Abstract

This piece of work covers thirteen (13) AIDS assistance programs sites over the period 1st January 2008 to 31st December 2015. The study is retrospective, descriptive, and cross-sectional based on 292 clinical cases of HIV infected children aged between 0 and 14 years old. A regional committee was charged to validate antiretroviral treatment (ART) prescriptions on a weekly basis. We have also used data from the regional committee register. HIV infected children represent 5.1% of casework on ART. The average starting age for ART was 4.5 years (1 - 180 months) with a sex ratio (Male/Female) of 0.9. The clinical classifications according to WHO guidelines were: Stage III (52.3%) and Stage IV (20.3%). The most frequent opportunistic infections were: wasting (40.12%), digestive candida infection (29.0%), acute respiratory infections (22.8%) and skin diseases (17.9%). The HIV type 1 was detected on all of the children (100%). The average rate of CD4 at the beginning of the ART was 552.98 cells/mm3, leading to a severe immuno-suppression in many cases (44.8%). The initial ART was essentially NEVIRAPINE + LAMIVUDINE + STAVUDINE. HIV infections diagnosis are usually late in the Central Region of Togo and will therefore be improved by the UNAIDS 90-90-90 strategic plan by 2020, through various initiatives. These are: the Prevention of Mother to Child HIV Transmission (PMTCT), the Early Infection Diagnosis (EID) based on Polymerase Chain Reaction (PCR) and the Provider Initiated Testing and Counseling (PITC).

Highlights

  • In 2014, 36.9 million people were living with Human Immunodeficiency virus (HIV) worldwide [1]

  • UNAIDS elaborated a strategy to decrease those prevalence rates further by 2020 with 3 targets: 90% of HIV infected children will be tested and their serological status be known by their parents; 90% of infected children will take antiretroviral treatment (ART) over their lifetime; and 90% of those who are taking treatment should attain an undetectable viral charge [1]

  • Despite the rapid expansion of the Prevention of Mother To Child Transmission of HIV (PMTCT) services and the improvement of ART coverage on children population, the pediatric HIV infection care is insufficient in Togo

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Summary

Background

In 2014, 36.9 million people were living with Human Immunodeficiency virus (HIV) worldwide [1]. Despite the rapid expansion of the Prevention of Mother To Child Transmission of HIV (PMTCT) services and the improvement of ART coverage on children population, the pediatric HIV infection care is insufficient in Togo. Stock-out of Polymerase Chain Reaction (PCR) tests, high rate of pregnant seropositive women lost of view in PMTCT program, lack of pediatricians, insufficiency of child care programs integration and the low task shifting limit the pediatric ART coverage improvement [4]. Several studies on the infected children have been performed in Togo [5] [6], but none of them focus on the Central Region. The purpose of this investigation is to describe epidemiological, clinical, biological and therapeutic characteristics of HIV infected children in the Central Region of Togo from 2008 to 2015

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