Team PATA

PATA Conferences - Rwanda 2008

The experience for PATA teams at the Kigali Forum included:

• 11 first-time attending teams
• Nutritionists in attendance
• A Larger Francophone contingent than ever before with 16/ 40 teams being French-speaking
• Field trip to Rwinkwavu Training centre on Day 3 of the conference
• Specialised, optional masterclasses in a variety of fields, including skin rashes in HIV, PATA adolescent workshop recommendations, the Mother 2 Mothers To Be programme, the technical aspects of nutrition for children with HIV/AIDS and the findings of the CHER study.
• CONFERENCE THEMES
• Care of the very young infant and Nutrition were the themes for PATA 2008 forum.

Dr Paul Roux from the Groote Schuur Hospital explains why these themes were chosen:

NUTRITION

"This is an over-arching issue affecting response to ARVs and care of HIV/AIDS at any age. It is a universal problem in Africa. It is an issue that needs to be addressed at clinic level and could result in many worthwhile clinic tasks being taken on. The world is facing a food crisis that can only make things worse. Partners in Health ran a three day nutrition conference in Boston in August 2007. Nigel Rollins (South Africa) and Tom Heijkens (Malawi) - both highly regarded paediatric nutrition experts - attended the PATA 2008 forum."

CARE OF THE VERY YOUNG INFANT

"Groundbreaking research done in Cape Town and Johannesburg by Mark Cotton and Avi Violari has showed that early access to ARVs for very young infants diagnosed with HIV infection has a 30% lower mortality rate than if you wait for their immune status or clinical condition to deteriorate. This work is referred to as the CHER study - Children with HIV Early Antiretroviral Therapy. Mark Cotton was at the forum in Rwanda."

THE GUEST SPEAKER LIST INCLUDED THE FOLLOWING:

Opening night : Keynote addresses by Dr Agnes Abinagwaho (National Centre for HIV/AIDS Control, Rwanda) and Dr Joia Mukherjee (PIH).

Day 1 - Care of the Very young infant with HIV (26th November)
Plenary input from James Nuttall, Leon Levin, Simone Honikman, Mark Cotton, Mitch Besser and others on the following:

1. Diagnosing HIV infection in infants and young children
2. Maternal and child health issues
3. Linking care at birth with medical care of the infant
4. Findings of the CHER study
5. Anti-retroviral therapy for the infant
6. The psycho-social consequences of raising a child with chronic illness

In the profession-specific workshops on day 1, participants discussed their experiences of HIV/AIDS in children under 1 year of age and try to establish what obstacles currently hamper quality care to this age group.

Treatment teams then discussed in workshops what interventions could be implemented within each clinic to improve the quality of care to children under 1 year of age.

Day 2 - Nutrition (27th November)
Plenary input from Tom Heikens, Agnes Malamule, Charlotte Adamczick and others on the following:

1. Translating the World Health Organisation's Ten Steps in the Care of HIV/AIDS
2. Drug interactions and pharmacokinetics in different stages of HIV/AIDS
3. Anti-microbials
4. Shock management and intravenous fluids
5. The role of F 75, F100, RUTF, weaning foods and mixed diets (composing energy dense weaning foods and mixed meals from local foods)
6. What and when to counsel and the counsellors' role with orphans
7. The psycho-social consequences of poverty and malnutrition

In professional groups, participants discussed what the opportunities and constraints in respect of nutritional interventions are, and how we can measure the state of nutrition and responses to intervention at clinic, district and national level.

Following this, treatment teams identified steps that can be implemented to improve the nutritional state of children seen in clinics.

Day 3 - Making Changes (28th November)

Day 3 was held at the Partners in Health (PIH)'s Rwinkwavu Training centre which is approximately 2 hours from Kigali. Staggered clinic visits were built into the programme.

Plenary input from Stephen Rollnick, Shaffiq Essajee and others on the following:
   How does one go about implementing them?
   What management styles are best suited to implementing change?

Conference Venue: Rwinkwavu Training Centre, Rwanda