Pediatric ART

Susan was only 12 months old when she was brought by her grandmother into the pediatric center at the University Teaching Hospital (UTH) in Lusaka, Zambia, one sunny October morning.  Susan was extremely frail, dull, and lifeless.

Less than a year ago, Susan would have followed so many other Zambian children to the grave after suffering silently from AIDS.  But with the help of anti-retroviral drugs supplied through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Susan has put on weight.  She now plays with her friends and has started to talk.

Before pediatric diagnosis and treatment of HIV/AIDS was more widely available, Susan may have easily slipped through the cracks of the healthcare system, as treatment in Zambia was generally limited to adults.  But now there is a striking change in this trend.  The UTH has enrolled 1,200 children on anti-retroviral therapy (ART) and about 2,000 in care.  In the next two years, the hospital plans to treat at least 3,000 children out of an estimated 25,000 who need the life-saving drugs.  Last year, 28% of children who were admitted to the hospital tested positive.  Mindful of the need to diagnose HIV infection in children early and start treatment quickly, nearly 75% of children and caretakers who are admitted receive counseling, and out of those 87% agree to be tested.  The challenge is daunting, however.

Susan is one of many fortunate HIV-positive children who might just survive this terrible epidemic, as most of those who go untreated will not even reach their third birthday.  Little wonder her grandmother’s outlook now is more comforting than when she first entered UTH a year ago.  Encouraged by the impact of the drugs, Susan’s grandmother remarked, “I would like a continuous supply of the medication that has given so much hope for the children.”

The hospital’s Department of Pediatrics and Child Health is supported by PEPFAR through the Centers for Disease Control and Prevention (CDC) and the International Training Center for AIDS Care and Treatment Programs (ICAP) of Columbia University.