Janneke published a generic on review on feasibility and challenges in providing Antiretroviral Treatment to children in Sub-Saharan Africa in Current Pediatric Reviews
Volume 7
Issue 3. The article is open access, and can be downloaded at http://www.benthamdirect.org/pages/content.php?CPR/2011/00000007/00000003/D0003PR.SGM. The article deals with the scale-up of pediatric antiretroviral therapy (ART) in
sub-Saharan Africa over the past decade that involved unprecedented political
and donor commitment. These pediatric ART programs have demonstrated
they can provide ART to human immunodeficiency virus (HIV)-infected
children and that these children achieve treatment outcomes comparable
to children in high-resource settings. Several obstacles, however, have
hindered program implementation and impacted treatment outcomes.
Challenges particularly affecting children include shortages of properly
trained healthcare providers, lack of laboratory capacity for infant
diagnosis and pediatric treatment monitoring, poor adherence, disclosure
of HIV infection status and attrition. Innovative solutions to these
challenges have been developed and programs are demonstrating they can
successfully expand services to increase ART coverage in affected
communities. As programs optimize the care and treatment of children,
and more efficiently provide HIV services within the health care system,
new challenges arise, including integration of child and family health
services, use of electronic health records and the potential need for
rationing antiretroviral drugs. Further evaluation of innovative
solutions to these challenges and barriers to care, as well as continued
commitment on the part of governments and donors, will be required if
all HIV-infected children are to receive proper care.
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