Grandir

The purpose of Growing Up Info is to provide those working in the field of AIDS regular updates on knowledge, practices, initiatives and research concerning prevention, medical and psychosocial care, treatment and support of children living with HIV/AIDS in Africa. It is above all a learning tool and a substantial part of each issue will be devoted to case studies and medical quizzes... Finally, fact sheets based on practical approaches for practitioners involved in pediatric HIV care will be soon available.

Sidaction & Initiative développement started GRANDIR-GROWING UP, wishing also to provide practical tools and advice to professionals working with HIV+ children. GRANDIR-GROWING UP will in particular present regular updates on different achievements, or specific projects, or practices in programs supported on the ground, in order to enhance experience sharing.

More information on GROWING UP available on the Sidaction website at: www.sidaction.org/pro/
international/grandir

More information on Initiative Développement at:
www.id-ong.org

Your comments and contributions are particularly welcome and you can send them to us at: grandir@sidaction.org

To subscribe or unsubscribe to Growing Up Info, please send an email to: grandir@sidaction.org

PMTCT: better late than never !

Most often the steps taken to reduce the risk of transmission of HIV from mother to child involve HIV+ pregnant women whose HIV status was discovered before or during pregnancy. Access to testing and medical procedures is still quite inadequate and most children are born into situations where the HIV status of the mother is unknown and they do not benefit from any of the existing protocols. For example, in 2003 it is estimated that only 5% of pregnant women in sub-Saharan Africa had access to PMTCT programs.
 
Given this situation, can the risk of transmission during delivery be reduced? WHO recommends postpartum testing of mothers as early as possible and in cases where they test positive to HIV giving their child a single dose of Nevirapine within 48 hours of birth in combination with AZT for 7 days. The combination of the two is the most efficient therapy but if AZT is unavailable Nevirapine can be administered alone as shown by a “multicenter study,” conducted in South Africa (AIDS. 2005 Aug. 12;19 (12):1289-97). Quality postpartum testing is always possible and paves the way for risk-reduction feeding practices for those who are found positive. Any opportunity to reduce mother to child HIV transmission should not be overlooked, including steps that could be taken after birth.

To find out more:
The Guidelines on Care, Treatment and Support for Women Living with HIV/AIDS and their Children can be downloaded free of charge from the WHO on their website at: www.who.int/hiv/pub/
mtct/guidelines/en

AFRICA
US Foundations Invest in Care and Treatment of children

The news in these last few months shows a growing concern with the situation of HIV+ children in Africa. We can only rejoice given how, up until now, children have been left out and ignored in the fight against AIDS.
 
The Clinton Foundation has recently announced that they intend to provide ARVs to 60,000 children in developing countries by the end of 2006. More and more new health centers specializing in pediatric care will be opening, for example in Malawi and in Burkina Faso. Their financial support comes mainly from foundations associated with the giants of the pharmaceutical industry such as the Abbott Fund and Bristol Meyers Squibb. The Baylor College of Medicine in the US will provide technical assistance.
 
Bearing in mind that not every child will have access to these “model centers”, it is essential that HIV pediatric care and treatment be insured by the health structures that usually take care of these children and their parents. It is important that quality family care and treatment services are developed to help ease family life and with an eye towards working together in an organized and coherently structured way.

To learn more:
AFRICA: Clinton Foundation to treat 60,000 HIV-positive children www. plusnews.org/
AIDSReport.ASP?ReportID=5046&
SelectRegion=Southern_Africa
&SelectCountry=AFRICA
 
Abbott Fund, Baylor College of Medicine and the Government of Malawi to Build New Clinic for HIV-Infected children www.prnewswire.com/
cgi-bin/stories.pl?ACCT=104&STORY=/
www/story/03-09-2005/0003157899&EDATE=
 
Burkina Faso: Soon a medical center for children living with AIDS bayloraids.org/programs/
burkinafaso/
 

What is your diagnosis?

A 7-year old child presents with a chronic cough for more than twelve months not responding to several courses of antibiotics. A thorough clinical examination reveals a moderately enlarged spleen, prurigo, a face slightly swollen corresponding to enlarged parotid glands and failure to thrive (-2DS for height and weight). The appearance of the child’s fingernails draws your attention.
 
1. What is wrong with his/her fingers?
 
2. What is the lung condition that you suspect this child has?
 
3. You suspect HIV infection but neither the child nor his/her parents are ready for an HIV test. Do you have enough information to begin cotrimoxazole prophylaxis while waiting to learn more?
 
4. In what category would you place this child in the WHO pediatrics staging list?

Does this case study interest you?
Send us your answers at: grandir@sidaction.org
You could be the winner of two major medical reference books regarding HIV treatment and care and the best answer will be published in the next volume of GROWING UP INFO. And if you have case studies like this one to submit to us, don’t hesitate!

A tool to help simplify the prescription of pediatric ARVs

Do you find prescribing ARVs to children puzzling? Well, be assured we do too! That’s why we have developed a little tool to help automatically calculate the optimal dose of those ARVs most often prescribed to children. This tool will simplify your prescriptions: simply enter the height and weight of the child and the right dosage will appear.
 
To be downloaded at www.sidaction.org/pro/international/grandir

You don’t have a computer at your facility?
No problem! We have thought of you too — a table of recommended dosages listed in liquid or tablet doses based on weight category will help you avoid having to make careful calculations. You can download it at the same URL address. Keep it on your desk, the time it saves you can now be spent with your little patients!