Evidence map›Paper›PMID 23921609›Full record

ArticleAIDS (London, England)2013

Breastfeeding is associated with decreased pneumonia incidence among HIV-exposed, uninfected Kenyan infants.

Kristjana H Ásbjörnsdóttir, Jennifer A Slyker, Noel S Weiss, Dorothy Mbori-Ngacha, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace John-Stewart

Abstract read
In one paragraph

Article in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Review
  10. Breastfeeding Is Associated with Decreased Risk of Hospitalization among HIV-Exposed, Uninfected Kenyan Infants.Journal of human lactation : official journal of International Lactation Consultant Association · 2016
    Article
  11. Article
  12. High Rates of Exclusive Breastfeeding in Both Arms of a Peer Counseling Study Promoting EBF Among HIV-Infected Kenyan Women.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2016
    Article
  13. Article
  14. Breast milk pharmacokinetics of efavirenz and breastfed infants' exposure in genetically defined subgroups of mother-infant pairs: an observational study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015
    Observational
  15. The effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2015
    Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Kristjana H ÁsbjörnsdóttiraDepartment of Epidemiology bDepartment of Global Health cDepartment of Pediatrics, University of Washington, Seattle, Washington USA dDepartment of Paediatrics & Child Health, University of Nairobi, Nairobi, Kenya eDepartment of Medicine, University of Washington, Seattle, Washington USA.
Jennifer A Slyker
Noel S Weiss
Dorothy Mbori-Ngacha
Elizabeth Maleche-Obimbo
Dalton Wamalwa
Grace John-Stewart
University of Washington · USUniversity of Nairobi · KE

Funding

Urgent Versus Post-Stabilization ART in HIV+ Children with Severe Co-infectionsR01HD023412 · NICHD · UNIVERSITY OF WASHINGTON · PI Grace C. John-Stewart, DALTON CHEKOKO WAMALWA · 1987 to 2026
$12.2M
Interdisciplinary Tranining in Cancer ResearchT32CA080416 · NCI · UNIVERSITY OF WASHINGTON · PI STODDARD, BARRY L. · 1998 to 2023
$9.7M
Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
Vertical CMV transmission in the setting of maternal HIV-1 infection in KenyaK01AI087369 · NIAID · UNIVERSITY OF WASHINGTON · PI SLYKER, JENNIFER ANN · 2010 to 2014
$616k
NCI NIH HHS T32 CA080416NIAID NIH HHS K01 AI087369NICHD NIH HHS K24 HD054314NICHD NIH HHS R01 HD023412NICHD NIH HHS R01 HD-23412
6 · The paper itself

Abstract

objectiveHIV-exposed uninfected (HEU) infants have higher infectious disease morbidity and mortality than unexposed infants. We determined the incidence and risk factors for pneumonia, a leading cause of infant mortality worldwide, in a cohort of HEU infants. Identifying predictors of pneumonia among HEU infants may enable early identification of those at highest risk.

designA retrospective cohort of HEU infants participating in a Kenyan perinatal HIV study, enrolled between 1999 and 2002.

methodsInfants were followed monthly from birth to 12 months. Incidence of pneumonia diagnosed at monthly study visits, sick-child visits or by means of averbal autopsy was estimated with a 14-day window for new episodes. Cox proportional hazards regression was used to identify predictors of first pneumonia occurrence.

resultsAmong 388 HEU infants with 328 person-years of follow-up, the incidence of pneumonia was 900/1000 child-years [95% confidence interval (CI) 800-1000]. Maternal HIV viral load at 32 weeks' gestation [hazard ratio 1.2 (1.0-1.5) per log10 difference] and being underweight (weight-for-age Z-score <-2) at the previous visit [hazard ratio 1.8 (1.1-2.8)] were associated with increased risk of pneumonia. Breastfed infants had a 47% lower risk of pneumonia than those never breastfed [hazard ratio 0.53 (0.39-0.73)], independent of infant growth, maternal viral load and maternal CD4%. Breastfeeding was also associated with a 74% lower risk of pneumonia-related hospitalization [hazard ratio 0.26 (0.13-0.53)].

conclusionsThe incidence of pneumonia in this cohort of HEU infants was high. Our observations suggest that maternal viral suppression and breastfeeding may reduce the burden of pneumonia among HEU infants.

Indexed as

Breast FeedingAdultCohort StudiesFemaleHIV InfectionsHumansIncidenceInfantInfant, NewbornKenyaLongitudinal StudiesMalePneumoniaRetrospective StudiesRisk FactorsYoung Adult

Identifiers

PMID23921609
PMCPMC4084504
OpenAlexW2065556234

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.