The Pediatric Infectious Disease Journal · 8 authors, 6 centres
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This cross-sectional study evaluated an HIV screening tool for children aged 5–14 in South African primary healthcare clinics. The central result is that a single-item tool asking about maternal HIV status (positive or unknown) had high sensitivity for identifying undiagnosed children living with HIV.
The study was a cross-sectional assessment conducted at primary healthcare clinics in South Africa between June 2021 and June 2022. Researchers enrolled 14,147 children aged 5–14 with HIV-negative or unknown status. They optimized an existing 10-item HIV screening tool using logistic regression and test performance metrics. The central result was that a single-item tool based on maternal HIV status (positive or unknown) demonstrated 95.2% sensitivity and 65.0% specificity, with a number needed to test of 84. This 1-item tool would have missed 5% of the 62 HIV-positive children identified, compared to 18% missed by a derived 5-item tool. Limitations include the reliance on caregiver-reported maternal HIV status and the study's setting in specific South African districts. The implication is that this simple, single-question tool could be a feasible and efficient method to improve case-finding for children living with HIV in resource-constrained primary healthcare settings.
