.
  • Belay Z; Centers for Disease Control and Prevention, Atlanta, GA.
  • Tilahun T; United States Agency for International Development, Addis Ababa, ET.
  • Kassa D; Ethiopian Public Health Institute, Addis Ababa.
  • Teferi W; Centers for Disease Control and Prevention, Addis Ababa, ET.
Pediatr Infect Dis J ; 40(12): 1090-1095, 2021 12 01.
Article em En | MEDLINE | ID: mdl-34609102
ABSTRACT

BACKGROUND:

Limited data in low HIV prevalence settings such as Ethiopia limit policy development and implementation of optimized pediatric testing approaches to close the treatment gap. This study aimed to determine HIV prevalence, testing yield and factors associated with HIV among children at 5 entry points.

METHODS:

We conducted a cross-sectional study from May 2017 to March 2018 in 29 public health facilities in Amhara and Addis Ababa regions in Ethiopia. Children 2-14 years were enrolled through 5 entry points. Data were obtained from registers, medical records and interviews with caregivers. HIV prevalence and testing yields were calculated for each entry point. Mixed-effects logistic regression analysis identified factors associated with undiagnosed HIV.

RESULTS:

The study enrolled 2166 children, of whom 94 were HIV positive (40 newly diagnosed). HIV prevalence and testing yield were the highest among children of HIV-positive adults (index testing; 8.2% and 8.2%, respectively) and children presenting to tuberculosis clinics (7.9% and 1.8%) or with severe malnutrition (6.5% and 1.4%). Factors associated with undiagnosed HIV included tuberculosis or index entry point [adjusted odds ratio (aOR), 11.97; 95% CI 5.06-28.36], deceased mother (aOR 4.55; 95% CI 1.30-15.92), recurrent skin problems (aOR 17.71; 95% CI 7.75-40.43), severe malnutrition (aOR 4.56; 95% CI 2.04-10.19) and urban residence (aOR 3.47; 95% CI 1.03-11.66).

CONCLUSIONS:

Index testing is a critical strategy for pediatric case finding in Ethiopia. Strategies and resources can prioritize minimizing missed opportunities in implementing universal testing for very sick children (tuberculosis, severe malnutrition) and implementing targeted testing in other entry points through use of factors associated with HIV.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Movimento Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans País/Região como assunto: Africa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Movimento Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans País/Região como assunto: Africa Idioma: En Ano de publicação: 2021 Tipo de documento: Article