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The burden of disease on HIV-infected orphaned and non-orphaned children accessing primary health facilities in a rural district with poor resources in South Africa: a cross-sectional survey of primary caregivers of HIV-infected children aged 5–18 years

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Infectious Diseases of Poverty 2015年第1期4卷 153-164,152页

作者： Mathildah M Mokgatle Sphiwe Madiba Department of Biostatistics School of Public HealthSefako Makgatho Health Sciences UniversityP O Box 215MedunsaSouth Africa Department of Environmental and Occupational Health School of Public HealthSefako Makgatho Health Sciences UniversityMedunsaSouth Africa

Background:provider-initiated HIV testing and counseling(PITC)is offered as part of the normal standard of care to increase access to treatment for HIV-infected *** practice,HIV diagnosis occurs in late childhood following recurrent and chronic *** investigated primary caregivers’reported reasons for seeking HIV testing for children aged 5–18 years,determined the orphan status of the children,and compared the clinical profile and disease burden of orphans and ***:This was a cross-sectional survey of primary caregivers of HIV-infected children accessing antiretroviral treatment(ART)from two community hospitals and 34 primary healthcare facilities in a rural district in Mpumalanga province,South ***:The sample consisted of 406 primary caregivers:319(78.6%)brought the child to the health facility for HIV testing because of chronic and recurrent *** half(n=183,45.1%)of the children were maternal orphans,128(31.5%)were paternal orphans,and 73(39.9%)were double orphans.A univariate analysis showed that maternal orphans were significantly more likely to be older(OR=2.57,p=0.000,CI:1.71–3.84),diagnosed late(OR=2.48,p=0.009,CI:1.26–4.88),and to start ART later(OR=2.5,p=0.007,CI:1.28–4.89)than *** was a high burden of infection among the children prior to HIV diagnosis;274(69.4%)presented with multiple *** logistic regression showed that ART start age(aOR=1.19,p=0.000,CI:1.10–1.29)and time on ART(aOR=2.30,p=0.000,CI:1.45–3.64)were significantly associated with orphanhood ***(n=203,(50.2%)of the children were admitted to hospital prior to start of ART,and hospitalization was associated with multiple infections(OR=1.27,p=0.004,CI:1.07–1.51).Conclusions:The study found late presentation with undiagnosed perinatal HIV infection and high prevalence of orphanhood among the *** health of maternal orphans was more compromised than *** PICT should be strengthened t

关键词： Primary level of care Hospitalization provider-initiated testing and counseling Perinatally infected olderchildren Burden of disease Orphanhood South Africa

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