ArticleBulletin of the World Health Organization2010
Scaling up antiretroviral therapy for HIV-infected children in Côte d'Ivoire: determinants of survival and loss to programme.
Article in Bulletin of the World Health Organization, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- HIV-related mortality time trends among children and young adolescents on antiretroviral therapy by age, treatment duration, and region: a systematic review and meta-regression analysis.The lancet. HIV · 2025Pooled it
- Implementation of antiretroviral therapy guidelines for under-five children in Tanzania: translating recommendations into practice.Journal of the International AIDS Society · 2015Guideline
- Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review.PloS one · 2013Pooled it
- Trial
- Clinical outcomes among HIV positive babies below 18 months of age, diagnosed under the Early Infant Diagnosis (EID) programme, India: a mixed-methods study.The Lancet regional health. Southeast Asia · 2025Article
- Disparities in dolutegravir utilisation in children, adolescents and young adults (0-24 years) living with HIV. An analysis of the IeDEA Pediatric West African cohort.BMJ global health · 2025Article
- Disparities in dolutegravir utilisation in children, adolescents and young adults (0-24 years) living with HIV: An analysis of the IeDEA Paediatric West African cohort.medRxiv : the preprint server for health sciences · 2024Article
- Time-varying age- and CD4-stratified rates of mortality and WHO stage 3 and stage 4 events in children, adolescents and youth 0 to 24 years living with perinatally acquired HIV, before and after antiretroviral therapy initiation in the paediatric IeDEA Global Cohort Consortium.Journal of the International AIDS Society · 2020Article
- Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Better Outcomes Among HIV-Infected Rwandan Children 18-60 Months of Age After the Implementation of "Treat All".Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Article
- Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation.Journal of the International AIDS Society · 2018Article
- Article
- Mortality in a Cohort of HIV-Infected Children: A 12-Month Outcome of Antiretroviral Therapy in Makurdi, Nigeria.Advances in medicine · 2018Article
- Brief Report: AIDS-Defining Events and Deaths in HIV-Infected Children and Adolescents on Antiretrovirals: A 14-Year Study in Thailand.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Pediatric HIV care and treatment services in Tanzania: implications for survival.BMC health services research · 2017Article
- Loss to follow-up among children in pre-ART care under the National AIDS Programme, Tamil Nadu, South India.Public health action · 2017Article
- Virological response and resistances over 12 months among HIV-infected children less than two years receiving first-line lopinavir/ritonavir-based antiretroviral therapy in Cote d'Ivoire and Burkina Faso: the MONOD ANRS 12206 cohort.Journal of the International AIDS Society · 2017Article
- Implementation and Operational Research: An Integrated and Comprehensive Service Delivery Model to Improve Pediatric and Maternal HIV Care in Rural Africa.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Predictors of Mortality and Mortality Rate in a Cohort of Children Living with HIV from India.Indian journal of pediatrics · 2016Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate deaths and losses to follow-up in a programme designed to scale up antiretroviral therapy (ART) for HIV-infected children in Côte d'Ivoire.
methodsBetween 2004 and 2007, HIV-exposed children at 19 centres were offered free HIV serum tests (polymerase chain reaction tests in those aged < 18 months) and ART. Computerized monitoring was used to determine: (i) the number of confirmed HIV infections, (ii) losses to the programme (i.e. death or loss to follow-up) before ART, (iii) mortality and loss-to-programme rates during 12 months of ART, and (iv) determinants of mortality and losses to the programme.
findingsThe analysis included 3876 ART-naïve children. Of the 1766 with HIV-1 infections (17% aged < 18 months), 124 (7.0%) died, 52 (2.9%) left the programme, 354 (20%) were lost to follow-up before ART, 259 (15%) remained in care without ART, and 977 (55%) started ART (median age: 63 months). The overall mortality rate during ART was significantly higher in the first 3 months than in months 4-12: 32.8 and 6.9 per 100 child-years of follow-up, respectively. Loss-to-programme rates were roughly double mortality rates and followed the same trend with duration of ART. Independent predictors of 12-month mortality on ART were pre-ART weight-for-age z-score < -2, percentage of CD4+ T lymphocytes < 10, World Health Organization HIV/AIDS clinical stage 3 or 4, and blood haemoglobin < 8 g/dl.
conclusionThe large-scale programme to scale up paediatric ART in Côte d'Ivoire was effective. However, ART was often given too late, and early mortality and losses to programme before and just after ART initiation were major problems.
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