Parental and child-level predictors of HIV testing uptake, seropositivity and treatment initiation among children and adolescents in Cameroon
Notice bibliographique
Résumé
BACKGROUND: There is a growing body of evidence positioning targeted provider-initiated testing and counselling (tPITC, also known as index case testing) as a promising HIV case-finding and linkage strategy among children and adolescents. However, the effectiveness and efficiency of this strategy is limited by low HIV testing uptake and case detection rates. Despite this fact, there is very little literature on factors associated with HIV testing uptake, HIV seropositivity and ART-enrolment in tPITC implementation among African children. This study aims to bridge this information gap and contribute in improving the effectiveness and efficiency of tPITC among children and adolescents in Cameroon and beyond. METHODS: In three ART clinics where tPITC was previously inexistent, we introduced the routine implementation of this strategy by inviting parents living with HIV/AIDS in care to have their biological children (6 weeks-19 years) HIV-tested. Children of consenting parents were HIV-tested; those testing positive were enrolled on ART. Parental and child-level characteristics associated with HIV testing uptake, seropositivity and ART-enrollment were assessed using bivariate and multivariate regression analysis at 5% significance level. RESULTS: We enrolled 1,236 parents, through whom 1,990 children/adolescents were recruited for HIV testing. Among enrolled parents, 46.2% (571/1,236) had at least one child tested, and 6.8% (39/571) of these parents had at least one HIV-positive child. Among enrolled children/adolescents, 56.7% (1,129/1,990) tested for HIV and 3.5% (40/1129) tested HIV-positive. Parental predictors of HIV testing uptake among children/adolescents were sex, occupation and duration on ART: female [aOR = 1.6 (1.1-2.5)], office workers/students [aOR = 2.0 (1.2-3.3)], and parents with ART duration > 5 years [aOR = 2.0 (1.3-2.9)] had significantly higher odds to test a child than male, farmers/traders, and parents with ART duration < 5 years respectively. The only child-level predictor of testing uptake was age: children < 18 months [aOR = 5(2-10)] had significantly higher odds to test for HIV than adolescents > 15 years. Parents of children identified as HIV-positive were more likely to be female, aged 40-60 years, farmers/traders, widows/divorcees and not on ART. Children found HIV-positive and who were ART-enrolled were more likely to be female and aged 5-9 years. However, none of the above-mentioned associations was statistically significant. CONCLUSIONS: Parents who were male, farmers/traders, and on ART for ≤ 5 years were less likely to test their children for HIV. Also, adolescents 10-19 years old were less likely to be tested. Therefore, these groups should be targeted with intensive counseling and follow-up to facilitate optimal testing uptake. No association was found between parental or child-level characteristics and HIV seropositivity among tested children. This finding prompts for further research to investigate approaches to better identify and target HIV testing to children/adolescents with the highest likelihood of HIV seropositivity. CLINICAL TRIAL REGISTRATION: Reg: CinicalTrials.gov # NCT03024762.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».