Appeal to enrol more infants on ART
RESEARCH has shown that HIV positive infants are more likely to die if they are not enrolled on antiretroviral treatment (ART) at the age of two as the mortality rate is as high as 75 per cent in the age group of affected children.
Centre for Infectious Disease and Research in Zambia (CIDRZ) representative Kupela Clark said enrollment should be enhanced and ART initiatives increased in children to reduce deaths. During the just ended national HIV/AIDS Prevention Convention held in Lusaka recently Dr Clark, however, said the matter was a challenge as current attrition programmes in Southern Africa were estimated at 35 per cent. She said to mitigate such challenges CIDRZ was working with Ministry of Health to follow up ART enrolment in children. There was no rigorous evaluation of the feasibility to follow up children in the community to increase treatment retention since 2005.
She called on community health workers to seriously get involved in the assessment programmes for infants on treatment so as to re-enroll them on treatment. She said adherence, counseling and follow ups on late clients could prevent under-five children on ART from dying and that reducing delinquency in ART would lead to unnecessary deaths. “The assessment programme is uncertain as to how good the follow ups schemes are at ensuring that children start ART promptly and stay on it. Assessing the follow up programme has been done before. Such an assessment has been done for the adult ART programme in 2005. “But not for children and their caregivers who may respond more favourably to community follow ups where referrals to ART and clinical appointments have been missed. “We need to do a cost effectiveness analysis that would include life years gained from early returns into care and costs attached to late returns into clinical care when children are desperately ill,” Dr Clark added. And Ministry of Health ART coordinator Dr Crispin Moyo said patient attrition and losses to follow ups have emerged as threats to the long-term success of prevention