{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:19:01Z","timestamp":1791299941719,"version":"4.1.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"Objective.<\/jats:title>To assess patterns of morbidity and associated factors in late infancy and early childhood among human immunodeficiency virus (HIV)-infected and -uninfected African children.<\/jats:p><\/jats:sec>Design.<\/jats:title>Prospective study.<\/jats:p><\/jats:sec>Setting.<\/jats:title>The Queen Elizabeth Central Hospital, Blantyre, Malawi.<\/jats:p><\/jats:sec>Participants.<\/jats:title>Children with known HIV status from an earlier perinatal intervention trial were enrolled during the first year of life and followed to \u223c36 months of age.<\/jats:p><\/jats:sec>Outcome Measures.<\/jats:title>Morbidity and mortality information was collected every 3 months by a questionnaire. A physical examination was conducted every 6 months. Blood to determine CD4+ values was also collected. Age-adjusted and Kaplan-Meier analyses were performed to compare rates of morbidity and mortality among infected and uninfected children.<\/jats:p><\/jats:sec>Results.<\/jats:title>Overall, 808 children (190 HIV-infected, 499 HIV-uninfected but born to infected mothers, and 119 born to HIV-uninfected mothers) were included in this study. Of these, 109 died during a median follow-up of 18 months. Rates of childhood immunizations were high among all children (eg, lowest was measles vaccination [87%] among HIV-infected children). Age-adjusted morbidity rates were significantly higher among HIV-infected than among HIV-uninfected children. HIV-infected children were more immunosuppressed than were uninfected children. By 3 years of age, 89% of the infected children died, 10% were in HIV disease category B or C, and only \u223c1% were without HIV symptoms. Among HIV-infected children, median survival after the first occurrence of acquired immunodeficiency syndrome-related conditions, such as splenomegaly, oral thrush, and developmental delay, was &lt;10 months. These same conditions, in addition to frequent bouts of fever, were the main morbidity predictors of mortality.<\/jats:p><\/jats:sec>Conclusions.<\/jats:title>The frequency of diseases was high, and progression from asymptomatic or symptomatic HIV disease to death was rapid. Management strategies that effectively reduce morbidity for HIV-infected children are needed.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.106.6.e77","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"e77-e77","source":"Crossref","is-referenced-by-count":113,"title":["Morbidity Among Human Immunodeficiency Virus-1-Infected and -Uninfected African Children"],"prefix":"10.1542","volume":"106","author":[{"given":"Taha E.","family":"Taha","sequence":"first","affiliation":[{"name":"From the Infectious Diseases Program, Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Graham","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Malawi, Blantyre, Malawi; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Newton 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