J Int AIDS Soc. 2013 Jan 15;16(1):17998. doi: 10.7448/IAS.16.1.17998.
There are limited data on paediatric HIV care and treatment programmes in low-resource settings.
A standardized survey was completed by International epidemiologic Databases to Evaluate AIDS paediatric cohort sites in the regions of Asia-Pacific (AP), Central Africa (CA), East Africa (EA), Southern Africa (SA) and West Africa (WA) to understand operational resource availability and paediatric management practices. Data were collected through January 2010 using a secure, web-based software program (REDCap).
A total of 64,552 children were under care at 63 clinics (AP, N=10; CA, N=4; EA, N=29; SA, N=10; WA, N=10). Most were in urban settings (N=41, 65%) and received funding from governments (N=51, 81%), PEPFAR (N=34, 54%), and/or the Global Fund (N=15, 24%). The majority were combined adult-paediatric clinics (N=36, 57%). Prevention of mother-to-child transmission was integrated at 35 (56%) sites; 89% (N=56) had access to DNA PCR for infant diagnosis. African (N=40/53) but not Asian sites recommended exclusive breastfeeding up until 4-6 months. Regular laboratory monitoring included CD4 (N=60, 95%), and viral load (N=24, 38%). Although 42 (67%) sites had the ability to conduct acid-fast bacilli (AFB) smears, 23 (37%) sites could conduct AFB cultures and 18 (29%) sites could conduct tuberculosis drug susceptibility testing. Loss to follow-up was defined as >3 months of lost contact for 25 (40%) sites, >6 months for 27 sites (43%) and >12 months for 6 sites (10%). Telephone calls (N=52, 83%) and outreach worker home visits to trace children lost to follow-up (N=45, 71%) were common.
In general, there was a high level of patient and laboratory monitoring within this multiregional paediatric cohort consortium that will facilitate detailed observational research studies. Practices will continue to be monitored as the WHO/UNAIDS Treatment 2.0 framework is implemented.
在资源有限的环境中，有关儿科艾滋病毒护理和治疗方案的数据十分有限。
通过国际艾滋病流行病学数据库对亚太地区（AP）、中非（CA）、东非（EA）、南部非洲（SA）和西非（WA）的儿科队列地点进行标准化调查，以了解运营资源的可用性和儿科管理实践。数据于 2010 年 1 月之前通过安全的网络软件程序（REDCap）收集。
共有 64552 名儿童在 63 个诊所接受护理（AP，N=10；CA，N=4；EA，N=29；SA，N=10；WA，N=10）。大多数在城市环境中（N=41，65%），并获得政府（N=51，81%）、PEPFAR（N=34，54%）和/或全球基金（N=15，24%）的资助。大多数为成人儿科联合诊所（N=36，57%）。有 35 个（56%）地点整合了母婴传播预防措施；89%（N=56）可以进行婴儿诊断的 DNA PCR。非洲（N=40/53）而不是亚洲地点建议母乳喂养至 4-6 个月。定期实验室监测包括 CD4（N=60，95%）和病毒载量（N=24，38%）。尽管 42 个（67%）地点有能力进行抗酸杆菌（AFB）涂片，但只有 23 个（37%）地点可以进行 AFB 培养，18 个（29%）地点可以进行结核病药物敏感性测试。失访定义为 25 个（40%）地点失去联系超过 3 个月，27 个（43%）地点失去联系超过 6 个月，6 个（10%）地点失去联系超过 12 个月。电话（N=52，83%）和外展工作者家访以追踪失访儿童（N=45，71%）是常见的。
总的来说，在这个多区域儿科队列联盟中，有很高的患者和实验室监测水平，这将促进详细的观察性研究。随着世卫组织/艾滋病规划署 2.0 治疗框架的实施，将继续监测这些做法。
