Wangai Abdul Majid, Wangai Maryam, Beckenham Mary, Beckenham Clive
New Life Home, P. O. Box 62610, City Square, Nairobi 00200, Kenya, East Africa.
Sultan Qaboos Univ Med J. 2007 Dec;7(3):239-46.
The number of orphaned and vulnerable children (OVC) worldwide has increased as a result of the Human Immunodeficiency Virus (HIV) pandemic. New Life Home (NLH) specialises in the care of infants who have been orphaned or abandoned, often because of their exposure to HIV and places them for adoption. This paper documents the lessons learnt from the Home's first 8.5 years of existence.
This retrospective study analyses the pattern of the 490 infants admitted at NLH. The characteristics of the infants' stay are analysed: bio-data, weight, HIV exposure, referring organisation/agent and outcome. This study ceased to follow infants after adoption, death, transferral to other homes, or reunion with own family. The infants came via health facilities (58%), local authorities (15%), good Samaritans (2%), and other children's homes (25%).
At the end of the study period, 425 (92%) of babies were still alive. Of those who died, 80% were less than 6 months old (p<0.003) and 45% were HIV positive. A child mortality rate of 77.6/1000 was demonstrated with the key associated factors being HIV exposure (p <0001), and weight at admission (p=0.002). The mortality rate for the HIV exposed was 71/1000 at 6 months, 94.7/1000 at 12 months and 100.6/1000 at 18 months, while for those not exposed to the virus it was 43.3/1000 at 6 months and 46.7/1000 at 12 months. The major cause of death in the HIV exposed was pneumonia (56%) and septicaemia (22%). The majority of infants, 323 (67%) were adopted, some were reabsorbed into their biological families 31(6.3%) and a minority 7(1.4%) transferred to other children's homes which cater for older children.
NLH demonstrates a possible model of care for OVC as majority of vulnerable child can have the opportunity to be adopted and thereby a 'second lease' of life. This strategy is worth studying and duplicating in the mitigation of the OVC dilemma in HIV high prevalence countries in sub-Saharan Africa.
由于人类免疫缺陷病毒（HIV）大流行，全球孤儿和弱势儿童（OVC）的数量有所增加。新生活之家（NLH）专门照顾那些因接触HIV而常常被孤儿或遗弃的婴儿，并为他们安排收养。本文记录了该之家成立头8.5年所吸取的经验教训。
这项回顾性研究分析了NLH收治的490名婴儿的情况。分析了婴儿住院期间的特征：生物数据、体重、HIV接触情况、转诊机构/中介以及结局。该研究在婴儿被收养、死亡、转至其他机构或与家人团聚后不再跟踪。婴儿来自卫生机构（58%）、地方当局（15%）、好心人（2%）以及其他儿童之家（25%）。
在研究期末，425名（92%）婴儿仍然存活。在死亡的婴儿中，80%小于6个月（p<0.003），45%为HIV阳性。显示儿童死亡率为77.6/1000，主要相关因素为HIV接触（p<0.001）和入院时体重（p=0.002）。接触HIV婴儿的死亡率在6个月时为71/1000，12个月时为94.7/1000，18个月时为100.6/1000，而未接触病毒婴儿在6个月时为43.3/1000，12个月时为46.7/1000。接触HIV婴儿死亡的主要原因是肺炎（56%）和败血症（22%）。大多数婴儿，323名（67%）被收养，一些被其亲生家庭重新接纳31名（6.3%），少数7名（1.4%）转至其他照顾大龄儿童的儿童之家。
NLH展示了一种可能的OVC照护模式，因为大多数弱势儿童有机会被收养，从而获得“第二次生命”。这种策略值得在撒哈拉以南非洲HIV高流行国家缓解OVC困境方面进行研究和效仿。
