Abstract:

Studies from sub-Saharan Africa have highlighted significant challenges in providing antiretroviral therapy (ART) to HIV positive Infants. In these studies, just 24% of HIV positive children are on treatment and in Cameroon Just 18% (UNAIDS, 2017), there are still gaps involved in treatment of these infants. This study aimed at evaluating the treatment gaps and identifying the health care system factors influencing the treatment gaps among HIV-positive infants in the Centre Region of Cameroon. The study was an observational study in which interviews were done in health facilities. Results obtained showed that the main factors that are influencing treatment gaps are occasional stock outs of ARVs and Patients who still find it difficult to accept their status. The factors influencing treatment gabs among HIV-infected infants did not show any difference between rural and urban areas (p=0.204). The main recommendation from this study is that health workers should be trained on Supply chain management.

References:

[1].Ahmad OB, Lopez AD, Inoue M. (2000) The decline in child mortality: a reappraisal. Bull World Health Organ; 78:1175–91. Google Scholar.

[2].Boender, T. S., Sigaloff, K. C. E., Kayiwa, J., Musiime, V., Calis, J. C. J., Hamers, R. L., … Kityo, C. (2012). Barriers to Initiation of Pediatric HIV Treatment in Uganda: A Mixed-Method Study. AIDS Research and Treatment, 2012. https://doi.org/10.1155/2012/817506.

[3].Care and Treatment for Children Living with HIV. (2019, January 9). Retrieved March 7, 2019, from https://www.thewellproject.org/hiv-information/care-and-treatment-children-living-hiv.

[4].Centers for Disease Control (CDC). (1989) Interpretation and use of the western blot assay for serodiagnosis of human immunodeficiency virus type 1 infections. MMWR Morb Mortal Wkly Rep;38(Suppl 7):1-7.

[5].Dabis F, Elenga N, Meda N et al. (2001) 18-Month mortality and perinatal exposure to zidovudine in West Africa. AIDS; 15:771–79. Google Scholar.

[6].Delila M. (2018). Pediatric HIV Infection Treatment & Management: Approach Considerations, Overview of Antiretroviral Therapy, Prophylaxis and Treatment of Opportunistic Infections. Retrieved from https://emedicine.medscape.com/article/965086-treatment.

[7].Dr. Wanjau, K. N., Muiruri, B. W., & Ayodo, E. (2012). Factors Affecting Provision of Service Quality in the Public Health Sector: A Case of Kenyatta National Hospital. Retrieved from https://karuspace.karu.ac.ke/handle/20.500.12092/1873.

[8].Gao F, Bailes E, Robertson DL, Chen Y, Rodenburg CM, Michael SF, Cummins LB, Arthur LO, Peeters M, Shaw GM, Sharp PM, Hahn BH. (1999) Origin of HIV-1 in the chimpanzee Pan troglodytes. Nature.;397:436–441.

[9].Joint United Nations Programme on HIV/AIDS (UNAIDS); (2015) The Gap Report ISBN: 978-92-9253-062-4.; 2014. [Accessed on 12 July 2015].

[10]. Joint United Nations Programme on HIV/AIDS (UNAIDS)-WHO. Wkly Epidemiol Rec 1997; 72:81-7.

[11]. Larru, B., Eby, J., & Lowenthal, E. D. (2014). Antiretroviral treatment in HIV-1 infected pediatric patients: focus on efavirenz. Pediatric Health, Medicine and Therapeutics, 5, 29–42. https://doi.org/10.2147/PHMT.S47794

[12]. Mann JM, Francis H, Davachi F et al. (1986) Human immunodeficiency virus seroprevalence in pediatric patients 2 to 14 years of age at Mama Yemo Hospital, Kinshasa, Zaire. Pediatrics; 78:673–77. Google Scholar

[13]. Mbori-Ngacha D, Nduati R, John G et al. (2001) Morbidity and mortality in breastfed and formula-fed infants of HIV-1-infected women: A randomized clinical trial. JAMA; 286:2413–20. Google Scholar

[14]. McCutchan FE (2000). Understanding the genetic diversity of HIV-1. AIDS.;14(suppl 3): S31–S44

[15]. Meier T, Knoll E, Henkes M, Enders G, Braun R. (2001) Evidence for a diagnostic window in fourth generation assays for HIV. J Clin Virol;23(1-2):113-6

[16]. Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 3(2), 77–89. https://doi.org/10.15171/ijhpm.2014.65

[17]. Nápoles‐Springer, A. M., Santoyo, J., Houston, K., Pérez‐Stable, E. J., & Stewart, A. L. (2005). Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expectations, 8(1), 4–17. https://doi.org/10.1111/j.1369-7625.2004.00298.x

[18]. Ng'weshemi J, Urassa M, Isingo R et al. (2003) HIV impact on mother and child mortality in rural Tanzania. J Acquir Immune Defic Syndr; 33:393–404. Google Scholar

[19]. Penazzato, M. (2014, May). Using antiretroviral drugs to treat children under 3 years old who have HIV infection. https://doi.org/10.1002/14651858.CD004772.pub4

[20]. Posse, M., Meheus, F., van Asten, H., van der Ven, A., & Baltussen, R. (2008). Barriers to access to antiretroviral treatment in developing countries: a review. Tropical Medicine & International Health: TM & IH, 13(7), 904–913. https://doi.org/10.1111/j.1365-3156.2008.02091.x

[21]. Quinn TC, Kline R, Moss MW, Livingston RA, Hutton N. (1993) Acid dissociation of immune complexes improves diagnostic utility of p24 antigen detection in perinatally acquired human immunodeficiency virus infection. J Infect Dis; 167:1193-6.

[22]. Remarque, E.J., Faber, B.W., Kocken, C.H., Thomas, A.W. (2008). Apical membrane antigen 1: a malaria vaccine candidate in review. Trends in Parasitology; 24:74–84.

[23]. Research Malaria Microscopy Standards Working Group. (2015). Microscopy for the detection, identification and quantification of malaria parasites on stained thick and thin films. Geneva: World Health Organization. Pp 25.

[24]. Rich JD, Merriman NA, Mylonakis E, et al. (1999) Misdiagnosis of HIV infection by HIV-1 plasma viral load testing: a case series. Ann Intern Med; 130:37-9

[25]. Ritchie J, Lewis J, O'Connor W. (2003) Carrying out qualitative analysis. In: Ritchie J, Lewis J, editors. Qualitative Research Practice. London, Uk: Sage; 2003. pp. 219–262

[26]. Ryder RW, Nsuami M, Nsa W et al. (1994) Mortality in HIV-1-seropositive women, their spouses and their newly born children during 36 months of follow-up in Kinshasa, Zaire. AIDS; 8:667–72. Google Scholar

[27]. Sharada P. Wasti, 1. P. (2012). Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed-Methods Study. PLoS One.

[28]. Sullivan, M. (2013, October 17). The Top Five Challenges Facing Today’s Hospitals. Retrieved March 7, 2019, from https://blog.schneider-electric.com/building-management/2013/10/17/top-five-challenges-facing-todays-hospitals/

[29]. Taha TE, Kumwenda NI, Broadhead RL et al. (1999) Mortality after the first year of life among human immunodeficiency virus type 1-infected and uninfected children. Pediatr Infect Dis J; 18:689–94. Google Scholar

[30]. Takehisa J, Zekeng L, Ido E, Yamaguchi-Kabata Y, Mboudjeka I, Harada Y, Miura T, Kaptué L, Hayami M. (1999) Human immunodeficiency virus type 1 intergroup (M/O) recombination in Cameroon. J Virol.;73:6810–6820

[31]. Tammy, M. (2008). (PDF) Challenges to Pediatric HIV Care and Treatment in South Africa. http://dx.doi.org/10.1086/521116

[32]. UNAIDS. AIDS Epidemic Update. Geneva: UNAIDS, 2003.Google Scholar

[33]. US CDC (2005). Supplemental testing for confirmation of reactive oral fluid rapid HIV antibody tests. MMWR;54(Dispatch):1.

[34]. Ward MJ, Lycett SJ, Kalish ML, Rambaut A, Leigh Brown AJ. (2013) Estimating the rate of intersubtype recombination in early HIV-1 group M strains. J Virol.;87:1967–1973.

[35]. WHO. (2017). WHO | Innovating and strengthening the postnatal package of care for HIV-exposed infants: ensuring comprehensive services for the first two years of life. Retrieved January 7, 2019, from http://www.who.int/hiv/pub/paediatric/postnatal-care-hiv-infant/en/

[36]. Yeap, A. D., Hamilton, R., Charalambous, S., Dwadwa, T., Churchyard, G. J., Geissler, P. W., & Grant, A. D. (2010). Factors influencing uptake of HIV care and treatment among children in South Africa - a qualitative study of caregivers and clinic staff. AIDS Care, 22(9), 1101–1107. https://doi.org/10.1080/09540121003602218