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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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SHOCKING: PR officer collapses and dies right after press briefing-VIDEO

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A Public Relations officer suddenly passed away while addressing a press conference on Tuesday evening.

Glory Mziray, who worked for the Tanzania Forestry Services (TFS) excused herself towards the end of her address saying she was feeling unwell.

According to journalists and government officials present at the event, Mziray started off her address speaking well but her condition deteriorated towards the end.

She was rushed to a nearby hospital where the doctors pronounce her dead.

“She started to become unconscious as she was taking questions from reporters and we were forced to take her out of the room so that she could get fresh air,” a reporter present at the press conference told The Citizen.

Source: SDE

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Uganda’s ruling party endorses Museveni for sixth term as President

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Uganda’s ruling party National Resistance Movement (NRM) top organ has endorsed President Yoweri Museveni as its flag bearer in the upcoming presidential elections.

The decision gives Museveni a shot for a sixth consecutive five-year term in office. Should he win, Museveni will have an opportunity to rule for a record four decades.

Uganda’s next presidential and general elections are two years away.

NRM party members had at a recent retreat christened President Museveni the ‘theoretician and principal strategist of the movement’.

“To emphatically recommend to the membership of the Movement and its organs that Yoweri Museveni, our leader and General of the African resistance, continues leading the Movement in 2021 and beyond as we eliminate the bottlenecks ‘to transformation’, the members noted in resolution after the retreat,” the party announced.

Asked whether the party had given Museveni the nod,  NRM spokesman said; “Exactly. That is what it means. I can only say that there is no danger in doing that. There is no law breached. This matter can continue to be sold to other party members as we get closer to the National Delegates Conference in November, this year.”

Suspicision that Museveni would seek re-elections gained momentum when he strongly supported a contentious Constitutional Amendment Bill, now law, to remove 75 years as the upper threshold age beyond which a person would be ineligible to stand for President.

The provision meant that Museveni, now 74 years old, would have been unable to contest.

Uganda Monitor

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Ugandan journalist kneels to interview President Museveni’s son

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A Ugandan journalist had to go on his knees to secure an interview with the son of Ugandan President Yoweri Museveni.

A photo of the journalist on his knees with a mic in hand while interviewing Lieutenant General Muhoozi Kainerugaba has elicited mixed reactions online.

The photo by the Daily Monitor captured Uganda Broadcasting Corporation’s Gyakenda Semakula in an unconventional poise while interviewing the Ugandan First Son who is seated next to wife at a public function.

The incident happened at an event where Muhoozi and 65 other officers of the Ugandan Army, who were recently promoted, got decorated.

After the ceremony, Muhoozi – who has been mentioned as a possible successor to his father – officially became a Lieutenant General.

Source: Daily Monitor and Nairobi News

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