Determinants of Survival Without Antiretroviral Therapy After Infancy in HIV-1-Infected Zambian Children in the CHAP Trial

Walker, A. Sarah; Mulenga, Veronica; Sinyinza, Frederick; Lishimpi, Kennedy; Nunn, Andrew; Chintu, Chifumbe; Gibb, Diana M

doi:10.1097/01.qai.0000226334.34717.dc

Cited by 69 publications

(78 citation statements)

References 30 publications

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“…Applications of imputation by chained equations have now appeared in quite diverse fields: addiction (Schnoll et al 2006;MacLeod et al 2008;Adamczyk and Palmer 2008;Caria et al 2009;Morgenstern et al 2009), arthritis and rheumatology (Wolfe et al 2006;Rahman et al 2008;van den Hout et al 2009), atherosclerosis (Tiemeier et al 2004;van Oijen et al 2007;McClelland et al 2008), cardiovascular system (Ambler et al 2005;van Buuren et al 2006a;Chase et al 2008;Byrne et al 2009;Klein et al 2009), cancer (Clark et al 2001Royston et al 2004;Barosi et al 2007;Fernandes et al 2008;Sharma et al 2008;McCaul et al 2008;Huo et al 2008;Gerestein et al 2009), epidemiology (Cummings et al 2006;Hindorff et al 2008;Mueller et al 2008;Ton et al 2009), endocrinology (Rouxel et al 2004;Prompers et al 2008), infectious diseases (Cottrell et al 2005;Walker et al 2006;Cottrell et al 2007;Kekitiinwa et al 2008;Nash et al 2008;Sabin et al 2008;Thein et al 2008;Garabed et al 2008;Michel et al 2009), genetics …”

Section: Applications Of Chained Equationsmentioning

confidence: 99%

mice: Multivariate Imputation by Chained Equations inR

Buuren¹,

2011

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The R package mice imputes incomplete multivariate data by chained equations. The software mice 1.0 appeared in the year 2000 as an S-PLUS library, and in 2001 as an R package. mice 1.0 introduced predictor selection, passive imputation and automatic pooling. This article documents mice 2.9, which extends the functionality of mice 1.0 in several ways. In mice 2.9, the analysis of imputed data is made completely general, whereas the range of models under which pooling works is substantially extended. mice 2.9 adds new functionality for imputing multilevel data, automatic predictor selection, data handling, post-processing imputed values, specialized pooling routines, model selection tools, and diagnostic graphs. Imputation of categorical data is improved in order to bypass problems caused by perfect prediction. Special attention is paid to transformations, sum scores, indices and interactions using passive imputation, and to the proper setup of the predictor matrix. mice 2.9 can be downloaded from the Comprehensive R Archive Network. This article provides a hands-on, stepwise approach to solve applied incomplete data problems.

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Section: Applications Of Chained Equationsmentioning

confidence: 99%

mice: Multivariate Imputation by Chained Equations inR

Buuren¹,

2011

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“…survival in both adults and children who live with HIV, even when they are receiving ART (10). SAM is defined anthropometrically by the WHO as a weight for height 23 SD below the mean, or a mid-upper arm circumference 11.5 cm in children aged 1-5 y old (9). A systematic review and metaanalysis of children who presented with SAM in sub-Saharan Africa reported an HIV seroprevalence of 29% with data from 17 studies.…”

Section: Introductionmentioning

confidence: 99%

Severe malnutrition and metabolic complications of HIV-infected children in the antiretroviral era: clinical care and management in resource-limited settings

Musoke¹,

Fergusson²

2011

The American Journal of Clinical Nutrition

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More than 2 million children globally are living with HIV infection and .90% of these reside in sub-Saharan Africa. Severe acute malnutrition (SAM) remains a major problem for HIV-infected children who live in resource-limited settings (RLS), and SAM is an important risk factor for mortality. SAM in HIV-infected children is associated with complications including electrolyte disorders, micronutrient deficiencies, and severe infections, which contribute to the high mortality. Access to antiretroviral therapy (ART) has significantly improved the survival of HIV-infected children, although the response to ART of children with SAM remains undocumented in the literature. Immune and virologic responses to ART in RLS are similar to those of infected children in resource-rich settings, but delays in initiation of therapy have led to a high early mortality. Antiretroviral drug toxicities have been described in children who receive therapy and may affect their quality of life and long-term survival. Metabolic complications of ART include lipodystrophy, dyslipidemia, lactic acidosis, insulin resistance, and osteopenia. These complications have been well described in adults and children from developed countries, but data from RLS are limited, and these complications may be compounded by SAM. In this article we review the epidemiology, clinical presentation, and complications of SAM in HIV-infected children and the metabolic complications of HIV-infected children in the era of ART, and discuss future research priorities for RLS.Am J Clin Nutr 2011;94(suppl):1716S-20S.

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“…29,31,33,34 It is possible that uninfected caregivers may be more stable, as they are less likely to get sick or die. 35 Poverty has been identified as a major barrier to accessing ART in other areas in South Africa. 8,16,29 Many caregivers depend on government grants and have to balance the needs of the whole family with those of the HIV-infected child.…”

Section: Discussionmentioning

confidence: 99%

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

Railton

Mash

2012

South African Family Practice

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Background: At Kgapane Hospital, Limpopo Province, only 20% of eligible children initiated antiretroviral treatment (ART) in 2007. The aim of this study was to improve the ART programme by assessing how children were accessing ART, and to explore the factors that facilitate or obstruct this access.Method: Mixed methods were used in a descriptive study of human immunodeficiency virus (HIV)-infected children admitted to the hospital over a seven-month period and their caregivers. Children's subsequent attendance for ART was tracked and caregivers were interviewed about factors influencing access and attendance.Results: Of 132 children initially admitted, 14 (10.6%) subsequently died and 13 (9.8%) relocated. Sixty of the remaining 105 (57.1%) returned within one month to the antiretroviral clinic, three (2.9%) attended later and 42 (40.0%) did not return at all. Quantitative data associated with poor attendance were younger age, higher CD4 count, maternal caregiver, no income and participation in the prevention of mother-to-child transmission program. Qualitative factors included a lack of money for transport, poor social support, and mothers who struggled to accept their diagnosis, had poor understanding of HIV and strong traditional beliefs. Primary care providers delayed HIV testing and referral, displayed poor attitudes, and were insufficient in number. Quantitative factors significantly associated with good attendance were prior knowledge of the child/mother's HIV status, mother's ART treatment and referral to the dietician. Conclusion:There are serious deficiencies in the prevention, diagnosis and treatment of HIV in children. Factors were identified to improve health services and these highlight the need for broader strategies aimed at addressing poverty, stigma and education.Peer reviewed.

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Determinants of Survival Without Antiretroviral Therapy After Infancy in HIV-1-Infected Zambian Children in the CHAP Trial

Abstract: Malnutrition and hospitalizations for respiratory/bacterial infections predict mortality independent of immunosuppression, suggesting that they capture HIV- and non-HIV-related mortality, whereas oral candidiasis is a proxy for immunosuppression.

Cited by 69 publications

References 30 publications

mice: Multivariate Imputation by Chained Equations inR

mice: Multivariate Imputation by Chained Equations inR

Severe malnutrition and metabolic complications of HIV-infected children in the antiretroviral era: clinical care and management in resource-limited settings

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

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