Changes in paediatric HIV-related hospital admissions and mortality in Soweto, South Africa, 1996-2011: light at the end of the tunnel?

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dc.contributor.authorMeyers, Tammy
dc.contributor.authorDramowski, Angela
dc.contributor.authorSchneider, Helen
dc.contributor.authorGardiner, Nicolene
dc.contributor.authorKuhn, Louise
dc.contributor.authorMoore, David
dc.date.accessioned2013-01-18T14:04:53Z
dc.date.available2013-01-18T14:04:53Z
dc.date.issued2012
dc.description.abstractBackground: With widespread availability of pediatric antiretro- viral therapy and improved access to prevention of mother-to-child transmission (PMTCT), it is important to monitor the impact on pediatric HIV-related hospital admissions and in-hospital mortality in South Africa. Methods: Over a 15-year period, 4 independent surveillance studies were conducted in the pediatric wards at Chris Hani Baragwanath Hospital in Soweto, South Africa (1996, 2005, 2007, and late 2010 to early 2011). Trends in HIV prevalence and HIV-related mortality were evaluated. Results: HIV prevalence was similar during the first 3 periods: 26.2% (1996), 31.7% (2005), and 29.5% (2007) P > 0.10, but was lower in 2010-2011 (19.3%; P = 0.0005). Median age of the children admitted with HIV increased in the latter periods from 9.13 (interquartile range 3.6-28.8) months to 10.0 (3.0-44.5) months (P > 0.10) and 18.0 (6.2-69.8) months (P = 0.048). Median admisĀ¬sion weight-for-age z-scores were similar (< -3 SD) for the latter 3 periods. Admission CD4 percentage increased from 0.0% (0.0-9.4) in 2005 to 15.0% (8.2-22.8) in 2007 (P < 0.0001) and was 18.7% (9.6-24.7) in 2010-2011 (P > 0.10). Mortality among all vs. HIV- infected admissions was 63 of 565 (11.2%) and 43 of 179 (24.0%) in 2005, 91 of 1510 (6.0%) and 53 of 440 (12.0%) in 2007, and 18 of 429 (4.2%) and 9 of 73 (12.3%) in 2010-2011. Conclusions: HIV prevalence and mortality among pediatric admissions is decreasing. This is likely a result of improved PMTCT and wider antiretroviral therapy coverage. Continued effort to improve PMTCT coverage and identify and treat younger and older HIV-infected children is required to further reduce HIV-related morbidity and mortality.en_US
dc.description.accreditationWeb of Scienceen_US
dc.identifier.citationMeyers, T., et al. (2012). Changes in paediatric HIV-related hospital admissions and mortality in Soweto, South Africa, 1996-2011: light at the end of the tunnel? Journal of Acquired Immune Deficiency Syndrome, 60: 503ā€“510en_US
dc.identifier.issn1525-4135
dc.identifier.urihttp://hdl.handle.net/10566/507
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherLippincott Williams & Wilkinsen_US
dc.rightsThis is the author postprint version of an article by Lippincott Williams & Wilkins. The file may be freely used, provided that acknowledgement of the source is given
dc.source.urihttp://dx.doi.org/10.1097/QAI.0b013e318256b4f8
dc.status.ispeerreviewedtrue
dc.subjectPediatric HIVen_US
dc.subjectAdmissions and mortalityen_US
dc.subjectChanges over timeen_US
dc.subjectSowetoen_US
dc.titleChanges in paediatric HIV-related hospital admissions and mortality in Soweto, South Africa, 1996-2011: light at the end of the tunnel?en_US
dc.typeArticleen_US

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