Index case-finding facilitates identification and linkage to care of children and young adults living with HIV/AIDS in Malawi

Ahmed, S., Sabelli, R.A., Simon, K., et al.

METHODS: HIV-infected patients enrolled in HIV services were screened and those who reported untested household members (index cases) were offered home or facility-based HIV testing and counseling (HTC) of their household by a community health worker (CHW). HIV-infected household members identified were enrolled in a follow-up program offering home and facility-based follow-up by CHWs.

RESULTS: Of the 1567 patients enrolled in HIV services, 1030 (65.7%) were screened and 461 (44.8%) identified as index cases. 93.5% consented to HIV testing of their households and of those, 279 (64.7%) reported an untested child or young person. CHWs tested 711 children and young adults, newly diagnosed 28 HIV-infected persons (yield 4.0%; 95% CI: 2.7-5.6), and identified an additional two HIV-infected
persons not enrolled in care. Of the 30 HIV-infected persons identified, 23 (76.6%) were linked to HIV services. 18 of the 20 eligible for ART (90.0%) were initiated. Median time (IQR) from identification to enrollment into HIV services was 4 days (1-8) and from identification to ART start was 6 days (1-8).

CONCLUSIONS: Almost half of HIV-infected patients enrolled in treatment services had untested household members, many of whom were children and young adults. Index case-finding, coupled with home-based testing and tracked follow-up is acceptable, feasible, and facilitates the identification and timely linkage to care of HIV-infected children and young adults.

June 19, 2017
Year of publication
Resource types
Journal and research articles
linkage to care, Malawi, case finding, index cases, untested household members, HIV testing and counseling (HTC), home-based counseling and testing (HBCT), facility-based HIV testing, HIV services, untested children, children, young adults