Scaling up antiretroviral therapy for HIV-infected children in Côte d'Ivoire: determinants of survival and loss to programme
Bull. W.H.O. (Online)
; 88(7): 490499-2010. ilus
Artigo
em Inglês
| AIM
| ID: biblio-1259864
Biblioteca responsável:
CG1.1
ABSTRACT
Objective:
To investigate deaths and losses to follow-up in a programme designed to scale up antiretroviral therapy (ART) for HIV- infected children in Cote d'Ivoire. Methods Between 2004 and 2007; HIV-exposed children at 19 centres were offered free HIV serum tests (polymerase chain reaction tests in those aged 18 months) and ART. Computerized monitoring was used to determine (i) the number of confirmed HIV infections; (ii) losses to the programme (i.e. death or loss to follow-up) before ART; (iii) mortality and loss-to-programme rates during 12 months of ART; and (iv) determinants of mortality and losses to the programme. Findings The analysis included 3876 ART-naive children. Of the 1766 with HIV-1 infections (17aged 18 months); 124 (7.0) died; 52 (2.9) left the programme; 354 (20) were lost to follow-up before ART; 259 (15) remained in care without ART; and 977 (55) started ART (median age 63 months). The overall mortality rate during ART was significantly higher in the first 3 months than in months 4-12 32.8 and 6.9 per 100 child-years of follow-up; respectively. Loss-to-programme rates were roughly double mortality rates and followed the same trend with duration of ART. Independent predictors of 12-month mortality on ART were pre-ART weight- for-age z-score -2; percentage of CD4+ T lymphocytes 10; World Health Organization HIV/AIDS clinical stage 3 or 4; and blood haemoglobin 8 g/dl. Conclusion The large-scale programme to scale up paediatric ART in Cote d'Ivoire was effective. However; ART was often given too late; and early mortality and losses to programme before and just after ART initiation were major problems
Texto completo:
DisponíveL
Índice:
AIM (África)
Assunto principal:
Pacientes Desistentes do Tratamento
/
Administração dos Cuidados ao Paciente
/
Infecções por HIV
/
Côte d'Ivoire
/
Fármacos Anti-HIV
Tipo de estudo:
Estudo prognóstico
País/Região como assunto:
África
Idioma:
Inglês
Revista:
Bull. W.H.O. (Online)
Ano de publicação:
2010
Tipo de documento:
Artigo
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