Early Mortality among HIV-positive Children Initiated Anti-retroviral Therapy in Eastern Ethiopia: A Retrospective Cohort Study

Abstract

About 1,400 children under the age of 15 years are infected with HIV every day and more than 90% of them live in sub-Saharan African countries. The speed of disease progression and death in HIV-infected children in poor countries study was to assess incidence of early mortality and identify the factors associated with it in HIV-infected children who began ART. A retrospective cohort study was conducted on 305 children receiving ART in Hiwot Fana Specialized University Hosp Ethiopia. All children enrolled into HIV care from September 2010 to March 2013 were included. Data were analyzed using SPSS, Version 20. Kaplan Meier was used to estimate the probability of survival and death of the children. Additionally, Cox regression analyses were undertaken to adjust for covariates. Out of the 305 cohort of children on ART, 255(83.6%) were alive, 28(9.2%) were deceased, and 22(7.2%) were lost to follow 7,312 child-months. Out of the 28 death, 18 [2.46 per 1000 child died within 6 months of the ART initiation. Children with baseline bed (aRR 8.8; 95% CI 1.4-53.8); baseline CD4 value <350 cells/mm adherence to ART <85% (aRR 8.9; 95% CI 3.5 (aRR 4.8; 95% CI 1.4-16.4) were factors which increased the likelihood of early mortality. There was a high rate of early mortality in our cohort. Baseline funct 350 cells/mm 3 ; adherence to ART <85%, and developing AIDS associated with early mortality. Hence, education and early ART initiation before CD4 values fall below 350 cells/mm 3 could optimize treatment outcomes of HIV