Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review

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dc.contributor.authorMugglin, Catrinaen_ZA
dc.contributor.authorWandeler, Gillesen_ZA
dc.contributor.authorEstill, Janneen_ZA
dc.contributor.authorEgger, Matthiasen_ZA
dc.contributor.authorBender, Nicoleen_ZA
dc.contributor.authorDavies, Mary-Annen_ZA
dc.contributor.authorKeiser, Oliviaen_ZA
dc.date.accessioned2016-01-02T05:08:34Z
dc.date.available2016-01-02T05:08:34Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: In adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined. METHODS: We searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate. RESULTS: Eight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years. CONCLUSION: Most children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings.en_ZA
dc.identifier.apacitationMugglin, C., Wandeler, G., Estill, J., Egger, M., Bender, N., Davies, M., & Keiser, O. (2013). Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review. <i>PLoS One</i>, http://hdl.handle.net/11427/16183en_ZA
dc.identifier.chicagocitationMugglin, Catrina, Gilles Wandeler, Janne Estill, Matthias Egger, Nicole Bender, Mary-Ann Davies, and Olivia Keiser "Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/16183en_ZA
dc.identifier.citationMugglin, C., Wandeler, G., Estill, J., Egger, M., Bender, N., Davies, M. A., & Keiser, O. (2013). Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review. PLoS One, 8(2), e56446. doi:10.1371/journal.pone.0056446en_ZA
dc.identifier.ris TY - Journal Article AU - Mugglin, Catrina AU - Wandeler, Gilles AU - Estill, Janne AU - Egger, Matthias AU - Bender, Nicole AU - Davies, Mary-Ann AU - Keiser, Olivia AB - BACKGROUND: In adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined. METHODS: We searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate. RESULTS: Eight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years. CONCLUSION: Most children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0056446 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review TI - Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review UR - http://hdl.handle.net/11427/16183 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16183
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0056446
dc.identifier.vancouvercitationMugglin C, Wandeler G, Estill J, Egger M, Bender N, Davies M, et al. Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review. PLoS One. 2013; http://hdl.handle.net/11427/16183.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Mugglin et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherDatabase searchingen_ZA
dc.subject.otherPediatricsen_ZA
dc.subject.otherSystematic reviewsen_ZA
dc.titleRetention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic reviewen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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