Skip to main content

Advertisement

SpringerLink
Log in

Effect Of Maternal HIV Infection On Child Survival In Ghana

  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

The purpose of this study was to measure the association between maternal HIV infection and infant mortality in Ghana. Using a censored synthetic cohort life table based on the birth history of 3,639 childbirths during 1999–2003 obtained from the interviews of a nationally representative sample of 5,691 women age 15–49 in 6,251 households in the 2003 Ghana Demographic and Health Survey. The survey collected demographic, socioeconomic, and health data of the respondents as well as obtained voluntary counseling test for HIV infection from all eligible women. The effects of maternal HIV status and other factors on infant mortality were estimated using multivariate survival regression analysis and the results are presented as Hazard Ratios (HR) with 95% confident interval (95% CI). Children born to HIV infected mothers were three times as likely to die during infancy as those born to uninfected mothers (HR=3.01; 95% CI: 1.64, 5.50). Controlling for other factors affecting infant mortality further sharpens this relationship (HR=3.51; 95% CI: 1.87, 6.61). Not receiving antenatal care, low birth weight, and living in households that use high pollution cooking fuels were associated with a higher risk of infant mortality. Maternal HIV status is a strong predictor of infant mortality in Ghana, independent of several other factors. The results of this study suggest that HIV/AIDS epidemic has had great impact on child well-being and child survival. This impact tends to increase as the HIV/AIDS epidemic matures and infection in adults increases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. Walker N, Swhartlander B, Bryce J (2002). Meeting international goals on child survival and HIV-AIDS. Lancet 360:284–289

    Article  PubMed  Google Scholar 

  2. UNIADS (2001). Children and Young people in the World of AIDS. Geneva, UNAIDS

    Google Scholar 

  3. Ghana Statistical Services (GSS), Noguchi Memorial Institute for Medical Research (NMIMR), ORC Macro. Ghana Demographic and Health Survey 2003. Accra, Ghana; Calverton Maryland: GSS, NMIMR, ORC Macro; 2004

  4. Uganda Bureau of Statistical (UBOS), ORC Macro. Uganda Demographic and Health Survey 2000–2001. Entebbe Uganda, Calverton Maryland: UBOS, ORC Macro; 2002

  5. Swhartlander B, Stanecki KA, Brown T et al. (1999). Country-specific estimates and models of HIV and AIDS: methods and limitations. AIDS 13:2445–2458

    Article  Google Scholar 

  6. Castetbon K, Ladner J, Leroy V et al. (1999). Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy: Pregnancy and HIV Study Group (EGE). J Trop Pediatr 45:152–157

    Article  PubMed  CAS  Google Scholar 

  7. Lee MJ, Hallmark RJ, Frenkel LM et al. (1998). Maternal syphilis and vertical perinatal transmission of human immunodeficiency virus type-1 infection. Int J Gynaecol Obstet 6:247–252

    Article  Google Scholar 

  8. UNAIDS. (1999). A Review of Household and Community Responses to the HIV/AIDS Epidemics in the Rural Areas of Sub-Saharan Africa. Geneva, UNAIDS

  9. Lee LM, Fleming PL (2003). Estimated number of children left motherless by AIDS in the United States, 1978–1998. J Acquir Immune Defic Syndr 34:231–236

    PubMed  Google Scholar 

  10. Poulter C. Psychological and Physical Needs Profile of Families Living with HIV/AIDS in Lusaka, Zambia. Lusaka: UNICEF; 1997: Research Brief No. 2

  11. Zaba B, Whitworth J, Marston M et al. (2005). HIV and mortality of mothers and children: evidence from cohort studies in Uganda, Tanzania, and Malawi. Epidemiology 16:275–280

    Article  PubMed  Google Scholar 

  12. Nathoo K, Rusakaniko S, Zijenah LS et al. (2004). Survival pattern among infants born to human immunodeficiency virus type-1 infected mothers and uninfected mothers in Harare, Zimbabwe. Cent Afr J Med 50:1–6

    PubMed  Google Scholar 

  13. Newell ML, Brahmbhatt H, Ghys PD (2004) Child mortality and HIV infection in Africa: a review. AIDS Suppl 2:S27–S34

    Article  Google Scholar 

  14. Macassa G, Ghilagaber G, Bernhardt E et al (2003). Trends in infant and child mortality in Mozambique during and after a period of conflict. Public Health 117:221–227

    Article  PubMed  Google Scholar 

  15. Verhoeff FH, Le Cessie S, Kalanda BF et al (2004). Post-neonatal infant mortality in Malawi: the importance of maternal health. Ann Trop Paediatr 24:161–169

    Article  PubMed  Google Scholar 

  16. Kiros GE, Hogan DP (2001). War, famine and excess child mortality in Africa: the role of parental education. Int J Epidemiol 30:447–455

    Article  PubMed  CAS  Google Scholar 

  17. Cutts FT, Dos Santos C, Novoa A et al. (1996). Child and maternal mortality during a period of conflict in Beira City, Mozambique. Int J Epidemiol 25:349–356

    PubMed  CAS  Google Scholar 

  18. Choe MK, Luther NY, Pandey A et al. (1999). Identifying children with high mortality risk. Natl Fam Health Surv Bull 12:1–4

    PubMed  Google Scholar 

  19. Rutstein SO, Rojas G (2003). Guide to DHS statistics. Calverton (MD), ORC Macro

    Google Scholar 

  20. ORC Macro (2005). Anemia and HIV Testing Field Manual: Demographic and Health Surveys. Calverton, Maryland, ORC Macro

    Google Scholar 

  21. ORC Macro (2005). HIV Testing Laboratory Manual: Demographic and Health Surveys. Calverton Maryland, ORC Macro

    Google Scholar 

  22. Earthman CP (2004). Evaluation of nutrition assessment parameters in the presence of human immunodeficiency virus infection. Nutr Clin Pract 194:330–339

    Article  Google Scholar 

  23. Wrthington C, Krentz HB (2005) Socio-economic factors and health-related quality of life in adults living with HIV. Int J STD AIDS 16:608–614

    Article  Google Scholar 

  24. Wojcicki JM (2005). Socioeconomic status as a risk factor for HIV infection in women in East, Central and Southern Africa: a systematic review. J Biosoc Sci 37:1–36

    Article  PubMed  Google Scholar 

  25. Berkman LK, Kawachi I (2000). Social Epidemiology. New York (NY), Oxford University Press

    Google Scholar 

  26. Defo BK (1996). Areal and socioeconomic differentials in infant and child mortality in Cameroon. Soc Sci Med 42:399–420

    Article  PubMed  CAS  Google Scholar 

  27. Peña R, Wall S, Persson L (2000). The effect of poverty, social inequality, and maternal education on infant mortality in Nicaragua, 1988–1993. Am J Public Health 90:64–69

    PubMed  Google Scholar 

  28. Stata Corporation, Inc. STATA Release 8.0. College Station (TX): Stata Press; 2003

  29. Crampin AC, Floyd S, Glynn JR et al. (2003). The long-term impact of HIV and orphanhood on the mortality and physical well-being of children in rural Malawi. AIDS 17:389–397

    Article  PubMed  Google Scholar 

  30. Nakiyingi JS, Bracher M, Whitworth JAG et al. (2003). Child survival in relation to mother’s HIV infection and survival: evidence from a Uganda cohort study. AIDS 17:1827–1834

    Article  PubMed  Google Scholar 

  31. Wekesa E (2000). The impact of HIV / AIDS on child survival and development in Kenya. AIDS Anal Afr 10:12–14

    PubMed  CAS  Google Scholar 

  32. Dabis F, Ekpini ER (2002). HIV-1/AIDS and maternal and child health in Africa. Lancet 9323:2097–2104

    Article  Google Scholar 

  33. Pelletier DL, Frongillo EA (2003). Changes in child survival are strongly associated with changes in malnutrition in developing countries. J Nutr 133:107–119

    PubMed  CAS  Google Scholar 

  34. Rice AL, Sacco L, Hyder A et al. (2000). Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull World Health Organ 78:1207–1221

    PubMed  CAS  Google Scholar 

  35. Nathoo K, Rusakaniko S, Zijenah LS et al. (2004). Survival pattern among infants born to human immunodeficiency virus type-1 infected mothers and uninfected mothers in Harare, Zimbabwe. Cent Afr J Med 50:1–6

    PubMed  Google Scholar 

  36. Escobar GJ, Littenberg B, Petitti DB (1991). Outcome among surviving very low birth-weight infants: a meta-analysis. Archive Disease of Childhood 66:204–211

    Article  CAS  Google Scholar 

  37. Mishra V (2003). Indoor air pollution from biomass combustion and acute respiratory illness in preschool age children in Zimbabwe. Int J Epidemiol 32:47–53

    Article  Google Scholar 

  38. Basu AM, Stephenson R (2005). Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. Soc Sci Med 60:2011–2023

    Article  PubMed  Google Scholar 

  39. Buor D (2003). Mothers’ education and childhood mortality in Ghana. Health Policy 64:297–309

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Global Health, School of Public Health and Health Services, George Washington University, 2175 K Street NW, Washington, DC, 20037, USA

    Rathavuth Hong DrPH, James E. Banta MD & James K. Kamau PhD (abd)

Authors
  1. Rathavuth Hong DrPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James E. Banta MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James K. Kamau PhD (abd)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rathavuth Hong DrPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hong, R., Banta, J.E. & Kamau, J.K. Effect Of Maternal HIV Infection On Child Survival In Ghana. J Community Health 32, 21–36 (2007). https://doi.org/10.1007/s10900-006-9032-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-006-9032-6

Keywords

Search

Navigation