Predictors of mortality in HIV-1 exposed uninfected post-neonatal infants at the Kenyatta National Hospital, Nairobi

  • C Gichuhi Department of Clinical Pharmacology and Therapeutics, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • E Obimbo Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • D Mbori-Ngacha Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • A Mwatha Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center
  • P Otieno Centre for Clinical Research, Kenya Medical Research Institute, Kenya
  • C Farquhar Department of Epidemiology and Medicine, University of Washington, US
  • G Wariua Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • D Wamalwa Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • R Bosire Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya
  • G John-Stewart Department of Epidemiology and Medicine, University of Washington, Visiting Research Scientist, University of Nairobi, Kenya

Abstract

Objectives: To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-l exposed uninfected infants.

Design: Prospective cohort study.

Setting: Kenyatta National Hospital, Nairobi, Kenya.

Subjects: Three hundred and fifty one HIV-l exposed uninfected post-neonatal infants who survived to one year of age.

Results: Sixteen infants died (post-neonatal mortality rate of 47/l000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0- 13.2, p=0.05) and symptomatic maternal HIV-l disease (RR=2.7, CI 0.9-7.7, p=0.06) were associated with infant mortality.

Conclusion: Prematurity, teenage motherhood and symptomatic HIV-l maternal disease were important predictors for post-neonatal mortality in this cohort of HIV-l exposed uninfected infants. These factors should be considered in monitoring and follow up in prevention of mother-to-child HIV-1 transmission (PMTCT) programs.

East African Medical Journal Vol. 82(9) 2005: 447-451
Published
2006-04-12
Section
Articles

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