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

Marais, B., Cooke, G.S., Little, K.E., Bland, R.M., Thulare, H. and Newell, M.-L. (2009) Need for timely paediatric HIV treatment within primary health care in rural South Africa. PLoS ONE, 4(9), e7101. (doi: 10.1371/journal.pone.0007101) (PMID:19771168) (PMCID:PMC2742735)

Abstract

<p>Background: 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.</p> <p>Methods: 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.</p> <p>Findings: 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%.</p> <p>Conclusion: 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.</p>

• Item Type: Articles
• Additional Information: This article has been formally corrected to address errors. For details go to: <a href="http://dx.doi.org/10.1371/journal.pone.0007101">http://dx.doi.org/10.1371/journal.pone.0007101</a>
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Bland, Dr Ruth
• Authors: Marais, B., Cooke, G.S., Little, K.E., Bland, R.M., Thulare, H., and Newell, M.-L.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: PLoS ONE
• Publisher: Public Library of Science
• ISSN: 1932-6203
• ISSN (Online): 1932-6203
• Published Online: 22 September 2009
• Copyright Holders: Copyright © 2009 The Authors
• First Published: First published in PLoS ONE 4(9):e7101
• Publisher Policy: Reproduced under a Creative Commons Licence