16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

FORECASTING HIV TREATMENT NEEDS IN CHILDREN TO GUIDE POLICY, PLANNING AND SCALE UP: A MULTI-COUNTRY EXPERIENCE FROM INDIA, MALAWI, CAMEROON, RWANDA AND COTE D’IVOIRE

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0205

Ngashi N.¹, Luo C.¹, Mulenga D.², Little K.³, Gass R.^1
1United Nations Children's Fund (UNICEF), Health, New York, United States, ²United Nations Children's Fund (UNICEF), HIV/AIDS, New York, United States, ³Institute of Child Health, Epidemiology, London, United Kingdom

BACKGROUND: Globally, less than 5% of people receiving ART are children (WHO 2005). Factors of low access include lack of appropriate drug formulations, diagnostic technologies and competencies to treat children. Furthermore, countries lack estimates of the number of HIV-infected children eligible for HIV treatment from a life cycle approach. UNICEF supported the estimation of disease burden and treatment needs in five countries.

METHODS: The London Institute of Child Health developed for UNICEF, a model for estimating the number of children eligible for HIV treatment, based on WHO clinical criteria, HIV prevalence in ANC settings, MTCT rates, infant and child mortality rates, and access to PMTCT services, cotrimoxazole prophylaxis and ART. The model was validated in Rwanda, Cameroon, Cote d’Ivoire, Malawi and India, in collaboration with country epidemiologists, WHO and UNAIDS.

RESULTS: In India, 2% (616) out of 27,300 children requiring ART receive it, 4% (1,149/28,000) children in Malawi, 5% (427/9,000) in Cameroon, 11% (710/6,400) in Rwanda and 13% (2,309/18,400) in Cote d’Ivoire. With the exception of Cote d’Ivoire and Malawi, cotrimoxazole prophylaxis is not included in the package of scaled up care interventions for children in all countries. The model demonstrated that cotrimoxazole prophylaxis could reduce child mortality by 43% (36.8% vs. 21%). Where early infant diagnosis is available, further mortality reductions could be achieved with a combination of cotrimoxazole and ART: from 36.8% to 12.4% by year one and 75% to 26% by year 10.

CONCLUSIONS: National programs have started using this information to revise national policies on pediatric care and to define realistic population-based targets, scale up plans and strategies for achieving these targets. The estimation of country-specific burden of disease and treatment needs is a powerful tool for advocacy and scale up planning and should be roll out.

Download PDF of this abstract.

2006-08-13
MoAb0205

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.