Pediatric HIV/AIDS Care Sihanoukville Province
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1 Pediatric HIV/AIDS Care Sihanoukville Province 1 st st National Conference on Pediatric AIDS Care in Cambodia February 5 th and 6 th, 2007
2 Geo-socio Demography in Sihanoukville 1-Distance: 224 Km from Phnom Penh -Surface Area : 1,283 Km2-22 Islands -93 Km coast long. 2-Total Population: 169,657 -Male = 83,055, Female = 86,602 -Population density : 132 p / Km2 3-Profession: - 45% farmers - 15% fishermen - 15% civil servants - 21% businessmen - 4% other
3 Geo-socio Demography in Sihanoukville 4-Standard of Living : -High 5% -Medium 20% -Low 75% 5-Administration : -03 Districts - Mittapheap - Stoeung Haov - Prey Nup -22 Communes - 94 Villages
4 Health Services Delivery 1-Health facilities : - 1 OD -1 RH - 10 HCs ( MPA ) 2-NGOs working on health in HIV field : - FRC: Support to OI/ART site and team - RHAC: Home Base Care - KWCD: Home Base Care - CRC: Home visits and community support - PPN +: Self Help Support Group
5 HIV/Aids Prevalence among target group in SHV Percent DFSW IDFSW Police** ANC** TB Patient
6 Results of counseling and testing at SHV VCCT % % 35.00% % 24.70% 22.70% % 30.00% 25.00% 20.00% % 10.00% 5.00% Total Negative Positive % Positive 0.00%
7 Chronology of development of Pediatric HIV/AIDS Care in SHV Sept 2003: Availability of OI consultation located in HC, guided & supported by WHO, no ARV provided yet. 2 August 04: Opening of OI & ART services for adults infected patients in Kdey Sangkhoeum (KS) Center Technical & financial support by French Red Cross (funded by GFATM) and NCHADS Both Children and Adults infected by HIV/Aids came to KS centre for having Care
8 Chronology of development of Pediatric HIV/AIDS Care in SHV April 2005 ART for Children available in KS October 2005: NCHADS identifies SHV as a site for developing HIV/Aids Care in children Pediatrician starts working in KS with Adults OI&ART team for follow up of CLHAs 01 Sept-14 Nov 2006: Renovation of pediatric ward supported by UNICEF
9 Chronology of development of Pediatric HIV/AIDS Care in SHV 22 Jan 07: all equipments are received from UNICEF Jan 07: pediatric OI/ART site is equipped and arranged 01 Feb 07: successful transfer of CLHAs from KS center to new pediatric ARV/OI site
10 A picture of KS Centre will be inserted here KS Centre Adults OI&ART Care
11 Human resources & Training courses 12 Jun-01 Sept 2006: 1 doctor and 1 nurse trained on Pain management in HIV infected children at NPH and Angkor Hospital organised by NCHADS and Douleur Sans Frontière. 01 Aug-15 Dec 2006: 1 st doctor pediatrician trained on HIV/Aids OI&ART Management in Children at NPH, organised by NCHADS(long term course) Oct 2006: 1 doctor and 2 nurses trained on OI&ART practical management at CHIC, NPH organised by NCHADS.
12 Human resources & Training courses 27 Mar-07 Apr 2006: 1nurse from pediatric site trained on OI&ART counseling and practical of blood sample management at KS Centre, organised by FRC. 24 Apr-05 May 2006: 1 doctor and 1 nurse from pediatric site tained on OI&ART practical management at KS Centre, organised by FRC. 15 Jan 07: 2 nd doctor is on training course at NCHADS on HIV/Aids OI&ART Management in Children (long term course) Jan 07: 2 nurses trained on nutrition counselling at NPH organised by NCHADS.
13 Actual Patients flow for OI&ART Children Counseling room MMM children/ Registration Pharmacy KS Hospitalizatio nward Consultation room Registration (database,file)
14 Actual Patients flow for OI&ART Children insert picture of MMM children/reception
15 Actual Patients flow for OI&ART Children insert picture of Medical consultation room
16 Actual Patients flow for OI&ART Children insert picture of counseling room
17 Results OI&ART Care Children from begining to Dec 2006 Total registration of children from 0-14 years old: 123 cases 62 cases: Females 61 cases: Males 77 (62%): age range from 5-9 years old.
18 HIV/AIDS Pediatric Active file in SHKV since August août-04 oct-04 déc-04 févr-05 avr-05 juin-05 août-05 oct-05 déc-05 févr-06 avr-06 juin-06 août-06 oct-06 déc-06 LF DC TR Active file
19 Children registered and started on ART since august août-04 oct-04 déc-04 févr-05 avr-05 juin-05 août-05 oct-05 déc-05 févr-06 avr-06 juin-06 août-06 oct-06 déc-06 Registration ARV
20 New cases registered in last 6 month of Y2006 New cases registered each month Jun-06 Jul-06 Aug-06 Sep-06 Oct-06 Nov-06 Dec-06 Mean New case register last 6 months of Y2006 : 4 cases /month
21 Results OI&ART Care Children from begining to Dec 2006 Total Children on HAART: 52 cases (F:26, M:26) Active children on HAART: 46 cases (F:25, M:21) Active OI children: 47 cases (F: 22, M: 25)
22 Results OI&ART Care Children from begining to Dec 2006 Death : 12 OI: 8 (F:4, M:4) ARV: 4 (F:1, M:3) LF Up: 9 OI: 8 (F:6, M:2) ARV: 1 (F:0, M:1) Transfer Out: 9 OI : 8 (F:4, M:4) ART: 1 (F:0, M:1) Total children Death+LFU+TR out : 30
23 Success points of HIV/Aids Care in children Existing of : Health Infrastructure Health Care providers Adult OI&ART Care VCCT HBCare Program (CRCVs, KWCD, Rhac) PMTCT Program Financial&Technical supported by: NCHADHS FRC Others partners (Unicef)
24 Difficulties faced & solutions done New OI&ART children team: Lack of experience in taking care of HIV/Aids children, but keep in contact with OI&ART adults team to share experience and technical supported from them, especially with Medical Adivisor of FRC. Lack of Human resourses: Only 4 persons (2 doctors and 2 nurses) who work in HIV/Aids children team Need more space to work: only 1 room of counseling, 1 room of medical consultation, 1 room of MMM children and 1 hospitalised room, w/o blood sample room,w/o registration or reception room, w/o pharmacy to distribute drug to patient.
25 Difficulties faced & solutions done New OI&ART children team: Consummable to use for blood sample: tube for blood collections, needles for blood collection, seringues, gloves, face masks etc. FRC provided some when we opened site last week Bureau materials to use for daily activities running: papers, pens, pencils,.etc. FRC provided some when we opened site last week, Waiting for incentive: even we started program but we haven't received any incentive yet from NCHADS for our pediatric team, Need more incentive: to share in whole team who work together in Pediatric ward. There are 7 persons who involve the activities of HIV/Aids pediatric care.
26 Recommendations All HIV/Aids children follow up actually at KS centre will be step by step transfer to OI&ART Pediatric site and will be finished in next 1 or 2 months, Keep in contact both sites Adults and Children to strengthen the care activities and share experiences each others, especially ask advice from experts of HIV/Aids Care such as FRC medical advisor, when the problem of OI& ART care management occurred.
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