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The study assessed how well body mass index (BMI: kg/m2) predicts survival, as identification of basic prognostic indicators of HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. It is found that BMI at diagnosis is a strong, independent predictor of survival in HIV-infected patients in West Africa, and BMI may also prove as a useful guide for deciding when to initiate antiretroviral therapy.

Background: As one of several countries that pledged to achieve the Millennium Development Goals (MDGs), Mozambique sought to reduce child, neonatal, and maternal mortality by two thirds by 2015. This study examines the impact of Mozambique's efforts between 1997 and 2015, highlighting the increases in intervention coverage that contributed to saving the most lives.Methods: A retrospective analysis of available household survey data was conducted using the Lives Saved Tool (LiST). Baseline mortality rates, cause-of-death distributions, and coverage of child, neonatal, and maternal interventions were entered as inputs. Changes in mortality rates, causes of death, and additional lives saved were calculated as results. Due to limited coverage data for the year 2015, we reported most results for the period 1997-2011. For 2011-2015 we reported additional lives saved for a subset of interventions. All analyses were performed at national and provincial level.Results: Our modelled estimates show that increases in intervention coverage from 1997 to 2011 saved an additional 422 282 child lives (0-59 months), 85 450 neonatal lives (0-1 month), and 6528 maternal lives beyond those already being saved at baseline coverage levels in 1997. Malaria remained the leading cause of child mortality from 1997 to 2011; prematurity, asphyxia, and sepsis remained the leading causes of neonatal mortality; and hemorrhage remained the leading cause of maternal mortality. Interventions to reduce acute malnutrition and promote artemisinin-based combination therapy (ACT) for malaria were responsible for the largest number of additional child lives saved in the 1997-2011 period. Increases in coverage of delivery management were responsible for most additional newborn and maternal lives saved in both periods in Mozambique.Conclusion: Mozambique has made impressive gains in reducing child mortality since 1997. Additional effort is needed to further reduce maternal and neonatal mortality in all provinces. More lives can be saved by continuing to increase coverage of existing health interventions and exploring new ways to reach underserved populations. [ABSTRACT FROM AUTHOR]

Objectives: Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS). Methods: Longitudinal analyses of clinical and immunologic parameters in HIV infected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania. Results: A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm3). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256- 490) and 427 (314-580) cells/mm3, at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm3, hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality. Conclusions: Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals. [ABSTRACT FROM AUTHOR]

Objectives: Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS)., Methods: Longitudinal analyses of clinical and immunologic parameters in HIV-infected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania., Results: A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm(3)). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm(3), at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm(3), hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality., Conclusions: Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals.