|dc.description.abstract||Background: Paediatric HIV infection is
a growing health challenge, especially in
sub-Saharan Africa. Most paediatric HIV
infections are perinatally transmitted. Early
Infant Diagnosis (EID) and immediate
initiation of treatment minimizes deaths.
Though EID services are widely available
in Kenya, uptake remains low, especially
in disadvantaged communities.
Objectives: To evaluate determinants of
EID and early treatment initiation among
HIV exposed children from informal
settlements in Nairobi, Kenya.
Methodology: A descriptive cross
sectional study was done; where HIV
infected mother-infant pairs attending
health care facilities were recruited.
Consent was sought. Non-biological
caretakers were excluded. Structured
questionnaires were administered to obtain
information on socio-demographics,
knowledge and uptake ofEID, Prevention
of Mother to Child Transmission (PMTCT)
and Antiretroviral (ARV) therapy.
Results: A total of 238 mother-infant
pairs were interviewed. Majority, (69.2%)
were aged below 30 years, 75% had
below secondary level of education,
67.6% were married, and 71.4% were of
poor social backgrounds. Most (77.4%)
had HIV diagnosis made in the preceding
year, 68.5% of them during pregnancy.
Knowledge on importance of EID was
poor, and only 53.8% had knowledge of
PMTCT interventions. Only 38.7% had
received ARV prophylaxis in pregnancy,
while 37.4% were on ARV therapy.
Majority, (63.5%) had delivered in a
health facility, but only 56.7% had EID at 6
weeks. While 19.7% of infants tested HIV
positive, only 10.6% of infected infants
were started on treatment immediately.
The main determinants of EID at 6 weeks
were maternal delivery at a public health
74 East and Central Africa Medical Journal 2015; 2: 74-79
facility (p = 0.000, bR 0.171, CI 0.065- 0.451),
receiving of psychosocial support (P = 0.000,
OR 0.173, CI 0.075- 0.398), high matemaI
knowledge on PMTCT (p =0.001), mothers
on ARV therapy (P= 0.017, OR 0.284,
CI 0.101- 0.795) and mother on ARV
prophylaxis (p = 0.020, OR 0.306173,
CI 0.113- 0.830). Factors associated with
early initiation of treatment were delivery
in public health (P=O.005) and receiving
of psychosocial support (P=O.OOO).
Conclusion: Knowledge of on PMTCT
and EID was low, and this lead to low EID
uptake. We recommend integration of
PMTCT and paediatric HJV care services
to MNCH settings.||en_US