Original ArticlePneumonia and Malnutrition are Highly Predictive of Mortality among African Children Hospitalized with Human Immunodeficiency Virus Infection or Exposure in the Era of Antiretroviral Therapy
Section snippets
Methods
The KCH pediatric ward is a crowded 215-bed referral facility averaging 42 and 34 daily admissions during the malaria and non-malaria seasons, respectively, for children <14 years of age. Data from every hospitalized inpatient with HIV infection and HIV exposure evaluated by an HIV-trained KCH clinician between September 1, 2007, and December 31, 2008, were recorded by COE pediatricians. The study was approved by the Malawi National Health Sciences Research Committee and Baylor College of
Results
During the 16-month study period, 15 271 children were admitted to KCH, and routine HIV testing identified 884 inpatients with HIV infection and 351 inpatients with HIV exposure (Table I). Although the overall mortality rate at KCH was 7.3%, the mortality rate was especially high in children who were HIV infected (16.6%) and HIV exposed (13.4%), and although the median duration between hospital admission and death at KCH was 2 days, most deaths in cohorts with HIV infection and HIV exposure
Discussion
From the beginning of the global scale-up of ART, children have been underrepresented as recipients of both HIV care and treatment.8 Most African children first gain access to HIV care in pediatric hospitals,4, 9 which face high burdens of HIV-related admissions and death.10 However, little is known about pediatric inpatients in the era of ART, and it is not yet known whether specific clinical features might predict which children who were infected or exposed to HIV are at especially high risk
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2023, Manson's Tropical Diseases, Fourth EditionFactors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country
2021, HeliyonCitation Excerpt :There were only a few studies about mortality predictive factors for pneumonia patients in the PICU that had been done. A study in 2017 concluded that hospital acquired pneumonia (HAP) and bacteremia were risk factors for mortality in pneumonia, with OR 2.92 and 5.03, respectively [10]. In 2012, a study revealed that congenital heart disease [11], Down syndrome, and cerebral palsy served as risk factors for fatality of severe pneumonia in PICU [12].
Supported by Baylor International Pediatric AIDS Initiative, Bristol Myers Squibb, Abbott Fund, Texas Children’s Hospital, UNICEF, and the Malawi Ministry of Health. The funders had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; and in the preparation, review or approval of the manuscript. The authors declare no conflicts of interest.