Considerations to Improve Pediatric HIV Testing and Close the Treatment Gap in 16 African Countries. Issue 2 (23rd November 2022)

• Record Type: Journal Article
• Authors: Gross, Jessica; Medley, Amy; Rivadeneira, Emilia; Battey, Katherine; Srivastava, Meena; Grillo, Michael; Wolf, Hilary; Simmons, Paige; Hast, Marisa; Patel, Monita
• Other Names: other.; Taasi Geoffrey author non-byline.; Nazziwa Esther author non-byline.; Apolot Madina author non-byline.; Nkolo Esther author non-byline.; Urasa Peris author non-byline.; Kagashe Margreth author non-byline.; Machege Edward author non-byline.; Rwabiyago Oscar author non-byline.; Rwegerera Fredrick author non-byline.; Neto Zoraima author non-byline.; Nwankwo-Igomu E. Amaka author non-byline.; Mayer Magdalene author non-byline.; Nzima Valery author non-byline.; Herve Prao Aka Kouame author non-byline.; Dagri Lucie author non-byline.; Longuma Henri author non-byline.; Teferi Wondimu author non-byline.; Temesgen Chanie author non-byline.; Tilahun Tsegaye author non-byline.; Quaye Silas author non-byline.; Houphouet Ekua author non-byline.; Nyabiage Lennah author non-byline.; Mutisya Immaculate author non-byline.; Simiyu Teresa author non-byline.; Anangwe Samson author non-byline.; Kayira Dumbani author non-byline.; Zomba Gerald author non-byline.; Kumwenda Owen author non-byline.; de Deus Maria Ines author non-byline.; Matsinhe Mercia author non-byline.; Jibrin Bilkisu Ibrahim author non-byline.; Fagbamigbe Omodele Johnson author non-byline.; Igboelina Onyeka author non-byline.; Ogundehin Dolapo author non-byline.; Kindra Gurpreet author non-byline.; Mabasa Hlamalani author non-byline.; Mondi John author non-byline.; Bunga Sudhir author non-byline.; Baabe Nicholas author non-byline.; Musokotwane Kebby author non-byline.; Itoh Megumi author non-byline.; Lingenda Godfrey author non-byline.; Maphosa Talent author non-byline.; Mukungunugwa Solomon author non-byline.;
• Is Part Of: Pediatric infectious disease journal. Volume 42:Issue 2(2023)
• Page Start: 110
• Page End: 118
• Publication Date: 2022-11-23
• Subjects: pediatric HIV -- testing -- risk screening -- Africa; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003778
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: In 2019, South Africa, Nigeria, Tanzania, Democratic Republic of Congo, Uganda, Mozambique, Zambia, Angola, Cameroon, Zimbabwe, Ghana, Ethiopia, Malawi, Kenya, South Sudan and Côte d'Ivoire accounted for 80% of children living with HIV (CLHIV) not receiving HIV treatment. This manuscript describes pediatric HIV testing to inform case-finding strategies. Methods: We analyzed US President's Emergency Plan for AIDS Relief monitoring, evaluation, and reporting data (October 1, 2018 to September 30, 2019) for these 16 countries. Number of HIV tests and positive results were reported by age band, country, treatment coverage and testing modality. The number needed to test (NNT) to identify 1 new CLHIV 1–14 years was measured by testing modality and country. The pediatric testing gap was estimated by multiplying the estimated number of CLHIV unaware of their status by NNT per country. Results: Among children, 6, 961, 225 HIV tests were conducted, and 101, 762 CLHIV were identified (NNT 68), meeting 17.6% of the pediatric testing need. Index testing accounted for 13.0% of HIV tests (29.7% of positive results, NNT 30), provider-initiated testing and counseling 65.9% of tests (43.6% of positives, NNT 103), and universal testing at sick entry points 5.3% of tests (6.5% of positives, NNT 58). Conclusions: As countries near HIV epidemic control for adults, the need to increase pediatric testing continues. Each testing modality – PITC, universal testing at sick entry points, and index testing – offers unique benefits. These results illustrate the comparative advantages of including a strategic mix of testing modalities in national programs to increase pediatric HIV case finding.