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

Simple item page
dc.contributor.authorMeyers T.
dc.contributor.authorDramowski A.
dc.contributor.authorSchneider H.
dc.contributor.authorGardiner N.
dc.contributor.authorKuhn L.
dc.contributor.authorMoore D.
dc.date.accessioned2012-08-13T07:39:19Z
dc.date.available2012-08-13T07:39:19Z
dc.date.issued2012
dc.description.abstractBackground: With widespread availability of pediatric antiretroviral 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 admission 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. © 2012 by Lippincott Williams & Wilkins.
dc.identifier.citationJournal of Acquired Immune Deficiency Syndromes
dc.identifier.citation60
dc.identifier.citation5
dc.identifier.citation503
dc.identifier.citation510
dc.identifier.issn15254135
dc.identifier.otherdoi:10.1097/QAI.0b013e318256b4f8
dc.identifier.urihttp://hdl.handle.net/10019.1/49185
dc.subjectadmissions and mortality
dc.subjectchanges over time
dc.subjectpediatric HIV
dc.subjectSoweto South Africa
dc.titleChanges in pediatric HIV-related hospital admissions and mortality in Soweto, South Africa, 1996-2011: Light at the end of the tunnel?
dc.typeArticle
Files
Collections
Stellenbosch University - Scopus Tygerberg Hospital Publications