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The Care And Treatment Of Hiv-Infected Children In Sub-Saharan Africa.

Overview

Background. Remarkable progress has been made in the scale-up of pediatric antiretroviral therapy (ART) programs in sub-Saharan Africa. Despite these successes, concerns have been raised about how well ART can be delivered in the region and how equitably access to ART has been distributed. Objectives. (1) to compare mortality rates between untreated HIV-infected and uninfected children in Zambia after 9 months of age; (2) to review the effectiveness of pediatric antiretroviral therapy in sub-Saharan Africa; (3) ...
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Overview

Background. Remarkable progress has been made in the scale-up of pediatric antiretroviral therapy (ART) programs in sub-Saharan Africa. Despite these successes, concerns have been raised about how well ART can be delivered in the region and how equitably access to ART has been distributed. Objectives. (1) to compare mortality rates between untreated HIV-infected and uninfected children in Zambia after 9 months of age; (2) to review the effectiveness of pediatric antiretroviral therapy in sub-Saharan Africa; (3) to compare the experiences of urban and rural clinics in Zambia in caring for and treating HIV-infected children. Methods. The first study was conducted from 2000-2002 in Lusaka, Zambia and enrolled 492 children aged 9 months and prospectively followed them until 3 years of age. The second study was a literature review of published studies and conference abstracts from pediatric ART programs in sub-Saharan Africa. The third study was conducted in two rural and one urban district in Zambia. Electronic and medical records were abstracted to retrospectively collect information on 1278 children enrolled in the ART clinics between program implementation and July 2008. Results. In the first study, mortality was significantly higher among HIV-infected children and was marginally higher among HIV-seropositive but uninfected children compared to HIV-seronegative children. In the second study, the review demonstrated that pediatric ART programs in sub-Saharan Africa could achieve comparable outcomes to those observed in high-income countries, although several challenges remain, including older age and stage of disease at ART initiation. In the third study, children in rural ART clinics were found to enroll and initiate ART with a better clinical and immunological profile and to achieve good treatment outcomes, although greater levels of malnutrition and travel distances were observed. Conclusions. This research demonstrated that clinics in sub-Saharan Africa and in urban and rural Zambia can effectively deliver care and treatment to large numbers of HIV-infected children. The results support the expansion of ART programs to increase access to treatment and reduce observed inequities. However, efforts should be made to improve the quality of HIV services and strengthen the links between programs to identify children at an earlier stage.
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Product Details

  • ISBN-13: 9781243699787
  • Publisher: BiblioLabsII
  • Publication date: 9/8/2011
  • Pages: 236
  • Product dimensions: 7.44 (w) x 9.69 (h) x 0.50 (d)

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