Predictors of survival among HIV-positive children on ART in Swaziland

dc.contributor.authorShabangu, Patrick L.
dc.contributor.authorBeke, Andy
dc.contributor.authorManda, S.O.M. (Samuel)
dc.contributor.authorMthethwa, Nobuhle
dc.date.accessioned2018-07-30T09:28:31Z
dc.date.available2018-07-30T09:28:31Z
dc.date.issued2017-11-13
dc.description.abstractThe objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively. The results reveal that the median survival time for children was 78 months (95% CI: 77–79). Children who were initiated early on ART had higher survival probability over time (HR: 0.35 [95% CI: 0.21–0.57], p < 0.001) compared to those whose ART initiation was delayed. Children within the age group of <1 years had higher hazard (HR = 1.55 [95% CI: 1.16–2.08], p < 0.001) of death than children within the age group of 1–14 years. Children who were nourished had 88% lower hazard of death (HR: 0.12 [95% CI: 0.07–0.19], p < 0.001) than severely malnourished children. The study demonstrates that ART paediatric services are effective in increasing survival among HIV infected children and early initiated children have high survival probability. Active tuberculosis (TB), malnutrition, and delayed ART initiation remain predictors of poor survival among children living with HIV.en_ZA
dc.description.departmentSchool of Health Systems and Public Health (SHSPH)en_ZA
dc.description.librarianam2018en_ZA
dc.description.urihttp://www.tandfonline.com/loi/raar20en_ZA
dc.identifier.citationPatrick Shabangu, Andy Beke, Samuel Manda & Nobuhle Mthethwa (2017) Predictors of survival among HIV-positive children on ART in Swaziland, African Journal of AIDS Research, 16:4, 335-343, DOI: 10.2989/16085906.2017.1386219.en_ZA
dc.identifier.issn1608-5906 (print)
dc.identifier.issn1727-9445 (online)
dc.identifier.other10.2989/16085906.2017.1386219
dc.identifier.urihttp://hdl.handle.net/2263/66025
dc.language.isoenen_ZA
dc.publisherNISC (Pty) Ltd and Informa UK Limited (trading as Taylor & Francis Group)en_ZA
dc.rights© The Authors. Open Access article distributed in terms of the Creative Commons Attribution License [CC BY 4.0] (http://creativecommons.org/licenses/by/4.0).en_ZA
dc.subjectART servicesen_ZA
dc.subjectClinical outcomesen_ZA
dc.subjectHIV infected childrenen_ZA
dc.subjectImmunological gainen_ZA
dc.subjectInitiated early on ARTen_ZA
dc.subjectAntiretroviral therapy (ART)en_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectTuberculosis (TB)en_ZA
dc.subjectEfficacyen_ZA
dc.subjectImpacten_ZA
dc.subjectSwazilanden_ZA
dc.titlePredictors of survival among HIV-positive children on ART in Swazilanden_ZA
dc.typeArticleen_ZA

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