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Initiation of Pediatric ART (Aug. 2007)

Summary
Dates of the event (from/to): 
Mon, 2007/08/27 - Fri, 2007/08/31
Type of Training: 
Initiation of Pediatric Antiretroviral Therapy
Training Center: 
Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia
Country of location: 
Ukraine
Location of training: 
Odessa
Country of trainees: 
Moldova
Country of trainees: 
Ukraine
Attendees: 
14 participants from Ukraine: Physicians: 6; Nurses: 5; Social workers: 3
10 participants from Moldova: Physicians: 3; Nurses: 3; Social workers: 3; Administrators: 1
Trainers: 
International: Mary Jo O`Hara, RN, MSN, ARNP International Training and Education Center on HIV (ITECH) Center for Health Education and Research, University of Washington Seattle, Washington;
Ukraine: Dr. Natalya Kotova, Associated Professor, Odessa State Medical University; Dr. Olena Starets, Associated Professor, Odessa State Medical University; Oksana Nakhayeva, Vice Director, NGO “Alternatyva”, social worker.
Source of funding: 
Funded by UNICEF
Initiation of Pediatric ART Training Course
(Odessa, Ukraine, 27-31 August 2007)
Agenda

 
DAY 1
10:00-11:00 Welcome, introduction of the participants, objectives of the course. Review of the training curriculum.
11:00-11:30 Pre-Workshop Questionnaires
11:30-12:15 Presentation 1. Pathogenesis of HIV-infection
Dr. Kotova
12:15-12:45 COFFEE BREAK
12.45-13:15 Presentation 2. Team approach in HIV/AIDS care and treatment. Roles and responsibilities of the care team members.
Mary Jo O'Hara
13:15-14:00 Presentation 3. Main principles of counseling.
Oksana Nakhayeva
14:00-14:45 LUNCH
14:45-15:45 Small group practical skills training on counseling.
15:45-16:45 Presentation 4. Goal of ART in pediatrics. General overview of ARV drugs, major toxicities . Brand and generic drugs.
Dr. Starets
16:45-17:30 Breakout discussion: Roles and responsibilities of care team members.
17:30-17:45 Knowledge assessment test. Summary of the day.
 
DAY 2
09:00-09:45 Presentation 5. Follow-up of HIV-exposed infants. HIV diagnostic testing. Vaccination.
Dr. Starets
09:45-10:45 Presentation 6. Signs and symptoms for HIV disease progression. Opportunistic infections. WHO staging system for HIV infection and disease in children (WHO, 2004). PCP prophylaxis
Dr. Kotova
10:45-11:00 COFFEE BREAK
11:00-12:00 Breakout discussion: Diagnosis of HIV infection in children born to HIV positive mother (common clinical and lab findings)
12:00-12:45 Breakout discussion: Vaccination of children born to HIV infected women and children with HIV infections. Case studies.
12:45-13:45 LUNCH
13:45-14:30 Presentation 7. Feeding of HIV infected children. Nutritional counseling.
Mary Jo O'Hara
14:30-15:00 Presentation 8. PMTCT and ARV regimens: general overview.
Dr. Kotova
14:30-15:30 Breakout discussion: Counseling the HIV-positive mother about infant feeding. Role play.
15.30-17.00 Small group clinical training: Caregiver counselling about care, PCP prophylaxis, vaccination and feeding of HIV-positive child.
17.00-17.15 Knowledge assessment test. Summary of the day.
 
DAY 3
09:00-10:00 Presentation 9. Child assessment and counseling caregiver before starting ART. Criteria for starting ART.1st line regimens (WHO and national protocols).
Dr. Kotova
10:00-11:00 Breakout group discussion: Discussion on first-line ART protocols (WHO and national protocols). Case studies.
11:00-11.15 COFFEE BREAK
11:15-12:00 Presentation 10. Adherence promotion and monitoring: Issues for children.
Dr. Starets/Mary Jo O'Hara
12:00-13:00 Counseling the caregiver about adherence. Role play.
13:00-14:00 LUNCH
14:00-15:00 Legal issues.
15:00-16:00 Small group training: Counseling caregiver before starting ART.
16:00-17:00 Breakout group discussion for physicians:
Opportunistic infections and TB. Case studies.
Breakout group discussion for nurses:
Nutrition of children receiving ART.
Breakout group discussion for social workers:
Role of a social worker in a multidisciplinary team. Discussion of problems and regional experience.
17:00-17:15 Knowledge assessment test. Summary of the day.
 
DAY 4
09:00-09:45 Presentation 11. Management of ART (managing a patient, monitoring response, toxicity, and adherence).
Dr. Kotova
09:45-10:30 Breakout discussions: ART initiation and management.
Case studies.
10:30-10:45 COFFEE BREAK
10:45-11:30 Presentation 12. Criteria to switch to second line ART regimen (side effects and therapeutic failure). Second-line regimens (WHO recommendations and National protocols).
Dr. Starets
11:30-12:15 Breakout discussions: ART side effects. Case studies.
12:15-13:30 Small group clinical training: Initiating and monitoring ART, adherence monitoring, counseling for care givers in treatment adherence.
13:30-14:30 LUNCH
14:30-15:15 Presentation 13. Stays by HIV infected children in organized children's collectives and psychosocial support to children with HIV.
Oksana Nakhayeva
15:15-16:00 Breakout discussions: Psychosocial support to children with HIV and their families. Discussion of problems and regional experience (orphanage house)
16:00-17:00 Orphanage house.
Small group clinical training for physicians:
Child assessment before starting ART. Initiation of ART.
Breakout group discussion for nurses:
Role of a nurse in a multidisciplinary team. Discussion of problems and regional experience.
Breakout group discussion for social workers:
Techniques of psychological support for people living with HIV and their families. Peer-to-peer groups
17:00-17:15 Knowledge assessment test. Summary of the day.
 
DAY 5
09:00-11:00 Case study presentations and discussions (each team presents 1 case study).
11:00-11:15 COFFEE BREAK
11:15-12:00 Presentation 14. Main components of HIV/AIDS care.
Mary Jo O'Hara
12:00-12:45 Presentation 15. Prevention of occupational exposure. Post-exposure prophylaxis. WHO recommendations and National protocols.
Dr. Starets/Mary Jo O'Hara
12:45-13:45 LUNCH
13:45-15:00 Counseling exposed medical worker about PEP. Role play.
15:00-16:30 Small group clinical training: Prevention of occupational exposure. Post-exposure prophylaxis.
16:30-17:15 Post-Workshop Questionnaires. Evaluation of the training. Wrap up.