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YOUTH ALIVE UGANDA

Authors:

Kimutai Emmanuel Charles

Adrian Kalemeera

James Byarugaba

Rose Nalubega

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Enhancing viral load suppression among children and adolescents <15yrs: �

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Optimizing daily observed treatment and support (DOTS) at Mayuge HCIV in East Central (EC) region of Uganda.

Leaders in integrated youth development programs

Rainbow Towers Hotel & Conference Centre Harare-Zimbabwe

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December 05, 2023

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The suppression Challenge:

Effective management of HIV infection in children and adolescents is crucial to ensure optimal health outcomes and prevent disease progression

Children and adolescents living with HIV (CALHIV) face unique challenges in achieving optimal viral suppression due to various factors

Medical adherence difficulties

Developmental transitions

The Region’s performance for children and adolescents (0-19yrs) on viral suppression stagnated at 79% in September 2022 below the 95% UNAIDS target

VLS 72%

Psychosocial issues

Dependency on caregivers for their medication

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Observed Results

What was done

1. Identification of DOTs Providers

Mayuge health center was supported to identify caregivers with CALHIV who were stable on antiretroviral therapy (ART) to train on HIV case management.

2. Trained identified Caregivers

Caregivers were trained on adherence to ART, proper medication administration, understanding viral load test results, recognizing signs of treatment failure, and promoting a healthy and stigma-free environment within households.

The caregivers of these children were called for a meeting to consent to peer support and household visits.

3. Consent and buy in

4. Attachment

The caregivers were assigned to household based on their proximity to conduct Directly Observed Therapy and support (DOTS) for CALHIV with non-suppressed viral loads below 15 years.

Line listing from clinical records

Free prior and informed Consent

MoH guidelines and tools

Community Peer to Peer support

22/24 non-suppressed CALHIV enrolled on DOTS improved adherence scores significantly from 82% to 97%

overall viral load suppression among children and adolescent below 15 years at Mayuge health center IV from 72% to 93% progressively

Strengthened Community involvement and response: Communities at the forefront

enabled early identification of potential side effects and complications, facilitating timely interventions and minimizing treatment interruptions.

  • DOTS optimizes adherence to ART and addresses psychosocial barriers through minimized risk of missed/incomplete doses thus reducing the likelihood of viral replication and the development of drug-resistant strains.
  • DOTS enabled early identification of potential side effects/complications thereby facilitating timely interventions and minimizing treatment interruptions.

LESSONS LEARNT

  • caregivers with stable HIV positive children and adolescents are engaged to provide home based care including directly observing treatment uptake
  • The DOTS hinges on strategic direction of strengthening peer to peer support at community level.

CAGDOTS

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Thank you!

Tatenda!

Siyabonga!

Asante!

Merci!

Gracias!

Leaders in integrated youth development programs

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