Abstract:

Background: Paediatric HIV infection and malnutrition remain two major health issues in Nigeria. Malnutrition is one of the clinical presentation of HIV in children who survive infancy undiagnosed, diagnoses usually occurs on presentation to health care services. We investigated the effectiveness of integrating provider-initiated testing and counselling (PITC) with nutrition services for children less under 5 years attending primary care clinics.

Methods: After an evaluation of HTC services for malnourished children aged 6-59 months in 2 primary health care facilities offering community management of acute malnutrition (CMAM) sites in Adamawa State, Nigeria, PITC was integrated into nutrition services. The change in the proportion of eligible children offered and receiving HIV tests and yield of HIV-positive diagnosis were compared for periods of 6 months before the integration of PITC and 6 months after the integration of PITC into CMAM OTP.

Results: There were 440 and 278 malnourished children eligible for HIV testing before and after the integration of PITC within nutrition services. The proportion of eligible malnourished children offered testing increased from 59% to 100% and test uptake improved from 50% to 98% in PITC integration period compared with before PITC integration period. The yield of HIV diagnosis increased from 0 to 1.5%, and a malnourished child attending the clinic post intervention had 0.03 increased adjusted risk (95% CI: 0.01 to 0.08) of receiving an HIV test in PITC integration period compared with pre-intervention period.

Conclusion: PITC integration into CMAM intensified paediatric HIV case finding.

Keywords: Nigeria, HIV, Malnourished Children, PITC.

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