The Early Infant Diagnosis (EID) Programme in Kenya: A Case-control Evaluation of PCR testing, ART Initiation and Adherence among HIV Exposed Children in Nairobi County
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 1
Abstract
Over half of 2 million children below 2 years who live with Human Immunodeficiency Virus (HIV) die by the second birthday if they are not diagnosed and treated. Early Infant Diagnosis (EID) of HIV permits timely initiation of Antiretroviral Therapy (ART) which reduces paediatric morbidity and mortality. The Kenyan government launched the EID programme in 2006 through which over 300,000 children have undergone Polymerase Chain Reaction (PCR) testing. Seven years after the launch and in view of the rapid up-scaling of ART usage we purposed to evaluate the success of the programme as seen by the age of PCR testing among HIV exposed children, the children’s adherence rate to ART and the maternal-child factors influencing pediatric ART adherence in Nairobi County. Using standardized questionnaires we established that 53% of HIV exposed children received a PCR test within 6 months of age, 29% of them between 6 and 18 months of life while 18% were tested after the age of 18 months. About half (52%) of the mothers faced situations that made it difficult to give ART to their children. Poor maternal ART adherence, caretaker forgetfulness and facing difficult situations negatively impacted on children’s ART adherence. Significantly higher (p=0.023) adherence was seen among PCR- children on prophylactic ART compared to PCR+ children on Highly Active Antiretroviral Therapy (HAART). We recommend health workers community networking and engagement, heightened public education on EID coupled with the use of maternal adherence reminder techniques to promote early PCR testing and enhance ART uptake and adherence.
Authors and Affiliations
Christopher L. Imbaya, Zipporah Ng’ang’a, Yeri Kombe
Keywords
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