Paediatric ART

peasPaediatrics (0-19years) are a key population group in the provision of antiretroviral therapy under HIV care and treatment. The cascade of care is the same for HIV-infected infants and children as for adults – diagnosis, linkage, enrolment, treatment, retention and viral suppression.  Most of the paediatric HIV indicators are identical to those for the adult population, with specific age dis-aggregation providing the information on children.

However, the collection, organization, reporting and interpretation of strategic information for children living with HIV  is a challenge.

  • ART coverage for children was consistently above 70%.
  • Capacity of health workers to handle paediatric patients improved (Due to onsite and offsite paediatric training and attachments for nurses and doctors at Baylor.
  • Availability and consistent provision of fixed drug combinations and other paediatric friendly formulations.
  • HIV positivity at 8 weeks is at 2%.

The adherence of PLHIV on ART is an area of focus, due to the fact that formulations for children are not palatable and frequently rejected by the children. Efforts have been put in place to introduce less bulky ARV formulations such as syrups to more child-friendly tablets, preferably fixed dose combination tablets. However, these efforts have been minimized by the threat of the development of ARV resistant strains of HIV among children who were exposed to PMTCT regimen.

This results in an increase in the number of children who are born HIV positive and require to be identified in order for them to benefit from early initiation of ART.  The national programme has put special focus on the treatment of children living with HIV, through establishing early infant diagnosis (EID), early initiation of ART and psychosocial support for the children and their families.  EID is still centralized, with only the National Referral Laboratory conducting the tests, however, an efficient system for collecting dried blood spots from peripheral facilities has been developed. This has resulted in over 85% of children who need DNA PCR test at 6-8weeks being able to access the test.



Current activities

  • Birth Testing for all Infants
  • Country has moved to Universal Access to Treatment

Relevant documents

Understanding the Barriers to Antiretroviral Therapy (ART) Initiation for HIV-Positive Children 2-18 Months of Age in Swaziland