Original articles

Acceptability, feasibility and impact of routine screening to detect undiagnosed HIV infection in 17 - 24-month-old children in the western sub-district of Cape Town

Michael Levin, Hlengani Mathema, Kathryn Stinson, Karen Jennings

Abstract


Objectives. To explore the acceptability and feasibility of routine HIV screening in children at primary healthcare clinics and ascertain the prevalence of previously undiagnosed HIV infection in 17 - 24 month old children accessing curative and routine services.
Methods. A survey was conducted in 4 primary health clinics in the western sub-district of Cape Town. Rapid HIV screening of 17 - 24 month old children was performed for consenting caregiver-child pairs. Data on demographics, child health and antenatal history were collected using questionnaires.
Results. During recruitment, 358 children (72%) were tested for HIV infection. Most of the children (95.8%) were accompanied by a parent. The prevalence of reported HIV exposure among children was 21% (107/499). Of these, 3 had previously confirmed HIV infection; 1 was reportedly confirmed by a 6-week HIV test, and the other 2 probably contracted the virus via late post-partum transmission. The overall transmission rate was 3.5% (3/86) and the confirmed proportion of HIV-infected children was 0.8% (3/361). No previously unknown HIV infection was detected.
Conclusions. Programmes to prevent mother-to-child transmission are effective, but at-risk infants who test negative at 6 weeks should be monitored for subsequent seroconversion. Parents of HIV-exposed infants are more likely to permit (re)testing of their infants than those whose offspring are not at risk. Routine HIV testing of children is feasible and acceptable at primary level, but may require additional resources to achieve universal coverage. Routine screening at an earlier age may detect previously undiagnosed HIV infection.

Authors' affiliations

Michael Levin, Division of Allergy, Department of Paediatrics and Child Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, and Kidzpositive Family Fund

Hlengani Mathema, Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town

Kathryn Stinson, Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town

Karen Jennings, Health Directorate, City of Cape Town

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Keywords

HIV; screening; undiagnosed

Cite this article

South African Medical Journal 2012;102(4):245-248.

Article History

Date submitted: 2011-09-23
Date published: 2012-03-07

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