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Trop Med Int Health. 2017 Aug;22(8):1021-1029. doi: 10.1111/tmi.12900. Epub 2017 Jun 20.

Index case finding facilitates identification and linkage to care of children and young persons living with HIV/AIDS in Malawi.

Author information

1
Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi.
2
Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
3
University of North Carolina, Chapel Hill, NC, USA.
4
Malawi Ministry of Health, Lilongwe, Malawi.

Abstract

OBJECTIVES:

Evaluation of a novel index case finding and linkage-to-care programme to identify and link HIV-infected children (1-15 years) and young persons (>15-24 years) to care.

METHODS:

HIV-infected patients enrolled in HIV services were screened and those who reported untested household members (index cases) were offered home- or facility-based HIV testing and counselling (HTC) of their household by a community health worker (CHW). HIV-infected household members identified were enrolled in a follow-up programme offering home and facility-based follow-up by CHWs.

RESULTS:

Of the 1567 patients enrolled in HIV services, 1030 (65.7%) were screened and 461 (44.8%) identified as index cases; 93.5% consented to HIV testing of their households and of those, 279 (64.7%) reported an untested child or young person. CHWs tested 711 children and young persons, newly diagnosed 28 HIV-infected persons (yield 4.0%; 95% CI: 2.7-5.6), and identified an additional two HIV-infected persons not enrolled in care. Of the 30 HIV-infected persons identified, 23 (76.6%) were linked to HIV services; 18 of the 20 eligible for ART (90.0%) were initiated. Median time (IQR) from identification to enrolment into HIV services was 4 days (1-8) and from identification to ART start was 6 days (1-8).

CONCLUSIONS:

Almost half of HIV-infected patients enrolled in treatment services had untested household members, many of whom were children and young persons. Index case finding, coupled with home-based testing and tracked follow-up, is acceptable, feasible and facilitates the identification and timely linkage to care of HIV-infected children and young persons.

KEYWORDS:

HIV testing; VIH pediátrico; VIH pédiatrique; adolescentes; adolescents; case finding; dépistage du VIH; hallazgo de casos; liaison aux soins; linkage to care; paediatric HIV; prueba del VIH; recherche des cas; vinculación a la atención

PMID:
28544728
PMCID:
PMC5575466
DOI:
10.1111/tmi.12900
[Indexed for MEDLINE]
Free PMC Article

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