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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Under-two child mortality according to maternal HIV status in Rwanda: Assessing outcomes within the National PMTCT Program
Pan African Medical Journal, Volume 9, Year 2011
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Description
Introduction: We sought to compare risk of death among children aged under-2 years born to HIV positive mother (HIV-exposed) and to HIV negative mother (HIV non-exposed), and identify determinants of under-2 mortality among the two groups in Rwanda. Methods: In a stratified, two-stage cluster sampling design, we selected mother-child pairs using national Antenatal Care (ANC) registers. Household interview with each mother was conducted to capture socio-demographic data and information related to pregnancy, delivery and post-partum. Data were censored at the date of child death. Using Cox proportional hazard model, we compared the hazard of death among HIV-exposed children and HIV nonexposed children. Results: Of 1,455 HIV-exposed children, 29 (2.0%; 95% CI: 1.3%-2.7%) died by 6 months compared to 18 children of the 1,565 HIV non-exposed children (1.2%; 95% CI: 0.6%-1.7%). By 9 months, cumulative risks of death were 3.0% (95%; CI: 2.2%-3.9%) and 1.3% (96%; CI: 0.7%-1.8%) among HIV-exposed and HIV non-exposed children, respectively. By 2 years, the hazard of death among HIVexposed children was more than 3 times higher (aHR:3.5; 95% CI: 1.8-6.9) among HIV-exposed versus non-exposed children. Risk of death by 9- 24 months of age was 50% lower among mothers who attended 4 or more antenatal care (ANC) visits (aHR: 0.5, 95% CI: 0.3-0.9), and 26% lower among families who had more assets (aHR: 0.7, 95% CI: 0.5-1.0). Conclusion: Infant mortality was independent of perinatal HIV exposure among children by 6 months of age. However, HIV-exposed children were 3.5 times more likely to die by 2 years. Fewer antenatal visits, lower household assets and maternal HIV seropositive status were associated with increased mortality by 9-24 months. © Placidie Mugwaneza et al.
Authors & Co-Authors
Mugwaneza, Placidie
Rwanda, Kigali
Centre for Treatment and Research on Aids
Wa Shema, Nadine Umutoni
Rwanda, Kigali
Centre for Treatment and Research on Aids
Ruton, Hinda
Rwanda, Kigali
Centre for Treatment and Research on Aids
Rukundo, Alphonse
Rwanda, Kigali
Centre for Treatment and Research on Aids
Lyambabaje, Alexandre
Rwanda, Butare
University of Rwanda
Bizimana, Jean Pierre Dieu
United States, Washington, D.c.
The World Bank, Usa
Tsague, Landry
United States, New York
Unicef
Wagner, Claire M.
United States, Boston
Harvard Medical School
Nyankesha, Elevanie
United States, New York
Unicef
Muita, Jane
United States, New York
Unicef
Mutabazi, Vincent
Rwanda, Kigali
Centre for Treatment and Research on Aids
Nyemazi, Jean Pierre
Rwanda, Kigali
Centre for Treatment and Research on Aids
Nsanzimana, Sabin
Rwanda, Kigali
Centre for Treatment and Research on Aids
Karema, Corine Kakizi
Rwanda, Kigali
Centre for Treatment and Research on Aids
Binagwaho, Agnès
United States, Boston
Harvard Medical School
Rwanda, Kigali
Ministry of Health of Rwanda
Statistics
Citations: 17
Authors: 15
Affiliations: 6
Identifiers
Doi:
10.4314/pamj.v9i1.71215
ISSN:
19378688
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Locations
Rwanda