TY - JOUR
T1 - High prevalence of late presentation of ART-naïve perinatally infected children for care in Pune, India
AU - Nimkar, Smita
AU - Kinikar, Aarti
AU - Chavan, Amol
AU - Sangle, Shashikala
AU - Rewari, Bharatbhushan
AU - Gupta, Amita
AU - Mave, Vidya
AU - Marbaniang, Ivan
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Delayed presentation to care of perinatally infected children in India continues to be a hindrance to achieving the “end pediatric HIV by 2020” goal. In this study, we characterize this issue by describing the prevalence, risk factors and temporal trends of delayed presentation to care of perinatally infected, antiretroviral therapy (ART)–naïve children using programmatic data from a tertiary care center in western India. Delayed presentation was defined as children presenting in moderate or severe WHO immunodeficiency categories. Of 269 children eligible for inclusion in the analysis, the median age at presentation was 4 years (IQR: 3–6 years) and prevalence of delayed presentation was 52%. Multivariable logistic regression identified domicile distance ≥20km from the ART center (OR: 2.2, 95% CI: 1.02–4.7) to be a risk factor for delayed presentation. An inverse association with increasing age (OR: 0.8, 95% CI: 0.7–0.9) was also seen. The proportion of children with delayed presentation between 2006 and 2016 remained unchanged (p = 0.36), although the median age at presentation over the same time period increased significantly (p < 0.001). Our results indicate the urgency of identifying strategies to improve linkage of perinatally infected ART-naïve children to care, earlier than what is currently observed.
AB - Delayed presentation to care of perinatally infected children in India continues to be a hindrance to achieving the “end pediatric HIV by 2020” goal. In this study, we characterize this issue by describing the prevalence, risk factors and temporal trends of delayed presentation to care of perinatally infected, antiretroviral therapy (ART)–naïve children using programmatic data from a tertiary care center in western India. Delayed presentation was defined as children presenting in moderate or severe WHO immunodeficiency categories. Of 269 children eligible for inclusion in the analysis, the median age at presentation was 4 years (IQR: 3–6 years) and prevalence of delayed presentation was 52%. Multivariable logistic regression identified domicile distance ≥20km from the ART center (OR: 2.2, 95% CI: 1.02–4.7) to be a risk factor for delayed presentation. An inverse association with increasing age (OR: 0.8, 95% CI: 0.7–0.9) was also seen. The proportion of children with delayed presentation between 2006 and 2016 remained unchanged (p = 0.36), although the median age at presentation over the same time period increased significantly (p < 0.001). Our results indicate the urgency of identifying strategies to improve linkage of perinatally infected ART-naïve children to care, earlier than what is currently observed.
KW - Delayed presentation
KW - India
KW - pediatrics
KW - perinatal HIV infection
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U2 - 10.1080/09540121.2020.1727407
DO - 10.1080/09540121.2020.1727407
M3 - Article
C2 - 32070118
AN - SCOPUS:85079740802
SN - 0954-0121
VL - 32
SP - 1415
EP - 1420
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 11
ER -