Assessing HIV Treatment Outcomes for Children in Tanzania

HIV/AIDS is a major health issue worldwide, particularly in sub-Saharan Africa. This region has the highest number of people affected by HIV, especially children. In 2020, around 1.8 million children aged 0-14 were living with HIV globally, with many new infections occurring that same year. Tanzania is no exception and faces its own challenges with HIV among children and adults.

#HIV in Tanzania

In Tanzania, approximately 110,000 children aged 0-14 were living with HIV at the end of 2020. There were also about 1.6 million adults affected by the virus. New infections among children were still occurring, highlighting the need for effective treatment options. Fortunately, a significant portion of children living with HIV in Tanzania is receiving antiretroviral therapy (Art), a treatment that helps manage the virus.

#Treatment Landscape

The National AIDS Control Programme (NACP) in Tanzania is working hard to provide quality HIV care and treatment across the country. Many health facilities, including public and private hospitals, have started offering ART. By late 2018, over 6,000 health facilities were providing care and treatment for those living with HIV.

#Goals for Treatment

Tanzania has set ambitious goals for HIV treatment. By 2022, all children living with HIV under 15 should start ART, with a target of keeping 90% of them on treatment. The focus is also to ensure that 95% of adolescents living with HIV are retained on ART. Effective treatment is essential for long-term health, and Viral Suppression is a key goal.

#UNAIDS Targets

Global targets set by the United Nations aim to eliminate HIV by 2030. These include diagnosing 95% of those infected, treating 95% of diagnosed people, and achieving viral suppression in 95% of those treated. However, there are challenges, especially for children and adolescents, in accessing and adhering to treatment, which affects the success of these goals.

#Access to Treatment

Access to ART has improved for adults more than for children. This is largely due to the challenges in developing appropriate treatment options for younger patients. Dolutegravir (DTG) is a newer medication used to treat HIV and has been recommended for children aged 6 and up or those weighing at least 20 kg. Children under this weight use different Treatments until they can transition to DTG.

#Study Rationale

Given the benefits of DTG, there is a need to assess how effective this treatment is for children and adolescents in Tanzania. Previous studies have indicated varying levels of treatment success across different regions. Therefore, studying the outcomes of DTG-based therapies among children in Tanzania is essential.

#Study Design

The study analyzed data from children and adolescents receiving DTG in Tanzania between January 2019 and December 2021. It focused on those aged 1 to 19 years who were receiving treatment and had been on ART for at least six months.

#Study Population

A total of 230,310 children and adolescents living with HIV in Tanzania were tracked during the study period. Of these, around 96,648 were on a DTG-based regimen. After applying exclusion criteria, the final number of participants was 63,453.

#Data Collection

The study used data from health facilities involved in HIV care, ensuring proper permission was obtained to access patient information. Finding ways to keep data private and confidential was also prioritized.

#What was Measured?

The main goal was to determine the level of viral suppression among participants, defined as having a viral load of less than 1,000 copies/ml. Various factors like age, gender, clinical stages, and treatment history were also analyzed to see how they impacted treatment outcomes.

#Results

Among the children and adolescents on a DTG-based regimen, 91.64% achieved viral suppression. This high rate indicates that the treatment is quite effective. Notably, individuals who were new to ART had a higher success rate compared to those who had been previously treated.

#Factors Impacting Success

Several factors were found to influence treatment success. Females were slightly more likely to achieve viral suppression than males. Children who were ART naïve at the start of DTG had better outcomes compared to those who had been on treatment before. Additionally, those who had received multi-month prescriptions were more likely to succeed.

#Age Matters

The age of participants played a role in treatment success. Younger children, particularly those aged 1-4 years, were more likely to achieve viral suppression compared to older children and adolescents. This difference suggests that younger patients may face fewer barriers in adhering to treatment.

#Treatment Duration

Another critical factor was the duration of ART. Those on treatment for less than 24 months had better rates of viral suppression compared to those on treatment for more than two years. This finding aligns with evidence suggesting that early and consistent treatment leads to better health outcomes.

#Retention in Care

Staying connected to healthcare services was essential for achieving viral suppression. Participants who had regular follow-ups were more likely to maintain their health than those who dropped out of care. This emphasizes the importance of ongoing support for young patients living with HIV.

#Nutritional Status

Nutrition also played a role in treatment outcomes. Those with nutritional issues had lower rates of viral suppression, indicating that overall health and well-being impact the effectiveness of HIV treatment.

#Conclusion

The findings of this study are encouraging for the future of HIV treatment in Tanzania. High rates of viral suppression among children and adolescents on DTG suggest that this medication is a strong option for managing HIV. However, the study also highlights areas for improvement.

#Recommendations

To improve outcomes, it is recommended that all children living with HIV who are not responding well to current treatments should consider switching to DTG-based therapies, if appropriate. The benefits observed in this study, particularly among younger and treatment-naïve patients, point to the need for widespread adoption of DTG where feasible.

#Future Directions

Further research is needed to understand the long-term effects of DTG, especially regarding weight gain and overall health. Continuous monitoring and support for children and adolescents living with HIV is crucial, as well as ensuring that those who need treatment receive it in a timely manner.

#Closing Thoughts

This study sheds light on the status of HIV treatment among children and adolescents in Tanzania. With proper treatment, support, and a focus on nutritional health, it is possible to improve the lives of those living with HIV, paving the way for healthier futures.