Original Research

How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa

Michael Christie, Ahmad Haeri Mazanderani, Gayle Sherman, Ute Feucht
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1557 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1557 | © 2024 Michael Christie, Ahmad Haeri Mazanderani, Gayle Sherman, Ute Feucht | This work is licensed under CC Attribution 4.0
Submitted: 08 December 2023 | Published: 20 May 2024

About the author(s)

Michael Christie, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria, South Africa
Ahmad Haeri Mazanderani, Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; and Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Gayle Sherman, Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; and Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Ute Feucht, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria, South Africa

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted paediatric HIV services across South Africa. Shortly before COVID-19, updated national HIV guidelines were released.

Objectives: This study describes COVID-19’s impact on paediatric HIV services in Tshwane District, South Africa.

Method: A retrospective review of National Institute for Communicable Diseases and District Health Information System data for Tshwane District from April 2019 to March 2022. Data included: Early Infant Diagnosis (EID), HIV viral load (VL) and CD4 monitoring and HIV management among children (< 15 years) living with HIV (CLHIV). Pre-pandemic (2019/2020) and pandemic periods (2020/2021, 2021/2022) were compared.

Results: Year-on-year, HIV testing improved at 10 weeks, 6 months, and 18 months, whereas birth testing decreased. HIV EID case rates were 485 (2019/2020), 410 (2020/2021) and 454 (2021/2022). HIV EID test positivity was 0.77% – 1.2%. Antiretroviral treatment initiation declined from 2019/2020 to 2020/2021, but improved in 2021/2022.

Initial HIV VL and CD4 testing declined, with HIV VL testing increasing in 2021/2022, and CD4 testing further declining. HIV VL suppression rate among CLHIV ranged from 69% to 73%.

Conclusion: Initially, COVID-19 resulted in reduced paediatric HIV services as children disengaged from care. Indicators eventually recovered to proximate pre-pandemic levels; however, compensatory increases did not occur. Thus, some children may not have returned to care.


Keywords

COVID-19; paediatric HIV; public health; HIV management; children living with HIV; HIV services.

Sustainable Development Goal

Goal 3: Good health and well-being

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