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Pediatric HIV/AIDS

Background

Working in partnership with the Federal Ministry of Health (FMOH), HIV/AIDS Prevention and Control Office (HAPCO), and Regional Health Bureaus (RHBs), Columbia University (CU)-ICAP supports comprehensive HIV/AIDS services at hospitals in the Oromia, Somali, Harari, and Dire Dawa regions of Ethiopia. CU-ICAP, with PEPFAR funding through CDC-Ethiopia, provides comprehensive support for all HIV/AIDS-related activities at 42 hospitals and selected health centers, with the overarching goals of quality service delivery and capacity building. This includes infrastructure development, training and supportive supervision of multi-disciplinary teams, assistance with laboratory, pharmacy and medical records, and establishment of systems to enhance enrollment, follow-up, and adherence. CU-ICAP’s regionalized technical assistance model enables ongoing site-level presence, intensive hands-on mentoring, and the effective transfer of clinical and programmatic skills.


Pediatric HIV/AIDS in Ethiopia

In Ethiopia, an estimated 134,000 children under age 15 are living with HIV/AIDS; in 2006, approximately 30,000 babies were born with HIV. Very few infants and children have access to the care and treatment services they need in order to survive. While 43,000 are eligible for anti-retroviral therapy (ART), only 3,000 (7%) initiated ART as of the end-2006. In January 2006, FMOH and CU-ICAP conducted the first annual Ethiopian pediatric HIV/AIDS situational analysis, which revealed that the care and treatment of HIV-exposed and HIV-infected infants and children posed serious challenges to Ethiopian policy makers, program managers, and clinicians. Findings of the analysis indicated:

The situational analysis findings and recommendations were used to develop a national agenda, supported by ICAP in partnership with FMOH/HAPCO.

CU-ICAP is engaging in activities at the national, regional, and site levels to support pediatric HIV/AIDS prevention, care, and treatment.

National and Regional Support

CU-ICAP provides comprehensive technical assistance to support the FMOH and RHBs to develop and implement a coordinated, comprehensive, and systematic pediatric care and treatment program. To support this work, ICAP-Ethiopia seconded a pediatric HIV/AIDS expert to work at the FMOH and led the formation of Ethiopia’s national Pediatric HIV/AIDS Care and Treatment Technical Working Group. CU-ICAP also provided expert guidance in the formation of national guidelines, policies, training curricula, and support tools for pediatric HIV/AIDS, as detailed below.

National Situational Analysis & Conference

Representatives of the Government of Ethiopia, national and international HIV/AIDS experts, children’s organizations and private donors met in January, 2006 in Addis Ababa to develop recommendations to expand access to pediatric HIV/AIDS care and treatment. The 2nd Annual Pediatrics Conference will take place April 12-13, 2007 in Addis Ababa.

Training

• Development of a two-day pediatric care and treatment training course, which has been incorporated into the national basic ART
training curriculum;
• In cooperation with other USG-funded partners, integrating pediatric HIV/AIDS care and treatment into pre-service training curricula;
• Regional and site-level training in DNA PCR using dried blood spots (DBS);
• Training on pediatric care and treatment for members of RHB HIV/AIDS teams;
• Partnership with the Ethiopian Pediatrics Society to sponsor annual continuing medical education workshops on pediatric HIV/AIDS for
all members;
• Support for multi-disciplinary care teams to participate in South-to- South advanced pediatric care and treatment training at Stellenbosch
University in Cape Town, South Africa.

Early Infant Diagnosis

In partnership with the Ethiopian Health and Nutrition Research Institute (EHNRI), the FMOH, and CDC-Ethiopia, CU-ICAP is supporting the national roll-out of infant HIV diagnosis services throughout Ethiopia using DNA PCR with dried blood spot technology. CU-ICAP is supporting renovations of regional laboratories to enable DNA PCR testing, training health workers, providing supportive supervision at sites, and implementing systems and standards for sample collection and management.

Guidelines and Materials

In collaboration with the FMOH and other partners, CU-ICAP has developed:

• A “minimum package” of pediatric HIV/AIDS care and treatment services for hospitals and health centers;
• Stand-alone national pediatric care and treatment guidelines;
• Additions to national pMTCT and HIV counseling and testing guidelines;
• Pediatric intake and follow-up forms for national use;
• A national infant HIV diagnosis algorithm and registers;
• A pediatric HIV/AIDS care and treatment pocket guide;
• A pediatric ART dosing guide;
• Desktop pediatrics reference calendar and posters on clinical staging;
• A pediatric training curriculum;
• A pediatric HIV/AIDS website for use in Ethiopia (www.columbia-icap.org/ethiopia).


Pediatric HIV/AIDS Resources

Columbia's International Center for AIDS Care and Treatment Programs (ICAP) has developed an extensive library of pediatric HIV/AIDS resources, including the Pediatric Clinical Manual, training materials and support tools, available here. We also provide links to resources and tools from other organizations (see below). If you would like to suggest additional resources or links, please email us at icap@columbia.edu.

ICAP clinical resources and tools
File Date Format Size
Pediatric HIV/AIDS Care & Treatment Pocket Guide (DRAFT) 2006* PDF 1.2 MB
The Columbia Clinical Manual: Pediatrics 2005* PDF 1.47 MB
Pediatric dosing guide 2006 PDF 114 KB
Pediatric care flowsheet 2004 Word 435 KB
Pediatric patient care forms: Infant HIV test results 2004 PDF 48 KB
Pediatric patient care forms: enrollment 2004 PDF 181 KB
ICAP-Ethiopia family enrollment form 2007 PDF 100KB
Pediatric patient care forms: follow up 2004 PDF 145 KB
Pediatric cotrimoxazole dosing card 2006 PDF 238 KB
Pediatric visit schedule (handout) 2005 PDF 19.5 KB
Practical tips for medication administration for infants & children 2005 PDF 27 KB
Developmental milestones 2005 Word 32.5 KB
*Revisions expected in 2007
Clinical resources and tools from other organizations
ICAP cannot accept responsibility for content of non-ICAP files
File Date Format Size
Pediatric growth charts from the US CDC 2006 PDF 555 KB
WHO Growth Charts 2006 PDF 515 KB
WHO cotrimoxazole guidelines 2006 PDF 984 KB
WHO pediatric guidelines 2006 PDF 1.1 MB
WHO TB guide for children 2006 PDF 788 KB
WHO peds pocket book 2006 PDF 7.8 MB
US Pediatric ARV Guidelines 11/06 PDF 4.42 MB
Revised WHO clinical pediatric staging (handout) 2005 Word 29 KB
US Perinatal Guidelines 11/05 PDF 1.73 MB
ANECCA Handbook on Paediatric HIV in Africa 2004 PDF 2.87 MB
HIV InSite database of antiretroviral drug interactions website
ICAP training resources
File Date Format Size
Baseline pediatric training curriculum: Ethiopia (participants manual) 2006 PDF 3.88 MB
Baseline pediatric training curriculum: Ethiopia (trainers manual) 2006 PDF 3.23 MB
Introduction to the ICAP Ethiopia pediatric training 2006 PowerPoint 1.05 KB
Infant diagnosis: lecture 2006 PowerPoint 8.62 KB
Infant diagnosis: case studies 2006 PowerPoint 2.01 MB
Care of the HIV-exposed infant 2006 PowerPoint 3.20 MB
Care of the HIV-infected child 2006 PowerPoint 7.7 KB
Cotrimoxazole prophylaxis 2006 PowerPoint 917 KB
Pediatric antiretroviral treatment: lecture 2006 PowerPoint 6.8 KB
Pediatric antiretroviral treatment: case studies 2006 PowerPoint 1.3 KB
Pediatric adherence 2006 PowerPoint 303 KB
Pediatric disclosure 2006 PowerPoint 220 KB
Training resources from other organizations
ICAP cannot accept responsibility for content of non-ICAP files
File Date Format Size
Baylor HIV Curriculum for the Health Professional 2006 PDF 11.1 MB
Baylor chapter on common illnesses in children 2006 PDF 148 KB
Baylor chapter on growth and development 2006 PDF 178 KB
Case studies from Baylor website
Pictoral atlas from Baylor website
Baylor primer on pill swallowing website
United States pediatric treatment guidelines 2005 (DHHS) 11/05 PowerPoint 338 KB
DHHS pain management slides 3/05 PowerPoint 149 KB
DHHS adverse effects slides 3/05 PowerPoint 177 KB
FHI HIV/AIDS Care and Treatment course: Module A3 "Special Issues in Managing Women and Children with HIV Disease" 12/04 PDF 89 KB
I-TECH Tambaram Nurses curriculum: ARVs in Children 10/04 PowerPoint 8.65 MB

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