Concerns about covert HIV testing are associated with delayed presentation of suspected malaria in Ethiopian children: a cross-sectional study

Haji, Yusuf, Deressa, Wakgari, Davey, Gail and Fogarty, Andrew W (2014) Concerns about covert HIV testing are associated with delayed presentation of suspected malaria in Ethiopian children: a cross-sectional study. Malaria Journal, 13. p. 301. ISSN 1475-2875

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Abstract

BACKGROUND

Early diagnosis is important in preventing mortality from malaria. The hypothesis that guardians' fear of covert human immunodeficiency virus (HIV) testing delays presentation of children with suspected malaria was tested.

METHODS

The study design is a cross-sectional survey. The study population consisted of guardians of children with suspected malaria who presented to health centres in Oromia Region, Ethiopia. Data were collected on attitudes to HIV testing and the duration of children's symptoms using interview administered questionnaires.

RESULTS

Some 830 individuals provided data representing a response rate of 99% of eligible participants. Of these, 423 (51%) guardians perceived that HIV testing was routinely done on blood donated for malaria diagnosis, and 353 (43%) were aware of community members who delayed seeking medical advice because of these concerns. Children whose guardians suspected that blood was covertly tested for HIV had longer median delay to presentation for evaluation at health centres compared to those children whose guardians did not hold this belief (three days compared to two days, p < 0.001). Children whose guardians were concerned about covert HIV testing were at a higher odds of a prolonged delay before being seen at a health centre (odds ratio 1.73, 95% confidence intervals: 1.10 to 270 for a delay of ≥ 3 days compared to those seen in ≤ 2 days).

CONCLUSION

Children whose guardians believed that covert testing for HIV was routine clinical practice presented later for investigation of suspected malaria. This may account for up to 14% of the delay in presentation and represents a reversible risk factor for suboptimal management of malaria.

Item Type: Article
Keywords: Malaria; HIV; Diagnosis; Delay; Stigma; Ethiopia
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and teaching. Research
Depositing User: Gharib Murbe
Date Deposited: 19 Feb 2015 13:20
Last Modified: 04 Aug 2017 05:21
URI: http://sro.sussex.ac.uk/id/eprint/53007

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