Prevention & Care of Pediatric HIV Infection in Ouagadougou, Burkina Faso: Knowledge, Attitudes & Practices of the Caregivers

Background

The paediatric Human Immunodeficiency Virus (HIV) epidemic still progresses because of operational challenges in implementing prevention of mother-to-child HIV transmission (PMCT) programs. We assessed the knowledge, attitudes and practices (KAP) of children’s caregivers regarding mother-to-child transmission (MTCT) of HIV, paediatric HIV infection, early infant diagnosis (EID), and paediatric antiretroviral treatment in Ouagadougou, Burkina Faso.

Methods

We undertook a qualitative survey in the four public hospitals managing HIV exposed or infected children, in Ouagadougou in 2011. A sociologist used a semi-structured questionnaire to interview caregivers of children less than 5 years old attending the paediatrics wards on their KAP. Study participants were divided into four groups as follows:

those who did not yet know their children’s HIV infection status, those who were waiting for their children’s HIV test results, those who were waiting for antiretroviral treatment, and those who were already on antiretroviral treatment.

Results

A total of 37 caregivers were interviewed. The mean age was 32.5 years, and 29 (78 %) were mothers. Twenty seven (73 %) caregivers had primary or higher level of education, and 15 (40 %) described their occupation as “housewife”. Overall, 36 (97 %) of caregivers knew that the main route of HIV transmission for infants was through MTCT and 14 (38 %) specified that it occurred during pregnancy or delivery. Five percent thought that MTCT of HIV occurred during conception. PMTCT interventions could help prevent infant HIV infection according to 32 (87 %) caregivers. Thirty five percent of caregivers stated EID as a prevention strategy. Fifty-four percent of the participants believed that replacement feeding option would prevent MTCT of HIV; 24 (65 %) stated that they would prefer medical practitioners seek caregivers’ consent before carrying out any HIV-test for their child, and that caregivers’ consent was not compulsory before antiretroviral treatment. All caregivers thought that it was necessary to treat HIV-infected children, although they did not know what interventions could be done.

Conclusions

This study highlighted the low level of caregivers’ knowledge on paediatric HIV prevention and care in Ouagadougou. Awareness programs targeting caregivers need to be strengthened in order to improve the uptake of HIV early infant diagnosis and care.

Caregivers’ knowledge, attitudes and perceptions in Ouagadougou, Burkina Faso, 2011

	Total N = 37 100 %	Group 1 N = 11 100 %	Group 2 N = 4 100 %	Group 3 N = 5 100 %	Group 4 N = 17 100 %	Groups 1 + 2 + 3 N = 20 100 %	P-value (Group 1 + 2 + 3 vs Group 4)
Caregiver’s knowledge of existing interventions to prevent MTCT of HIV
Yes	30 (81)	7 (64)	4 (100)	3 (60)	16 (94)	14 (70)	0.16
No	1 (3)	0 (0)	0 (0)	1 (20)	0 (0)	1 (5)
No response	6 (16)	4 (36)	0 (0)	1 (20)	1 (6)	5 (25)
Caregiver’s knowledge regarding existing methods of infant HIV diagnosis
Yes	32 (86)	8 (73)	4 (100)	5 (100)	15 (88)	17 (85)	0.77
No	5 (14)	3 (27)	0 (0)	0 (0)	2 (12)	3 (15)
Caregiver’s knowledge regarding existing treatment of HIV-infected infants
Yes	37 (100)	11 (100)	4 (100)	5 (100)	17 (100)		Not applicable
No	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
Caregiver’s attitude regarding the practice of their child systematic HIV testing
For	31 (84)	11 (100)	3 (75)	4 (80)	13 (76)	18 (90)	0.26
Against	6 (16)	0 (0)	1 (25)	1 (20)	4 (24)	2 (10)
Caregiver’s attitude regarding the antiretroviral treatment of HIV-infected children
For	37 (100)	11 (100)	4 (100)	5 (100)	17 (100)	20 (100)	Not applicable
Against	0 (0)	0 (0)	0 (0)	0 (0.0)	0 (0.0)	0 (0)
Parent’s consent needed for child HIV-test
Yes	24 (65)	8 (73)	3 (75)	4 (80)	9 (53)	15 (75)	0.16
No	13 (35)	3 (27)	1 (25)	1 (20)	8 (47)	5 (25)
Parent’s consent needed for child treatment
Yes	11 (30)	6 (55)	0 (0)	1 (20)	4 (24)	7 (35)	0.25
No	24 (65)	4 (36)	3 (75)	4 (80)	13 (76)	11 (55)
No response	2 (5)	1 (9)	1 (25)	0 (0)	0 (0)	2 (10)

Group 1: caregivers of HIV-infected child currently treated with antiretroviral therapy

Group 2: caregivers of HIV-infected child not yet initiated on antiretroviral therapy

Group 3: caregivers waiting for their child’s HIV post-test result

Group 4: caregivers attending paediatric ward, with an unknown HIV child status

Vs versus

Full article at:   http://goo.gl/1Dwg43

By:  Malik Coulibaly, Elisabeth Thio, Caroline Yonaba, Sylvie Ouédraogo, Nicolas Meda, Fla Kouéta, Désiré Lucien Dahourou, Angèle Kalmogho, Mady Gansonré, Diarra Yé, Ludovic Kam, Valériane Leroy, and for the MONOD Study Group*

Projet MONOD, ANRS 12206, Centre de Recherche Internationale pour la Santé, 09 BP 168 Ouagadougou, Burkina Faso

Centre Muraz, Bobo Dioulasso, Burkina Faso

CHU Charles De Gaules, Service de Pédiatrie médicale, Ouagadougou, Burkina Faso

CHU Yalgado Ouédraogo, Service de Pédiatrie, Ouagadougou, Burkina Faso

Inserm U1219, Institut de Santé Publique, Epidémiologie et Développement, Université de Bordeaux, Bordeaux, France

Inserm U1027 Université Paul Sabatier, Toulouse 3, Toulouse, France

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health