Incidence of mortality and its predictors among HIV-infected children receiving antiretroviral therapy in Amhara region: a multicenter retrospective follow-up study.

• Tác giả: Ousman Adal, Abraham Tsedalu Amare, Fikadie Dagnew Baye, Bekalu Mekonen Belay, Asnake Gashaw Belayneh, Tiruye Azene Demile, Mengistu Melak Fekadie, Betelhem Amha Haile, Bruck Tesfaye Legesse, Sosina Tamre Mamo, Gebrehiwot Berie Mekonnen, Mengistu Abebe Messelu, Sileshi Mulatu, Birhanu Mengist Munie, Birara Ayichew Tilaye, Yeshimebet Tamir Tsehay, Wubet Tazeb Wondie
• Ngôn ngữ: eng
• Ký hiệu phân loại: 025.3173 Bibliographic analysis and control
• Thông tin xuất bản: England : Italian journal of pediatrics , 2025
• Bộ sưu tập: NCBI
• ID: 693429

Tóm tắt

 BACKGROUND: Evidence shows that earlier access to Antiretroviral Therapy (ART) helps to increase the survival of children by delaying the progression to advanced stages of HIV-related diseases. However, the effect of testing and treatment strategies on mortality among children receiving ART has remained a limited study in Ethiopia. This study aimed to assess the incidence of mortality and its predictors among HIV-infected children receiving ART in Amhara Region Specialized Hospitals, after the test and treat strategy. METHODS: A multicenter facility-based retrospective follow-up study was conducted on 475 HIV-infected children receiving ART at Amhara Region Comprehensive Specialized Hospitals from June 10, 2014, to February 28, 2022. A simple random sampling technique was used to select the study participants. Data were collected using national antiretroviral intake and follow-up forms via the KoBo Toolbox. Data analysis was done using STATA version 17. Descriptive analyses were summarized using the Kaplan-Meier curve, and a log-rank test was used to estimate and compare. Both bivariable and multivariable Weibull regression model were fitted to identify predictors of mortality. Finally, an adjusted hazard ratio with 95% CI was computed, and variables having a p-value <
  0.05 were considered as statistically significant predictors of mortality. RESULTS: Among the 461 (97.1%) records included in the final analysis [42], 9.11% of the individuals died within the follow-up period. In this study, the overall mortality rate was found to be 2.53 per 100 child-year observations (95% Confidence Interval (CI): 1.87, 3.43). HIV-infected children presenting with opportunistic infections (OIs) other than tuberculosis infection (adjusted hazard ratio (AHR): 3.81, 95% CI: 1.66, 8.72), tuberculosis (AHR: 7.14, 95% CI: 2.86, 17.79), wasting (AHR: 2.83, 95% CI: 1.44, 5.56), and advanced disease staging (AHR: 4.02, 95% CI: 1.84, 8.78) were at higher risk of mortality. CONCLUSION: In this study, the mortality rate was high after the test-and-treat strategy. HIV-infected children presenting with OIs, advanced disease staging, and wasting were at higher risk of mortality. Therefore, to increase the survival rate for HIV-positive children, clinicians should place a strong emphasis on early screening, controlling OIs, and optimizing nutritional supplements.