Late diagnosis triggering more deaths in HIV-positive children – Study – Kenya Satellite News Network
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Late diagnosis triggering more deaths in HIV-positive children – Study

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Latest study: Late diagnosis triggering more deaths in HIV-positive children

By ALLAN TAWAI

Latest study shows that more children infected with HIV are dying early in hospitals in spite of anti-retroviral therapy (ART) being available, blaming delayed diagnosis among this pool of patients for the problem.

The study which was conducted in four hospitals in Kenya – Kenyatta National Hospital and Mbagathi District Hospital in Nairobi and Jaramogi Oginga Odinga Teaching and Referral Hospital and Kisumu County Hospital in Nyanza between April 2013 and November 2015 indicates that HIV infection in most is only known when they are admitted to hospitals, an indication that there has been little or no focus for routine checks for status among children.

The findings published in the Lancet Health Journal last week reveal that ART has not helped increase chances of survival for hospitalized children.

“Many HIV-infected children in sub-Saharan Africa are frequently diagnosed during hospitalisation for an acute co-infection and experience high early mortality,” it stated.

It also stated that anti-retroviral therapy among hospitalised HIV-infected children might not speed up recovery and may in fact inhibit immune regeneration.

The research was done on 191 (76 percent) out of the 250 hospitalised HIV-infected children in the hospitals. They were aged between 0-12 years.

Of these, 181 children were randomly enrolled, 90 to urgent anti-retroviral therapy (done within 48 hours of enrolment) and 91 to post-stabilization ART (done 7-14 days after enrolment).

Overall, almost a quarter (21 percent) of children died in the first 3 months.

Eighteen (10 percent) of 181 children died in the first week. 12 (13 percent) of 90 children died in the urgent ART group and six (7 percent) of 91 children died in the post-stabilisation group.

Most of the deaths of the children occurred in the first month and dropped strikingly between one month and three months.

No deaths occurred between three months and six months after ART initiation.

“Overall it was observed that there was a high mortality rate in the first few weeks after ART initiation, with more than 80 percent of deaths occurring in the first month and all deaths occurring within three months,” said the study.

Results show that speeding up anti-retroviral therapy during hospitalisation does not have any survival benefit.

“Though rapid HIV diagnosis within one day of enrolment was practised at the four hospital sites, ART initiated within 48 hours did not reduce mortality when compared with ART initiated between 7 days and 14 days,” the research revealed.

A previous study in Kenya showed that 41 percent of hospitalised infants died before ART initiation at the average of 11 days after diagnosis, suggesting a narrow window for intervention in children.

Researchers in that study also found no survival benefit of initiating ART within seven days compared with 21 days in a hospitalised pediatric unit.

“Together, these studies suggest that waiting for more than 21 days might be too late while expediting to less than seven days might not provide survival benefit,” said the study.

The research also found out that delays by caregivers in providing ART treatment to the children were common and may have increased the risk of death.

More than a third of the children who had previously been hospitalised had not started ART either because of not having been tested for HIV, having been diagnosed but not referred for ART, or failing to link to ART services.

Pre-ART loss to follow-up rates of 15·2 per 100 people were also reported from a large treatment programme in western Kenya and 16 percent of children who did not follow-up died.

“Once children are discharged from the hospital, they often fail to return to clinic to start ART,” it read.

“This missed opportunity for earlier HIV diagnosis and treatment too often resulted in mortality,” added the report.

According to the World Health Organisation (WHO), about 1.6 million persons in Kenya are infected with HIV and only about one million are on ART.

Kenya has an estimated 71,034 new HIV infections among adults and about 6,613 new infections among children annually.

Approximately 120, 000 children in Kenya are living with HIV while only 78, 700 children (65 percent) are accessing anti-retroviral treatment.

In 2016, about 4, 800 children died due to HIV/AIDS.

The study proposes that the high mortality risk observed despite accelerated ART emphasizes the need for alternative strategies to improve survival in HIV-infected children who are presented late to care as well as interventions to test and treat children.

 

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IRONY: CNN Publishes Larry Madowo’s article after “Daily Nation’ rejects it

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Celebrated NTV news anchor Larry Madowo was on Wednesday dealt a major blow by his employer Nation Media Group (NMG), days after his controversial opinion piece on Interior and Coordination Cabinet Secretary Fred Matiang’i.

In a tweet, Mr. Madowo disclosed that the Daily Nation, a paper published by the Aga Khan-owned media house, refused to publish his opinion piece on his FrontRow column.

NTV news anchor Larry Madowo (Facebook)

The outspoken journalist noted that it was the first time in nearly four years that such a thing happened during his employment at NMG.

“This week, the @dailynation refused to print my column for the first time in nearly 4 years,” he tweeted.

Though the Daily Nation refused to publish Madowo’s Wednesday opinion piece titled: Why it’s a perilous time to be a journalist in Kenya, International Media company CNN took up the article and published it.

“The irony aside, the same piece is now published on CNN,” he said.

In the piece, Madowo speaks of how he spent the night at his office after plain clothed police officers camped outside NMG’s building along Kimathi street with the intention of arresting him NTV Managing Editor Linus Kaikai and anchor Ken Mijungu.

The trio was being hunted down by police for refusing to adhere to Government’s order not to broadcast the controversial swearing-in of NASA leader Raila Odinga as the People’s President.

“They had orders to arrest my colleagues Linus Kaikai who also chairs the Editors Guild, reporter Ken Mijungu and myself without a warrant which would have set a dangerous precedent.

“The next day, we had to sneak out into a safe house as our lawyers battled to keep us from getting detained,” Madowo mentions in his piece.

Before Odinga’s oath-taking Madowo entered into a scuffle with his bosses over media independence during an official meeting.

The NTV news anchor was particularly agitated that the company had not taken any meaningful action to protect Justus Wanga – a Nation reporter who faced threats from Deputy President William Ruto’s press secretary David Mugonyi.

A source privy to the details of the meeting told Pulselive.co.ke that the management was considering scrapping Madowo’s column from the Daily Nation.

Read the full article here courtesy of CNN

-pulse.co.ke

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VIDEO: Noisy Ghanaian parliament welcomes the president for state of the nation address

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VIDEO: AU summit ends in Addis amid claims of bugging by the Chinese

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The 30th AU summit wound up Monday in Addis Ababa, Ethiopia after 8 days of deliberations on a myriad of topics.

Meanwhile, China has dismissed reports it bugged the African Union (AU) headquarters as “preposterous”.

Kuang Weilin, the Chinese ambassador to the AU, told reporters in Ethiopia the “absurd” claim in France’s Le Monde was “very difficult to understand”.

He spoke out three days after the newspaper published an article claiming data from the Chinese-built AU building was being copied to Shanghai.

The article said the discovery resulted in all the AU servers being switched.

Le Monde spoke to a number of anonymous sources, who claimed the alleged transfer was taking place late at night [link in French], and was only spotted in January 2017 due to the spike in activity between midnight and 02:00, despite no-one being in the building.

It was suggested the alleged data transfer had been taking place since 2012, when the building, in the Ethiopian capital Addis Ababa, was opened.

Officials also brought in security experts from Algeria to sweep the entire headquarters for potential bugs, the newspaper said, leading to the discovery of microphones in desks.

But Mr Kuang – who hailed the headquarters as a “monument” to his country’s relationship with the continent – said it was entirely untrue.

“I really question its intention,” he told reporters on Monday. “I think it will undermine and send a very negative message to people. I think it is not good for the image of the newspaper itself.

“Certainly, it will create problems for China-Africa relations.”

-Agencies

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