scholarly journals Addressing the Challenges and Relational Aspects of Index-Linked HIV testing for Children and Adolescents: Insights From The B-GAP Study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents.Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing. Contributions to the literature • Although promoted and recommended by the World Health Organization; index-linked HIV testing for children has not been standard practice in routine HIV care for many countries including Zimbabwe.• Prior this study, no study has evaluated the factors that influence and affect uptake of index-linked HIV testing for children and adolescents as reported in our manuscript. • Our findings have the potential to bridge the HIV testing gap for children and optimize index-linked testing, a strategy that has been shown to result in higher yield of HIV when compared to universal testing but where uptake remains suboptimal.

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing. Contributions to the literature • Although promoted and recommended by the World Health Organization; index-linked HIV testing for children has not been standard practice in routine HIV care for many countries including Zimbabwe.• Prior this study, no study has evaluated the factors that influence and affect uptake of index-linked HIV testing for children and adolescents as reported in our manuscript. • Our findings have the potential to bridge the HIV testing gap for children and optimize index-linked testing, a strategy that has been shown to result in higher yield of HIV when compared to universal testing but where uptake remains suboptimal.


2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.


2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A. Weiss ◽  
...  

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family-centred approach can optimise index-linked testing.


Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.


Author(s):  
Katarzyna Dereń ◽  
Justyna Wyszyńska ◽  
Serhiy Nyankovskyy ◽  
Olena Nyankovska ◽  
Marta Yatsula ◽  
...  

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character—more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.


2021 ◽  
pp. 8-10
Author(s):  
Niraj Kumar Singh ◽  
Ayan Ghosh ◽  
Debrashi Jana

INTRODUCTION: India is the second largest contributor to Rabies mortality in the world. According to a recent report of World Health Organization (WHO), approximately 55,000 human deaths are reported every year worldwide due to rabies, with an overwhelming majority of 32,000 cases reported in Asia of which 20,000 occur in India. AIMS: The general awareness about the rabies in general population, awareness of people about anti rabies vaccines and health services utilization. MATERIAL AND METHOD: The study was an observational, questionnaire-based study. For the purpose of this thesis, a descriptive co relational analytical survey was used, in which a qualitative approach was undertaken to determine the answers of mentioned research questions. st st The study was slum to the general people. The expected duration of the study was approximately six months between 1 January 2019 to 30 Dec 2019. RESULTAND DISCUSSION:We found that 77(51.3%) patients answered that on being bitten from an infected animal, both people and animals can get rabies, 46(30.7%) patients answered that on several sorts of contact with an infected animal (e.g. bite, lick, scratch) people and animals can get rabies and 27(18.0%) patients don't know how can people and animals get rabies. It was found that 113(75.3%) patients had answered that the person who is infected with rabies gets crazy/mad/dangerous, 10(6.7%) patients had answered that the person who is infected with rabies of some can get better/get treatment/do not die and 27(18.0%) patients had answered they don't know about the outcome of the treatment. It was found that 60(40.0%) patients had answered rabies treatable, 63(42.0%) patients had answered no and 27(18.0%) patients had answered do not know. We found that 145(96.7%) patients preferred to take Anti-rabies vaccine. 75(50.0%) patients answered yes, these vaccines available free of cost in govt. hospitals, 82.0% of the study populations were found to have heard about rabies; Most of them had good knowledge regarding rst-aid measures. Our ndings indicate that the urban community has good knowledge about rabies but unfortunately, they are unaware about rabies fatality. Hence, there is need to create awareness regarding wound management and post-exposure immunization. CONCLUSION:The knowledge, attitude and practices with respect to prevention and treatment of rabies were found adequate amongst the urban population. Thus, community based health education may be increased in these areas to create awareness regarding rabies.


Author(s):  
Fernanda Karla Nascimento ◽  
Roberta Alvarenga Reis ◽  
Alexandre Saadeh ◽  
Fran Demétrio ◽  
Ivaneide Leal Ataide Rodrigues ◽  
...  

Objective: to describe attributes associated with the Quality of Life of Brazilian transgender children and adolescents according to their own perception. Method: descriptive study conducted with 32 participants between eight and 18 years old, who were either interviewed or participated in focus groups. The statements were transcribed, grouped with the aid of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software, version 0.7 alpha 2 and described according to the definition of Quality of Life by the World Health Organization concerning to the mental, physical, and social dimensions. Results: it was possible to identify the family nucleus as the main social support for transgender children and adolescents. However, the experience of prejudice and discrimination were negative attributes associated with Quality of Life. Conclusion: the statements indicate that lives of transgender children and adolescents are impacted by social, physical, and mental factors due to the stigma and discrimination experienced. It is expected to contribute to the formulation of public policies related to transgender children and adolescents and expand the discussion on the citizens’ duties and rights in relation to transsexuality.


2020 ◽  
Author(s):  
Rewel Kariuki ◽  
Gilbert Koome Rithaa ◽  
Oyugi Elvis ◽  
Daniel Gachathi

Abstract Background: Identification of people living with HIV is key in HIV prevention and control. Partner Notification service is a World Health Organization backed strategy of reaching out to sexual partners of people diagnosed with HIV for HIV testing. However, its adoption and success rate in Kenya remains unknown.Methods: A cross sectional facility based study was undertaken in five purposively selected health facilities in Muranga County, Kenya. A retrospective review of patient medical records data for HIV positive index clients and their Sexual Partners conducted. Census approach applied to extract data for study subjects from Partner Notification Service registers for the period covering January 2017 to August 2018. Epi Info software was used for data analysis.Results: A total of 183 index clients offered Partner notification services. The mean age of the indexed clients studied was 39(SD ±13.1). Females comprised 64 % of clients studied. Of the 183 indexed clients, 89% accepted the services and elicited 216 sexual partners for tracing. The ratio of elicited sexual partners to index client was 1.3:1. Out of the 216 sexual partners, 77% were reached and tested. A total of 46 [32%] of the sexual partners elicited and traced, tested HIV positive. The most preferred approaches were provider referral (51%) and contract referral (45%). Dual referral (4%) was the least preferred approach. Conclusions: Partner notification services is acceptable and an effective strategy of increasing HIV case identification and raising awareness to exposed sexual partners in low resource countries.


The World Health Organization has set a target to achieve by 2030 that 90% of people with HIV are aware of their diagnosis, 90% of those are on treatment, and 90% of these have an undetectable viral load. People with HIV who are not aware of their diagnosis are more likely to be diagnosed late with increased morbidity and mortality, and 50% of new transmissions are from people unaware of their status. This chapter describes the challenges in increasing testing and diagnosis, recommendations for HIV testing, and initial assessment and management of those newly diagnosed with HIV infection.


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