Pediatric HIV Infection in Togo: Situation of Child Care in the Central Region from 2008 to 2015

Abstract

This piece of work covers thirteen (13) AIDS assistance programs sites over the period 1st Jan 2008 to 31st Dec 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).