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Bedside paediatric HIV testing in Malawi: Impact on testing rates

Marita Macken1,2, James Chan1, Bernadette O'Hare3,4

  • 1Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.

Malawi Medical Journal : the Journal of Medical Association of Malawi
|June 7, 2018
PubMed

Insights

Implementing bedside HIV testing significantly boosted testing rates in Malawian pediatric inpatients. This improvement is crucial for early HIV treatment and reducing child mortality.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Provider-initiated testing and counselling (PITC) is recommended for all inpatients in Malawi, but HIV testing rates remain low among children.
  • Auditing existing HIV testing services revealed low testing uptake among pediatric inpatients.

Purpose of the Study:

  • To audit the effect of implementing a bedside diagnostic HIV testing service to improve testing rates among pediatric inpatients.
  • To determine if a bedside HIV testing service could increase the proportion of children tested during admission.

Main Methods:

  • An initial audit of HIV testing services was conducted.
  • A bedside diagnostic HIV testing service was introduced, supported by health system strengthening measures.
  • A re-audit was performed to assess the impact of the bedside testing service.

Main Results:

  • The proportion of pediatric inpatients with documented HIV tests increased significantly from 63% to 94.8% after implementing bedside testing.
  • The percentage of children tested for HIV during admission rose from 31.9% to 68.1%.
  • The proportion of tested children with results within the last 3 months increased from 61% to 94.5%.

Conclusions:

  • Implementing a bedside HIV testing service significantly improved HIV testing rates among pediatric inpatients at Queen Elizabeth Central Hospital.
  • Increased HIV testing in pediatric inpatients has crucial implications for earlier treatment initiation.
  • Improved testing can lead to reduced HIV-associated morbidity and mortality in children.
Abstract

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