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Provider Initiated HIV Screening for Children Attending Nutritional Ward in KTH

Provider Initiated HIV Screening for Children Attending Nutritional Ward in KTH. Operations research proposal Presented by Tamadur Elnour Elsadig Pediatrician, KTH, Khartoum ,Sudan. Background. Sudan Demographics. Population 40,218,456 (July 2008 est.) Age structure

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Provider Initiated HIV Screening for Children Attending Nutritional Ward in KTH

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  1. Provider Initiated HIV Screening for Children Attending Nutritional Ward in KTH Operations research proposal Presented by Tamadur Elnour Elsadig Pediatrician, KTH, Khartoum ,Sudan Cape Town 17/07/09

  2. Background Cape Town 17/07/09

  3. Sudan Demographics • Population 40,218,456 (July 2008 est.) • Age structure 0-14 years: 41.1% (male 8,451,576/female 8,093,609) 15-64 years: 56.4% (male 11,407,233/female 11,275,685) 65 years and over: 2.5% (male 518,822/female 471,530) (2008 est.) Cape Town 17/07/09

  4. Population growth rate 2.134% (2008 est.) • Birth rate 34.31 births/1,000 population (2008 est.) • Death rate 13.64 deaths/1,000 population (2008 est.) • Infant mortality rate total: 86.98 deaths/1,000 live births male: 87.09 deaths/1,000 live births female: 86.86 deaths/1,000 live births (2008 est.) Cape Town 17/07/09

  5. HIV/AIDS in Sudan • HIV/AIDS - adult prevalence rate 2.3% (2001 est.) • HIV/AIDS - people living with HIV/AIDS 400,000 (2001 est.) • HIV/AIDS - deaths 23,000 (2003 est.) Cape Town 17/07/09

  6. The worldwide magnitude of protein-energy malnutrition • The findings confirm that more than a third of the world's children are affected. For all the indicators (wasting, stunting, and underweight) in Asia most countries have high or very high prevalence's; and in Africa a combination of both these circumstances is found.( Bulletin of the World Health Organization 1993;71:703-120) Cape Town 17/07/09

  7. Malnutrition in Sudan • In Sudan, 18% of children aged under 5 suffer from acute malnutrition (wasting) and 48% are chronically malnourished (stunted), according to WHO data. • Malnutrition wards in paediatrics hospitals are the busiest wards with the longest duration of hospital stay. • Malnourished children have high incidence of TB infection compared to other children Cape Town 17/07/09

  8. Although TB is highly stigmatized disease, but routine TB screening in nutritional wards is reasonably accepted • Increasing epidemic of TB/HIV co-infection globally • Providing HIV screening to all severely malnourished my help as a tool to increase families and community utilization of VCT services Cape Town 17/07/09

  9. Objectives • To determine the incidence of HIV infection among severely malnourished children • To determine the incidence of TB infection among HIV infected malnourished children. Cape Town 17/07/09

  10. Research Team • One paediatrician as principal investigator • Two medical officer to conduct questionnaires filling and physical examinations • Two counsellors • One nutritionist • One nurse for blood collection • Two laboratory technicians to do the investigation • Data analyst Cape Town 17/07/09

  11. Methods • This will be a cross sectional, prospective, hospital based case series study. • Population include all children age less than 5 years with diagnoses of severe malnutrition using WHO ZD – score weight for height classification attending paediatrics' nutritional wards in Khartoum Teaching Hospital during a period of six month • Data will be collected using a questionnaire for base line data collection. A full physical examination of each child Cape Town 17/07/09

  12. Investigations include: HIV rapid test, TB screening &CBC for all children; CD4 count and percentage for those who found to be HIV infected , other investigation will be done according to individual needs of each child • The data were analyzed using Statistical Package for Scientific Studies (SPSS 11.0) computer program. • Nutritional analysis, using Epi info computer program Cape Town 17/07/09

  13. Impact • If the results of the study show high incidence of HIV among those hospitalized children this will leads to consideration of the concept of provider initiated VCT and this can lead to large implementation in different departments of the hospital like the surgical and obstetrics & gynaecological department and this in the long term can lead to increase community acceptance of HIV -VCT. Cape Town 17/07/09

  14. Cost • The cost includes the cost research preparation, of investigations for the children, the incentives for the study team, and for data analysis and processing this estimated roughly as about 10.000 $. Cape Town 17/07/09

  15. Cape Town 17/07/09

  16. Malnutrition in Sudan Cape Town 17/07/09

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