{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T20:23:36Z","timestamp":1749414216491},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T00:00:00Z","timestamp":1371686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"name":"MSF"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine age differences in mortality and programme attrition amongst paediatric patients treated in four <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frican <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> programmes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Longitudinal analysis of data from patients enrolled in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> care. Two\u2010year mortality and programme attrition rates per 1000 person\u2010years stratified by age group (&lt;2, 2\u20134 and 5\u201315\u00a0years) were calculated. Associations between outcomes and age and other individual\u2010level factors were studied using multiple <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox proportional hazards (mortality) and <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>oisson (attrition) regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six thousand two hundred and sixty\u2010one patients contributed 9500 person\u2010years; 27.1% were aged &lt;2\u00a0years, 30.1% were 2\u20134, and 42.8% were 5\u201314\u00a0years old. At programme entry, 45.3% were underweight and 12.6% were in clinical stage 4. The highest mortality and attrition rates (98.85 and 244.00 per 1000 person\u2010years), and relative ratios (adjusted hazard ratio [<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>]\u00a0=\u00a01.92, 95% CI 1.56\u20132.37; incidence ratio [<jats:styled-content style=\"fixed-case\">aIR<\/jats:styled-content>]\u00a0=\u00a02.10, 95% CI 1.86\u20132.37, respectively, compared with the 5\u2010 to 14\u2010year group) were observed amongst the youngest children. Increased mortality and attrition were also associated with advanced clinical stage, underweight and diagnosis of tuberculosis at programme entry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results highlight the need to increase access, diagnose and provide early <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> care and to accelerate antiretroviral treatment initiation for those eligible. Adapted education and support for children and their families would also be important.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12142","type":"journal-article","created":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T07:33:26Z","timestamp":1371713606000},"page":"1065-1074","source":"Crossref","is-referenced-by-count":3,"title":["Paediatric <scp>HIV<\/scp> care in sub\u2010<scp>S<\/scp>aharan <scp>A<\/scp>frica: clinical presentation and 2\u2010year outcomes stratified by age group"],"prefix":"10.1111","volume":"18","author":[{"given":"Jihane","family":"Ben\u2010Farhat","sequence":"first","affiliation":[{"name":"Epicentre Clinical Research Department Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Gale","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Szumilin","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suna","family":"Balkan","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Poulet","sequence":"additional","affiliation":[{"name":"Epicentre Clinical Research Department Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar","family":"Pujades\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Epicentre Clinical Research Department Paris France"},{"name":"University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.10.0538"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181e583da"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39238.399444.55"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000302262.51286.a5"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-182"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181e0c4cf"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir950"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-010-9877-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/595012"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181eb611a"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328355d0ce"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2010.09.002"},{"key":"e_1_2_7_14_1","first-page":"55","article-title":"Vital statu of pre\u2010ART and ART patients defaulting from care in rural Malawi","volume":"15","author":"McGuire M","year":"2010","journal-title":"TMIH"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038044"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318278bcb0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.03000.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200406002-00004"},{"key":"e_1_2_7_19_1","first-page":"CD004772","article-title":"Effectiveness of antiretroviral therapy in HIV\u2010infected children under 2\u00a0years of age","volume":"7","author":"Penazzato M","year":"2012","journal-title":"Cochrane Database Systematic Review"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e3283339b27"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-9-54"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318196761c"},{"key":"e_1_2_7_23_1","unstructured":"ShermanG(2012)Diagnosing HIV infection in infants: are we there yet?Presented in Session 34 \u2013 CROI 2012 \u2013 Symposium: Recognizing risk in HIV\u2010exposed and \u2013infected infants and children."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318253844b"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70180-4"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029294"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0800971"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3182587796"},{"key":"e_1_2_7_29_1","unstructured":"WHO(2010)Antiretroviral therapy for HIV infection in infants and children: towards universal access. 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