THPE081 - Poster Exhibition
Trends in characteristics and factors for delayed enrollment of pediatrics in HIV care and treatment services in DSM, Tanzania
Management and Development for Health, Strategic Information, Dar es Salaam, Tanzania, United Republic of
Background: Few studies
have described factors leading to late enrollment and time-based trends of
children enrolling in HIV and AIDS care. We present findings of a study that
explored factors affecting timely enrollment and trends in baseline
characteristics of children enrolling into 26 public HIV care facilities.
Methods: We used data
collected from all children enrolled in October 2004 to September 2011, and interviewed
key informants both from districts and facilities. We used year of enrollment
as the predictor, analyzed continuous variables using log-binomial regression
and continuous variables using linear regression. P-values under 0.05 were
considered significant. In qualitative, we used grounded theory to analyze
thematically factors identified to hamper scale up of services.
Results: We enrolled a
total of 6,579 children with median age of 5 years. Over the period of follow
up, proportion of children presented with advanced stage (III or IV) rose from
35% to 58%. The median age at enrollment
rose from 5 to 6 years (p < 0.0001), with the fraction of children under two
decreasing from 35% to 29%, while the fraction of children over ten rose from
16% to 27%. About 49% of the children
were male. The median Hemoglobin level rose from 9.1g/dl to 10.3g/dl (P
bottlenecks identified included issues on inadequate coverage of Early Infant
Diagnosis (EID) services, with only 64% of HIV exposed infants receiving the
test, fragmentation of PMTCT, EID and HAART services within the same facilities
and insufficient capacity of service providers in management of pediatric HIV.
Conclusions: Our study
found that children are being enrolled in care and treatment services at an
older age and with more advanced disease. Late enrollment is associated with
issues pertaining to programmatic and health system factors. We recommend more
efforts be focused in scaling up early HIV infant diagnosis.
Back to the Programme-at-a-Glance