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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-01
The Early Infant Diagnosis (EID) Programme in Kenya: A Case-control Evaluation of PCR testing, ART Initiation and Adherence among HIV Exposed Children in Nairobi County
Christopher L. Imbaya, Zipporah Ng’ang’a, Yeri Kombe
Published: March 30, 2015 |
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DOI: 10.36347/sjams.2015.v03i01.079
Pages: 396-407
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Abstract
Over half of 2 million children below 2 years who live with Human Immunodeficiency Virus (HIV) die by the
second birthday if they are not diagnosed and treated. Early Infant Diagnosis (EID) of HIV permits timely initiation of
Antiretroviral Therapy (ART) which reduces paediatric morbidity and mortality. The Kenyan government launched the
EID programme in 2006 through which over 300,000 children have undergone Polymerase Chain Reaction (PCR)
testing. Seven years after the launch and in view of the rapid up-scaling of ART usage we purposed to evaluate the
success of the programme as seen by the age of PCR testing among HIV exposed children, the children’s adherence rate
to ART and the maternal-child factors influencing pediatric ART adherence in Nairobi County. Using standardized
questionnaires we established that 53% of HIV exposed children received a PCR test within 6 months of age, 29% of
them between 6 and 18 months of life while 18% were tested after the age of 18 months. About half (52%) of the
mothers faced situations that made it difficult to give ART to their children. Poor maternal ART adherence, caretaker
forgetfulness and facing difficult situations negatively impacted on children’s ART adherence. Significantly higher
(p=0.023) adherence was seen among PCR- children on prophylactic ART compared to PCR+ children on Highly Active
Antiretroviral Therapy (HAART). We recommend health workers community networking and engagement, heightened
public education on EID coupled with the use of maternal adherence reminder techniques to promote early PCR testing
and enhance ART uptake and adherence.