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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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Africa

Ethiopia plane crash victims to be buried Thursday

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Families who lost loved ones in the ill-fated Ethiopian Airlines plane crash on March 10, 2019 will begin receiving their remains on Monday for burial, the Nation has learnt.

The Nairobi-bound Ethiopian Airlines flight ET-302 crashed in Bishoftu, a few minutes after take-off from Bole International Airport in Addis Ababa.

On Sunday, the family of John Quindos Karanja, who lost five relatives, told the Nation that they will be ferrying the remains ahead of burial on Thursday.

“We thank all Kenyans for the overwhelming emotional, spiritual and financial support towards our family. On Monday we shall be ferrying the remains of our loved ones after they were successfully identified. We plan to have the burial on Thursday, October 17,” said Mr Karanja.

The International Criminal Police Organisation (Interpol) announced in September that it had positively identified all the 149 passengers and eight crew who died in the crash.

Interpol Secretary General Jürgen Stock said the organisation had to rely on accurate DNA sampling from close blood relatives of the victims to make correct identification, which took the group six months.

The Nakuru family’s five members, among them Mr Karanja’s wife Ann Wangui Karanja, daughter Caroline Quinns Karanja and three grandchildren Ryan Njoroge (7), Kellie Wanjiku (5) and Rubi Wangui (9 months) perished in the plane crash.

The family from Kwa Amos village in Kabatini, Bahati in Nakuru County intended to slaughter three goats to celebrate the return.

Mr Karanja’s wife was to bring home her grandchildren who had been living in Canada when the tragedy struck.

A relative of another family from Kipkelion that lost their son – Cosmas Kipng’etich Rogony – also confirmed some members had travelled to Ethiopia to pick his remains.

“The family of the late Rogony travelled and are expected back this week,” said the relative.

Mr Rogony, who until his death was an employee of General Electric’s healthcare division, left behind a one-year-old daughter and a 27-year-old widow Miriam Wanja.

He hailed from Saoset village in Kipkelion West Sub-County.

In March, the families held prayers for their departed relatives but there were no caskets or bodies.

by Nation.co.ke

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Africa

Ethiopian Airlines jet makes emergency landing

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An Ethiopian Airlines jet made an emergency landing in Dakar with one of its engines on fire, though all 90 passengers and crew were unharmed, airport and airline officials said.

The Boeing 767 aircraft had just taken off from Dakar airport en route to Addis Ababa when the pilot asked to return and make an emergency landing, Tidiane Tamba, a spokesperson for the Senegal airport said.

Ethiopian Airlines confirmed one of its jets had suffered a “mechanical problem” and had safely returned to its point of departure, without giving more details on the cause.

The airline said all those onboard were safe.

The Dakar incident came after an Ethiopian Airlines Boeing 737 MAX crashed in March shortly after taking off from Addis Ababa, killing all 157 people onboard.

BY AFP

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Africa

Burundi president receives his wife as ‘special guest’ at State House

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Burundi President Pierre Nkurunziza has yet again managed to create chatter on social media after receiving a ‘special’ guest at his presidential palace on Monday.

President Nkurunziza was picture standing next to his wife Denise Nkurunziza (the special guest) who paid him an official visit to present awards she received on her humanitarian work.

The First Lady was awarded a Certificate of Honour in recognition of her contribution in raising awareness among administrative and religious leaders, women and youth on the need to overcome the growing population in Burundi.

Pictures shared by the Burundi State House capture Mrs Nkurunziza waiting patiently at the what looks like a conference room for receiving visitors

Other pictures captures the first couple standing side by side while displaying the award certificates.

“At a hearing @KwaNtare, the First Lady of #Burundi SE @1stLady Burundi presented to the Head of State SE @pnkurunziza the awards received in recognition of his action in the transformation of society and his commitment to the most needy,” tweeted @NtareHouse.

Ntare Rushatsi House@NtareHouse

Lors d’une audience @KwaNtare, la Première Dame du S.E @1stLadyBurundi a présenté au Chef de l’Etat S.E @pnkurunziza les récompenses reçues en guise de reconnaissance de son action dans la transformation de la société et son engagement en faveur des plus nécessiteux.

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This attracted varied reactions from the online community who could not understand why the First Lady had to seek a formal audience with her husband.

“This killed me in so many respects I don’t know what to list and what to leave out! But first, when did a wife need a formal audience with her husband! Sacré Burundi,” said @KalindaMwene.

“Do they live together? It is bringing rumours on a possible separation in the presidential palace!” wrote @mugireje.

“Is this a Joke?” asked @solemanzi.

“Hold up whattt!!? So president Nkurunziza received special guest (His wife) in state house,” commented @FerdinandTurat.

In May this year, President Nkurunziza made headlines for publicly gifting his 12-year-old daughter with an envelope of cash for being well behaved.

Naomie Nkurunziza was awarded alongside senior state officials, farmers and the country’s national football team which had just qualified for the 2019 Africa Cup of Nations

Also awarded at the ceremony which was held on May 1, 2019 was a judo champion, governors and district administrators. The ceremony took place at a sports stadium at Rumonge, about 80km from the capital Bujumbura.

By Nairobi News

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