Long-term outcomes of a pediatric HIV treatment program in Maputo, Mozambique
A cohort study
Bibliographic Data
| ID | 19530508 |
|---|---|
| Authors | Jan Walter (0000-0002-2973-0491), Lucas Molfino (Médecins Sans Frontières, corresponding author), Verena Moreno, C Edwards (0009-0000-6326-0318), Celeste G Edwards, Mafalda Chissano, Angels Prieto, Tatiana Bocharnikova (Ministry of Health), Annick Antierens (Médecins Sans Frontières), Johnny Lujan (Médecins Sans Frontières) |
| Year | 2015 |
| Volume | 8 |
| Issue | 1 |
| Pages | 26652 |
| Publication date | 2015-12-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Global Health Action (JOURNAL) |
| Journal identifiers | ISSN: 1654-9716 • E-ISSN: 1654-9880 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.3402/gha.v8.26652 |
| PMID | 26287397 |
| OpenAlex | W1910583573 |
| Language | EN |
| Citations received | 2 |
| References cited | 2 |
OBJECTIVE: To describe long-term treatment outcomes of a pediatric HIV cohort in Mozambique. DESIGN: Retrospective analysis of routine monitoring data. SETTING: Secondary health care facilities in the Chamanculo Health District of Maputo. SUBJECTS: A total of 1,335 antiretroviral treatment (ART) naïve children <15 years of age enrolled in HIV care between 2002 and 2010. INTERVENTION: HIV care, ART (since 2003), task shifting to lower cadre nurses, counseling by lay counselors, active patient tracing, nutritional support, support by a psychologist, targeted viral load testing, and switch to second-line treatment. MAIN OUTCOME MEASURES: Kaplan-Meier estimates for retention in care (RIC), CD4 cell percentage, body mass index for age z-score, and adjusted incidence rate ratios for attrition (death or loss to follow-up) as calculated by Poisson regression. RESULTS: The RIC at 6 years in the pre-ART cohort was 44% (95% confidence interval: 38-49), and the one at 8 years in the ART cohort was 70% (64-75). Risk factors for attrition included young age, low CD4 percentage, underweight, active tuberculosis, and enrollment/treatment initiation after 2006. The mean CD4 percentage increased strongly at 1 year on treatment and remained high thereafter. The body mass index for age z-score sharply increased at 1 year after treatment initiation before stabilizing at pre-ART levels thereafter. CONCLUSIONS: Good clinical and immunological treatment outcomes up to 8 years of follow-up on ART can be achieved in a context of shortage of health workers and a high level of task-shifting approach
Body mass index · Cohort · Environmental health · Overweight · Poisson regression · Population · Retrospective cohort study · Underweight · Adolescent Sexual and Reproductive Health · Demography · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Internal Medicine · Pediatrics
| Citations per year | 0.2 |
|---|---|
| Citation span | 2016 - 2019 (4) |
| Highly cited | No |