Incidence of common opportunistic infections among HIV-infected children on ART at Debre Markos referral hospital, Northwest Ethiopia: a retrospective cohort study.
- Publisher:
- BMC
- Publication Type:
- Journal Article
- Citation:
- BMC infectious diseases, 2020, 20, (1), pp. 50
- Issue Date:
- 2020-01-16
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Field | Value | Language |
---|---|---|
dc.contributor.author | Melkamu, MW | |
dc.contributor.author | Gebeyehu, MT | |
dc.contributor.author | Afenigus, AD | |
dc.contributor.author | Hibstie, YT | |
dc.contributor.author | Temesgen, B | |
dc.contributor.author | Petrucka, P | |
dc.contributor.author | Alebel, A | |
dc.date.accessioned | 2021-05-23T21:23:12Z | |
dc.date.available | 2020-01-07 | |
dc.date.available | 2021-05-23T21:23:12Z | |
dc.date.issued | 2020-01-16 | |
dc.identifier.citation | BMC infectious diseases, 2020, 20, (1), pp. 50 | |
dc.identifier.issn | 1471-2334 | |
dc.identifier.issn | 1471-2334 | |
dc.identifier.uri | http://hdl.handle.net/10453/149088 | |
dc.description.abstract | BACKGROUND:Opportunistic infections (OIs) are the leading cause of morbidity and mortality among children living with human immunodeficiency virus (HIV). For better treatments and interventions, current and up-to-date information concerning occurrence of opportunistic infections in HIV-infected children is crucial. However, studies regarding the incidence of common opportunistic infections in HIV-infected children in Ethiopia are very limited. Hence, this study aimed to determine the incidence of opportunistic infections among HIV-infected children on antiretroviral therapy (ART) at Debre Markos Referral Hospital. METHODS:A facility-based retrospective cohort study was undertaken at Debre Markos Referral Hospital for the period of January 1, 2005 to March 31, 2019. A total of 408 HIV-infected children receiving ART were included. Data from HIV-infected children charts were extracted using a data extraction form adapted from ART entry and follow-up forms. Data were entered using Epi-data™ Version 3.1 and analyzed using Stata™ Version 14. The Kaplan Meier survival curve was used to estimate the opportunistic infections free survival time. Both bi-variable and multivariable Cox proportional hazard models were fitted to identify the predictors of opportunistic infections. RESULTS:This study included the records of 408 HIV-infected children-initiated ART between the periods of January 1, 2005 to March 31, 2019. The overall incidence rate of opportunistic infections during the follow-up time was 9.7 (95% CI: 8.13, 11.48) per 100 child-years of observation. Tuberculosis at 29.8% was the most commonly encountered OI at follow-up. Children presenting with advanced disease stage (III and IV) (AHR: 1.8, 95% CI: 1.2, 2.7), having "fair" or "poor" ART adherence (AHR: 2.6, 95% CI: 1.8, 3.8), not taking OI prophylaxis (AHR:1.6, 95% CI: 1.1, 2.4), and CD4 count or % below the threshold (AHR:1.7, 95% CI: 1.1, 2.6) were at a higher risk of developing opportunistic infections. CONCLUSIONS:In this study, the incidence rate of opportunistic infections among HIV-infected children remained high. Concerning predictors, such as advanced disease stage (III and IV), CD4 count or % below the threshold, "fair" or "poor" ART adherence, and not taking past OI prophylaxis were found to be significantly associated with OIs. | |
dc.format | Electronic | |
dc.language | eng | |
dc.publisher | BMC | |
dc.relation.ispartof | BMC infectious diseases | |
dc.relation.isbasedon | 10.1186/s12879-020-4772-y | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | 0605 Microbiology, 1103 Clinical Sciences, 1108 Medical Microbiology | |
dc.subject.classification | Microbiology | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Tuberculosis | |
dc.subject.mesh | Pneumonia, Bacterial | |
dc.subject.mesh | AIDS-Related Opportunistic Infections | |
dc.subject.mesh | Sarcoma, Kaposi | |
dc.subject.mesh | HIV Infections | |
dc.subject.mesh | CD4 Lymphocyte Count | |
dc.subject.mesh | Incidence | |
dc.subject.mesh | Survival Rate | |
dc.subject.mesh | Proportional Hazards Models | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Socioeconomic Factors | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Child | |
dc.subject.mesh | Child, Preschool | |
dc.subject.mesh | Infant | |
dc.subject.mesh | Infant, Newborn | |
dc.subject.mesh | Ethiopia | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | AIDS-Related Opportunistic Infections | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | CD4 Lymphocyte Count | |
dc.subject.mesh | Child | |
dc.subject.mesh | Child, Preschool | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Ethiopia | |
dc.subject.mesh | Female | |
dc.subject.mesh | HIV Infections | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Incidence | |
dc.subject.mesh | Infant | |
dc.subject.mesh | Infant, Newborn | |
dc.subject.mesh | Male | |
dc.subject.mesh | Pneumonia, Bacterial | |
dc.subject.mesh | Proportional Hazards Models | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Sarcoma, Kaposi | |
dc.subject.mesh | Socioeconomic Factors | |
dc.subject.mesh | Survival Rate | |
dc.subject.mesh | Tuberculosis | |
dc.title | Incidence of common opportunistic infections among HIV-infected children on ART at Debre Markos referral hospital, Northwest Ethiopia: a retrospective cohort study. | |
dc.type | Journal Article | |
utslib.citation.volume | 20 | |
utslib.location.activity | England | |
utslib.for | 1103 Clinical Sciences | |
utslib.for | 1108 Medical Microbiology | |
utslib.for | 0605 Microbiology | |
utslib.for | 1103 Clinical Sciences | |
utslib.for | 1108 Medical Microbiology | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health/Public Health | |
utslib.copyright.status | open_access | * |
dc.date.updated | 2021-05-23T21:23:09Z | |
pubs.issue | 1 | |
pubs.publication-status | Published | |
pubs.volume | 20 | |
utslib.citation.issue | 1 |
Abstract:
BACKGROUND:Opportunistic infections (OIs) are the leading cause of morbidity and mortality among children living with human immunodeficiency virus (HIV). For better treatments and interventions, current and up-to-date information concerning occurrence of opportunistic infections in HIV-infected children is crucial. However, studies regarding the incidence of common opportunistic infections in HIV-infected children in Ethiopia are very limited. Hence, this study aimed to determine the incidence of opportunistic infections among HIV-infected children on antiretroviral therapy (ART) at Debre Markos Referral Hospital. METHODS:A facility-based retrospective cohort study was undertaken at Debre Markos Referral Hospital for the period of January 1, 2005 to March 31, 2019. A total of 408 HIV-infected children receiving ART were included. Data from HIV-infected children charts were extracted using a data extraction form adapted from ART entry and follow-up forms. Data were entered using Epi-data™ Version 3.1 and analyzed using Stata™ Version 14. The Kaplan Meier survival curve was used to estimate the opportunistic infections free survival time. Both bi-variable and multivariable Cox proportional hazard models were fitted to identify the predictors of opportunistic infections. RESULTS:This study included the records of 408 HIV-infected children-initiated ART between the periods of January 1, 2005 to March 31, 2019. The overall incidence rate of opportunistic infections during the follow-up time was 9.7 (95% CI: 8.13, 11.48) per 100 child-years of observation. Tuberculosis at 29.8% was the most commonly encountered OI at follow-up. Children presenting with advanced disease stage (III and IV) (AHR: 1.8, 95% CI: 1.2, 2.7), having "fair" or "poor" ART adherence (AHR: 2.6, 95% CI: 1.8, 3.8), not taking OI prophylaxis (AHR:1.6, 95% CI: 1.1, 2.4), and CD4 count or % below the threshold (AHR:1.7, 95% CI: 1.1, 2.6) were at a higher risk of developing opportunistic infections. CONCLUSIONS:In this study, the incidence rate of opportunistic infections among HIV-infected children remained high. Concerning predictors, such as advanced disease stage (III and IV), CD4 count or % below the threshold, "fair" or "poor" ART adherence, and not taking past OI prophylaxis were found to be significantly associated with OIs.
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