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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Changes in pediatric HIV-related hospital admissions and mortality in Soweto, South Africa, 1996-2011: Light at the end of the tunnel?
Journal of Acquired Immune Deficiency Syndromes, Volume 60, No. 5, Year 2012
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Description
Background: With widespread availability of pediatric antiretroviral therapy and improved access to prevention of mother-to-child transmission (PMTCT), it is important to monitor the impact on pediatric HIV-related hospital admissions and in-hospital mortality in South Africa. Methods: Over a 15-year period, 4 independent surveillance studies were conducted in the pediatric wards at Chris Hani Baragwanath Hospital in Soweto, South Africa (1996, 2005, 2007, and late 2010 to early 2011). Trends in HIV prevalence and HIV-related mortality were evaluated. Results: HIV prevalence was similar during the first 3 periods: 26.2% (1996), 31.7% (2005), and 29.5% (2007) P > 0.10, but was lower in 2010-2011 (19.3%; P = 0.0005). Median age of the children admitted with HIV increased in the latter periods from 9.13 (interquartile range 3.6-28.8) months to 10.0 (3.0-44.5) months (P > 0.10) and 18.0 (6.2-69.8) months (P = 0.048). Median admission weight-for-age z-scores were similar (<-3 SD) for the latter 3 periods. Admission CD4 percentage increased from 0.0% (0.0-9.4) in 2005 to 15.0% (8.2-22.8) in 2007 (P < 0.0001) and was 18.7% (9.6-24.7) in 2010-2011 (P > 0.10). Mortality among all vs. HIV-infected admissions was 63 of 565 (11.2%) and 43 of 179 (24.0%) in 2005, 91 of 1510 (6.0%) and 53 of 440 (12.0%) in 2007, and 18 of 429 (4.2%) and 9 of 73 (12.3%) in 2010-2011. Conclusions: HIV prevalence and mortality among pediatric admissions is decreasing. This is likely a result of improved PMTCT and wider antiretroviral therapy coverage. Continued effort to improve PMTCT coverage and identify and treat younger and older HIV-infected children is required to further reduce HIV-related morbidity and mortality. © 2012 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Meyers, Tammy M.M.
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Dramowski, Angela
South Africa, Tygerberg
Tygerberg Hospital
Schneider, Helen
South Africa, Bellville
University of the Western Cape
Gardiner, Nicolene
South Africa, Johannesburg
The Aurum Institute
Kuhn, Louise
United States, New York
Gertrude H. Sergievsky Center
United States, New York
Mailman School of Public Health
Moore, David Paul
United States, Singapore City
National Research Foundation
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 14
Authors: 6
Affiliations: 8
Identifiers
Doi:
10.1097/QAI.0b013e318256b4f8
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
South Africa