An urgent need for a paradigm shift in HIV testing for older children: A sine qua non condition to achieve an AIDS-free generation
Bibliographic record
Abstract
Abstract Background Achieving an AIDS-free generation requires effective pediatric testing and treatment services. While pediatric HIV testing has been more focused on children below 18 months through PMTCT, the yield of this approach remains unclear comparatively to testing children above 18 months through routine PITC. This study aimed at bridging this evidence gap and provide knowledge to guide pediatric HIV testing investments. Materials and Methods Parents visiting or receiving HIV care in three hospitals in Cameroon were invited to test their children for HIV. HIV testing was done using PCR and antibody rapid tests for children < 18 months and those ≥18 months, respectively. We compared HIV case detection and ART initiation between the two subgroups of children and this using Chi-square test at 5% significant level. Results A total of 4079 children aged 6 weeks-15 years were included in the analysis. Compared to children < 18 months, children group ≥18 months was 4-fold higher among those who enrolled in the study (80.3% vs 19.7%, p<0.001); 3.5-fold higher among those who tested for HIV (77.6% vs 22.4%, p<0.001); 6-fold higher among those who tested HIV+ (85.7% vs 14.3%, p=0.241) and 11-fold higher among those who enrolled on ART (91.7% vs 8.3%, p< 0.028). Conclusions Our results show that 4 out of 5 children who tested HIV+ and over 90% of ART enrolled cases were children ≥ 18 months. Thus, while rolling out PCR HIV testing technology for neonates and infants, committing adequate and proportionate resources in antibody rapid testing for older children is a sine quo none condition to achieve an AIDS-free generation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".