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6th International AIDS Society Conference<br />Better Diagnostics Are Needed to Achieve an AIDS-Free Generation<br />UNITA...
Percentage of pregnant women living with HIV receiving ARVs for PMTCT 2005, 2008 and 2009<br />
Distribution of antiretroviral regimens provided to pregnant women, in 2007 (59 countries) and 2009 (86 countries)<br />
Paediatric HIV Treatment<br />In 2009, about 356,400 children under 15 received antiretroviral treatment, an increase from...
Ideally, this would be done as soon after delivery as possible.
Developing a test that would do this is one of UNICEF and partners’ top goals.
EID can also be routine during 6-week immunization visits, hospital admissions or as part of family-based care for parents...
Expanding CD4 Testing  in low-level facilities<br /><ul><li>Compelling argument for investing low cost technologies to bri...
Zimbabwe is working on a national approach to scale  up point of care CD4 machines.</li></li></ul><li>Low utilization EID ...
8<br />Maximizing Impact of Early Infant Diagnosis<br />BOTTLENECK: Less than 1/3 of infants tested for HIV at birth recei...
10<br />RESULT: increased # of children correctly identified and enrolled to receive treatment <br />Benefits<br /><ul><li...
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Better Diagnostics Are Needed to Achieve an AIDS-Free Generation

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Presentation at the IAS 2011 conference on 18 July 2011 by Jimmy Kolker, UNICEF.

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Better Diagnostics Are Needed to Achieve an AIDS-Free Generation

  1. 1. 6th International AIDS Society Conference<br />Better Diagnostics Are Needed to Achieve an AIDS-Free Generation<br />UNITAID Satellite Event<br />18 July 2011<br />Jimmy Kolker<br />Chief, HIV/AIDS Section <br />UNICEF Programme Division<br />New York<br />
  2. 2. Percentage of pregnant women living with HIV receiving ARVs for PMTCT 2005, 2008 and 2009<br />
  3. 3. Distribution of antiretroviral regimens provided to pregnant women, in 2007 (59 countries) and 2009 (86 countries)<br />
  4. 4. Paediatric HIV Treatment<br />In 2009, about 356,400 children under 15 received antiretroviral treatment, an increase from only 75,000 in 2005.<br />However, this is only 28% of the 1.27 million childrenin need of ART under the new guidelines are receiving it.<br /><ul><li>The key entry point is widespread testing of HIV-exposed newborns.
  5. 5. Ideally, this would be done as soon after delivery as possible.
  6. 6. Developing a test that would do this is one of UNICEF and partners’ top goals.
  7. 7. EID can also be routine during 6-week immunization visits, hospital admissions or as part of family-based care for parents and older children.</li></li></ul><li>Point of Care Diagnostics in PMTCT and Paediatric Care and Treatment<br />POC assays hold promise to help expand ART to lower-level clinics and reach the unreached<br />This is especially important for access to HAART for pregnant women (CD4) and infants (EID)<br />POC assays are not a solution alone to the poor follow-up of mothers and infants<br />The goal is to strengthen access to and quality of the needed continuum of care<br />
  8. 8. Expanding CD4 Testing in low-level facilities<br /><ul><li>Compelling argument for investing low cost technologies to bring CD4 screening in less capacitated ANC facilities to treat more pregnant mothers with ART.
  9. 9. Zimbabwe is working on a national approach to scale up point of care CD4 machines.</li></li></ul><li>Low utilization EID testing at lower-level clinics:15% of EID sites in Namibia collected >93% of all samples<br />
  10. 10. 8<br />Maximizing Impact of Early Infant Diagnosis<br />BOTTLENECK: Less than 1/3 of infants tested for HIV at birth receiving treatment after one year<br />Without investment through the entire follow-up continuum, the maximum impact of Early Infant Diagnosis (EID) will not be realized.<br />48%<br />131<br />76%<br />34%<br />68<br />29%<br />45<br />32<br />Receive Results<br />HIV+ infants<br />Enrolled in counseling & treatment <br />Infants still active after 1 year<br />Of those who enroll in HIV services, almost 1/3 are no longer tracked at the site.<br />48% of HIV+ infants never received results. Several died prior to receiving results. Not all infants were on CTX.<br />Follow up of infants testing HIV+ Jinia Regional Hospital, Zambia <br />Jan 1, 2008 – December 1, 2009<br />
  11. 11.
  12. 12. 10<br />RESULT: increased # of children correctly identified and enrolled to receive treatment <br />Benefits<br /><ul><li>Speed – Wait time for results is cut in half
  13. 13. Cost – No SMS cost for clinic staff
  14. 14. Scale – Easier scalability using clinic staff’s own phones
  15. 15. Reporting – Web portal provides national view of clinic’s DBS usage</li></li></ul><li>Aggregated Web Reports<br />
  16. 16. Investing in diagnostics in eMTCT and Paediatric care<br />Assess where there is the greatest unmet need<br />Involve providers and clients to assess key bottlenecks <br />Identify evidence-informed solutions and investments<br />Scale-up priority intervention as component of MNCH services<br />HIV testing and counseling<br />CD4 and ARVS including ART for HIV positive pregnant wowen<br />Early Infant Diagnostic technologies and supportive system responses such as SMS <br />

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