ArticlePloS one2012
Mortality and health outcomes of HIV-exposed and unexposed children in a PMTCT cohort in Malawi.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
58 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Early neurodevelopment of HIV-exposed uninfected children in the era of antiretroviral therapy: a systematic review and meta-analysis.The Lancet. Child & adolescent health · 2022Pooled it
- Essential components of postnatal care - a systematic literature review and development of signal functions to guide monitoring and evaluation.BMC pregnancy and childbirth · 2022Pooled it
- A Meta-analysis Assessing Diarrhea and Pneumonia in HIV-Exposed Uninfected Compared With HIV-Unexposed Uninfected Infants and Children.Journal of acquired immune deficiency syndromes (1999) · 2019Pooled it
- What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature.AIDS care · 2016Pooled it
- Nutritional status and complementary feeding among HIV-exposed infants: a prospective cohort study.Maternal & child nutrition · 2017Trial
- Complementary Feeding and Diarrhea and Respiratory Infection Among HIV-Exposed Tanzanian Infants.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Malaria burden in a birth cohort of HIV-exposed uninfected Ugandan infants living in a high malaria transmission setting.Malaria journal · 2016Trial
- The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding.Paediatrics and international child health · 2016Trial
- Efficacy and safety of three regimens for the prevention of malaria in young HIV-exposed Ugandan children: a randomized controlled trial.AIDS (London, England) · 2014Trial
- Growth, infection, and humoral immunity in children who are HIV exposed and uninfected.Frontiers in cellular and infection microbiology · 2026Article
- BeyondFrontiers in genetics · 2026Review
- The effect of environment and in-utero HIV exposure on neurodevelopment in infants.AIDS (London, England) · 2025Article
- Clinical and immunological outcomes of HIV-exposed uninfected and HIV-unexposed uninfected children in the first 24 months of life in Western Kenya.BMC infectious diseases · 2024Article
- A 12-month Prospective Study of HIV-infected and HIV-uninfected Women and Their Infants in Malawi: Comparative Analysis of Clinical Events and Infant Growth.The American journal of tropical medicine and hygiene · 2023Article
- Neurocognitive outcomes of children exposed to and living with HIV aged 3-5 years in Kilifi, Kenya.Frontiers in reproductive health · 2023Article
- Dynamics of the infant gut microbiota in the first 18 months of life: the impact of maternal HIV infection and breastfeeding.Microbiome · 2022Article
- Observational
- HIV-exposed uninfected infant morbidity and mortality within a nationally representative prospective cohort of mother-infant pairs in Zimbabwe.AIDS (London, England) · 2020Article
- Increased platelets count in HIV-1 uninfected infants born from HIV-1 infected mothers.Hematology reports · 2019Article
- Reduced Transplacental Transfer of Antimalarial Antibodies in Kenyan HIV-Exposed Uninfected Infants.Open forum infectious diseases · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMortality and morbidity among HIV-exposed children are thought to be high in Malawi. We sought to determine mortality and health outcomes of HIV-exposed and unexposed infants within a PMTCT program.
methodData were collected as part of a retrospective cohort study in Zomba District, Malawi. HIV-infected mothers were identified via antenatal, delivery and postpartum records with a delivery date 18-20 months prior; the next registered HIV-uninfected mother was identified as a control. By interview and health record review, data on socio-demographic characteristics, service uptake, and health outcomes were collected. HIV-testing was offered to all exposed children.
results173 HIV-infected and 214 uninfected mothers were included. 4 stillbirths (1.0%) occurred; among the 383 livebirths, 41 (10.7%) children died by 20 months (32 (18.7%) HIV-exposed and 9 unexposed children (4.3%; p<0.0001)). Risk factors for child death included: HIV-exposure [adjOR2.9(95%CI 1.1-7.2)], low birthweight [adjOR2.5(1.0-6.3)], previous child death (adjOR25.1(6.5-97.5)] and maternal death [adjOR5.3(11.4-20.5)]. At 20 months, HIV-infected children had significantly poorer health outcomes than HIV-unexposed children and HIV-exposed but uninfected children (HIV-EU), including: hospital admissions, delayed development, undernutrition and restrictions in function (Lansky scale); no significant differences were seen between HIV-EU and HIV-unexposed children. Overall, no difference was seen at 20 months among HIV-infected, HIV-EU and HIV-unexposed groups in Z-scores (%<-2.0) for weight, height and BMI. Risk factors for poor functional health status at 20 months included: HIV-infection [adjOR8.9(2.4-32.6)], maternal illness [adjOR2.8(1.5-5.0)] and low birthweight [adjOR2.0(1.0-4.1)].
conclusionChild mortality remains high within this context and could be reduced through more effective PMTCT including prioritizing the treatment of maternal HIV infection to address the effect of maternal health and survival on infant health and survival. HIV-infected children demonstrated developmental delays, functional health and nutritional deficits that underscore the need for increased uptake of early infant diagnosis and institution of ART for all infected infants.
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