AEGiS-14IAC: Care of children infected and affected by HIV/AIDS: Adapting the integrated management of childhood illness strategy.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Care of children infected and affected by HIV/AIDS: Adapting the integrated management of childhood illness strategy.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrF1290)

Goga AE, Mazibuko SN, de Klerk HE, Loening WE
National Department of Health, Pretoria, South Africa

ISSUES: Infant care and follow up is crucial in programmes that prevent HIV transmission from mother to child (PMTCT). In many African countries including South Africa (SA) PMTCT (and therefore infant follow-up) is being integrated into existing routine maternal and child health services. The Integrated Management of Childhood Illness strategy (IMCI) is often an essential component of these services. However, initially (1995), IMCI did not specifically include HIV. Hence, SA developed an algorithm enabling health workers at primary care facilities with limited resources to identify children with suspected symptomatic HIV infection (SSHI). Notwithstanding this, a South African (SAn) survey (2001) found that only 6% of these health workers correctly classified children with SSHI. This algorithm was subsequently modified to simplify identification of children with confirmed (or suspected) symptomatic HIV infection (CoSSHI) at these facilities. More recently, guidelines on care of children infected or affected by HIV/AIDS (CIAHA) have been developed for inclusion in IMCI.

DESCRIPTION: These guidelines: advocate for cotrimoxazole prophylaxis, routine vitamin A supplementation, pain relief, and palliative care, and counseling for CIAHA and their caregivers promote exclusive breastfeeding for about 6 months in children with CoSSHI or when maternal HIV status is unknown or negative

ISSUES: Non-ambiguous infant feeding guidelines, counseling skills and on-going support for health workers are essential when managing CIAHA

RECOMMENDATIONS: Accelerate and monitor implementation of adapted SAn IMCI guidelines; evaluate their impact on care for CIAHA, and share SAn experiences with organisations, and countries currently adapting IMCI guidelines to include HIV

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, HIV Seropositivity, Child Health Services, Breast Feeding, South Africa, Child, Human, Infant, organization & administration

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