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AIDS and Behavior

, Volume 22, Supplement 1, pp 99–104 | Cite as

Mortality Rate and Predictors in Children Under 15 Years Old Who Acquired HIV from Mother to Child Transmission in Paraguay

  • Gloria Aguilar
  • Angélica Espinosa Miranda
  • George W. Rutherford
  • Sergio Munoz
  • Nancy Hills
  • Tania Samudio
  • Fernando Galeano
  • Anibal Kawabata
  • Carlos Miguel Rios González
Original Paper

Abstract

We estimated mortality rate and predictors of death in children and adolescents who acquired HIV through mother-to-child transmission in Paraguay. In 2000–2014, we conducted a cohort study among children and adolescents aged < 15 years. We abstracted data from medical records and death certificates. We used the Cox proportional hazards model for the multivariable analysis of mortality predictors. A total of 302 subjects were included in the survey; 216 (71.5%) were younger than 5 years, 148 (51.0%) were male, and 214 (70.9%) resided in the Asunción metropolitan area. There were 52 (17.2%) deaths, resulting in an overall mortality rate of 2.06 deaths per 100 person-years. The children and adolescents with hemoglobin levels ≤ 9 g/dL at baseline had a 2-times higher hazard of death compared with those who had levels > 9 g/dL (HR 2.27, 95% CI 1.01–5.10). The mortality of HIV-infected children and adolescents in Paraguay is high, and anemia is associated with mortality. Improving prenatal screening to find cases earlier and improving pediatric follow-up are needed.

Keywords

HIV Child Mortality Paraguay 

Resumen

Estimamos la tasa de mortalidad y los predictores de muerte en niños y adolescentes que contrajeron el VIH por transmisión de madre a hijo en el Paraguay en el periodo entre el 2000-2014 Realizamos un estudio de cohorte entre los niños y adolescentes < 15 años de edad. Se extrajeron los datos clínicos de los registros médicos, y se obtuvieron datos de los registros y certificados de defunción. Utilizamos el modelo de Cox para el análisis multivariado de los predictores de mortalidad. Un total de 302 sujetos fueron incluidos en en el estudio, 216 (71.5%) eran menores de cinco años, 148 (51.0%) fueron varones y 214 (70.9%) vivian en el área metropolitana de Asunción. Se registraron 52 (17.2%) muertes, lo que resultó en una mortalidad general de 2.06 muertes/100 años-persona. Los niños y adolescentes con niveles de hemoglobina basal de  ≤ 9 g/dL tuvieron un riesgo de muerte dos veces mayor en comparación con aquellos con niveles ≥ 9 g/dL (HRo: 2.27; IC 95%, 1.01-5.10). La mortalidad de los niños con VIH en Paraguay es alta y la anemia está asociada con la mortalidad. Se necesita mejorar la atención prenatal para detectar casos en forma más precoz y mejorar el seguimiento pediátrico.

Palabras-claves

VIH niños y adolescentes mortalidad Paraguay 

Notes

Acknowledgements

We wish to acknowledge support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712 and the Starr Foundation Scholarship Fund.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

The Ethics Committee of the Institute of Tropical Medicine in Paraguay approved this study.

Informed Consent

For this type of study formal consent is not required.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Gloria Aguilar
    • 1
    • 2
    • 3
  • Angélica Espinosa Miranda
    • 3
  • George W. Rutherford
    • 4
  • Sergio Munoz
    • 5
  • Nancy Hills
    • 6
  • Tania Samudio
    • 2
  • Fernando Galeano
    • 7
  • Anibal Kawabata
    • 8
  • Carlos Miguel Rios González
    • 8
  1. 1.Research Directorate GeneralNational University of CaaguazúCoronel OviedoParaguay
  2. 2.Department of Strategic Information and Surveillance, National HIV ProgramAsunciónParaguay
  3. 3.Post Graduation Program in Infectious DiseasesFederal University of Espirito SantoVitoriaBrazil
  4. 4.Global Health Sciences, University of CaliforniaSan FranciscoUSA
  5. 5.Department of Public HealthUniversity of the FrontierTemucoChile
  6. 6.Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoUSA
  7. 7.Department of PediatricsInstitute of Tropical MedicineAsunciónParaguay
  8. 8.Faculty of Medical SciencesNational University of CaaguazúCoronel OviedoParaguay

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