PMID- 22789648 OWN - NLM STAT- MEDLINE DCOM- 20121119 LR - 20220331 IS - 1758-2652 (Electronic) IS - 1758-2652 (Linking) VI - 15 Suppl 2 IP - Suppl 2 DP - 2012 Jul 11 TI - Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe. PG - 17404 LID - 10.7448/IAS.15.4.17404 [doi] LID - 17404 [doi] AB - INTRODUCTION: Early diagnosis of children living with HIV is a prerequisite for accessing timely paediatric HIV care and treatment services and for optimizing treatment outcomes. Testing of HIV-exposed infants at 6 weeks and later is part of the national prevention of mother to child transmission (PMTCT) of HIV programme in Zimbabwe, but many opportunities to test infants and children are being missed. Early childhood development (ECD) playcentres can act as an entry point providing multiple health and social services for orphans and vulnerable children (OVC) under 5 years, including facilitating access to HIV treatment and care. METHODS: Sixteen rural community-based, community-run ECD playcentres were established to provide health, nutritional and psychosocial support for OVC aged 5 years and younger exposed to or living with HIV, coupled with family support groups (FSGs) for their families/caregivers. These centres were located in close proximity to health centres giving access to nurse-led monitoring of 697 OVC and their caregivers. Community mobilisers identified OVC within the community, supported their registration process and followed up defaulters. Records profiling each child's attendance, development and health status (including illness episodes), vaccinations and HIV status were compiled at the playcentres and regularly reviewed, updated and acted upon by nurse supervisors. Through FSGs, community cadres and a range of officers from local services established linkages and built the capacity of parents/caregivers and communities to provide protection, aid psychosocial development and facilitate referral for treatment and support. RESULTS: Available data as of September 2011 for 16 rural centres indicate that 58.8% (n=410) of the 697 children attending the centres were tested for HIV; 18% (n=74) tested positive and were initiated on antibiotic prophylaxis. All those deemed eligible for antiretroviral therapy were commenced on treatment and adherence was monitored. CONCLUSIONS: This community-based playcentre model strengthens comprehensive care (improving emotional, cognitive and physical development) for OVC younger than 5 years and provides opportunities for caregivers to access testing, care and treatment for children exposed to, affected by and infected with HIV in a secure and supportive environment. More research is required to evaluate barriers to counselling and testing of young children and the long-term impact of playcentres upon specific health and developmental outcomes. FAU - Patel, Diana AU - Patel D AD - Organisation for Public Health Interventions and Development Trust, 3 Rowland Sq., Milton Park, Harare, Zimbabwe. dpatel@ophid.co.zw FAU - Matyanga, Priscilla AU - Matyanga P FAU - Nyamundaya, Tichaona AU - Nyamundaya T FAU - Chimedza, Delia AU - Chimedza D FAU - Webb, Karen AU - Webb K FAU - Engelsmann, Barbara AU - Engelsmann B LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20120711 PL - Switzerland TA - J Int AIDS Soc JT - Journal of the International AIDS Society JID - 101478566 RN - 0 (Anti-HIV Agents) SB - IM MH - Adult MH - Anti-HIV Agents/*therapeutic use MH - Child MH - Child Day Care Centers MH - Child Development MH - Child, Orphaned MH - Child, Preschool MH - Community Networks MH - Female MH - HIV Infections/*diagnosis/*drug therapy/prevention & control/virology MH - HIV-1/genetics/isolation & purification MH - Humans MH - Infant MH - Male MH - *Rural Health MH - Young Adult MH - Zimbabwe PMC - PMC3499882 EDAT- 2012/07/14 06:00 MHDA- 2012/12/10 06:00 PMCR- 2012/07/11 CRDT- 2012/07/14 06:00 PHST- 2011/12/12 00:00 [received] PHST- 2012/05/16 00:00 [accepted] PHST- 2012/07/14 06:00 [entrez] PHST- 2012/07/14 06:00 [pubmed] PHST- 2012/12/10 06:00 [medline] PHST- 2012/07/11 00:00 [pmc-release] AID - 17404 [pii] AID - 10.7448/IAS.15.4.17404 [doi] PST - epublish SO - J Int AIDS Soc. 2012 Jul 11;15 Suppl 2(Suppl 2):17404. doi: 10.7448/IAS.15.4.17404.