Modified Integrated Algorithm for Detection of HIV Among Sick Children Aged 0–14 Year Seeking Care at Healthcare Facilities in India

Sinha, Anju; Washington, Reynold; Sethumadhavan, Rajeev; Vanamail, Perumal; Potty, Rajaram Subramanian; Isac, Shajy

doi:10.1007/s13312-020-1891-x

Cited by 3 publications

(2 citation statements)

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“…The ndings indicate that Belgaum district had an overall HIV prevalence of 0.23% among children (0-14 years) and about 3266 children living with HIV, during the year 2013, making the proportion of Pediatric infections 10.4% of all HIV infections in the district. This is about a third higher than the national estimates (based on projections of adult infections) ranging between 6-7% of all HIV infections, during the same period 17,18 . The results of this study could be generalized to other similar districts with high HIV prevalence, high coverage of HIV screening during pregnancy/delivery and high levels of treatment coverage among those living with HIV 19 .…”

Section: Discussionmentioning

confidence: 59%

Estimating the burden of Paediatric HIV in an ‘A’ category district in India: An epidemiological study

Sinha

Washington

Sethumadhvan

et al. 2021

Preprint

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Background: Epidemiological information on the disease burden of paediatric HIV is lacking in India. The National AIDS Control Program (NACP) provides estimates of paediatric HIV based on its projections of adult infections. The window of opportunity for diagnosis and treatment is very narrow a third of HIV infected children do not see their first birthday and half of them do not reach their second birthday. Early detection of pediatric HIV is crucial for prevention of morbidities, growth delays and death. Methods: The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. The study used an innovative multipronged methodology to estimate the disease burden in a high burden district in India. Details of methodology have been published and include early case detection in infants (0-18 months) born to HIV positive women, among children in families with HIV positive parents, and among sick children (0 to 14 years) presenting in a health facility and screened using a modified IMCI-HIV algorithm, were methods used. The overall burden of paediatric HIV was calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy.Results: The existing pool of HIV infection in the district works out to be 3266 HIV positive children <15 years of age, among a mid-year (2013) projected child population of 1401688, thus giving us an overall HIV prevalence among children of 0.23%. The proportion of children among all people living with HIV in the district works out to 10.4% (3266/ (3266+28119)Conclusions: The study reported a higher prevalence than reported earlier from projections of the NACP. An overall 0.23% HIV prevalence among children was estimated which is 2.5 times that of the earlier reported prevalence for Karnataka state. The proportion of children among all persons living with HIV in Belgaum district in this study is 10.4% against 6.54% reported earlier for India. The study methodology is replicable for other settings and other diseases.

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Section: Discussionmentioning

confidence: 59%

Estimating the burden of Paediatric HIV in an ‘A’ category district in India: An epidemiological study

Sinha

Washington

Sethumadhvan

et al. 2021

Preprint

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“…They also developed operational definitions for each criterion in the algorithm before training health care providers from the four participating talukas. Sick children (0–14 years) presenting with suspected signs and symptoms and satisfying the ‘Modified Integrated Algorithm’, were tested at health care facilities using age-appropriate HIV tests [ 20 ]. The research team visited these facilities once weekly to supervise the process and to compile and track HIV test results.…”

Section: Methodsmentioning

confidence: 99%

Estimating the burden of pediatric HIV in an ‘A’ category district in India: an epidemiological study

Sinha

Washington²,

Sethumadhavan

et al. 2021

BMC Pediatr

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Background India lacks epidemiological information on the disease burden of pediatric HIV. The National AIDS Control Program (NACP) estimates the numbers of HIV-positive children as a proportion of adult persons living with HIV. A third of HIV-positive children die before their first birthday and a half before they reach their second birthday. The early detection of HIV is crucial for the prevention of morbidities, growth delays, and death among HIV-positive children. Methods The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. An ‘A’ category district is defined by the presence of > 1% HIV prevalence among the general population, as estimated by HIV Sentinel Surveillance. The study used an innovative three-pronged strategy combining cross-sectional and longitudinal methods. The overall burden of pediatric HIV was calculated as a product of cases detected multiplied by a net inflation factor, for each of three strategies. Results The existing pool of HIV infection in the district is estimated to be 3266 (95% CI: 2621–4197) HIV positive children < 15 years of age, in a mid-year (2013) projected child population of about 1.4 million, thus giving an HIV prevalence of 0.23% (CI: 0.19–0.30) among children (0–14 years of age). The proportion of children among all people living with HIV in the district works out to 10.4% (CI: 8.6–13.5%). Conclusions The study estimate of 0.23% HIV prevalence among children (0–14 years of age) is higher than the NACP estimates (0.02) and is 2.5 higher than the Karnataka state estimate (0.09)22. Similarly, the proportion of children among all persons living with HIV in Belgaum district is 10.4% in this study, as against 6.54% for India. The study methodology is replicable for other settings and other diseases.

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Clinical Algorithm for Screening of HIV Among High-risk Children — Need of the Hour!

Shah

Poojari

2020

Indian Pediatr

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Modified Integrated Algorithm for Detection of HIV Among Sick Children Aged 0–14 Year Seeking Care at Healthcare Facilities in India

Cited by 3 publications

References 6 publications

Estimating the burden of Paediatric HIV in an ‘A’ category district in India: An epidemiological study

Estimating the burden of Paediatric HIV in an ‘A’ category district in India: An epidemiological study

Estimating the burden of pediatric HIV in an ‘A’ category district in India: an epidemiological study

Clinical Algorithm for Screening of HIV Among High-risk Children — Need of the Hour!

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