Evidence map›Paper›PMID 34261465›Full record

ArticleBMC pediatrics2021

Treatment outcomes among children younger than five years living with HIV in rural Zambia, 2008-2018: a cohort study.

Jessica L Schue, Janneke H van Dijk, Francis Hamangaba, Mutinta Hamahuwa, Nkumbula Moyo, Philip E Thuma, William J Moss, Catherine G Sutcliffe

Open access · goldAbstract read
In one paragraph

Article in BMC pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 51% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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

8 authors at 3 institutions in 3 countries.

Jessica L SchueJohns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA.
Janneke H van DijkErasmus University, Burgemeester Oudlaan 50, 3062, PA, Rotterdam, Netherlands.
Francis HamangabaMacha Research Trust, Choma, Zambia.
Mutinta HamahuwaMacha Research Trust, Choma, Zambia.
Nkumbula MoyoMacha Research Trust, Choma, Zambia.
Philip E ThumaJohns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA.
William J MossJohns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA.
Catherine G SutcliffeJohns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA. csutcli1@jhu.edu.
Johns Hopkins University · USGolden Valley Agricultural Research Trust · ZMErasmus University Rotterdam · NL

Funding

PEPFAR
6 · The paper itself

Abstract

backgroundHIV testing and treatment guidelines for children in sub-Saharan Africa have evolved over time, such that children are now treated at younger ages. The objective of this study was to describe the treatment experience for immunologic, virologic, and growth outcomes among HIV-infected Zambian children younger than 5 years of age from 2008 to 2018.

methodsParticipants enrolled in a clinical cohort study in Macha, Zambia and initiating antiretroviral treatment before 5 years of age between 2008 and 2015 were included in the analysis and followed up to the end of 2018. Outcomes, including growth, CD4+ T-cell percentage, viral suppression, and mortality, were evaluated among all children using longitudinal and survival analyses. Comparisons by age at treatment initiation (< 1, 1 to < 2, and 2 to < 5 years) were also evaluated.

resultsThree hundred eighty-one children initiating treatment before 5 years of age between 2008 and 2015 were included in the analysis. Growth metrics and CD4+ T-cell percentage improved over time after treatment initiation. However, 20% of children remained underweight and 40% of children remained stunted after the first 36 months of treatment. 85% of children had a viral load < 400 copies/mL after 12 months of treatment. However, children < 1 year at treatment initiation were more likely to have a detectable viral load in the first 12 months of treatment and less likely to achieve viral suppression compared to older children. Mortality was highest in the first 12 months of treatment, among underweight children, and among children initiating treatment in 2008-2010 compared to 2011-2015.

conclusionsMost children initiating antiretroviral treatment from 2008 to 2015 in rural Zambia responded well to treatment. However, many children remained underweight and stunted, and experienced high mortality rates during the first few months of treatment. This supports continued efforts to improve early infant diagnosis, nutritional support, and pediatric drug formulations.

Indexed as

Anti-HIV AgentsHIV InfectionsAdolescentCD4 Lymphocyte CountChildCohort StudiesHumansInfantTreatment OutcomeViral LoadZambiaAnti-HIV AgentsAntiretroviral therapyHIVPediatricsSub-Saharan Africa

Identifiers

PMID34261465
PMCPMC8278691
OpenAlexW3182116640

What OpenQuestion holds

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Registered trials

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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.