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RAPID IMPLEMENTATION OF AN INTEGRATED LARGE-SCALE HIV COUNSELING AND TESTING, MALARIA, AND DIARRHEA PREVENTION CAMPAIGN IN RURAL KENYA

Thursday, 26th of May 2011

'Through integrated campaigns it is feasible efficiently to cover large proportions of eligible adults in rural underserved communities with multiple disease preventive services simultaneously achieving various national and international health development goals.'

Best read at http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012435

Background

Integrated disease prevention in low resource settings can increase coverage, equity and efficiency in controlling high burden infectious diseases. A public-private partnership with the Ministry of Health, CDC, Vestergaard Frandsen and CHF International implemented a one-week integrated multi-disease prevention campaign.

Method

Residents of Lurambi, Western Kenya were eligible for participation. The aim was to offer services to at least 80 percent of those aged 15-49. 31 temporary sites in strategically dispersed locations offered: HIV counseling and testing, 60 male condoms, an insecticide treated bednet, a household water filter for women or an individual filter for men, and, for those testing positive, a 3 month supply of cotrimoxazole and referral for follow-up care and treatment.

Findings

Over 7 days, 47,311 people attended the campaign with a 96 percent uptake of the multi-disease preventive package. Of these, 99.7 percent were tested for HIV (87 percent in the target 15-49 age group); 80 percent had previously never tested. 4 percent of those tested were positives, 61 percent were women (5 percent of women and 3 percent of men), 6 percent had median CD4 counts of 541cell/ml (IQR; 356, 374). 386 certified counselors attended to an average 17 participants per day, consistent with recommended national figures for mass campaigns. Among women, HIV infection varied by age, and was more likely with an ended marriage (e.g. widowed vs. never married, OR 3.91; 95 percent VCI, 2.8705.34), and lack of occupation.

In men, quantitatively stronger relationships were found (e.g. widowed vs. never married, OR 7.0; 95 percent VI 3.5-13.9). always using condoms with a non-steady partners was more common among HIV infected women participants who knew their status compared to those who did not (OR 5.4, 95 percent CI, 2.3-128.).

Conclusion

Through integrated campaigns it is feasible to efficiently cover large proportions of eligible adults in rural underserved communities with multiple disease preventive services simultaneously achieving various national and international health development goals.