Patricia Myung ¹, David Pugatch ^2*, Mark F. Brady ³, Phok Many ⁴, Joseph I. Harwell ⁵, Mark Lurie ³, John Tucker ⁴

¹ University of California at Irvine
² Rhode Island Hospital
³ Brown Medical School
⁴ Maryknoll Little Sprouts Program
⁵ The Miriam Hospital

^* To whom correspondence should be addressed. E-mail: dpugatch{at}lifespan.org.

	Abstract

Antiretroviral medications are becoming available for HIV-infected children in resource-limited settings. Maryknoll, an international Catholic charity, provided directly observed antiretroviral therapy to HIV-infected children in Phnom Penh, Cambodia. Child care workers administered generic antiretroviral drugs twice daily to children, ensuring adherence.

Treatment began with 117 late-stage HIV-infected children; 22 died of AIDS during the first 6 months. The rest were treated for at least 6 months and showed CD4 count increases comparable to those achieved in US and European children. Staffing cost for this program was approximately US $5 per child per month, or 15% more than the price of the medications. Drug toxicities were uncommon and easily managed.

Directly observed antiretroviral therapy appears to be a promising, low-cost strategy for ensuring adherent treatment for HIV-infected children in a resource-limited setting.

Key Words: Community Health, Global Health, Health Care Facilities/Services, HIV/AIDS