Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study.

Alebel, A; Engeda, EH; Kelkay, MM; Petrucka, P; Kibret, GD; Wagnew, F; Asmare, G; Bitew, ZW; Ketema, DB; Gedif, G; Temesgen, B; Hibstie, YT; Melkamu, MW; Eshetie, S

Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study.

Alebel, A Engeda, EH Kelkay, MM Petrucka, P Kibret, GD Wagnew, F Asmare, G Bitew, ZW Ketema, DB Gedif, G Temesgen, B Hibstie, YT Melkamu, MW Eshetie, S

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Publisher:: Springer Science and Business Media LLC
Publication Type:: Journal Article
Citation:: BMC public health, 2020, 20, (1)
Issue Date:: 2020-08-27

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Field	Value	Language
dc.contributor.author	Alebel, A
dc.contributor.author	Engeda, EH
dc.contributor.author	Kelkay, MM
dc.contributor.author	Petrucka, P
dc.contributor.author	Kibret, GD
dc.contributor.author	Wagnew, F
dc.contributor.author	Asmare, G
dc.contributor.author	Bitew, ZW
dc.contributor.author	Ketema, DB
dc.contributor.author	Gedif, G
dc.contributor.author	Temesgen, B
dc.contributor.author	Hibstie, YT
dc.contributor.author	Melkamu, MW
dc.contributor.author	Eshetie, S
dc.date.accessioned	2021-05-26T04:36:22Z
dc.date.available	2020-08-20
dc.date.available	2021-05-26T04:36:22Z
dc.date.issued	2020-08-27
dc.identifier.citation	BMC public health, 2020, 20, (1)
dc.identifier.issn	1471-2458
dc.identifier.issn	1471-2458
dc.identifier.uri	http://hdl.handle.net/10453/149238
dc.description.abstract	<h4>Background</h4>Though highly active antiretroviral therapy (HAART) has been available for more than a decade in Ethiopia, information regarding mortality rates of human immunodeficiency virus (HIV)-positive children after antiretroviral therapy antiretroviral therapy (ART) initiation is very scarce. Thus, this study intends to determine the predictors of mortality among HIV-positive children receiving ART in Amhara Region.<h4>Methods</h4>A multicenter facility-based historical cohort study was conducted in 538 HIV-positive children on ART from January 2012 to February 2017. We employed a standardized data extraction tool, adapted from ART entry and follow-up forms. Descriptive analyses were summarized using the Kaplan-Meier survival curve and log rank test. Then, the Cox-proportional hazard regression model was employed to estimate the hazard of death up to five-years after ART initiation. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables.<h4>Results</h4>The cohort contributed a total follow-up time of 14,600 child-months, with an overall mortality rate of 3.2 (95% CI: 2.3, 4.3) per 100 child-years. This study also indicated that HIV-infected children presenting with opportunistic infections (OIs) (AHR: 2.5, 95% CI: 1.04, 5.9), anemia (AHR: 3.1, 95% CI: 1.4, 6.7), severe immunodeficiency (AHR: 4.4, 95% CI: 1.7, 11.7), severe stunting (AHR: 3.3, 95% CI: 1.4, 8.0), severe wasting (AHR: 3.1, 95% CI: 1.3, 7.3), and advanced disease staging (III and IV) (AHR: 3.0, 95% CI: 1.2, 7.1) were at higher risk of mortality.<h4>Conclusion</h4>A higher rate of mortality was observed in our study as compared to previous Ethiopian studies. HIV-positive children presenting with anemia, OIs, severe immunodeficiency, advanced disease staging (III and IV), severe stunting, and severe wasting were at higher risk of mortality.
dc.format	Electronic
dc.language	eng
dc.publisher	Springer Science and Business Media LLC
dc.relation.ispartof	BMC public health
dc.relation.isbasedon	10.1186/s12889-020-09418-6
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.mesh	Adolescent
dc.subject.mesh	AIDS-Related Opportunistic Infections
dc.subject.mesh	Anti-Retroviral Agents
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	Infant
dc.subject.mesh	Male
dc.subject.mesh	Survival Analysis
dc.subject.mesh	Humans
dc.subject.mesh	AIDS-Related Opportunistic Infections
dc.subject.mesh	HIV Infections
dc.subject.mesh	Anti-Retroviral Agents
dc.subject.mesh	Survival Analysis
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Infant
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	Anti-Retroviral Agents
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	Infant
dc.subject.mesh	Male
dc.subject.mesh	Survival Analysis
dc.title	Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study.
dc.type	Journal Article
utslib.citation.volume	20
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
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	*
pubs.consider-herdc	false
dc.date.updated	2021-05-26T04:36:19Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	20
utslib.citation.issue	1

Abstract:

Background

Though highly active antiretroviral therapy (HAART) has been available for more than a decade in Ethiopia, information regarding mortality rates of human immunodeficiency virus (HIV)-positive children after antiretroviral therapy antiretroviral therapy (ART) initiation is very scarce. Thus, this study intends to determine the predictors of mortality among HIV-positive children receiving ART in Amhara Region.

Methods

A multicenter facility-based historical cohort study was conducted in 538 HIV-positive children on ART from January 2012 to February 2017. We employed a standardized data extraction tool, adapted from ART entry and follow-up forms. Descriptive analyses were summarized using the Kaplan-Meier survival curve and log rank test. Then, the Cox-proportional hazard regression model was employed to estimate the hazard of death up to five-years after ART initiation. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables.

Results

The cohort contributed a total follow-up time of 14,600 child-months, with an overall mortality rate of 3.2 (95% CI: 2.3, 4.3) per 100 child-years. This study also indicated that HIV-infected children presenting with opportunistic infections (OIs) (AHR: 2.5, 95% CI: 1.04, 5.9), anemia (AHR: 3.1, 95% CI: 1.4, 6.7), severe immunodeficiency (AHR: 4.4, 95% CI: 1.7, 11.7), severe stunting (AHR: 3.3, 95% CI: 1.4, 8.0), severe wasting (AHR: 3.1, 95% CI: 1.3, 7.3), and advanced disease staging (III and IV) (AHR: 3.0, 95% CI: 1.2, 7.1) were at higher risk of mortality.

Conclusion

A higher rate of mortality was observed in our study as compared to previous Ethiopian studies. HIV-positive children presenting with anemia, OIs, severe immunodeficiency, advanced disease staging (III and IV), severe stunting, and severe wasting were at higher risk of mortality.

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http://hdl.handle.net/10453/149238