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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The first 5 years of the family clinic for HIV at Tygerberg hospital: Family demographics, survival of children and early impact of antiretroviral therapy
Journal of Tropical Pediatrics, Volume 52, No. 1, Year 2006
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Description
Background: Family clinics address the problems of HIV-infected children and their families. The aims were to document demographics of the children and caregivers attending the Family Clinic for HIV at Tygerberg Academic Hospital (TAH) and to investigate factors affecting disease progression in children. Methods: A retrospective folder review of children and parents attending the Family Clinic at TAH between January 1997 and December 2001, a period noted for its lack of antiretroviral treatment. Results: Of 432 children seen for testing, 274 children, median age 16.9 months, were HIV-infected. During follow-up, 46 children died (median age 23 months) and 113 were lost to follow-up. The majority of children were malnourished. Those <2 years of age had lower weight for age Z-scores (WAZ) than older children (p<0.001). At presentation, 47 per cent were in clinical stage B and two-thirds had moderate or severe CD4+ T cell depletion. Seventeen children had received highly active antiretroviral therapy (HAART), 12 dual and 31 monotherapy. HAART was associated with improved survival compared to dual or monotherapy. Risk of death was reduced from eleven-fold for a WAZ <-4 to four-fold between -2 and -3. There was no association with immunological and clinical classification at entry and risk of mortality. Only 18 per cent of parents were evaluated in the clinic. Non-parental care was documented for 25 per cent of families. Conclusions: A low WAZ is associated with poor survival in children. Nutritional status should receive more attention in HIV disease classification in children. Parent utilization of the clinic was inadequate. Even in the absence of HAART, extended survival in children is possible. © The Author [2005]. Published by Oxford University Press. All rights reserved.
Authors & Co-Authors
van Kooten Niekerk, N. K.M.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Knies, M. M.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Howard, J.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Rabie, Helena
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Zeier, Michèle Desiré
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
van Rensburg, Anita Janse
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Frans, N.
South Africa, Tygerberg
Tygerberg Hospital
Schaaf, Hendrik Simon
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Fatti, Geoffrey L.
South Africa, Cape Town
University of Cape Town
Little, Francesca
South Africa, Cape Town
University of Cape Town
Cotton, Mark Fredric
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Statistics
Citations: 48
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1093/tropej/fmi047
ISSN:
01426338
e-ISSN:
14653664
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study