Transcript Slide 1

Agenda
Points for Discussion
Scaling Up Early Infant Diagnosis
Session SUSS0303
18 July 2010, Vienna
Matt Barnhart, UNICEF
Of those infants testing HIV positive via EID, attrition post testing
is significant (2008 data from multi-country review)
Follow up of Infants Testing Positive via EID at Review Sites
Uganda-72% not alive & on ART
3500
Cambodia- 67% not alive & on ART
3182
100
100
93
90
2330
2500
Infants
Infants
3000
2000
1500
40
Infants
30
38
878
33
25
No
data
500
0
87
50
1170
1000
50
75
Positive
Rec. Enrolled Initiated Active
via EID Results
on ART on ART
Positive
PC R
Results
Enrolled
Initiated
Alive
Senegal 67% not alive & on ART
0
Positive Results Received Initiated Active2330
via EID at Site Results/ on ART on ART
Enrolled
Positive
PC R
Results
Enrolled
Initiated
Alive
27
20
14
10
0
No
data
6
4
Positive
Results
Enrolled
Initiated
Alive
Positive
Enrolled
Received
Initiated
Alive
on
PC R
via EID Results
ART
Patients EID tested
Patients lost
Less than one half of infants ever tested via EID across four
countries were tested in their first two months of life in 2008.
Coverage of the optimal service (early testing) was lower
Portion of HIV Exposed Infants in Need Receiving EID Service in First Two Months of Life
Missed early
testing
opportunities:
PMTCT follow
up
appointments,
vaccination
schedule
Key Points for Discussion
• EID services must integrated into broader package of care and
treatment for HIV-exposed infants
• Paradigm shift away from vertical EID programs needed
• Back to Basics: Cotrimoxazole and Infant Feeding
• CTX coverage only 8% versus 15% for EID in multi-country reviews!
• Stronger linkages to ART urgently needed
• Need to improve organization of services at site-level. SOPs, QI approaches, and case
management.
• Laboratory expansion is not the optimal way in many cases to
invest resources to improve outcomes for the end user.
• National programs and partners should consider collection site and testing laboratory
expansion carefully versus other investments in ensuring ART initiation occurs.
• Point of care diagnostics urgently needed
• But, while we await these, let’s improve the other components of care!
Agenda
Thank you!
S Tripathi, C Kiyaga, M Nghatanga, M Chhi Vun,
A S Wade, R Gass, A Chatterjee, R Ekpini, C
Luo
Please see “ART in Children: Programme
Outcomes” Session TUPDB205 on Tuesday for
fuller discussion of multi-country EID review.