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Evaluation of nutritional conditions, haemoglobin levels, retention in care and viral suppression in a cohort of HIV-infected Malawian adolescents undergoing a one-year tailored intervention within the Diseases Relief through Excellence and Advanced Means

F Ciccacci, S Orlando, J B SAGNO, M Kamponda, J Gondwe, R Lunghi, M C Marazzi, L Palombi

Abstract


Background. The United Nations Children’s Fund (UNICEF) reported that ~1 770 000 adolescents were living with HIV infection in 2017, of whom >80% were in sub-Saharan Africa. In Malawi, ~25 000 boys and 46 000 girls are infected with HIV.

Objective. The present study aimed to evaluate a specific adolescent-friendly service implemented in a Diseases Relief through Excellence and Advanced Means (DREAM) health centre in Malawi.

Methods. All HIV-positive patients aged 10 - 19 years in the care of the DREAM centre in Blantyre on 17 December 2016 were included in the study and followed-up until 1 January 2018. The service was organised for one adult-free day, with some side activities managed by a co-ordinator and youth leaders. Assessments were performed at the end of the period (EOP).

Results. On 17 December 2016, 425 patients were enrolled in the study. Follow-up status at EOP was 403 (94.8%) patients in care, 7 (1.6%) lost to follow-up (LTFU), 2 (0.5%) died and 13 (3.1%) were transferred to other facilities. Death and LTFU rates were 0.72/100 and 2.9/100 person-years, respectively. Moreover, 50.6% (n=198/391) of patients had an improvement in body mass index (BMI)-for-age z-scores, and 70.2% (n=33/47) of patients who were malnourished at baseline improved (higher improvement in older patients). Mean (standard deviation (SD)) haemoglobin levels increased from 12.5 (1.5) mg/dL to 13.1 (1.9) mg/dL (significance level p=0.000). At the EOP, 79.0% (n=309/391) of patients had viral suppression.

Conclusion. Care of adolescent HIV+ patients remains a challenge, but the implementation of specific projects involving adolescents and youth leaders can increase adherence and improve viral suppression.


Authors' affiliations

F Ciccacci, UniCamillus, International University of Health and Medical Science, Rome, Italy

S Orlando, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

J B SAGNO, Diseases Relief through Excellence and Advanced Means Program, Community of Sant’Egidio, Blantyre, Malawi

M Kamponda, Diseases Relief through Excellence and Advanced Means Program, Community of Sant’Egidio, Blantyre, Malawi

J Gondwe, Diseases Relief through Excellence and Advanced Means Program, Community of Sant’Egidio, Blantyre, Malawi

R Lunghi, Diseases Relief through Excellence and Advanced Means Program, Community of Sant’Egidio, Rome, Italy

M C Marazzi, LUMSA, Rome, Italy

L Palombi, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

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Cite this article

South African Journal of Child Health 2020;14(4):228. DOI:10.7196/SAJCH.2020.v14i4.01751

Article History

Date submitted: 2020-12-14
Date published: 2020-12-14

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