Abstract
Objective
To test the ability and to identify unique criteria in a Modified Integrated Algorithm developed by Indian Council of Medical Research (ICMR) to detect HIV infection among sick children 0 to 14 years, seeking care in a health care facility.
Design
Facility based cross-sectional survey.
Setting
Four talukas of Belgaum District, Karnataka, India during 2013–2014.
Patients
Sick children 0–14 years seeking care at healthcare facilities in the study area.
Procedure
A total of 10 health care facilities were selected using specific criteria. Trained health care providers in these facilities used the WHO generic Integrated Management of Childhood Illnesses screening algorithm for HIV, applicable for children to 0–5 years and ICMR modified integrated algorithm for >5–14 years, to screen and test children for HIV, when they sought care in these facilities.
Main Outcome measure
Prevalence of HIV in children screened positive by the Modified Integrated Algorithm.
Results
Of the total 33342 children who visited the 10 health care facilities, 24342 were screened by the physician. Of the 527 screened positive sick children with suspected signs/symptoms, 509 consented and were tested with age appropriate HIV testing. 97 children tested positive (HIV prevalence 19.1%: 5% in <5yrs and 28% in ≥5–14 years). The result of Classification and Regression Tree and logistics regression consistently identified parents with HIV and orphan child, as important predictor of HIV infection.
Conclusion
ICMR Modified integrated algorithm may be used as a screening tool in the public and private health care facilities to increase case detection of pediatric HIV.
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Funding
Funding: Indian Council of Medical Research.
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Contributions
Contributor: AS: coordinated the study, conceived the idea, wrote the proposal, monitored study implementation, contributed to statistical analysis, provided critical inputs to the manuscript and approved it; RW and RS were responsible for obtaining and field level compliance for ethics, regulatory and financial approvals, study implementation, data collection, and provided inputs for revising the manuscript; PV: conducted advanced statistical analyses, contributed to the manuscript, reviewed and revised the manuscript; RSP: conducted data analyses, reviewed the draft manuscript; and SI was responsible for regular guidance and support, reviewed the manuscript.
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Sinha, A., Washington, R., Sethumadhavan, R. et al. Modified Integrated Algorithm for Detection of HIV Among Sick Children Aged 0–14 Year Seeking Care at Healthcare Facilities in India. Indian Pediatr 57, 631–635 (2020). https://doi.org/10.1007/s13312-020-1891-x
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DOI: https://doi.org/10.1007/s13312-020-1891-x