Grandir

This 10^th issue of  Growing Up Info celebrates our one year anniversary. You, our subscribers are more than 1000 strong and the entire team at Growing Up would like to take this opportunity to thank you sincerely for all of your contributions to this newsletter.

We invite you to participate in a survey that will help us to know you better and make it easier for us to cover the issues that are of interest to you. We wholeheartedly encourage you to answer this survey as the information will be very useful to us!  It will only take few minutes of your time. The 5 first people who answer will receive a book on pediatric HIV. Thank you.

Send your answers at: grandir@sidaction.org 

A questionnaire, in Word format, to fill and send back is available to you at the following address: 

www.sidaction.org/pro/
international/grandir/
sondage2006/

Chigata – Ivory Coast: a pioneering organization

This month Growing Up Info would like to tell you about Chigata, an Ivorian organization started in 2001 by parents or caregivers of children living with HIV. Chigata works with the main pediatric healthcare centers in Abidjan, like Cepref and the CHU Yopougon, to provide social services to HIV+ children and their families.

Chigata organizes informational and support groups where parents are helped to identify key steps in children’s comprehensive care. For example, they address issues such as how to deal with children and adherence, especially when a child is getting better and no longer wants to take his or her medicine. Parents are also given advice on how to explain to children in simple, metaphoric and reassuring terms why it is important to take medicine to boost the immune system in order to help fight against opportunistic infections. Older children who are more aware of their HIV status can choose to participate in a support group for adolescents where, they can talk with a supervising psychologist about their lives as teenagers living with HIV. The support group also provides them with a forum to talk about sexual health. Younger children in the orphans and vulnerable children group, participate in recreational and educational activities where children both HIV infected and affected play and learn together.

At Chigata, social assistance and education are interwoven: for example, Chigata’s nutritionist-trained counselors conduct regularly workshops on nutrition: they prepare a meal for dozens of parents and children. Then, while everybody is enjoying the meal, they hand out recipes, explain the nutritional benefits for children, and at the end distribute food kits to families that need them.

In 2004 Chigata opened a residence with 10 beds for orphans living with HIV. The residence is for children from families who live outside Abidjan or for children who have been rejected by their foster family. The children receive appropriate nutritional support as well as a structured daily routine. For up to six months they are housed and cared for by child care workers. Foster families are encouraged to stay in contact on a monthly basis with their children. During these monthly meetings parents are able to talk about their experiences and become better prepared for the child’s return to the family. While Chigata’s residence can’t be considered an orphanage because of the temporary nature of the services it provides, it is still able to offer the kind of peaceful safe haven necessary for effective pediatric medical treatment.  Many families are already torn apart by HIV/AIDS, and children living with HIV continue to be rejected all too often.

To find out more
Chigata’s website (in french)
www.chigata.org

To contact Chigata
(Rose Dossou or Agnès Dakin)
E-mail : chigataorg@yahoo.fr
Phone: +225 23 46 11 16

Growing Up program’s call for proposals: 8 programs in the field get underway

Initiative Développement (ID) and Sidaction, the 2 French NGOs who run the Growing Up program have, for several years, provided technical and financial support to African AIDS organizations who offer comprehensive care (medical and psychosocial) to people living with HIV/AIDS and their families at community-based care centers. Last September, Growing Up put out a restricted call for proposals that strengthen PMTCT and care and support activities for children living with HIV. Centers of reference for pediatric treatment need to be reinforced however our goal is to support care and treatment programs for mothers and children within community-based comprehensive HIV care centers. 

21 organizations most involved in this area were pre-selected from among the network of Sidaction and ID’s partners. The technical review board, comprising of both African and French experts, evaluated 17 project proposals. 8 organizations were awarded one year grants averaging 25.000 € per project. These include: REVS+ (Burkina Faso) – Racines (Bénin) – ARCAD-Sida (Mali) – Kenedougou Solidarité (Mali) – Centre SAS (Ivory Coast) – Centre Djenandoum Naasson (Tchad) – EVT (Togo) – AMC (Togo).

The programs strengthen existing activities in three main areas: infant feeding and nutrition of children exposed to HIV or infected by HIV; medical care and treatment; psychosocial support to children living with HIV and their families. These organizations face many challenges:  enlarge HIV counseling and testing services for children in families affected by HIV; improve access to virologic tests for early diagnosis ; counsel HIV+ mothers on infant feeding and facilitate access to breast-milk substitutes for women opting for replacement feeding; improve the availability of pediatric ARVs; and provide adherence support to children, including encouraging them to talk about their experiences of living with HIV and being on ARV therapy. The partnerships will start up in January 2007. We well keep you updated on these projects’ progress!

To find out more
Summary of all grants awarded by Sidaction in 2006:
www.sidaction.org/pro/
international/actualites/
actufinancements2006

Presentation of field programs supported by Growing Up’s first call for proposals
http://www.sidaction.org/pro/
international/grandir/terrain/

Another call for proposals to renew the grants will be launched at the end of 2007

Pediatric ARV dosages: New recommendations, new charts! 

The World Health Organisation (WHO) has issued new, simplified recommendations on pediatric ARV dosages based on weight. To prescribe AZT or nevirapine it is no longer necessary to calculate the body surface area (BSA)! This method based on the child’s weight and height is not very practical and can be confusing. Knowing the child’s weight is now enough to prescribe the correct dosage for each medication.

Growing Up has compiled these new recommendations into dosing charts available in PDF format. Once printed (preferably, in color) you can use these charts during your consultations with children. Finally, we advise you to stop calculating dosages using the CALCUL-ART-1 method that the Growing Up program developed in the beginning of 2006 since CALCUL-ART no longer corresponds to WHO’s most recent recommendations.

Important notice: while these new dosing charts are based solely on weight, it is still essential to measure the child at each visit and continue to monitor both his/her weight and height.  

To find out more
WHO recommended ARV dosages for children
Annex B – Pages 100-135
(1.57 Mo – in English only)
http://www.who.int/entity/
hiv/pub/guidelines/
WHOpaediatric.pdf

Download the new pediatric dosage charts at: http://www.sidaction.org/
pro/international/
grandir/outils/

Answers to last issue's exercise

In the last issue Growing Up Info asked you to locate events in the lives of two children on the basis of their growth charts. Here are the answers:

1. C: An episode of severe of pneumonia causes weight loss.
2. A: Problems with adherence can impede weight-gain and negatively impact both on weight and height over the long term if problems persist.
3. B: Counseling and reinforced follow-up encourage adherence and lead to the child’s improved growth.

The standard percentile curves on the WHO website:
www.who.int/childgrowth/
standards/chart_catalogue
/en/index.html