ArticleHIV medicine2025
Trends of severe HIV disease and mortality among children in rural Tanzania.
Article in HIV medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Survival and mortality predictors among children living with HIV initiating antiretroviral therapy in Angola: a retrospective cohort study.BMC public health · 2026Article
- Trends of severe HIV disease and mortality among children in rural Tanzania.HIV medicine · 2025Article
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12 authors.
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Abstract
objectiveTo assess trends of severe HIV disease (SHD) and mortality/loss to follow-up (LTFU) among children living with HIV in rural Tanzania.
methodsAmong children aged 0-14 years living with HIV enrolled in the prospective Kilombero & Ulanga Antiretroviral Cohort in January 2005-December 2023, we determined WHO-defined SHD prevalences at enrolment, mortality/LTFU incidence during follow-up using Kaplan-Meier methods, and associated factors using regression models.
resultsAt enrolment, among 1089 children [567 (52%) males, 587 (54%) aged <5 years and 530 (49%) with a HIV WHO stage III/IV], 112/332 (34%) had CD4 cell count <200 cells/μL among those aged 5-14 years. In children aged 5-14 years, SHD was diagnosed in 265/502 (53%) with a prevalence of 35-94% declining after 2013. Among children aged <5 years, 374/587 (64%) had SHD with no change over time. Male gender [adjusted odds ratio = 1.45; 95% confidence interval: 1.10-1.90], age <5 years versus older (1.64; 1.13-2.37), hospitalization versus outpatients (6.72; 3.35-13.5), antiretroviral treatment (ART) start within 30 days versus later (2.18; 1.52-3.13), and enrolment during 2013-2016 versus before (2.29; 1.54-3.41) were associated with SHD. After a median follow-up of 3.3 years [interquartile ratio: 0.8-7.8], 130 (12%) children died and 359 (35%) were LTFU. Predictors of mortality/LTFU were SHD [adjusted hazard ratio (aHR) = 1.54; 95% CI: 1.26-1.89], age <5 years versus older (1.28; 1.01-1.66), hospitalization versus outpatients (1.93; 1.42-2.63), living ≥50 km versus ≤1 km away (1.72; 1.37-2.16) and delayed ART initiation versus within 30 days (3.40; 2.70-4,27), while enrolment 2017-2023 versus before (0.51; 0.37-0.70) was protective.
conclusionsThe persisting high prevalence of paediatric SHD and high mortality/LTFU underscores the need for early diagnosis and care.
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