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. 2022 Nov 23;17(11):e0277613.
doi: 10.1371/journal.pone.0277613. eCollection 2022.

A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)

Immaculate Mutisya  1 , Evelyn Muthoni  2 , Raphael O Ondondo  1 , Jacques Muthusi  1 , Lennah Omoto  1 , Charlotte Pahe  2 , Abraham Katana  1 , Evelyn Ngugi  1 , Kenneth Masamaro  1 , Leonard Kingwara  2 , Trudy Dobbs  3 , Megan Bronson  3 , Hetal K Patel  3 , Nicholas Sewe  2 , Doris Naitore  4 , Kevin De Cock  1 , Catherine Ngugi  2 , Lucy Nganga  1
Affiliations

A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)

Immaculate Mutisya et al. PLoS One. .

Abstract

We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from caregivers or guardians on child's demographics, HIV testing, and treatment history. Blood specimens were collected for HIV serology and if HIV-positive, the samples were tested for viral load and antiretrovirals (ARV). For participants <18 months TNA PCR is performed. We computed weighted proportions with 95% confidence intervals (CI), accounting for the complex survey design. We used bivariable and multivariable logistic regression to assess factors associated with HIV prevalence. Separate survey weights were developed for interview responses and for biomarker testing to account for the survey design and non-response. HIV burden was estimated by multiplying HIV prevalence by the national population projection by age for 2018. Of 9072 survey participants (< 15 years), 87% (7865) had blood drawn with valid HIV test results. KENPHIA identified 57 HIV-positive children, translating to an HIV prevalence of 0.7%, (95% CI: 0.4%-1.0%) and an estimated 138,900 (95% CI: 84,000-193,800) of HIV among children in Kenya. Specifically, children who were orphaned had about 2 times higher odds of HIV-infection compared to those not orphaned, adjusted Odds Ratio (aOR) 2.2 (95% CI:1.0-4.8). Additionally, children whose caregivers had no knowledge of their HIV status also had 2 times higher odds of HIV-infection compared to whose caregivers had knowledge of their HIV status, aOR 2.4 (95% CI: 1.1-5.4)". From the unconditional analysis; population level estimates, 78.9% of HIV-positive children had known HIV status (95% CI: 67.1%-90.2%), 73.6% (95% CI: 60.9%-86.2%) were receiving ART, and 49% (95% CI: 32.1%-66.7%) were virally suppressed. However, in the clinical cascade for HIV infected children, 92% (95% CI: 84.4%-100%) were receiving ART, and of these, 67.1% (95% CI: 45.1%-89.2%) were virally suppressed. The KENPHIA survey confirms a substantial HIV burden among children in Kenya, especially among orphans.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
90-90-90 HIV cascade among children living with HIV, KENPHIA 2018, a) conditional; b) unconditional.
See this image and copyright information in PMC

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