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Pediatric HIV Care & Treatment in Uganda

Pediatric HIV Care & Treatment in Uganda. A Five-Day Training Course For Health Professionals. Module I: Introduction to Paediatric HIV Care & Treatment in Uganda. Key questions: Why is there a need for Paediatric HIV care and treatment? (WHY ARE WE HERE?)

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Pediatric HIV Care & Treatment in Uganda

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  1. Pediatric HIV Care & Treatmentin Uganda A Five-Day Training Course For Health Professionals

  2. Module I: Introduction to Paediatric HIV Care & Treatment in Uganda Key questions: • Why is there a need for Paediatric HIV care and treatment? (WHY ARE WE HERE?) • What difference can Paediatric HIV care and treatment make? • Why is Paediatric HIV care for children and infants so challenging? • How is Uganda currently addressing Paediatric HIV Care & Treatment? • How can you be part of the solution?

  3. Global & National HIV Estimate for adults and children, 2009

  4. Overall HIV Prevalence in Uganda by Sex What percentage of infants are exposed to HIV? 7.5 % of infants are exposed to HIV

  5. What key factors contribute to the high HIV prevalence in children in Uganda? • High prevalence of HIV infection in women of child bearing age • Low coverage of PMTCT interventions • Stigma • Lack of male partner involvement • Multiple and concurrent sexual partners • Intergeneration sexual issues

  6. Modes Of HIV Transmission To Children Vertical transmission Refers to mother-to-child transmission of HIV (MTCT); contributes 95% of infected infants • In an untreated breastfeeding population the total transmission rate is 30 - 45% How or when does MTCT occur? During pregnancy 5-10% During labor & delivery 10-15% Through breast feeding 5-20%

  7. Contribution of AIDS to Child Mortality Is AIDS the leading cause of death among children? 30% of children admitted with malnutrition have HIV HIV predisposes one to pneumonia and diarrhoea

  8. What main activities are included in Paediatric HIV Prevention, Care & Treatment program? • Maximize Interventions for prevention of Mother to child transmission • Increase availability of EID services • Proactively identify and link to care HIV exposed and HIV infected infants and children. • Ensure quality care , treatment, follow up of HIV exposed / infected infants and children • Increase availability of and access to Paedaitric ART • Promote family centered care model.

  9. Strategic Framework for Prevention of HIV Infection in Infants and Young Children Primary Prevention Of HIV Prevention of unintended pregnancies in HIV infected women Prevention of mother-to-child HIV transmission Provision of care and support for HIV-infected women, their children, and their families

  10. Uganda has adopted Option A with plan to transition to Option B when sufficient resources are available

  11. 2010 National PMTCT Guidelines Option A

  12. Dosing schedule for infant NVP prophylaxis

  13. What difference can Paediatric HIV care & treatment make?

  14. Provide care for exposed and infected infants Without ART, 50% of HIV-positive infants will die by age 2 Newell et al. Lancet 2004: vol 364: 1236-43 14

  15. Provide care for exposed and infected infants Without ART, 50% of HIV-positive infants will die by age 2 Typical age at initiation of ART Newell et al. Lancet 2004: vol 364: 1236-43 15

  16. Provide care for exposed and infected infants Without ART, 50% of HIV-positive infants will die by age 2 Typical age at initiation of ART Newell et al. Lancet 2004: vol 364: 1236-43 16

  17. Why is it so challenging to care and treat HIV exposed children and infants in our country? What are the challenges you experience? What are the main barriers you face? Activity: Pair work Discuss with your partner, and then in your Guides, list the main BARRIERS or CHALLENGES you experience in your working areas/clinics in caring for and treating HIV exposed / infected children.

  18. What did we learn about the challenges and barriers we face in implementing effective Paediatric HIV care? • There are certainly many challenges, but there are also several actions you can take to help mitigate some of these barriers! • This training is designed to provide you with knowledge and skills to help you take appropriate actions and better serve HIV exposed and infected children and their families.

  19. You are part of the solution!We hope you will become front-line pediatric HIV care and treatment providers. This training will help you: • Gain the necessary skills, knowledge, and tools to effectively treat and care for HIV infected children/infants. • Gain the confidence, knowledge and skills to communicate with caretakers of HIV exposed or infected children/infants. • Become equipped with the tools and skills to improve your systems to effectively integrate pediatric HIV services into your clinics.

  20. The Government is also part of the solution Ugandan Government is committed to: • To virtually eliminate Paediatric HIV/AIDS by 2015 • Scale up care & treatment for HIV Infected children to all sites providing ARV’s by 2012 Level of effort: • Strengthen the PMTCT-EID program & scale up to 20% of HCIII • Train and mentor • Ensure availability of commodities • Strengthen lab capacity for EID to improve turn around time • Ensure availability of ARV’s

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