Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study
Background Studies have shown a high rate of mortality among adults despite the introduction of highly active antiretroviral therapy (HAART). However, long-term outcomes of HAART among children remain poorly documented in Ethiopia. This study aimed to estimate the survival rate and identify associat...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/9/1/e003022.full |
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| author | Yimam Getaneh Yared Dejene Birhanemeskel T. Adankie Siti Qamariyah Khairunisa Dominicus Husada Kuntaman Kuntaman Maria Inge Lusida |
| author_facet | Yimam Getaneh Yared Dejene Birhanemeskel T. Adankie Siti Qamariyah Khairunisa Dominicus Husada Kuntaman Kuntaman Maria Inge Lusida |
| author_sort | Yimam Getaneh |
| collection | DOAJ |
| description | Background Studies have shown a high rate of mortality among adults despite the introduction of highly active antiretroviral therapy (HAART). However, long-term outcomes of HAART among children remain poorly documented in Ethiopia. This study aimed to estimate the survival rate and identify associated factors among HIV-infected children on antiretroviral therapy.Methods A retrospective cohort study was conducted from August to December 2022 in 13 health facilities (HFs) using records of 554 children (<15 years old) initiating HAART from 2007 to 2019. HFs were selected using probability proportional to the size of patients. Survival rate and predictors of mortality were estimated using Kaplan-Meier and Cox-proportional hazards, respectively. The analysis was done using STATA V.16.0.Result Overall mortality among HIV-positive children taking HAART in Ethiopia in 12-year follow-up was 25.5%. Moreover, the mortality rate was 24 per 100 child-year observation. Survival during the median 9.65 (95% CI=9.30 to 10.00) years of follow-up was 0.50. There was a significant drop in the survival rate from the 6th year of follow-up (0.96) to the 8th year (0.78) till the 12th year (0.18). By the end of the follow-up period, 172 (23.69%) were lost to follow-up. There was a high risk of mortality among female (adjusted HRs (AHRs) (95% CI) =1.35 (1.14 to 1.65)), those with poor adherence (AHR (95% CI) =1.29 (1.13 to 1.35)), CD4 count of ≤200 cells/mm3 (AHR (95% CI) =1.75 (1.33 to 2.30)) and baseline haemoglobin≤12 g/dL (AHR (95% CI) =1.8 (1.66 to 1.98)).Conclusion The significant drop in the survival rate as of the 6th year follow-up and the high loss rate to follow-up call for programme attention. Close follow-up of children with low CD4 count, low haemoglobin and poor adherence could help improve survival. |
| format | Article |
| id | doaj-art-7b66645e52c147e8ab7cae855daae2ea |
| institution | Kabale University |
| issn | 2399-9772 |
| language | English |
| publishDate | 2025-01-01 |
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| series | BMJ Paediatrics Open |
| spelling | doaj-art-7b66645e52c147e8ab7cae855daae2ea2025-01-17T08:20:08ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-01-019110.1136/bmjpo-2024-003022Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort studyYimam Getaneh0Yared Dejene1Birhanemeskel T. Adankie2Siti Qamariyah Khairunisa3Dominicus Husada4Kuntaman Kuntaman5Maria Inge Lusida61 Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia4 St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia4 St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia3 Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia5 Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia5 Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia3 Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, IndonesiaBackground Studies have shown a high rate of mortality among adults despite the introduction of highly active antiretroviral therapy (HAART). However, long-term outcomes of HAART among children remain poorly documented in Ethiopia. This study aimed to estimate the survival rate and identify associated factors among HIV-infected children on antiretroviral therapy.Methods A retrospective cohort study was conducted from August to December 2022 in 13 health facilities (HFs) using records of 554 children (<15 years old) initiating HAART from 2007 to 2019. HFs were selected using probability proportional to the size of patients. Survival rate and predictors of mortality were estimated using Kaplan-Meier and Cox-proportional hazards, respectively. The analysis was done using STATA V.16.0.Result Overall mortality among HIV-positive children taking HAART in Ethiopia in 12-year follow-up was 25.5%. Moreover, the mortality rate was 24 per 100 child-year observation. Survival during the median 9.65 (95% CI=9.30 to 10.00) years of follow-up was 0.50. There was a significant drop in the survival rate from the 6th year of follow-up (0.96) to the 8th year (0.78) till the 12th year (0.18). By the end of the follow-up period, 172 (23.69%) were lost to follow-up. There was a high risk of mortality among female (adjusted HRs (AHRs) (95% CI) =1.35 (1.14 to 1.65)), those with poor adherence (AHR (95% CI) =1.29 (1.13 to 1.35)), CD4 count of ≤200 cells/mm3 (AHR (95% CI) =1.75 (1.33 to 2.30)) and baseline haemoglobin≤12 g/dL (AHR (95% CI) =1.8 (1.66 to 1.98)).Conclusion The significant drop in the survival rate as of the 6th year follow-up and the high loss rate to follow-up call for programme attention. Close follow-up of children with low CD4 count, low haemoglobin and poor adherence could help improve survival.https://bmjpaedsopen.bmj.com/content/9/1/e003022.full |
| spellingShingle | Yimam Getaneh Yared Dejene Birhanemeskel T. Adankie Siti Qamariyah Khairunisa Dominicus Husada Kuntaman Kuntaman Maria Inge Lusida Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study BMJ Paediatrics Open |
| title | Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study |
| title_full | Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study |
| title_fullStr | Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study |
| title_full_unstemmed | Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study |
| title_short | Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study |
| title_sort | exploring survival rates in hiv infected ethiopian children receiving haart a retrospective cohort study |
| url | https://bmjpaedsopen.bmj.com/content/9/1/e003022.full |
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