Connect with us

Africa

Late diagnosis triggering more deaths in HIV-positive children – Study

Published

on

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.

 

Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Africa

Kenyans reject Uhuru’s avocado, baby carrots deal with Mauritius

Published

on

The news that Mauritius had lifted a ban on Kenyan avocados has not been well received by the Kenyan online community.

Kenyans online have lamented that they are already grappling with a decrease in production of their “dear avocados” and did not want a trade deal involving the produce.

The government of Mauritius lifted a ban on several Kenyan farm produce, including avocados, baby carrots, baby beans and broccoli.

The decision was is part of a trade deal made during bilateral talks between President Uhuru Kenyatta and his host Prime Minister Pravind Jugnauth.

President Kenyatta said the lifting of the ban will help improve Kenya’s export and will greatly boost horticultural farmers in the country, especially women who are the majority in the sector.

At the same time, China on Sunday completed an inspection tour by two experts from the Chinese National Plant Protection Organisation who were hosted by the Kenya Plant Health Inspectorate Service (Kephis) for eight days as a prerequisite given by the country before it opens its market for Kenyan avocados.

ONLINE UPROAR

But online Kenyans were not happy about the recent deal with Mauritius citing shortages of the prized fruit.

“Why export when local demand and supply is still wanting?” Sarati A. Richard wondered.

“Ile drought iko huku jamani badala zipelekwe huko Kwanza…. We don’t have an oversupply of the produce in discussion,” Migwi Sam lamented.

“DP told us guys to diversify tukasema maize maize… sasa ona,” Cherotich Carren Kiki wrote.

“This ovacado thing kumbe was true! Maize farmers kwisha,” Buluma Godwin commented.

“Ati avocado? Mkipeleka wapi? Msijaribu,” Kenneth Makau warned.

“We don’t even have enough avocadoes in Kenya to feed the demand in the country,” Wachira Jackson commented.

source:nairobinews

Continue Reading

Africa

PHOTOS: Uhuru arrives in Mauritius for four-day State Visit

Published

on

President Uhuru Kenyatta on Tuesday evening arrived in Port Louis, Mauritius for a four-day State Visit.

The plane carrying Mr Kenyatta and his entourage touched down at the Sir Seewoosagur Ramgoolam International Airport shortly before 7pm local time.

On arrival, the President – who was received by Prime Minister Pravind Jugnauth – inspected a guard of honour mounted by a detachment of the special mobile force of the Mauritius Police Service followed by a 21-gun salute.

After the arrival ceremonies,  Kenyatta paid a courtesy call on the Acting President of Mauritius Paramasivum Pillay Vyapoory at State House, Le Reduit.

His visit to Mauritius is largely aimed at boosting the economic, cultural and social ties between the two nations, according to PSCU.

The forum will be used to showcase trade and investment opportunities in Mauritius and Kenya.

President Kenyatta is accompanied by Cabinet Secretaries Monica Juma (Foreign Affairs) and Prof. George Magoha (Education) among other senior government officials.

PHOTO COURTESY: PSCU

Continue Reading

Africa

PHOTOS: Narcotic miraa seized at JKIA

Published

on

Detectives at Jomo Kenyatta airport, Nairobi, have intercepted 500 kilogrammes of narcotic dry miraa concealed as tea packets for export to the US, Australia and Austria.

The drugs were hidden in 52 packets, packed as green stevia tea, according to a statement from the Directorate of Criminal Investigations (DCI).

DCI on Tuesday said the packets were sent by various exporters and were on their way out when detectives smoked out the drugs during a routine screening.

The heroin that was found hidden inside speakers at Jomo Kenyatta International Airport in Nairobi. PHOTO | COURTESY

The Kenya Revenue Authority has issued a seizure notice on the narcotics.

While this was khat (also qat) laced with hard drugs, debate on whether miraa is a drug or a harmless stimulant has been raging on for years.

The leaf, whose active ingredient is cathinone, is grown mainly in Yemen and East Africa— Kenya, Ethiopia, some parts of Uganda and in Madagascar.

It has been associated with various health problems, such as impotence in men, dental complications as well as heart conditions.

The compounds cathinone and cathine, active ingredients of the mild stimulant, were listed in a schedule of harmful compounds in the 2000s, effecting the ban on the crop in the US, Norway, Canada and Sweden.

Khat is quasi-legal (its legality is ambiguous), as Lee Cassanelli, a scholar who wrote a seminal chapter on the drug, once said.

The heroin that was found concealed as make-up. PHOTO | COURTESY

In Kenya, it is not only legal but also a main cash crop in Meru and Tharaka Nithi counties.

Miraa gained popularity in the rest of the world after Somalis, who are very fond of it, trevelled with it around the globe.

But in 2013, the Netherlands, which acted as a transport hub for the drug to rest of the world, also banned it.

The then Dutch Immigration Minister Gerd Leers is quoted by Radio Netherlands as saying that 10 percent of Somali men in the country were badly affected by the drug.

“They are lethargic and refuse to co-operate with the government or take responsibility for themselves or their families,” he said.

A government report released to back the ban also cited that noise, litter and perceived public threat posed by the men who used the drug were the reasons behind the move.

The UK soon after declared miraa a class C drug, banning further imports of the stimulant into the country.

Kenya’s biggest market for miraa today is Somalia, with 90 percent of the product going there.

Mogadishu once banned the stimulant after Nairobi banned direct flights between the two cities over terrorism fears.

source:nation.co.ke

Continue Reading

Trending

error: Content is protected !!