Need for timely paediatric HIV treatment within primary health care in rural South Africa.

<h4>Background</h4>In areas where adult HIV prevalence has reached hyperendemic levels, many infants remain at risk of acquiring HIV infection. Timely access to care and treatment for HIV-infected infants and young children remains an important challenge. We explore the extent to which p...

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Autores principales:	Graham S Cooke, Kirsty E Little, Ruth M Bland, Hilary Thulare, Marie-Louise Newell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3abef5e0c1674d40869fb92bf07a992d
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spelling	oai:doaj.org-article:3abef5e0c1674d40869fb92bf07a992d2021-12-02T20:12:05ZNeed for timely paediatric HIV treatment within primary health care in rural South Africa.1932-620310.1371/journal.pone.0007101https://doaj.org/article/3abef5e0c1674d40869fb92bf07a992d2009-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19771168/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In areas where adult HIV prevalence has reached hyperendemic levels, many infants remain at risk of acquiring HIV infection. Timely access to care and treatment for HIV-infected infants and young children remains an important challenge. We explore the extent to which public sector roll-out has met the estimated need for paediatric treatment in a rural South African setting.<h4>Methods</h4>Local facility and population-based data were used to compare the number of HIV infected children accessing HAART before 2008, with estimates of those in need of treatment from a deterministic modeling approach. The impact of programmatic improvements on estimated numbers of children in need of treatment was assessed in sensitivity analyses.<h4>Findings</h4>In the primary health care programme of HIV treatment 346 children <16 years of age initiated HAART by 2008; 245(70.8%) were aged 10 years or younger, and only 2(<1%) under one year of age. Deterministic modeling predicted 2,561 HIV infected children aged 10 or younger to be alive within the area, of whom at least 521(20.3%) would have required immediate treatment. Were extended PMTCT uptake to reach 100% coverage, the annual number of infected infants could be reduced by 49.2%.<h4>Conclusion</h4>Despite progress in delivering decentralized HIV services to a rural sub-district in South Africa, substantial unmet need for treatment remains. In a local setting, very few children were initiated on treatment under 1 year of age and steps have now been taken to successfully improve early diagnosis and referral of infected infants.Graham S CookeKirsty E LittleRuth M BlandHilary ThulareMarie-Louise NewellPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 9, p e7101 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Graham S Cooke Kirsty E Little Ruth M Bland Hilary Thulare Marie-Louise Newell Need for timely paediatric HIV treatment within primary health care in rural South Africa.
description	<h4>Background</h4>In areas where adult HIV prevalence has reached hyperendemic levels, many infants remain at risk of acquiring HIV infection. Timely access to care and treatment for HIV-infected infants and young children remains an important challenge. We explore the extent to which public sector roll-out has met the estimated need for paediatric treatment in a rural South African setting.<h4>Methods</h4>Local facility and population-based data were used to compare the number of HIV infected children accessing HAART before 2008, with estimates of those in need of treatment from a deterministic modeling approach. The impact of programmatic improvements on estimated numbers of children in need of treatment was assessed in sensitivity analyses.<h4>Findings</h4>In the primary health care programme of HIV treatment 346 children <16 years of age initiated HAART by 2008; 245(70.8%) were aged 10 years or younger, and only 2(<1%) under one year of age. Deterministic modeling predicted 2,561 HIV infected children aged 10 or younger to be alive within the area, of whom at least 521(20.3%) would have required immediate treatment. Were extended PMTCT uptake to reach 100% coverage, the annual number of infected infants could be reduced by 49.2%.<h4>Conclusion</h4>Despite progress in delivering decentralized HIV services to a rural sub-district in South Africa, substantial unmet need for treatment remains. In a local setting, very few children were initiated on treatment under 1 year of age and steps have now been taken to successfully improve early diagnosis and referral of infected infants.
format	article
author	Graham S Cooke Kirsty E Little Ruth M Bland Hilary Thulare Marie-Louise Newell
author_facet	Graham S Cooke Kirsty E Little Ruth M Bland Hilary Thulare Marie-Louise Newell
author_sort	Graham S Cooke
title	Need for timely paediatric HIV treatment within primary health care in rural South Africa.
title_short	Need for timely paediatric HIV treatment within primary health care in rural South Africa.
title_full	Need for timely paediatric HIV treatment within primary health care in rural South Africa.
title_fullStr	Need for timely paediatric HIV treatment within primary health care in rural South Africa.
title_full_unstemmed	Need for timely paediatric HIV treatment within primary health care in rural South Africa.
title_sort	need for timely paediatric hiv treatment within primary health care in rural south africa.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/3abef5e0c1674d40869fb92bf07a992d
work_keys_str_mv	AT grahamscooke needfortimelypaediatrichivtreatmentwithinprimaryhealthcareinruralsouthafrica AT kirstyelittle needfortimelypaediatrichivtreatmentwithinprimaryhealthcareinruralsouthafrica AT ruthmbland needfortimelypaediatrichivtreatmentwithinprimaryhealthcareinruralsouthafrica AT hilarythulare needfortimelypaediatrichivtreatmentwithinprimaryhealthcareinruralsouthafrica AT marielouisenewell needfortimelypaediatrichivtreatmentwithinprimaryhealthcareinruralsouthafrica
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Need for timely paediatric HIV treatment within primary health care in rural South Africa.

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