dc.contributor.advisor | http://profiles.uonbi.ac.ke/cgichuhi/publications/performance-integrated-management-childhood-illness-algorithm diagnosis-hiv-1 | |
dc.contributor.author | Diener | |
dc.contributor.author | Slyker, Jennifer | |
dc.contributor.author | Christinei, Gichuh | |
dc.contributor.author | Dalton, Wamalwa | |
dc.contributor.author | Lara, C. | |
dc.contributor.author | Tapia, Kenneth A | |
dc.contributor.author | Richardson, Barbra A. | |
dc.contributor.author | Dalton, Wamalwa | |
dc.contributor.author | Farquhar, Carey | |
dc.contributor.author | Overbaugh, Julie Maleche-Obimbo Elizabeth | |
dc.contributor.author | Maleche-Obimbo, Elizabeth | |
dc.contributor.author | John-Stewart, Grace | |
dc.date.accessioned | 2013-06-07T13:25:58Z | |
dc.date.available | 2013-06-07T13:25:58Z | |
dc.date.issued | 2012 | |
dc.identifier.citation | Performance of the integrated management of childhood illness algorithm for diagnosis of HIV-1 infection among African infants., Diener, Lara C., Slyker Jennifer A., Christine Gichuhi, Dalton Wamalwa, Tapia Kenneth A., Richardson Barbra A., Dalton Wamalwa, Farquhar Carey, Overbaugh Julie, Maleche-Obimbo Elizabeth, and John-Stewart Grace , AIDS (London, England), 2012 Sep 24, Volume 26, Issue 15, p.1935-41, (2012) | en |
dc.identifier.uri | http://profiles.uonbi.ac.ke/cgichuhi/publications/performance-integrated-management-childhood-illness-algorithm-diagnosis-hiv-1 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/30157 | |
dc.identifier.uri | http://journals.lww.com/aidsonline/Fulltext/2012/09240/Performance_of_the_integrated_management_of.10.aspx | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pubmed/22824627 | |
dc.description.abstract | Objectives: Early infant HIV-1 diagnosis and treatment substantially improve survival. Where virologic HIV-1 testing is unavailable, integrated management of childhood illness (IMCI) clinical algorithms may be used for infant HIV-1 screening. We evaluated the performance of the 2008 WHO IMCI HIV algorithm in a cohort of HIV-exposed Kenyan infants. Methods: From 1999 to 2003, 444 infants had monthly clinical assessments and quarterly virologic HIV-1 testing. Using archived clinical data, IMCI sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using virologic testing as a gold standard. Linear regression and survival analyses were used to determine the effect of age on IMCI performance and timing of diagnosis. Results: Overall IMCI sensitivity, specificity, PPV, and NPV value were 58, 87, 52, and 90%, respectively. Sensitivity (1.4%) and PPV (14%) were lowest at 1 month of age, when 81% of HIV infections already had occurred. Sensitivity increased with age (P < 0.0001), but remained low throughout infancy (range 1.4–35%). Specificity (range 97–100%) was high at each time point and was not associated with age. Fifty-eight percent of HIV-1-infected infants (50 of 86) were eventually diagnosed by IMCI, and use of IMCI was estimated to delay diagnosis in HIV-infected infants by a median of 5.9 months (P < 0.0001). Conclusion: IMCI had low sensitivity during the first month of life, when the majority of HIV-1 infections had already occurred and initiation of treatment is most critical. Although sensitivity increased with age, the substantial delay in HIV-1 diagnosis using IMCI limits its utility in early infant HIV-1 diagnosis | |
dc.language.iso | en | en |
dc.publisher | University of Nairobi | en |
dc.title | Performance Of The Integrated Management Of Childhood Illness Algorithm For Diagnosis Of Hiv-1 Infection Among African Infants. | en |
dc.type | Article | en |
local.publisher | School of medicine (Paediatrics) | en |