Eastern Deanery AIDS relief program (EDARP), is a local Catholic Faith Based Organization founded in 1993, to provide Community-based quality HIV and TB prevention, testing, treatment and care services in the Eastern slums of Nairobi. The target area has 95 informal settlements and an estimated population of 2,157,960 people. The area is served by only one Sub-County (Level -4). EDARP has provided high quality HIV/TB testing, prevention, treatment and care services for the past 24years. Nairobi County has the highest HIV burden in Kenya with 178,270 people estimated to be living with HIV and a HIV prevalence of 6.1%, EDARP serves a target population within Nairobi County with a much higher prevalence estimated at 12% in urban slums. EDARP implements an integrated evidence based community model of care which responds to the needs of the community. EDARP project implementation is supported through 1,123 Community Health Workers (CHWs), organized around 92 Community Units (CUs) made up of 15-20 members from the same locality. CHWs mobilize, from their assigned area, follow up and refer (as appropriate) clients for services at EDARP clinics. Each CU is supervised by a clinician with the aim of ensuring positive patient outcomes at the community level.
EDARP implements all activities in collaboration with the ministry of health under the devolved health system structure through the County Health Management Team (CHMT) and Sub County Health Management Teams (SCHMT) in the respective 5 sub counties; Embakasi, Ruaraka, New Kasarani, Kamukunji and Starehe. During this reporting period, EDARP has been working towards bridging the gaps towards the ambitious UNAIDS 90:90:90 targets which aims to identify 90% of PLHIV, 90% of people diagnosed with HIV infection receive sustained ART and 90% of PLHIV receiving ART are virally suppressed. Additionally EDARP was tasked to provide Voluntary Medical Male Circumcision (VMMC) in the entire Nairobi County.
In the year 2017, EDARP was able to reach a total of 159,274 individuals with quality assured HIV testing and counselling including 49,492 children and adolescent. Index family testing of PLHIV family members including children had the highest positivity at 11% while the overall positivity across all testing strategies was at 1.9%. During this period EDARP reached a total of 13,495 pregnant women with HIV testing and the positivity rate was 3.6% among those testing at ANC, double the average positivity rate, with 100% of all PLHIV pregnant women identified receiving ART and the overall mother to child HIV transmission rate was at 3.5% in line with the target for elimination of mother to child transmission.
By the end of 2017, a total of 26,844 adults and children were receiving HIV care in EDARP, out of these 99.9% received ART treatment in line with revised national guidelines that recommend test and treat with ART for all PLHIV regardless of CD4 or WHO stage. Notably EDARP currently provides ART to 21 % of all children and 20% of all adults living with HIV in Nairobi County (NASCOP dashboard); during the year 3,155 adults and 177 children were newly initiated into lifesaving ART. EDARP strengthened the quality of adolescent living with HIV care by providing a comprehensive adolescent package of care in line with national guidelines.
In the year 2017, EDARP strengthened its Maternal and Child health department as a strategy to reach more children infected with and exposed to HIV, during this period a total of 23,795 children aged less than 5 years were received child welfare clinical services, including immunization, HIV testing, nutritional assessment and counseling services.
EDARP provides universal HIV testing in TB setting having fully integrated TB/HIV service delivery model with 100% of the TB/HIV co-infected adults and children receiving Cotrimoxazole prophylaxis and ART. EDARP ensured that children were screened for TB using Gene Xpert by providing sputum aspiration services to increase TB detection among children.
EDARP continues to provide quality laboratory services and in 2017, EDARP cardinal Otunga laboratory maintained its ISO 15189 accreditation.