Addition of Questions on Parental Factors to the WHO (Integrated Management of Childhood Illnesses) IMCI-HIV Algorithm Improves the Utility of the Algorithm for Diagnosis of HIV Infection in Children. (28th February 2018)

• Record Type: Journal Article
• Authors: Chandra, Jagdish; Sahi, Puneet Kaur; Gupta, Sourabh; Gupta, Rohini Ajay; Dutta, Renu; Sherwal, B L; Seth, Anju; Kumar, Praveen; Singh, Varinder
• Is Part Of: Journal of tropical pediatrics. Volume 65:Number 1(2019:Feb.)
• Page Start: 29
• Page End: 38
• Publication Date: 2018-02-28
• Subjects: paediatric HIV -- WHO IMCI-HIV algorithm -- parental factors; Pediatrics -- Periodicals; Tropical medicine -- Periodicals; Pediatrics -- Periodicals; Tropical Medicine -- Periodicals; Environmental Health -- Periodicals; Infant; Child; 618.929883
• DOI: 10.1093/tropej/fmy008
• Languages: English
• ISSNs: 0142-6338

Abstract

Abstract: The WHO Integrated Management of Childhood Illnesses-HIV (IMCI-HIV) algorithm and its regional adaptation have shown variable performance in clinically identifying HIV-infected children with lack of validation in low prevalence areas. Addition of certain 'parental factors' (proxy indicators of parental HIV) may improve its utility. In this study, children aged 2 months to 5 years were enrolled into Group A ( n = 1000, 'suspected symptomatic HIV infected' children as per the IMNCI-HIV algorithm) and group B ( n = 50, children newly diagnosed with HIV infection). Parental factors were asked and HIV infection was tested for in Group A. For Group B, retrospective data were collected regarding IMNCI-HIV algorithm signs and parental factors. Utility of individual and various combinations of IMNCI-HIV signs and parental factors to predict HIV status was evaluated. Results showed that incorporating parental factors to IMNCI-HIV algorithm improved its sensitivity and positive predictive value in identifying HIV-infected children while maintaining the same sensitivity.