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Five-year Outcomes Among Children Receiving Antiretroviral Therapy in a Community-based Accompaniment Program in

Felix Cyamatare Rwabukwisi1, Bethany L Hedt-Gauthier, Muhayimpundu Ribakare

  • 1From the *Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda; †Department of Global Health and Social Medicine, Harvard Medical School, Boston, Masachusetts; ‡Rwanda Biomedical Center, Kigali, Rwanda; §Ministry of Health, Rwanda; and ¶Division of Global Health Equity, Brigham and Women's Hospital, Boston, Masachusetts.

The Pediatric Infectious Disease Journal
|October 19, 2016
PubMed

Insights

Community-based programs significantly improve retention in care for children with HIV in rural Rwanda. Over 95% of children remained in care for 5 years, with high rates of viral load suppression.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • HIV infection in children presents unique challenges in resource-limited settings.
  • Community-based programs are crucial for sustained pediatric HIV care.
  • Long-term retention and viral suppression are key indicators of successful HIV management.

Purpose of the Study:

  • To evaluate the long-term effectiveness of a community-based accompaniment program for HIV-infected children in rural Rwanda.
  • To assess patient retention rates and viral load suppression outcomes over a 5-year period.

Main Methods:

  • Retrospective analysis of a cohort of 277 HIV-infected children enrolled in a community-based program.
  • Tracking patient retention, deaths, and defaults over 5 years.
  • Analysis of viral load suppression rates (<1000 copies/mL) among children with available data.

Main Results:

  • High retention in care: 95.0% of children remained in the program after 5 years.
  • Low mortality and default rates: only 3.3% deaths and 1.1% defaults observed.
  • Significant viral load suppression: 85.5% of children with documented viral load achieved suppression.

Conclusions:

  • Community-based accompaniment programs are highly effective in retaining HIV-infected children in care in rural Rwanda.
  • These programs contribute to achieving sustained viral load suppression, crucial for long-term health outcomes.
  • The findings support the scalability and importance of such programs in similar settings.

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