UTILIZATION OF EARLY INFANT DIAGNOSIS SERVICES BY CARETAKERS OF INFANTS IN SELECTED COUNTY HOSPITALS IN KENYA

Emily Chemng'etich Rono Barsito, Dennis Magu, Yeri Kombe, Charles Mbakaya

Abstract


Introduction: Early infant diagnosis among human immunodeficiency virus (HIV)-exposed infants is critical for preventing mother-to-child transmission programs. The Kenya Ministry of Health recently revised their early infant diagnosis (EID) guidelines to align with World Health guidelines on managing HIV and treatment for infants. Despite these interventions to address barriers to IED, Kenya faces challenges in the uptake of EID. This study explored health outcomes of EID on HIV/AIDS and determinants of its utilization in selected level 4 and level 5 public health facilities in Kenya

Methods: A cross-sectional descriptive design was adopted for this study. A structured questionnaire was administered to 351 caregivers of infants presenting in level 4 and 5 hospitals in Baringo, Homa Bay, Kiambu, Machakos and Trans Nzoia counties of Kenya. The study also reviewed medical records for the caregivers and linked the medical records with the caregiver survey. The infants had been enrolled in comprehensive care clinics over for at least one year. Regression analysis and descriptive statistics were utilized in data analysis.

Results: Knowledge of EID services was 86.66%(n=351), of whom 25%(n=318)  did not know about EID before delivery. 20% of caregivers reported they did not know a facility where EID services are offered during their pregnancy. 12.23% of the infants did not receive HIV prophylaxis after delivery. 78.3% of caregivers reported that they knew the benefits of EID. the main barrier to EID services is stigma and discrimination on HIV. Caregivers' age was associated with poor health outcomes (p= 0.004). Unemployment status, reduced number of times attending HIV counselling at MCH and attendance of ANC visits were associated with more poor health outcomes  (p= 0.003, p=0.001 and p= 0.006), respectively 

Conclusions and recommendations: While HIV knowledge among caregivers was high, knowledge of  EID services were low in Kiambu and Trans Nzoia counties. The main barriers of EID services were stigma and discrimination and lack of awareness of availability of EID services in facilities. Therefore, interventions to increase awareness and address stigma are critical factors in increasing EID services' uptake and utilisation.


Keywords


HIV, Early Infant Diagnosis, Treatment, Kenya

Full Text:

PDF

References


Ankrah, A. K., & Dako-Gyeke, P. (2021). Factors influencing the delivery and uptake of early infant diagnosis of HIV services in Greater Accra, Ghana: A qualitative study. PloS one, 16(2), e0246876.

Barlow‐Mosha, L., Musiime, V., Davies, M. A., Prendergast, A. J., Musoke, P., Siberry, G., & Penazzato, M. (2017). Universal antiretroviral therapy for HIV‐infected children: a review of the benefits and risks to consider during implementation. Journal of the International AIDS Society, 20(1), 21552.

Erola, J., Jalonen, S., & Lehti, H. (2016). Parental education, class and income over early life course and children's achievement. Research in Social Stratification and Mobility, 44, 33-43.

Farid, S. (2018). Assessing the cost-effectiveness of national Kenyan repeat maternal HIV testing guidelines.

Finocchario-Kessler, S., Gautney, B., Cheng, A., Wexler, C., Maloba, M., Nazir, N., . . . Odeny, T. A. (2018). Evaluation of the HIV Infant Tracking System (HITSystem) to optimise quality and efficiency of early infant diagnosis: a cluster-randomised trial in Kenya. The Lancet HIV, 5(12), e696-e705.

Gill, M. M., Hoffman, H. J., Mokone, M., Tukei, V. J., Nchephe, M., Phalatse, M., . . . Mofenson, L. (2017). Assessing very early infant diagnosis turnaround times: findings from a birth testing pilot in Lesotho. AIDS research and treatment, 2017.

Goggin, K., Hurley, E. A., Staggs, V. S., Wexler, C., Nazir, N., Gautney, B., . . . Finocchario-Kessler, S. (2019). Rates and predictors of HIV-exposed infants lost to follow-up during early infant diagnosis services in Kenya. AIDS patient care and STDs, 33(8), 346-353.

Helfrecht, C., & Meehan, C. L. (2016). Sibling effects on nutritional status: Intersections of cooperation and competition across development. American Journal of Human Biology, 28(2), 159-170.

HIV/AIDS, J. U. N. P. o. (2017). Ending AIDS: Progress towards the 90-90-90 targets. Global AIDS update.

Jani, I. V., Meggi, B., Loquiha, O., Tobaiwa, O., Mudenyanga, C., Zitha, A., . . . Bollinger, T. (2018). Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients. Aids, 32(11), 1453-1463.

Kiilu, E. M. (2021). Determinants of Selected Health Outcomes Among Infants Enrolled for Early Infant Diagnosis Services of HIV in Hospitals In Nairobi County, Kenya. JKUAT-COHES.

Makau, G., Okwara, F., & Oyore, J. (2015). Determinants of early infant diagnosis and treatment of HIV among exposed infants in informal settlements in Nairobi, Kenya. East Cent Afr Med J, 2, 74-79.

Manggala, A. K., Kenwa, K. W. M., Kenwa, M. M. L., Jaya, A. A. G. D. P., & Sawitri, A. A. S. (2018). Risk factors of stunting in children aged 24-59 months. Paediatrica Indonesiana, 58(5), 205-212.

Manjate Cuco, R. M., Munguambe, K., Bique Osman, N., Degomme, O., Temmerman, M., & Sidat, M. M. (2015). Male partners’ involvement in prevention of mother-to-child HIV transmission in sub-Saharan Africa: a systematic review. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 12(1), 87-105.

Masyuko, S., Mukui, I., Njathi, O., Kimani, M., Oluoch, P., Wamicwe, J., . . . Muchiri, P. (2018). Pre-exposure prophylaxis rollout in a national public sector program: the Kenyan case study. Sexual health, 15(6), 578-586.

Modi, S., Broyles, L. N., Montandon, M., Itoh, M., Ochanda, B., Langat, A., . . . Dale, H. (2018). Beyond early infant diagnosis: changing the approach to HIV-exposed infants. Journal of acquired immune deficiency syndromes (1999), 78(Suppl 2), S107.

Mwau, M., Syeunda, C. A., Adhiambo, M., Bwana, P., Kithinji, L., Mwende, J., . . . Boeke, C. E. (2018). Scale-up of Kenya’s national HIV viral load program: Findings and lessons learned. PloS one, 13(1), e0190659.

Odeny, T. A., Onono, M., Owuor, K., Helova, A., Wanga, I., Bukusi, E. A., . . . Abuogi, L. L. (2018). Maximizing adherence and retention for women living with HIV and their infants in Kenya (MOTIVATE! study): study protocol for a randomized controlled trial. Trials, 19(1), 77.

Pricilla, R. A., Brown, M., Wexler, C., Maloba, M., Gautney, B. J., & Finocchario-Kessler, S. (2018). Progress toward eliminating mother to child transmission of HIV in Kenya: review of treatment guidelines uptake and pediatric transmission between 2013 and 2016—a follow up. Maternal and child health journal, 22(12), 1685-1692.

Ramokolo, V. (2017). Growth of HIV-exposed and HIV–unexposed children in South Africa. Anthropometric nutritional status and growth rates.

Sam-Agudu, N. A., Ramadhani, H. O., Isah, C., Anaba, U., Erekaha, S., Fan-Osuala, C., . . . Charurat, M. (2017). The impact of structured mentor mother programs on 6-month postpartum retention and viral suppression among HIV-positive women in rural Nigeria: a prospective paired cohort study. JAIDS Journal of Acquired Immune Deficiency Syndromes, 75, S173-S181.

Samson, S., Mpembeni, R. N., Njau, P. F., & Kishimba, R. S. (2018). Uptake of early infant diagnosis (EID) at six weeks after cessation of breastfeeding among HIV exposed children: A cross sectional survey at six high volume health facilities in Iringa, Tanzania. Journal of Interventional Epidemiology and Public Health, 1(10).

Singhal, A. (2017). Long-term adverse effects of early growth acceleration or catch-up growth. Annals of Nutrition and Metabolism, 70(3), 236-240.

Wexler, C., Nazir, N., Maloba, M., Brown, M., Goggin, K., Gautney, B., . . . Mabachi, N. (2020). Programmatic evaluation of feasibility and efficiency of at birth and 6-week, point of care HIV testing in Kenyan infant. PloS one, 15(10), e0240621.

Wilkinson, R. G., & Pickett, K. E. (2017). The enemy between us: The psychological and social costs of inequality. European Journal of Social Psychology, 47(1), 11-24.


Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 Kenyan Journal of Nursing & Midwifery



© Numid Publishers        ISSN:  2518-8631