{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:26:36Z","timestamp":1762503996956,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,7,23]],"date-time":"2014-07-23T00:00:00Z","timestamp":1406073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004441","name":"Swedish International Development Cooperation Agency","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"crossref"}]},{"name":"South African National Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To report on risk factors for severe events (hospitalisation or infant death) within the first half of infancy amongst <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010unexposed infants in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frican data from the multisite community\u2010based cluster\u2010randomised trial <jats:styled-content style=\"fixed-case\">PROMISE EBF<\/jats:styled-content> promoting exclusive breastfeeding in three sub\u2010Saharan countries from 2006 to 2008 were used. The <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frican sites were <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>aarl in the <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>estern <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ape <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>rovince, and <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>mlazi and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ietvlei in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>wa<jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ulu\u2010<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>atal. This analysis included 964 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative mother\u2013infant pairs. Data on severe events and infant feeding practices were collected at 3, 6, 12 and 24\u00a0weeks post\u2010partum. We used a stratified extended <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox model to examine the association between the time to the severe event and covariates including birthweight, with breastfeeding status as a time\u2010dependent covariate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy infants (7%) experienced a severe event. The median age at first hospitalisation was 8\u00a0weeks, and the two main reasons for hospitalisation were cough and difficult breathing followed by diarrhoea. Stopping breastfeeding before 6\u00a0months (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.4; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u20135.1) and low birthweight (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.4; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.3\u20134.3) were found to increase the risk of a severe event, whilst maternal completion of high school education was protective (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 0.3; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.1\u20130.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A strengthened primary healthcare system incorporating promotion of breastfeeding and appropriate caring practices for low birthweight infants (such as kangaroo mother care) are critical. Given the leading reasons for hospitalisation, early administration of oral rehydration therapy and treatment of suspected pneumonia are key interventions needed to prevent hospitalisation in young infants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12355","type":"journal-article","created":{"date-parts":[[2014,7,23]],"date-time":"2014-07-23T07:46:04Z","timestamp":1406101564000},"page":"1162-1169","source":"Crossref","is-referenced-by-count":6,"title":["Severe events in the first 6\u00a0months of life in a cohort of <scp>HIV<\/scp>\u2010unexposed infants from <scp>S<\/scp>outh <scp>A<\/scp>frica: effects of low birthweight and breastfeeding status"],"prefix":"10.1111","volume":"19","author":[{"given":"Tanya","family":"Doherty","sequence":"first","affiliation":[{"name":"Health Systems Research Unit Medical Research Council Cape Town South Africa"},{"name":"School of Public Health University of the Western Cape Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"Jackson","sequence":"additional","affiliation":[{"name":"School of Public Health University of the Western Cape Cape Town South Africa"},{"name":"UNICEF New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Swanevelder","sequence":"additional","affiliation":[{"name":"Biostatistics Unit Medical Research Council Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Lombard","sequence":"additional","affiliation":[{"name":"Biostatistics Unit Medical Research Council Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingunn M. 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