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.