Missed opportunities of inclusion in a cohort of HIV-infected children to initiate antiretroviral treatment before the age of two in West Africa, 2011 to 2013

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dc.contributor.authorDahourou, Desire L.en_ZA
dc.contributor.authorAmorissani-Folquet, Madeleineen_ZA
dc.contributor.authorCoulibaly, Maliken_ZA
dc.contributor.authorAvit-Edi, Divineen_ZA
dc.contributor.authorMeda, Nicolasen_ZA
dc.contributor.authorTimite-Konan, Margueriteen_ZA
dc.contributor.authorArendt, Vicen_ZA
dc.contributor.authorYe, Diarraen_ZA
dc.contributor.authorAmani-Bosse, Clarisseen_ZA
dc.contributor.authorSalamon, Rogeren_ZA
dc.contributor.authorLepage, Philippeen_ZA
dc.contributor.authorLeroy, Valerianeen_ZA
dc.contributor.authorCotton, Marken_ZA
dc.date.accessioned2017-07-12T12:32:46Z
dc.date.available2017-07-12T12:32:46Z
dc.date.issued2016-03-23
dc.descriptionCITATION: Dahourou, D. L. et al. 2016. Missed opportunities of inclusion in a cohort of HIV-infected children to initiate antiretroviral treatment before the age of two in West Africa, 2011 to 2013. Journal of the International AIDS Society, 19:20601, doi:10.7448/IAS.19.1.20601.
dc.descriptionThe original publication is available at http://www.jiasociety.org
dc.description.abstractIntroduction: The World Health Organization (WHO) 2010 guidelines recommended to treat all HIV-infected children less than two years of age. We described the inclusion process and its correlates of HIV-infected children initiated on early antiretroviral therapy (EART) at less than two years of age in Abidjan, Côte d’Ivoire, and Ouagadougou, Burkina Faso. Methods: All children with HIV-1 infection confirmed with a DNA PCR test of a blood sample, aged less than two years, living at a distance less than two hours from the centres and whose parents (or mother if she was the only legal guardian or the legal caregiver if parents were not alive) agreed to participate in the MONOD ANRS 12206 project were included in a cohort to receive EART based on lopinavir/r. We used logistic regression to identify correlates of inclusion. Results: Among the 217 children screened and referred to the MONOD centres, 161 (74%) were included and initiated on EART. The main reasons of non-inclusion were fear of father’s refusal (48%), mortality (24%), false-positive HIV infection test (16%) and other ineligibility reasons (12%). Having previously disclosed the child’s and mother’s HIV status to the father (adjusted odds ratio (aOR): 3.20; 95% confidence interval (95% CI): 1.55 to 6.69) and being older than 12 months (aOR: 2.05; 95% CI: 1.02 to 4.12) were correlates of EART initiation. At EART initiation, the median age was 13.5 months, 70% had reached WHO Stage 3/4 and 57% had a severe immune deficiency. Conclusions: Fear of stigmatization by the father and early competing mortality were the major reasons for missed opportunities of EART initiation. There is an urgent need to involve fathers in the care of their HIV-exposed children and to promote early infant diagnosis to improve their future access to EART and survival.en_ZA
dc.description.urihttp://www.jiasociety.org/index.php/jias/article/view/20601
dc.description.versionPublisher's version
dc.format.extent11 pages
dc.identifier.citationDahourou, D. L. et al. 2016. Missed opportunities of inclusion in a cohort of HIV-infected children to initiate antiretroviral treatment before the age of two in West Africa, 2011 to 2013. Journal of the International AIDS Society, 19:20601, doi:10.7448/IAS.19.1.20601.
dc.identifier.issn1758-2652 (online)
dc.identifier.otherdoi:10.7448/IAS.19.1.20601
dc.identifier.urihttp://hdl.handle.net/10019.1/101959
dc.language.isoen_ZAen_ZA
dc.publisherInternational AIDS Society
dc.rights.holderAuthors retain copyright
dc.subjectAIDS (Disease) -- Africa, Westen_ZA
dc.subjectHIV infections -- Africa, Westen_ZA
dc.subjectAIDS (Disease) in children -- Africa, Westen_ZA
dc.subjectAntiretroviral therapyen_ZA
dc.titleMissed opportunities of inclusion in a cohort of HIV-infected children to initiate antiretroviral treatment before the age of two in West Africa, 2011 to 2013en_ZA
dc.typeArticleen_ZA
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