Mortality risk factors among HIV‐exposed infants in rural and urban Cameroon

Abstract

Abstractobjectives HIV-exposed infants, including those who do not become infected, have higher morbidity and mortality rates than HIV unexposed infants. The underlying mechanisms of this difference are largely unknown. The objective of this study was to identify the risk factors for mortality among HIV-exposed (infected as well as uninfected) infants in a prevention of motherto-child transmission (PMTCT) programme in Cameroon. results Two hundred and eighty-five medical records were included in the final analysis. Infant mortality rates were 23.9%, 20.0% and 5.3% in group I, II and III, respectively (P = 0.02). Hazard ratios of infant mortality were 6.4 (P < 0.001) for prematurity, 4.6 (P = 0.04) for no maternal use of ARTs, 5.6 (P = 0.025) for mixed feeding, 2.7 for home deliveries (P = 0.087) and 0.4 (P = 0.138) for urban study group.conclusions In this programme, prematurity, no ART use, and the practice of mixed feeding were independent predictors of infant mortality. Mixed feeding and not using ART increased the hazard of death, probably through its increased risk of HIV infection. Although mortality rates were significantly higher in the rural area, rural setting was not a risk factor for infant mortality. These findings may contribute to the development of tailor-made programmes to reduce infant mortality rates among HIV-exposed infants.

Causes and Predictors of Mortality among HIV-Exposed Infants in Rural North-Central Nigeria: Results of a Simple Verbal Autopsy Survey

“…Bivariate analysis correlated the following with HEI mortality: non-facility delivery, new maternal HIV diagnosis, maternal efavirenz-based regimen assisted delivery, unskilled birth attendant, post-postpartum maternal death and infant's non-receipt of nevirapine prophylaxis within 72 hours of life. Several studies support our ndings of non-facility delivery, new maternal HIV diagnosis, maternal efavirenz, non-vaginal delivery, unskilled birth attendant, post-postpartum maternal death as correlates of HEI mortality (32,34,38,48). In our study however, only non-receipt of infant nevirapine within 72 hours persisted as a correlate of HEI mortality in multivariate analysis.…”

Predictors of mortality among HIV exposed infants at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

“…The incidence of child mortality reported 5/1000 person-year in India [10] and 150 per 1000 person-years in Zimbabwe [11]. It is also reported in Uganda (3.9%) [12], Cameron (23.9%) [13], Malawi (6.3–9.3%) [14], Rwanda (4.8%) [15], and Kenya 39% [16].…”

“…The High mortality of infants born from HIV positive mother has been attributed to different predictors. Some of the predictors identified in the previous studies from different countries include advanced maternal disease [17], HIV infection of the child [11, 14, 18], low birth weight [14], maternal survival status [19], early and abrupt breastfeeding cessation and mixed feeding [13, 15, 20], and prematurity [13].…”

Predictors of early breastfeeding cessation among HIV‐infected women in Botswana

“…Breastfeeding is a critical component of child survival and maybe most important among HIV-exposed children (both infected or uninfected) who have high rates of infant mortality [5,10,11,17,18]. Early cessation of breastfeeding has been associated with increased risk of infant mortality and morbidity in several studies in Africa [10,18].…”

“…The rollout of three‐drug antiretroviral therapy (ART) for prevention of mother‐to‐child transmission (PMTCT) has dramatically reduced HIV transmission between mothers and infants in low‐resource settings . Breastfeeding (BF) is a critical component of childhood survival in these same settings , and recent evidence suggests that HIV‐infected women receiving ART may be able to safely breastfeed their infants . WHO recommends 1 year of breastfeeding (6 months exclusive and 6 months with complementary feeding) with maternal ART prophylaxis for HIV‐exposed infants to achieve optimal health, growth and development of the child .…”