Challenges to pediatric HIV care and treatment in South Africa
Date
2007
Authors
Meyers T.
Moultrie H.
Naidoo K.
Cotton M.
Eley B.
Sherman G.
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Journal ISSN
Volume Title
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Abstract
It is estimated that almost 300,000 children in South Africa have human immunodeficiency virus (HIV) infection. The disease is responsible for reversing decreases in child mortality. Few data exist evaluating the outcomes of the prevention of mother-to-child transmission of HIV (PMTCT) program, although PMTCT coverage appears to be low. Hospitals are still witnessing large numbers of admissions of HIV-infected children. Postnatal transmission of HIV is high, reflecting poor education of and support for women in their infant feeding choices. Too few infants and children are entering care through early diagnosis, which should be widely available. Cotrimoxazole prophylaxis coverage is inadequate, contributing to high morbidity and mortality in infants. The number of children receiving antiretroviral therapy (ART) is increasing steadily. However, significant inequalities in access to ART exist between and within provinces. Challenges for pediatric ART include a lack of sufficiently trained health care personnel and inadequate facilities, as well as the complexity of drug regimens and formulations. The compartmentalization of the ART rollout program hinders PMTCT and makes it difficult for children to be identified and referred into appropriate services. This article delineates the challenges to pediatric HIV care in South Africa and provides some practical recommendations to improve it. © 2007 by the Infectious Diseases Society of America. All rights reserved.
Description
Keywords
antiretrovirus agent, cotrimoxazole, nevirapine, stavudine, zidovudine, childhood mortality, clinical practice, combination chemotherapy, conference paper, health care, health program, health service, highly active antiretroviral therapy, human, Human immunodeficiency virus infection, incidence, patient counseling, patient education, Pneumocystis jiroveci, pneumonia, polymerase chain reaction, priority journal, prophylaxis, South Africa, virus load, virus transmission, world health organization, child, disease transmission, female, Human immunodeficiency virus, isolation and purification, methodology, pediatrics, pregnancy, pregnancy complication, review, virology, Antiretroviral Therapy, Highly Active, Child, Disease Transmission, Vertical, Female, HIV, HIV Infections, Humans, Pediatrics, Pregnancy, Pregnancy Complications, Infectious, South Africa
Citation
Journal of Infectious Diseases
196
SUPPL. 3
196
SUPPL. 3