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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
12-month mortality and loss-to-program in antiretroviral-treated children: The IeDEA pediatric West African database to evaluate AIDS (pWADA), 2000-2008
BMC Public Health, Volume 11, Article 519, Year 2011
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Description
Background: The IeDEA West Africa Pediatric Working Group (pWADA) was established in January 2007 to study the care and treatment of HIV-infected children in this region. We describe here the characteristics at antiretroviral treatment (ART) initiation and study the 12-month mortality and loss-to-program of HIV-infected children followed in ART programs in West Africa. Methods. Standardized data from HIV-infected children followed-up in ART programs were included. Nine clinical centers from six countries contributed to the dataset (Benin, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal). Inclusion criteria were the followings: age 0-15 years and initiated triple antiretroviral drug regimens. Baseline time was the date of ART initiation. WHO criteria was used to define severe immunosuppression based on CD4 count by age or CD4 percent < 15%. We estimated the 12-month Kaplan-Meier probabilities of mortality and loss-to-program (death or loss to follow-up > 6 months) after ART initiation and factors associated with these two outcomes. Results: Between June 2000 and December 2007, 2170 children were included. Characteristics at ART initiation were the following: median age of 5 years (Interquartile range (IQR: 2-9) and median CD4 percentage of 13% (IQR: 7-19). The most frequent drug regimen consisted of two nucleoside reverse transcriptase inhibitors and one non-nucleoside reverse transcriptase inhibitors (62%). During the first 12 months, 169 (7.8%) children died and 461(21.2%) were lost-to-program. Overall, in HIV-infected children on ART, the 12-month probability of death was 8.3% (95% Confidence Interval (CI): 7.2-9.6%), and of loss-to-program was 23.1% (95% CI: 21.3-25.0%). Both mortality and loss-to program were associated with advanced clinical stage, CD4 percentage < 15% at ART initiation and year (2005) of ART initiation. Conclusion: Innovative and sustainable approaches are needed to better document causes of death and increase retention in HIV pediatric clinics in West Africa. © 2011 Ekouevi et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Ékouévi, Didier Koumavi
France, Paris
Inserm
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Azondékon, Alain
Benin
Hôpital D’instruction Des Armées
Dicko-Traoré, Fatoumata B.
Mali, Bamako
Hopital Gabriel Toure
Malateste, Karen
France, Paris
Inserm
Touré, Pety
Cote D'ivoire, Abidjan
Aconda
Eboua, François Tanoh
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Yopougon
Kouadio, Kouakou
Cote D'ivoire, Abidjan
Centre Intégré de Recherches Biocliniques D'abidjan Cirba
A Renner, Lorna
Ghana, Accra
Korle bu Hospital
Peterson, Kevin L.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Dabis, Franćois Ç.Ois
France, Paris
Inserm
Sy, Haby Signaté
Senegal, Dakar
Hopital D'enfants Albert-royer Dakar
Leroy, Valeriane
France, Paris
Inserm
Statistics
Citations: 62
Authors: 12
Affiliations: 10
Identifiers
Doi:
10.1186/1471-2458-11-519
e-ISSN:
14712458
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Multi-countries
Benin
Gambia
Ghana
Ivory Coast
Mali
Senegal