Open AccessDirectly Observed Highly Active Antiretroviral Therapy for HIV-Infected Children in Cambodia
Author(s) -
Patricia Myung,
David Pugatch,
Mark F. Brady,
Phok Many,
Joseph I. Harwell,
Mark N. Lurie,
John Tucker
Publication year - 2007
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2005.083253
Subject(s) - medicine , staffing , antiretroviral therapy , human immunodeficiency virus (hiv) , pediatrics , sida , antiretroviral treatment , antiretroviral agents , developing country , viral load , family medicine , viral disease , nursing , economic growth , economics
Antiretroviral medications are becoming available for HIV-infected children in resource-limited settings. Maryknoll, an international Catholic charity, provided directly observed antiretroviral therapy to HIV-infected children in Phnom Penh, Cambodia. Child care workers administered generic antiretroviral drugs twice daily to children, ensuring adherence. Treatment began with 117 late-stage HIV-infected children; 22 died of AIDS during the first 6 months. The rest were treated for at least 6 months and showed CD4 count increases comparable to those achieved in US and European children. Staffing cost for this program was approximately US $5 per child per month, or 15% more than the price of the medications. Drug toxicities were uncommon and easily managed. Directly observed antiretroviral therapy appears to be a promising, low-cost strategy for ensuring adherent treatment for HIV-infected children in a resource-limited setting.