Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children

Lisa M. Nathan, Lina M. Nerlander, Jedediah R. Dixon, Ruth M. Ripley, Ruanne Barnabas, Brent E. Wholeben, Rachel Musoke, Tresa Palakudy, Angelo D'Agostino, Rana Chakraborty

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: As a result of the HIV epidemic in Africa, much debate exists on whether institutionalized compared with community-based care provides optimum management of infected children. Previous reports calculated 89% mortality by age 3 years among outpatients in Malawi. No similar data are available for infected children in institutionalized care. We characterized patterns of morbidity and mortality among HIV-1-infected children residing at an orphanage in Nairobi. Methods: Medical records for 174 children followed over 5 years were reviewed. Mortality was analyzed by Kaplan-Meier methods with adjustment to account for survival in the community before admission. Anthropometric indices were calculated to include mean z scores for weight for length and length for age. Low indices reflected wasting and stunting. Opportunistic infections were documented. Results: Of 174 children, 64 had died. Survival was 70% at age 3 years. Morbidity included recurrent respiratory tract infections, gastroenteritis, parotitis, and lymphoid interstitial pneumonitis. No new cases of tuberculosis disease were noted after admission. Mean z scores for length for age suggested overall stunting (z = -1.65). Wasting was not observed (z = -0.39). Conclusion: The optimal form of care for HIV-infected children in resource-poor settings may be the development of similar homes. Absence of tuberculosis disease in long-standing residents may have contributed to improved survival. Stunting in the absence of wasting implied that growth was compromised by opportunistic infections and other cofactors.

Original languageEnglish (US)
Pages (from-to)237-241
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume34
Issue number2
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

Fingerprint

HIV-1
Growth Disorders
Morbidity
Mortality
Growth
Opportunistic Infections
Tuberculosis
Institutionalized Child
Orphanages
HIV
Parotitis
Malawi
Interstitial Lung Diseases
Gastroenteritis
Respiratory Tract Infections
Medical Records
Outpatients
Weights and Measures

Keywords

  • Africa
  • Children
  • Growth
  • HIV infection
  • Morbidity
  • Mortality

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Nathan, L. M., Nerlander, L. M., Dixon, J. R., Ripley, R. M., Barnabas, R., Wholeben, B. E., ... Chakraborty, R. (2003). Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children. Journal of Acquired Immune Deficiency Syndromes, 34(2), 237-241. https://doi.org/10.1097/00126334-200310010-00015

Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children. / Nathan, Lisa M.; Nerlander, Lina M.; Dixon, Jedediah R.; Ripley, Ruth M.; Barnabas, Ruanne; Wholeben, Brent E.; Musoke, Rachel; Palakudy, Tresa; D'Agostino, Angelo; Chakraborty, Rana.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 34, No. 2, 01.10.2003, p. 237-241.

Research output: Contribution to journalArticle

Nathan, LM, Nerlander, LM, Dixon, JR, Ripley, RM, Barnabas, R, Wholeben, BE, Musoke, R, Palakudy, T, D'Agostino, A & Chakraborty, R 2003, 'Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children', Journal of Acquired Immune Deficiency Syndromes, vol. 34, no. 2, pp. 237-241. https://doi.org/10.1097/00126334-200310010-00015
Nathan, Lisa M. ; Nerlander, Lina M. ; Dixon, Jedediah R. ; Ripley, Ruth M. ; Barnabas, Ruanne ; Wholeben, Brent E. ; Musoke, Rachel ; Palakudy, Tresa ; D'Agostino, Angelo ; Chakraborty, Rana. / Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children. In: Journal of Acquired Immune Deficiency Syndromes. 2003 ; Vol. 34, No. 2. pp. 237-241.
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