1
|
Wright S, Amzel A, Ikoro N, Srivastava M, Leclerc-Madlala S, Bowsky S, Miller H, Phelps BR. Talking to children about their HIV status: a review of available resources, tools, and models for improving and promoting pediatric disclosure. AIDS Care 2017; 29:1019-1025. [PMID: 28081616 DOI: 10.1080/09540121.2016.1273471] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As children living with HIV (CLHIV) grow into adolescence and adulthood, caregivers and healthcare providers are faced with the sensitive challenge of when to disclose to a CLHIV his or her HIV status. Despite WHO recommendations for CLHIV to know their status, in countries most affected by HIV, effective resources are often limited, and national guidance on disclosure is often lacking. To address the need for effective resources, gray and scientific literature was searched to identify existing tools and resources that can aid in the disclosure process. From peer-reviewed literature, seven disclosure models from six different countries were identified. From the gray literature, 23 resources were identified including children's books (15), job aides to assist healthcare providers (5), and videos (3). While these existing resources can be tailored to reflect local norms and used to aid in the disclosure process, careful consideration must be taken in order to avoid damaging disclosure practices.
Collapse
Affiliation(s)
- S Wright
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - A Amzel
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - N Ikoro
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - M Srivastava
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - S Leclerc-Madlala
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - S Bowsky
- b Futures Group International , Washington , USA
| | - H Miller
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| | - B R Phelps
- a U.S. Agency for International Development, Office of HIV/AIDS , Washington , DC , USA
| |
Collapse
|
2
|
Abstract
Probiotics are defined by the WHO as 'live microorganisms which when administered in adequate amounts confer a health benefit on the host'. Ongoing research has shown probiotics provide benefits to humans, including protection and restoration of the gastrointestinal and other mucosal tracts. As human immunodeficiency virus (HIV) activates gut-associated lymphoid tissue (GALT), several studies have investigated the effect of probiotics on CD4 cell count and related outcomes among those living with HIV. These studies are summarised here. Manuscripts were identified using the search terms 'probiotics', 'synbiotics', 'HIV', and 'CD4', and were reviewed for relevance and inclusion of CD4 count as an immunologic endpoint. Bibliographies of relevant manuscripts were also reviewed for additional studies matching inclusion and exclusion criteria. The search yielded 91 results; 13 included relevant outcomes. Seven of these studies produced beneficial CD4 outcomes, while the remaining 6 reported on insignificant beneficial or negative CD4 outcomes. The studies summarised here collectively suggest that daily consumption of probiotics over a prolonged period of time may improve CD4 count in people living with HIV.
Collapse
Affiliation(s)
- H Miller
- 1 USAID Office of HIV/AIDS, 1300 Pennsylvania Avenue, Washington, DC 20523, USA
| | - R Ferris
- 1 USAID Office of HIV/AIDS, 1300 Pennsylvania Avenue, Washington, DC 20523, USA
| | - B R Phelps
- 1 USAID Office of HIV/AIDS, 1300 Pennsylvania Avenue, Washington, DC 20523, USA
| |
Collapse
|
3
|
Joel DR, Steenhoff AP, Mullan PC, Phelps BR, Tolle MA, Ho-Foster A, Mabikwa V, Kgathi BG, Ncube R, Anabwani GM. Diagnosis of paediatric tuberculosis using sputum induction in Botswana: programme description and findings. Int J Tuberc Lung Dis 2015; 18:328-34. [PMID: 24670571 DOI: 10.5588/ijtld.13.0243] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Four public hospitals in Botswana, a high tuberculosis (TB) burden setting. OBJECTIVES To assess the feasibility and utility of sputum induction in the diagnosis of paediatric TB. DESIGN From 2008 to 2010, children aged ≤18 years referred for suspected pulmonary TB underwent sputum induction. Confirmed TB was defined as the presence of at least one of the signs and symptoms suggestive of TB and positive Mycobacterium tuberculosis culture. Information on TB-associated symptoms (cough, fatigue, night sweats, low appetite, chest pain, weight loss, haemoptysis and contact with a TB case) was collected for three risk groups: human immunodeficiency virus (HIV) positive children, HIV-negative children aged <3 years and HIV-negative children aged ≥3 years. RESULTS The median age of the 1394 subjects who underwent sputum induction was 3.8 years (IQR 1.3-8.4); 373 (27%) were HIV-positive, 419 (30%) were HIV-negative and 602 (43%) had unknown HIV status. TB was confirmed in 84 (6.0%); cases were more likely to have weight loss, chest pain or TB household contacts. There were no serious complications attributable to sputum induction during and after the procedure; only 0.8% (9/1174) of patients reported minor complications. CONCLUSIONS In Botswana, paediatric sputum induction was feasible, safe and assisted bacteriological confirmation in a subgroup of children treated for TB.
Collapse
Affiliation(s)
- D R Joel
- Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana; Department of Paediatrics, Faculty of Health Sciences, University of Botswana School of Medicine, Gaborone, Botswana
| | - A P Steenhoff
- Department of Paediatrics, Faculty of Health Sciences, University of Botswana School of Medicine, Gaborone, Botswana; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - P C Mullan
- Children's National Medical Center, Washington, DC, USA
| | - B R Phelps
- Office of HIV/AIDS, US Agency for International Development, Washington, DC, USA
| | - M A Tolle
- Baylor College of Medicine, Houston, Texas, USA; Baylor Children's Foundation-Tanzania, Mwanza, Tanzania
| | - A Ho-Foster
- Botswana-UPenn Partnership, Gaborone, Botswana; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - V Mabikwa
- Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana
| | - B G Kgathi
- Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana
| | - R Ncube
- Ministry of Health, Botswana National TB Programme, Gaborone, Botswana
| | - G M Anabwani
- Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana; Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|