Under-two child mortality according to maternal HIV status in Rwanda: assessing outcomes within the National PMTCT Program.
Pan Afr Med J
; 9: 37, 2011.
Article
em En
| MEDLINE
| ID: mdl-22145068
ABSTRACT
INTRODUCTION:
We sought to compare risk of death among children aged under-2 years born to HIV positive mother (HIV-exposed) and to HIV negative mother (HIV non-exposed), and identify determinants of under-2 mortality among the two groups in Rwanda.METHODS:
In a stratified, two-stage cluster sampling design, we selected mother-child pairs using national Antenatal Care (ANC) registers. Household interview with each mother was conducted to capture socio-demographic data and information related to pregnancy, delivery and post-partum. Data were censored at the date of child death. Using Cox proportional hazard model, we compared the hazard of death among HIV-exposed children and HIV non-exposed children.RESULTS:
Of 1,455 HIV-exposed children, 29 (2.0%; 95% CI 1.3%-2.7%) died by 6 months compared to 18 children of the 1,565 HIV non-exposed children (1.2%; 95% CI 0.6%-1.7%). By 9 months, cumulative risks of death were 3.0% (95%; CI 2.2%-3.9%) and 1.3% (96%; CI 0.7%-1.8%) among HIV-exposed and HIV non-exposed children, respectively. By 2 years, the hazard of death among HIV-exposed children was more than 3 times higher (aHR3.5; 95% CI 1.8-6.9) among HIV-exposed versus non-exposed children. Risk of death by 9-24 months of age was 50% lower among mothers who attended 4 or more antenatal care (ANC) visits (aHR 0.5, 95% CI 0.3-0.9), and 26% lower among families who had more assets (aHR 0.7, 95% CI 0.5-1.0).CONCLUSION:
Infant mortality was independent of perinatal HIV exposure among children by 6 months of age. However, HIV-exposed children were 3.5 times more likely to die by 2 years. Fewer antenatal visits, lower household assets and maternal HIV seropositive status were associated with increased mortality by 9-24 months.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Infantil
/
Soropositividade para HIV
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
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Infant
/
Male
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article