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Coverage and predictors of pediatric index case testing (ICT) among children of HIV Infected parent(s), analysis of population HIV impact assessment (PHIA) surveys

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  • Submited: June 3, 2022
  • Published: October 1, 2022

Abstract

Background: Antiretroviral therapy (ART) coverage in many Sub-Saharan African countries remains low (48%) for children <15 years living with HIV. One possible reason for this low performance is low pediatric HIV case finding. In this study we describe the coverage of HIV testing for children of infected parent(s) (also called index case testing or ICT) and factors affecting it.

Methods: Secondary analysis of the Zambia, Malawi, Eswatini, and Tanzania Population HIV Impact Assessment (PHIA) household surveys which were conducted between 2015-2016 were used for this study. Couples where there is at least one HIV infected person were identified and matched to their children <15 years. HIV testing status of children was measured and factors associated with testing of children studied using logistic regression. Sampling weights were applied during analysis taking into account complex sampling design of these surveys.

Results: 3,435 children <15 years had at least one infected parent. Of those children, 38.9% (32.9%-44.8%) were tested for HIV. Rural areas had more undiagnosed children in all study countries. Maternal HIV testing was associated with the highest odds of testing for children (adjusted Odds ratio: 84.51 (10.72-666)) as was maternal HIV infection (Odds ratio: 5.9 (95% confidence interval (CI): 3.9-8.9)).

Conclusion: Pediatric HIV testing for children of HIV infected parent(s) was found to be low. Maternal HIV testing was found to be the single most important factor associated with testing of children of HIV infected parent(s). Rural settings need to be prioritized for ICT in order to address testing gap.

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References

  1. UNAIDS: Data (Accessed from https://www.unaids.org/en/resources/documents/2019/2019-UNAIDS-data). 2019.
  2. Saito S, Chung H, Mahy M, Radin AK, Jonnalagadda S, Hakim A, Awor AC, Mwila A, Gonese E, Wadonda-Kabondo N: Pediatric HIV treatment gaps in 7 East and Southern African Countries: examination of modeled, survey, and routine program data. JAIDS Journal of Acquired Immune Deficiency Syndromes 2018, 78:S134-S141.
  3. PEPFAR: Annual Report to Congress. 2019.
  4. Marston M, Becquet R, Zaba B, Moulton LH, Gray G, Coovadia H, Essex M, Ekouevi DK, Jackson D, Coutsoudis A: Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa. International journal of epidemiology 2011, 40(2):385-396.
  5. Newell M, Coovadia H, Cortina-Borja M, Rollins N, Gaillard P, Dabis F: Ghent International AIDS Society (IAS) Working Group on HIV Infection in Women and Children. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet 2004, 364(9441):1236-1243.
  6. Lewis Kulzer J, Penner JA, Marima R, Oyaro P, Oyanga AO, Shade SB, Blat CC, Nyabiage L, Mwachari CW, Muttai HC: Family model of HIV care and treatment: a retrospective study in Kenya. Journal of the International AIDS Society 2012, 15(1):8-8.
  7. Musarandega R, Mutede B, Mahomva A, Nyamayaro W, Mushavi A, Lindan C, Machekano R: Scaling up pediatric HIV testing by incorporating provider-initiated HIV testing into all child health services in Hurungwe District, Zimbabwe. Journal of acquired immune deficiency syndromes (1999) 2018, 77(1):78.
  8. Simon KR, Flick RJ, Kim MH, Sabelli RA, Tembo T, Phelps BR, Rosenberg NE, Ahmed S: Family testing: an index case finding strategy to close the gaps in pediatric HIV diagnosis. Journal of acquired immune deficiency syndromes (1999) 2018, 78(Suppl 2):S88.
  9. Wagner AD, Mugo C, Njuguna IN, Maleche-Obimbo E, Sherr K, Inwani IW, Hughes JP, Wamalwa DC, John-Stewart GC, Slyker JA: Implementation and operational research: active referral of children of HIV-positive adults reveals high prevalence of undiagnosed HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes 2016, 73(5):e83-e89.
  10. Bandason T, Langhaug LF, Makamba M, Laver S, Hatzold K, Mahere S, Munyati S, Mungofa S, Corbett EL, Ferrand RA: Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare, Zimbabwe: a mixed methods study. AIDS care 2013, 25(12):1520-1526.
  11. Wagner AD, O’malley G, Firdawsi O, Mugo C, Njuguna IN, Maleche-Obimbo E, Inwani IW, Wamalwa DC, John-Stewart GC, Slyker JA: Disclosure, consent, opportunity costs, and inaccurate risk assessment deter pediatric HIV testing: a mixed-methods study. Journal of acquired immune deficiency syndromes (1999) 2018, 77(4):393.
  12. Strauss M, Rhodes B, George G: A qualitative analysis of the barriers and facilitators of HIV counselling and testing perceived by adolescents in South Africa. BMC health services research 2015, 15(1):250.
  13. Yeap A, Hamilton R, Charalambous S, Dwadwa T, Churchyard G, Geissler P, Grant A: Factors influencing uptake of HIV care and treatment among children in South Africa–a qualitative study of caregivers and clinic staff. AIDS care 2010, 22(9):1101-1107.
  14. Population-based HIV Impact Assessment (PHIA) Data Use Manual 2019. New York; 2019.
  15. World Health Organisation: WHO Guidelines on HIV Testing; 2015.
  16. Marwa R, Anaeli A: Perceived Barriers Toward Provider-Initiated HIV Testing and Counseling (PITC) in Pediatric Clinics: A Qualitative Study Involving Two Regional Hospitals in Dar-Es-Salaam, Tanzania. HIV/AIDS (Auckland, NZ) 2020, 12:141.
  17. Woldesenbet SA, Jackson D, Goga AE, Crowley S, Doherty T, Mogashoa MM, Dinh T-H, Sherman GG: Missed opportunities for early infant HIV diagnosis: results of a national study in South Africa. Journal of acquired immune deficiency syndromes (1999) 2015, 68(3):e26.
  18. USAID: Maximizing coverage of index testing for biological children of mothers living with HIV: Standard Operating Procedure (SOP) (from: http://ovcsupport.org/wp-content/uploads/2020/07/OVC-Index-Testing-SOP-07.17.20.pdf). 2020.
  19. World Health Organisation: Guideline on HIV self testing and partner notification; 2016.
  20. Zambian Ministry of Health: Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016: Final Report. Lusaka; 2019.
  21. Tanzania Commission for AIDS (TACAIDS) ZACZTHIS: Tanzania HIV Impact Survey (THIS) 2016-2017: Final Report. Dar es Salaam, Tanzania. 2018.
  22. Cohen D, Lungu M, Van Oosterhout J: HIV testing coverage of family members of adult antiretroviral therapy patients in Malawi. AIDS care 2010, 22(11):1346-1349.
  23. Ahmed S, Kim MH, Sugandhi N, Phelps BR, Sabelli R, Diallo MO, Young P, Duncan D, Kellerman SE, Prevention CSWGotITTot et al: Beyond early infant diagnosis: case finding strategies for identification of HIV-infected infants and children. AIDS (London, England) 2013, 27(0 2):S235.
  24. Federal Ministry of Health: Reference Manual for PMTCT Option B+ Update Training. 2013.
  25. Wall KM, Kilembe W, Nizam A, Vwalika C, Kautzman M, Chomba E, Tichacek A, Sardar G, Casanova D, Henderson F: Promotion of couples’ voluntary HIV counselling and testing in Lusaka, Zambia by influence network leaders and agents. BMJ open 2012, 2(5).
  26. Kelley AL, Karita E, Sullivan PS, Katangulia F, Chomba E, Carael M, Telfair J, Dunham SM, Vwalika CM, Kautzman MG: Knowledge and perceptions of couples' voluntary counseling and testing in urban Rwanda and Zambia: a cross-sectional household survey. PloS one 2011, 6(5):e19573.
  27. Kankasa C, Carter RJ, Briggs N, Bulterys M, Chama E, Cooper ER, Costa C, Spielman E, Katepa-Bwalya M, M'soka T: Routine offering of HIV testing to hospitalized pediatric patients at university teaching hospital, Lusaka, Zambia: acceptability and feasibility. Journal of acquired immune deficiency syndromes (1999) 2009, 51(2):202.
  28. McCollum ED, Preidis GA, Kabue MM, Singogo EB, Mwansambo C, Kazembe PN, Kline MW: Task shifting routine inpatient pediatric HIV testing improves program outcomes in urban Malawi: a retrospective observational study. PloS one 2010, 5(3):e9626.
  29. UNICEF U, UNFPA, ILO, WHO and World Bank,: Opportunity in crisis: preventing HIV from early adolescence to early adulthood. New York: UNICEF; 2011.
  30. Ferrand RA, Luethy R, Bwakura F, Mujuru H, Miller RF, Corbett EL: HIV infection presenting in older children and adolescents: a case series from Harare, Zimbabwe. Clinical infectious diseases 2007, 44(6):874-878.
  31. Goggin K, Hurley EA, Staggs VS, Wexler C, Nazir N, Gautney B, Khamadi SA, Maloba M, Lwembe R, Finocchario-Kessler S: Rates and Predictors of HIV-Exposed Infants Lost to Follow-Up During Early Infant Diagnosis Services in Kenya. AIDS patient care and STDs 2019, 33(8):346-353.
  32. Gesesew HA, Ward P, Woldemichael K, Lyon P, Mwanri L: Policy and practice suggestions to improve performance on the UNAIDS 90‐90‐90 targets: Results from a nominal group technique with HIV experts in Southwest Ethiopia. Health Expectations 2020.
  33. Ministry of Health: National Comprehensive HIV Prevention, Care and Treatment Training for Health care Providers; 2017.
  34. Croft TN, Marshall AM, Allen CK, Arnold F, Assaf S, Balian S: Guide to DHS statistics. Rockville: ICF 2018.
How to Cite
Kesetebirhan. (2022). Coverage and predictors of pediatric index case testing (ICT) among children of HIV Infected parent(s), analysis of population HIV impact assessment (PHIA) surveys. Ethiopian Medical Journal, 60(4). Retrieved from https://emjema.org/index.php/EMJ/article/view/2171

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