Format

Send to

Choose Destination
PLoS One. 2014 Oct 31;9(10):e111240. doi: 10.1371/journal.pone.0111240. eCollection 2014.

Missed opportunities for early access to care of HIV-infected infants in Burkina Faso.

Author information

1
Projet MONOD ANRS 12206, Centre de Recherche Internationale pour la Santé, Site ANRS Burkina, Université de Ouagadougou, Ouagadougou, Burkina Faso.
2
Projet MONOD ANRS 12206, Centre de Recherche Internationale pour la Santé, Site ANRS Burkina, Université de Ouagadougou, Ouagadougou, Burkina Faso; Centre Muraz, Bobo Dioulasso, Burkina Faso.
3
Service de Pédiatrie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
4
Service de Pédiatrie Médicale, CHU Charles de Gaulle, Ouagadougou, Burkina Faso.
5
Laboratoire de Bactériologie - Virologie CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
6
Service de laboratoire, CHU Charles de Gaulle, Ouagadougou, Burkina Faso.
7
Groupe hospitalier Necker- Enfants malades, Paris, France.
8
Inserm U1058, Université Montpellier 1, Montpellier, France.
9
Inserm, U897, Institut de Santé Publique, Epidémiologie et Développement (ISPED), Université de Bordeaux, Bordeaux, France.

Abstract

OBJECTIVE:

The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIV-infected children before the age of two since 2010, but this implies an early identification of these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.

METHODS:

We conducted a cross-sectional survey in 2011 in all health care facilities involved in PMTCT and pediatric HIV care in Ouagadougou. We assessed them according to their coverage in pediatric HIV care and WHO standards, through a desk review of medical registers and a semi-structured questionnaire administered to health-care workers (HCW).

RESULTS:

In 2011, there was no offer of care in primary health care facilities for HIV-infected children in Ouagadougou. Six district hospitals and two university hospitals provided pediatric HIV care. Among the 67 592 pregnant women attending antenatal clinics in 2011, 85.9% were tested for HIV. The prevalence of HIV was 1.8% (95% Confidence Interval: 1.7%-1.9%). Among the 1 064 HIV-infected pregnant women attending antenatal clinics, 41.4% received a mother-to-child HIV transmission prevention intervention. Among the HIV-exposed infants, 313 (29.4%) had an early infant HIV test, and 306 (97.8%) of these infants tested received their result within a four-month period. Among the 40 children initially tested HIV-infected, 33 (82.5%) were referred to a health care facility, 3 (9.0%) were false positive, and 27 (90.0%) were initiated on ART. Although health care facilities were adequately supplied with HIV drugs, they were hindered by operational challenges such as shortage of infrastructures, laboratory reagents, and trained HCW.

CONCLUSIONS:

The PMTCT cascade revealed bottle necks in PMTCT intervention and HIV early infant diagnosis. The staffing in HIV care and quality of health care infrastructures were also insufficient in 2011 in Ouagadougou.

PMID:
25360551
PMCID:
PMC4215985
DOI:
10.1371/journal.pone.0111240
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center