Evidence map›Paper›PMID 40221651›Full record

SynthesisBMC infectious diseases2025

Incidence and predictors of common opportunistic infections among children less than 15 years of age on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.

Muluken Amare Wudu, Melaku Ashagrie Belete, Selamyhun Tadesse Yosef, Aragaw Tesfaye Gelmo, Yimer Seid Ali, Tarikua Afework Birhanu

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC infectious diseases, 2025. 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
–field-weighted citation impact
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.

  1. Review
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

6 authors.

Muluken Amare WuduDepartment of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia. 385mule@gmail.com.
Melaku Ashagrie BeleteDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia.
Selamyhun Tadesse YosefDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Woldiya University, Woldiya, Ethiopia.
Aragaw Tesfaye GelmoDepartment of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Woldiya University, Woldiya, Ethiopia.
Yimer Seid AliCDC Project, Amhara Regional State Health Bureau, Zonal HIV Program Coordinator, Dessie, Ethiopia.
Tarikua Afework BirhanuDepartment of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite significant efforts to enhance access to antiretroviral therapy (ART), opportunistic infections among children on ART remain a major concern in low-income countries, including Ethiopia. Currently, there are no pooled estimates of opportunistic infections incidence among children on ART in Ethiopia. Consequently, this review aimed to determine the pooled incidence and identify the predictors of opportunistic infections among children under 15 years of age on ART, addressing the existing information gap.

methodsThis systematic review followed the PRISMA guidelines, and relevant studies were obtained from the PubMed, CINAHL, Scopus, EMBASE, and Google Scholar databases. Data analysis for pooled estimates of incidence and predictors of opportunistic infections was conducted via STATA 17 software with random-effects model. Heterogeneity was evaluated via Cochrane's Q-test and the I

resultsOf the 5,631 studies identified, 20 studies involving 9,196 participants were included in the meta-analysis. The pooled incidence of opportunistic infections among children under 15 years of age on antiretroviral therapy was 5.61 per 100 person-years (95% CI: 4.37-6.86), based on 36,716.4 person-years of observation. Predictors of opportunistic infections included advanced WHO clinical stage (HR 1.45, 95% CI: 1.35-1.55), poor ART adherence (HR 1.49, 95% CI: 1.35-1.63), lack of isoniazid (HR 1.56, 95% CI: 1.40-1.74) and cotrimoxazole preventive therapy (HR 1.56, 95% CI: 1.38-1.66), malnutrition (HR 1.50, 95% CI: 1.34-1.67), and severe immunosuppression (HR 1.39, 95% CI: 1.27-1.51).

conclusionThe incidence of opportunistic infections in this review was high, highlighting the need for intensified efforts to achieve the 2030 target. Moreover, advanced WHO clinical stage, poor adherence, lack of isoniazid and cotrimoxazole preventive therapy, malnutrition, and severe immunosuppression were identified as predictors of opportunistic infections. This suggests that early initiation of ART, regular nutritional assessments, intensive follow-up and monitoring, and a multidisciplinary approach need be prioritized to address the identified predictors.

Indexed as

AIDS-Related Opportunistic InfectionsAnti-HIV AgentsAnti-Retroviral AgentsHIV InfectionsOpportunistic InfectionsAdolescentChildChild, PreschoolEthiopiaFemaleHumansIncidenceInfantMaleRisk FactorsAnti-HIV AgentsAnti-Retroviral AgentsAntiretroviral TherapyChildrenEthiopiaIncidenceMeta-analysisOpportunistic InfectionsPredictorsSystematic review

Identifiers

PMID40221651
PMCPMC11993947

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.