Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
S Afr Med J. 2012 Mar 7;102(4):245-8.
To explore the acceptability and feasibility of routine HIV screening in children at primary healthcare clinics and ascertain the prevalence of previously undiagnosed HIV infection in 17 - 24 month old children accessing curative and routine services.
A survey was conducted in 4 primary health clinics in the western sub-district of Cape Town. Rapid HIV screening of 17 - 24 month old children was performed for consenting caregiver-child pairs. Data on demographics, child health and antenatal history were collected using questionnaires.
During recruitment, 358 children (72%) were tested for HIV infection. Most of the children (95.8%) were accompanied by a parent. The prevalence of reported HIV exposure among children was 21% (107/499). Of these, 3 had previously confirmed HIV infection; 1 was reportedly confirmed by a 6-week HIV test, and the other 2 probably contracted the virus via late post-partum transmission. The overall transmission rate was 3.5% (3/86) and the confirmed proportion of HIV-infected children was 0.8% (3/361). No previously unknown HIV infection was detected.
Programmes to prevent mother-to-child transmission are effective, but at-risk infants who test negative at 6 weeks should be monitored for subsequent seroconversion. Parents of HIV-exposed infants are more likely to permit (re)testing of their infants than those whose offspring are not at risk. Routine HIV testing of children is feasible and acceptable at primary level, but may require additional resources to achieve universal coverage. Routine screening at an earlier age may detect previously undiagnosed HIV infection.
探索在基层医疗诊所对儿童进行常规 HIV 筛查的可接受性和可行性，并确定在接受治疗和常规服务的 17-24 个月大的儿童中，先前未诊断出的 HIV 感染的流行率。
在开普敦西部分区的 4 个初级保健诊所进行了一项调查。对同意的照顾者-儿童对进行了快速 HIV 筛查。使用问卷收集人口统计学、儿童健康和产前史数据。
在招募期间，对 358 名（72%）17-24 个月大的儿童进行了 HIV 感染检测。大多数儿童（95.8%）都有父母陪同。报告的儿童 HIV 暴露率为 21%（499 名中的 107 名）。其中，有 3 名儿童先前已确诊 HIV 感染；1 名据报道通过 6 周 HIV 检测确诊，另外 2 名可能通过产后晚期传播感染了病毒。总的传播率为 3.5%（86 名中的 3 名），HIV 感染儿童的确诊比例为 0.8%（361 名中的 3 名）。未发现新的未知 HIV 感染。
预防母婴传播的方案是有效的，但在 6 周时检测呈阴性的高危婴儿应监测后续的血清转换。HIV 暴露婴儿的父母比那些子女没有风险的父母更有可能允许（重新）检测他们的婴儿。在基层一级进行常规 HIV 检测是可行且可接受的，但可能需要额外的资源来实现普遍覆盖。在更早的年龄进行常规筛查可能会发现先前未诊断出的 HIV 感染。
