ArticleBMC infectious diseases2011
Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009.
Article in BMC infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cotrimoxazole prophylactic treatment prevents malaria in children in sub-Saharan Africa: systematic review and meta-analysis.Tropical medicine & international health : TM & IH · 2014Pooled it
- Validation and calibration of a computer simulation model of pediatric HIV infection.PloS one · 2013Trial
- Prevention of mother-to-child transmission of HIV in Kermanshah, west of Iran from 2014 to 2021.BMC pediatrics · 2023Article
- Home-based HIV Testing for Children: A Useful Complement for Caregivers with More Children, Who are Male, and with an HIV Negative Partner.AIDS and behavior · 2022Article
- Adapting strategies for effective and efficient pediatric HIV case finding in low prevalence countries: risk screening tool for testing children presenting at high-risk entry points in Ethiopia.BMC infectious diseases · 2022Article
- The Cascade of Care From Routine Point-of-Care HIV Testing at Birth: Results From an 18-Months Pilot Program in Eswatini.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Mortality and its association with CD4 cell count and hemoglobin level among children on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.Tropical medicine and health · 2020Article
- Perinatal HIV Transmission Prevention: Challenges among Women Living with HIV in sub-Saharan Africa.International journal of MCH and AIDS · 2020Article
- Integration of Neonatal and Child Health Interventions with Pediatric HIV Interventions in Global Health.International journal of MCH and AIDS · 2018Review
- Characterizing Pediatric Non-Malarial Fever and Identifying the At-Risk Child in Rural Malawi.Global pediatric health · 2018Article
- Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study.Translational pediatrics · 2016Article
- Effect of cotrimoxazole prophylaxis on the incidence of malaria in HIV-infected children in 2012, in Abidjan, Côte d'Ivoire: a prospective cohort study.BMC infectious diseases · 2015Article
- Cost-effectiveness of first-line antiretroviral therapy for HIV-infected African children less than 3 years of age.AIDS (London, England) · 2015Article
- Association between age at antiretroviral therapy initiation and 24-month immune response in West-African HIV-infected children.AIDS (London, England) · 2014Article
- Incidence of World Health Organization stage 3 and 4 events, tuberculosis and mortality in untreated, HIV-infected children enrolling in care before 1 year of age: an IeDEA (International Epidemiologic Databases To Evaluate AIDS) East Africa regional analysis.The Pediatric infectious disease journal · 2014Article
- Morbidity and health care resource utilization in HIV-infected children after antiretroviral therapy initiation in Côte d'Ivoire, 2004-2009.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- Missed opportunities for early access to care of HIV-infected infants in Burkina Faso.PloS one · 2014Article
- Resource Utilization and Costs of Care prior to ART Initiation for Pediatric Patients in Zambia.AIDS research and treatment · 2014Article
- Reasons for hospitalization in HIV-infected children in West Africa.Journal of the International AIDS Society · 2014Article
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Abstract
backgroundClinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART) is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children.
methodsAll HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation) and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation.
results405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8) at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT) intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71) versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1) at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42).
conclusionsHaving benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.
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