dc.contributor.author | Mutisya,Immaculate | |
dc.date.accessioned | 2013-05-23T13:06:47Z | |
dc.date.available | 2013-05-23T13:06:47Z | |
dc.date.issued | 2010 | |
dc.identifier.citation | Master in Medicine (Paediatrics) | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24928 | |
dc.description.abstract | Despite efforts to scale up provider initiated testing and counselling (PITC) and early infant
diagnosis (EID) services, it is not known what proportion of newly diagnosed HIV infected and
exposed children are successfully linked into long term care. The purpose of the study was to
determine the proportion of newly diagnosed HIV exposed and infected children in K..l\ffi who
.are successfully linked to long term care and to identify and describe the common barriers to
HIV care after diagnosis.
Methods
This was a short longitudinal survey. We enrolled and followed up newly diagnosed HN
exposed children and infected children referred for long term care from KNH. We verified
linkage one week after the expected date of appointment as follows; by medical record for
children referred to KNH CCC, Mbagathi district Hospital CCC and Lea Toto clinics and by
telephone for those referred to other sites. Structured phone based questionnaires were used to
evaluate barriers to care.
Results
We enrolled 195 children, 104 (53%) females and 91 (47%) males. Median age was 12
months (Interquartile range [IQR] of 5 to 21 months). One hundred and forty two children (73%)
were confirmed HN infected and 53(27%) were of indeterminate status. Ninety eight children
(50%) were successfully linked into long term HIV care while 87(45%) were not linked. Ten
children (5%) were lost to follow up. The most common barrier to care was nondisclosure of the
child's HIV status to spouse (32%); this was closely followed by lack of information on long
term HIV care (12%), lack of money for transport (11%) and family disruptions following
revelation of the child's HIV status (11%). Other barriers included caregiver indecision to start
care (8%), unavailability due to ill health (5%) or commitment at work (2%), stigma (6%),
maternal death (5%) and seeking care from faith based healers (5%) or traditional healers (2%).
A few caregivers (3%) were unable to explain reasons for defaulting.
Conclusion
Only half of newly diagnosed HIV exposed and HIV infected children are successfully linked
.•..
to long term care. The main barriers to care emanate from the family unit, stigma and inadequate
counselling and support of caregivers of these children. | en |
dc.language.iso | en | en |
dc.publisher | University Of Nairobi | en |
dc.title | Linkage to long term care of newly diagnosed Hiv exposed and HIV infected children at Kenyatta national hospital | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | College of Health Sciences | en |