1. Mortality and Health Outcomes of HIV-Exposed and Unexposed Children in a PMTCT Cohort in Malawi
- Author
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Monique van Lettow, Adrienne K. Chan, Erik J. Schouten, Richard Bedell, Megan Landes, and Isabell Mayuni
- Subjects
Pediatrics ,Malawi ,Time Factors ,HIV Infections ,Social and Behavioral Sciences ,Cohort Studies ,Cost of Illness ,Risk Factors ,Medicine ,Child ,Multidisciplinary ,Mortality rate ,Child Health ,virus diseases ,Obstetrics and Gynecology ,AIDS ,Breast Feeding ,HIV epidemiology ,Health ,Child, Preschool ,Cohort ,Child Mortality ,Infectious diseases ,Maternal death ,Female ,Public Health ,medicine.symptom ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Science ,Sexually Transmitted Diseases ,Mothers ,Viral diseases ,Humans ,business.industry ,Genitourinary Infections ,HIV ,Infant ,Retrospective cohort study ,medicine.disease ,Survival Analysis ,Infant mortality ,Infectious Disease Transmission, Vertical ,Child mortality ,Low birth weight ,Women's Health ,Preventive Medicine ,business - Abstract
BackgroundMortality and morbidity among HIV-exposed children are thought to be high in Malawi. We sought to determine mortality and health outcomes of HIV-exposed and unexposed infants within a PMTCT program.MethodData were collected as part of a retrospective cohort study in Zomba District, Malawi. HIV-infected mothers were identified via antenatal, delivery and postpartum records with a delivery date 18-20 months prior; the next registered HIV-uninfected mother was identified as a control. By interview and health record review, data on socio-demographic characteristics, service uptake, and health outcomes were collected. HIV-testing was offered to all exposed children.Results173 HIV-infected and 214 uninfected mothers were included. 4 stillbirths (1.0%) occurred; among the 383 livebirths, 41 (10.7%) children died by 20 months (32 (18.7%) HIV-exposed and 9 unexposed children (4.3%; pConclusionChild mortality remains high within this context and could be reduced through more effective PMTCT including prioritizing the treatment of maternal HIV infection to address the effect of maternal health and survival on infant health and survival. HIV-infected children demonstrated developmental delays, functional health and nutritional deficits that underscore the need for increased uptake of early infant diagnosis and institution of ART for all infected infants.
- Published
- 2012