ABSTRACT
HIV has been shown to have significant effects on the development of a child. Currently; there is limited South African research regarding HIV and specific characteristics of communication development; and the treatment thereof; in the child infected with HIV. The objective of the research was to describe the communication characteristics of a group of children between the ages of 0 and 5 years infected with HIV at a hospital in Gauteng; South Africa. Clinic records of 203 children infected with HIV between the ages of 0 and 5 years were reviewed using a pre-designed checklist within the outreach clinic of a large regional hospital. A questionnaire was completed by four medical practitioners working with this population within the outreach clinic. A total of 91.62 of the infected children were diagnosed as being either in Stage III or IV of the disease (according to the WHO classification system of 2005); with all infants presenting with a CD4 count of =60. Most (75.37 of the total sample) were receiving Highly Active Antiretroviral Therapy (HAART) at the time the data were collected. According to their medical; social; communication and general development; almost all the children qualified for Early Communication Intervention (ECI) but were not recorded as being referred for such services. A large proportion of the target population presented with opportunistic infections and/or HIV associated conditions. The results highlight the developmental characteristics of children living with HIV; and identify the need for medical doctors and allied health professionals to be provided with relevant literature or training regarding the communication development of children infected with HIV. This will facilitate appropriate referrals for ECI services
Subject(s)
Antiretroviral Therapy, Highly Active , Child , Communication , HIV Infections , Opportunistic Infections , Physicians , Speech-Language PathologyABSTRACT
Infant hearing screening has become increasingly widespread as research evidence a dramatic benefit when early identification of hearing loss occurs before six-months of age. The Health Professions Council of South Africa (HPCSA) has recently published a hearing screening position statement recommending infant hearing screening in three contexts: the well-baby nursery; at discharge from the neonatal intensive care unit (NICU); and at Maternal and Child Health (MCH) clinics. The well-baby nursery and NICUs are esta- blished and internationally recognised screening contexts abundantly reported on whilst MCH clinics have not been investigated as screening contexts previously. The objective of this study was therefore to describe the context and interactional processes during an infant hearing screening programme at MCH clinics in a South African community to ascertain whether clinics provide a suitable milieu for hearing screening programmes. An exploratory descriptive design implementing a qualitative methodology was selected to describe the context and interactional processes experienced during an infant hearing screening programme at two MCH clinics in the Hammanskraal community. Five fieldworkers conducting the screening programme at the clinics documented experiences using systematic field notes and critical reflections for a fivemonth period. The two MCH clinics investigated proved to be suitable contexts to screen infants for hearing loss despite prevailing contextual barriers that are characteristic of primary healthcare clinics in developing contexts of South Africa. Interactional processes between fieldworkers; nursing staff and caregivers revealed that collaborative partnerships fostered by consistent service delivery; maintenance of an open channel of communication and basic courteousness; facilitated an effective initial infant hearing screening at the two clinics. MCH clinics demonstrate promise as a practical contextual solution to achieve widespread screening coverage in South Africa