A E Njom Nlend1, A B Loussikila2. 1. Department of pediatrics, National Social Insurance Fund Hospital, centre hospitalier d'ESSOS, PO Box 5777, Yaoundé, Cameroon. Electronic address: anne.njom@gmail.com. 2. École polytechnique Yaoundé, Specialized Masters in Mathematics, Yaoundé, Cameroon. Electronic address: branly.loussikila@gmail.com.
Abstract
BACKGROUND AND OBJECTIVES: The mortality rate of HIV-infected children can be reversed under highly active antiretroviral therapy (HAART). The impact of HAART on the mortality of HIV-infected children in Cameroon has not been extensively documented. We aimed to measure the mortality rate of HIV-infected children under HAART and to identify predictive factors of mortality. METHODS: Retrospective cohort study of 221 children initiated on HAART from 2005 to 2009 and followed-up until 2013. Survival data was analyzed using Kaplan Meier method and Cox regression model to identify independent predictors of child mortality on HAART. RESULTS: Overall, 9.9% of children (n=22) died over a follow-up period of 755 child-years (mortality of 2.9 per 100 child-years); 70% of deaths occurred during the first six months of HAART. The probability of survival after four years of treatment was 88.7% (95% CI=[84.2-93.3]). During the multivariate analysis of baseline variables, we observed that the WHO clinical stages III and IV (HR: 3.55 [1.09-13.6] and HR: 7.7 [3.07-31.2]) and age≤1year at HAART initiation were independently associated with death (HR: 2.1 [1.01-5.08]). Neither orphanhood, baseline CD4 count or hemoglobin level nor low nutritional status predicted death in this cohort. CONCLUSION: The mortality of children receiving HAART was low after five years of follow-up and it was strongly associated with WHO stages III and IV and a younger age at treatment initiation.
BACKGROUND AND OBJECTIVES: The mortality rate of HIV-infectedchildren can be reversed under highly active antiretroviral therapy (HAART). The impact of HAART on the mortality of HIV-infectedchildren in Cameroon has not been extensively documented. We aimed to measure the mortality rate of HIV-infectedchildren under HAART and to identify predictive factors of mortality. METHODS: Retrospective cohort study of 221 children initiated on HAART from 2005 to 2009 and followed-up until 2013. Survival data was analyzed using Kaplan Meier method and Cox regression model to identify independent predictors of child mortality on HAART. RESULTS: Overall, 9.9% of children (n=22) died over a follow-up period of 755 child-years (mortality of 2.9 per 100 child-years); 70% of deaths occurred during the first six months of HAART. The probability of survival after four years of treatment was 88.7% (95% CI=[84.2-93.3]). During the multivariate analysis of baseline variables, we observed that the WHO clinical stages III and IV (HR: 3.55 [1.09-13.6] and HR: 7.7 [3.07-31.2]) and age≤1year at HAART initiation were independently associated with death (HR: 2.1 [1.01-5.08]). Neither orphanhood, baseline CD4 count or hemoglobin level nor low nutritional status predicted death in this cohort. CONCLUSION: The mortality of children receiving HAART was low after five years of follow-up and it was strongly associated with WHO stages III and IV and a younger age at treatment initiation.
Authors: Jane N Mutanga; Simon Mutembo; Amara E Ezeamama; Xiao Song; Robert C Fubisha; Kunda Mutesu-Kapembwa; Derrick Sialondwe; Brenda Simuchembu; Jelita Chinyonga; Philip E Thuma; Christopher C Whalen Journal: BMC Public Health Date: 2019-01-28 Impact factor: 3.295
Authors: Sophie Desmonde; Anne M Neilan; Beverly Musick; Gabriela Patten; Kulkanya Chokephaibulkit; Andrew Edmonds; Stephany N Duda; Karen Malateste; Kara Wools-Kaloustian; Andrea L Ciaranello; Mary-Ann Davies; Valériane Leroy Journal: J Int AIDS Soc Date: 2020-10 Impact factor: 5.396