12-month mortality and loss-to-program in antiretroviral-treated children: The IeDEA pediatric West African Database to evaluate AIDS (pWADA), 2000-2008
2011

12-Month Mortality and Loss-to-Program in HIV-Infected Children on Antiretroviral Treatment in West Africa

Sample size: 2170 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ekouevi Didier K, Azondekon Alain, Dicko Fatoumata, Malateste Karen, Touré Pety, Eboua François T, Kouadio Kouakou, Renner Lorna, Peterson Kevin, Dabis François, Sy Haby Signaté, Leroy Valeriane

Primary Institution: INSERM, U897, & Institut de Santé Publique, Epidémiologie et Développement (ISPED), Université Victor Segalen Bordeaux 2, Bordeaux, France

Hypothesis

What are the 12-month mortality and loss-to-program rates for HIV-infected children receiving antiretroviral treatment in West Africa?

Conclusion

The study found that 8.3% of HIV-infected children on ART died within 12 months, and 23.1% were lost to follow-up.

Supporting Evidence

  • 169 children (7.8%) died during the first 12 months of ART.
  • 461 children (21.2%) were lost to program during the same period.
  • The 12-month probability of death was 8.3% and loss-to-program was 23.1%.
  • Both mortality and loss-to-program were associated with advanced clinical stage and low CD4 percentage at ART initiation.

Takeaway

In West Africa, many children with HIV who start treatment don't stay in care, and some sadly die within a year.

Methodology

Data from HIV-infected children aged 0-15 years on ART from nine clinical centers in six West African countries were analyzed.

Potential Biases

Potential underestimation of mortality due to high loss-to-follow-up rates.

Limitations

The study may not represent all children on ART in West Africa due to data collection challenges and missing information.

Participant Demographics

Median age of participants was 5 years, with 51.8% exhibiting severe immunosuppression at ART initiation.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI: 7.2-9.6%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2458-11-519

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