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
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
