The At Risk Child Clinic (ARCC): 3 Years of Health Activities in Support of the Most Vulnerable Children in Beira, Mozambique

The concept of “children at risk” changes worldwide according to each specific context. Africa has a large burden of overall risk factors related to childhood health and development, most of which are of an infective or social origin. The aim of this study was to report and analyze the volumes of activities of fifteen At Risk Child Clinics (ARCCs) within the Beira District (Mozambique) over a 3 year-period in order to define the health profile of children accessing such health services. We retrospectively analyzed the data from all of the children accessing one of the 15 Beira ARCCs from January 2015 to December 2017. From this, 17,657 first consultations were registered. The motivations for accessing the services were in order of relevance: HIV exposure (n. 12,300; 69.7%), other risk conditions (n. 2542; 14.4%), Moderate Acute Malnutrition (MAM) (n. 1664; 9.4%), Severe Acute Malnutrition (SAM) (n. 772; 4.4%), and TB exposure (n. 542; 3.1%). During the first consultations, 16,865 children were screened for HIV (95.5%), and 7.89% tested HIV-positive. In our three years of experience, HIV exposure was the main indication for children to access the ARCCs in Mozambique. ARCCs could represent a strategic point to better understand health demands and to monitor the quality of care provided to this vulnerable population group, however significant effort is needed to improve the quality of the data collection.

[1]  C. Giaquinto,et al.  Pathways of care for HIV infected children in Beira, Mozambique: pre-post intervention study to assess impact of task shifting , 2018, BMC Public Health.

[2]  K. Goggin,et al.  Utilization of prevention of mother-to-child transmission (PMTCT) services among pregnant women in HIV care in Uganda: a 24-month cohort of women from pre-conception to post-delivery , 2018, BMC Research Notes.

[3]  D. Pizzol,et al.  Predictors of therapy failure in newly diagnosed pulmonary tuberculosis cases in Beira, Mozambique , 2018, BMC Research Notes.

[4]  Didi Bertrand Farmer,et al.  Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia , 2017, BMC Health Services Research.

[5]  C. Menéndez,et al.  Effects of HIV infection on maternal and neonatal health in southern Mozambique: A prospective cohort study after a decade of antiretroviral drugs roll out , 2017, PloS one.

[6]  Kingsley E Agho,et al.  Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016) , 2017, PloS one.

[7]  N. Veronese,et al.  Social determinants of therapy failure and multi drug resistance among people with tuberculosis: A review. , 2017, Tuberculosis.

[8]  F. Branca,et al.  Childhood stunting: a global perspective , 2016, Maternal & child nutrition.

[9]  W. Landman,et al.  Regional Projections of Extreme Apparent Temperature Days in Africa and the Related Potential Risk to Human Health , 2015, International journal of environmental research and public health.

[10]  A. Stein,et al.  Risk factors affecting child cognitive development: a summary of nutrition, environment, and maternal–child interaction indicators for sub-Saharan Africa , 2015, Journal of Developmental Origins of Health and Disease.

[11]  S. Gimbel,et al.  Early ART initiation among HIV-positive pregnant women in central Mozambique: a stepped wedge randomized controlled trial of an optimized Option B+ approach , 2015, Implementation Science.

[12]  A. Garcia-Basteiro,et al.  Non-tuberculous mycobacteria in children: muddying the waters of tuberculosis diagnosis. , 2015, The Lancet. Respiratory medicine.

[13]  A. Garcia-Basteiro,et al.  High tuberculosis burden among people living with HIV in southern Mozambique , 2014, European Respiratory Journal.

[14]  L. Sherr,et al.  Poverty, AIDS and child health: identifying highest-risk children in South Africa. , 2013, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[15]  P. Awah,et al.  Malnutrition in Sub – Saharan Africa: burden, causes and prospects , 2013, The Pan African medical journal.

[16]  R. Martorell,et al.  Maternal and child undernutrition and overweight in low-income and middle-income countries , 2013, The Lancet.

[17]  C. Nelson,et al.  Inequality in early childhood: risk and protective factors for early child development , 2011, The Lancet.

[18]  P. Landrigan,et al.  Children's Vulnerability to Environmental Exposures: Science and Social Justice Global Climate Change and Children's Health: Threats and Strategies for Prevention , 2022 .

[19]  F. Dabis,et al.  Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire. , 2008, Preventive medicine.

[20]  N. Rollins,et al.  Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study , 2007, The Lancet.

[21]  F. Mockenhaupt,et al.  Malaria, anemia, and malnutrition in african children--defining intervention priorities. , 2006, The Journal of infectious diseases.

[22]  I KUCERA,et al.  [Causes of child mortality]. , 1956, Ceskoslovenska pediatrie.

[23]  M. Onis,et al.  WHO global database on child growth and malnutrition , 1997 .