Zambian Guidelines for Antiretroviral Therapy of HIV Infection in Infants and Children: Towards Universal Access. Recomendations for a Public Health Approach, 2007
(2007; 102 pages)

Abstract

Globally about 1800 children under 15 years of age are infected with HIV everyday; more than 90% of these infections are occurring in the developing world and Mother-to-Child Transmission (MTCT) is by far the largest source of HIV infection in these children.

According to UNAIDS estimates, more than 90 percent of children acquire the virus through Mother-to-Child Transmission. Therefore the most efficient and cost effective way to tackle paediatric HIV is to reduce mother-to-child transmission of HIV. Therefore, there is a need to rapidly scale up the Prevention-of Mother-to Child-Transmission (PMTCT) programme in Zambia so that it reaches every woman who needs it. Antiretroviral therapy (ART) should be offered a timely manner to infants and children who become infected with HIV in spite of on going preventive efforts.

Zambia is one of the countries hardest hit by the HIV/AIDS epidemic, has a very high HIV prevalence among pregnant women, but the magnitude of HIV infection among infants and children remains unknown, although it is estimated to be about 10% of that of infected adults.

The Government of the Republic of Zambia has an obligation, and is committed to provide the country with equitable access to cost effective and quality health care, as close to the family as possible. It is against this background that the Ministry of Health is committed to achieve universal access to ART for both adults and children by 2010.

This can only be achieved through the expansion and integration of ART services into maternal and child health (MCH) and related health care services. The paediatric ART intervention entails, among other approaches, the establishment of linkages to other support programmes within the framework of a continuum of care for HIV positive people.

Paediatric ART services will be linked to PMTCT interventions, to adult care, and along with other child survival programmes will ensure a reduction in maternal and childhood morbidity and mortality.

This document has been adapted for use by health care providers in Zambia, and it gives guidelines on how to implement paediatric ART services at health facilities. It is hoped that these guidelines will provide guidance and help accelerate efforts towards universal access to ART by Zambian children. It will be periodically updated as paediatric ART management evolves with changing times, and as need dictates.

 
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