Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy

Boettiger, David; Muktiarti, Dina; Kurniati, Nia; Truong, Khanh Huu; Saghayam, Suneeta; Ly, Penh Sun; Hansudewechakul, Rawiwan; Nguyen, Lam Van; Chau, Viet; Sudjaritruk, Tavitiya; Lumbiganon, Pagakrong; Chokephaibulkit, Kulkanya; Bunupuradah, Torsak; Yusoff, Nik Khairulddin Nik; Wati, Dewi Kumara; Razali, Kamarul Azahar Mohd; Fong, Moy Siew; Nallusamy, Revathy; Sohn, Annette H.; Kariminia, Azar

doi:10.1093/cid/ciw514

Cited by 7 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of death among children who took baseline cotrimoxazole preventive therapy was reduced by 73%. This finding was supported in previous studies in Ethiopia [ 31 , 51 , 52 ], Sub-Saharan Africa [ 53 ], and Asia [ 54 ]. The possible justification might be related to the therapy’s crucial role in preventing opportunistic infections and promoting immune recovery [ 55 ].…”

Section: Discussionsupporting

confidence: 90%

Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 – 2020, a multicenter retrospective cohort study

Moga Lencha,

Mekonnen Workie,

Tadesse Mequanint

et al. 2024

BMC Pediatr

View full text Add to dashboard Cite

Background In environments with limited resources, undernutrition is a serious public health risk. Its dual relationship to human immunodeficiency virus infection (HIV) leads to crises in a child's physical, emotional, social, and economic spheres of life. Nevertheless, little research has been done on the survival rate and risk factors that lead to poor survival outcomes in undernourished children receiving antiretroviral therapy. This study sought to evaluate survival status and its predictors among undernourished children on antiretroviral therapy (ART) in public health facilities, Bahir Dar city, September 1, 2010 – December 31, 2020. Methods An institution-based retrospective cohort study design was used among 414 study participants from September 1, 2010 – December 31, 2020. A simple random sampling method was applied to select study participants. All collected data were entered into epi data version 4.6 and exported to STATA version 14.0 for analysis. Each independent predictor variable with a p-value < 0.05 in the multivariable Cox proportional hazard regression was considered statistically significant. Results The overall incidence of mortality was 11.6 deaths per 1000 child year observation (95%CI: 7.7- 17.5). Baseline weight for age < -3 Z score (adjusted hazard ratio (AHR) = 4.9, 95% CI: 1.30–18.98), height for age < -3 Z score (AHR = 4.34, 95%CI 1.13–16.6), cotrimoxazole prophylaxis given (AHR = 0.27, 95%CI 0.08–0.87), hemoglobin level < 10 g/dl (AHR = 3.7, 95%CI 1.1–12.7), CD4 cells < threshold (AHR = 4.86, 95%CI 1.9–12.7), and WHO clinical disease stage III and IV (AHR = 8.1, 95%CI 1.97–33) were found independent predictors of mortality. Conclusion and recommendation The incidence of mortality was determined in the study to be 11.6 per 1000 child years. Mortality was predicted by severe stunting, severe underweight, a low hemoglobin level, a low CD4 count, and WHO clinical stages III and IV. But the risk of death is reduced by starting cotrimoxazole preventative therapy early. The risk factors that result in a low survival status should be the primary focus of all concerned bodies, and early cotrimoxazole preventive treatment initiation is strongly recommended.

show abstract

Section: Discussionsupporting

confidence: 90%

Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 – 2020, a multicenter retrospective cohort study

Moga Lencha,

Mekonnen Workie,

Tadesse Mequanint

et al. 2024

BMC Pediatr

View full text Add to dashboard Cite

show abstract

“…In particular, regular growth monitoring may detect growth deviations at early stages and allow for access to nutritional support. Recently, cotrimoxazole prophylaxis was shown to be linked to improved weight and height development in HIV-infected Asian infants with relatively preserved immune systems [ 38 ]. Although this intervention has not yet been investigated in HIV-EU children, it is possible that cotrimoxazole could also have a protective effect in this population (for example, for reduction of malaria and common bacterial infections), and this intervention is currently being studied in a randomized controlled trial in South Africa [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Growth pattern in Ethiopian infants – the impact of exposure to maternal HIV infection in relation to socio-economic factors

Walles

Balcha

Winqvist

et al. 2017

Global Health Action

View full text Add to dashboard Cite

Background: Infants exposed to maternal HIV infection who remain HIV-uninfected (HIV-exposed/uninfected; HIV-EU) may be at increased risk of growth retardation, which could be due both to directly HIV-related effects and to socio-economic factors overrepresented among HIV-positive women.Objective: To investigate growth development at 9–12 months of age in HIV-EU infants participating in prevention of mother-to-child transmission (PMTCT) care compared to HIV unexposed (HIV-U) infants in relation to socio-economic conditions.Methods: Anthropometric and socio-economic data were collected retrospectively from PMTCT registers (for HIV-EU infants), with HIV-U controls recruited at measles vaccination at public health facilities in Ethiopia. Growth was compared with regard to HIV exposure and socio-economic variables in multivariate regression analysis.Results: The following growth measurements were found for 302 HIV-EU and 358 HIV-U infants at 9–12 months of age, respectively: mean weight-for-age z-score (WAZ) 0.04 and −0.21, p < 0.001 (proportion underweight 5.7% and 6.7%, p = 0.60); median length-for-age z-score (LAZ) −0.92 and −0.91, p = 0.53 (proportion stunted 25.1% and 20.5%, p = 0.17). In multivariate analysis, lower WAZ was associated with male sex (p = 0.021), lower maternal education (p < 0.001), presence of siblings (p < 0.01) and HIV-U (p < 0.01). Underweight was associated with male sex (p = 0.017) and absence of maternal education (p = 0.019). Lower LAZ was associated with male sex (p < 0.001), presence of siblings (p < 0.001) and poor maternal education (p < 0.01), while stunting was associated with male sex (p < 0.001), presence of siblings (p < 0.001), few rooms in the home (p < 0.01), access to running water (p = 0.026) and low level of maternal education (p = 0.014).Conclusions: At 9–12 months of age, HIV-EU infants had non-inferior growth and higher mean WAZ than HIV-U controls. Poor growth development was associated with socio-economic factors. This suggests health benefits from PMTCT participation for infant growth. Similar interventions could be considered for Ethiopian infants, irrespective of HIV exposure, with a particular focus on children with poor socio-economic status.

show abstract

“…However, children on second-line treatment are more likely to experience wasting than those on first-line ART [19]. Use of cotrimoxazole prophylaxis (for prevention of pneumonia, malaria, and other opportunistic infections) along with ART was found to provide benefits in weight recovery in the TaPHOD cohort in Asia, although these benefits did not extend to those with CD4%<10% at ART initiation [27]. Cotrimoxazole use did not appear to confer benefits in height recovery within two years after ART initiation, regardless of CD4% at ART initiation.…”

Section: Predictors Of Growth Reconstition After Art Initiationmentioning

confidence: 99%

Growth and pubertal development in HIV-infected adolescents

Williams

Jesson

2018

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

show abstract

Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy

Abstract: Cotrimoxazole use is associated with benefits to WAZ but not HAZ during early ART in Asian children.

Cited by 7 publications

References 25 publications

Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 – 2020, a multicenter retrospective cohort study

Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 – 2020, a multicenter retrospective cohort study

Growth pattern in Ethiopian infants – the impact of exposure to maternal HIV infection in relation to socio-economic factors

Growth and pubertal development in HIV-infected adolescents

Contact Info

Product

Resources

About