risk factors for pre-treatment mortality among hiv-infected children in rural zambia a cohort study前处理感染艾滋病毒的儿童死亡率的危险因素在农村赞比亚队列研究.pdfVIP

Risk Factors for Pre-Treatment Mortality among HIV- Infected Children in Rural Zambia: A Cohort Study 1 2 2 2 Catherine G. Sutcliffe *, Janneke H. van Dijk , Bornface Munsanje , Francis Hamangaba , Pamela 2 2 1 Siniwymaanzi , Philip E. Thuma , William J. Moss 1 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, 2 Macha Research Trust, Macha Hospital, Choma, Zambia Abstract Background: Many HIV-infected children in sub-Saharan Africa enter care at a late stage of disease. As preparation of the child and family for antiretroviral therapy (ART) can take several clinic visits, some children die prior to ART initiation. This study was undertaken to determine mortality rates and clinical predictors of mortality during the period prior to ART initiation. ¨ Methods: A prospective cohort study of HIV-infected treatment-naıve children was conducted between September 2007 and September 2010 at the HIV clinic at Macha Hospital in rural Southern Province, Zambia. HIV-infected children younger ¨ than 16 years of age who were treatment-naıve at study enrollment were eligible for analysis. Mortality rates prior to ART initiation were calculated and risk factors for mortality were evaluated. Results: 351 children were included in the study, of whom 210 (59.8%) were eligible for ART at study enrollment. Among children ineligible for ART at enrollment, 6 children died (mortality rate: 0.33; 95% CI:0.15, 0.74). Among children eligible at enroll