LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Morbidity and health care resource utilization in HIV-infected children after antiretroviral therapy initiation in Côte d'Ivoire, 2004-2009.

Publication

Author(s):

Desmonde S, Essanin JB, Aka AE, Messou E, Amorissani-Folquet M, Rondeau V, Ciaranello A, Leroy V.

Pub Title:

Morbidity and health care resource utilization in HIV-infected children after antiretroviral therapy initiation in Côte d'Ivoire, 2004-2009.

Pub Date:

Mar 1 2014

Pub Region(s):

West Africa

Journal:

Title: 
AIDS
Link: 
http://ovidsp.tx.ovid.com/sp-3.11.0a/ovidweb.cgi?QS2=434f4e1a73d37e8c6056533a8d0c69ec4868b595a3b754553ae06dcada7386b6c69826525fda7e45a0d3146f40d7ce28eb0c99162fb0fbc3a02abdf3bb2ece90193e283c013bb63df1d24070e2f4ca17c0530d8a66ad0bb638341e41e76a2917c7ce30c5a2

PubMed: 24525473
Pub PDF: PDF icon 24525473.pdf

Abstract
BACKGROUND:
We describe severe morbidity and health care resource utilization (HCRU) among HIV-infected children on antiretroviral therapy (ART) in Abidjan, Côte d'Ivoire.

METHODS: All HIV-infected children enrolled in an HIV-care program (2004-2009) were eligible for ART initiation until database closeout, death, ART interruption, or loss to follow-up. We calculated incidence rates (IRs) of density per 100 child-years (CYs) for severe morbidity, HCRU (outpatient care and inpatient care), and associated factors using frailty models with a Weibull distribution.

RESULTS: Of 332 children with a median age of 5.7 years and median follow-up of 2.5 years, 65.4% were severely immunodeficient by World Health Organization (WHO) criteria, and all received cotrimoxazole prophylaxis. We recorded 464 clinical events in 228 children; the overall IR was 57.6/100 CYs [95% confidence interval (CI): 52.1 to 62.5]. Severe morbidity was more frequent in children on protease inhibitor (PI)-based ART compared to those on other regimens [adjusted hazards ratio (aHR): 1.83; 95% CI: 1.35 to 2.47] and to those moderately/severely immunodeficient compared to those not (aHR: 1.57; 95% CI: 1.13 to 2.18 and aHR: 2.53; 95% CI: 1.81 to 3.55, respectively). Of the 464 events, 371 (80%) led to outpatient care (IR: 45.6/100 CYs) and 164 (35%) to inpatient care (IR: 20.2/100 CYs). In adjusted analyses, outpatient care was significantly less frequent in children older than 10 years compared with children younger than 2 years (aHR: 0.49; 95% CI: 0.31 to 0.78) and in those living furthest from clinics compared with those living closest (aHR: 0.65; 95% CI: 0.47 to 0.90). Both inpatient and outpatient HCRU were negatively associated with cotrimoxazole prophylaxis.

CONCLUSIONS: Despite ART, HIV-infected children still require substantial utilization of health care services.

The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Desmonde S, Essanin JB, Aka AE, Messou E, Amorissani-Folquet M, Rondeau V, Ciaranello A, Leroy V. Morbidity and health care resource utilization in HIV-infected children after antiretroviral therapy initiation in Côte d'Ivoire, 2004-2009. J Acquir Immune Defic Syndr. 2014 Mar 1;65(3):e95-103. doi: 10.1097/QAI.0b013e3182a4ea6f. PubMed PMID: 24525473.