Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania

BMC Infectious Diseases

Wafaie Fawzi¹  Guerino Chalamilla²  Ellen Hertzmark¹  Till Baernighausen¹  Elizabeth Jackson¹  Aisa Muya²  Eric Aris²  Mary Mwanyika-Sando²  Lameck Machumi²  Donna Spiegelman¹  David Sando² 

[1] Harvard T.H. Chan School of Public Health (HSPH), Dar es Salaam, Tanzania;Management and Development for Health (MDH), Dar es Salaam, Tanzania

关键词: Pediatric;    AIDS;    HIV;   

Others  :  1173928
DOI  :  10.1186/s12879-015-0875-2

 received in 2014-08-07, accepted in 2015-03-10,  发布年份 2015

【 摘 要 】

Background

Few studies have described time-based trends of clinical and demographic characteristics of children enrolling in HIV and AIDS care and treatment services. We present findings of a study that explored time-based trends of baseline characteristics among children enrolling into 26 public HIV care facilities in Dar es Salaam, Tanzania.

Methods

Children enrolled between October 2004 and September 2011 was included in these analyses. The year of enrollment was used as the primary predictor of interest, and log linear and linear regressions model were used to analyze dichotomous and continuous variables respectively. P-values under 0.05 were considered significant.

Results

Among the 6,579 children enrolled, the proportion with advanced disease at enrollment increased from 35% to 58%, mean age increasing from 5.0 to 6.2 years (p < 0.0001), proportion of children less than 2 years decreased from 35% to 29%. While the median hemoglobin concentration rose from 9.1 g/dl to 10.3 g/dl (P <0.0001), proportion with a history of past TB dropped from 25% to 12.8% (P < 0.0001). Over time, health centers and dispensaries enrolled more children as compared to hospitals (P < 0.0001). Temeke district, which has the lowest socioeconomic status among the three districts in Dar es Salaam, had a significant increase in enrollment from 22% to 25% (P = 0.02).

Conclusion

We found that as time progressed, children were enrolled in care and treatment services at an older age sicker status as evidenced by increase in mean age and more advanced disease stage at first contact with providers. We recommend more efforts be focused on scaling up early HIV infant diagnosis and enrollment to HIV care and treatment.

【 授权许可】

   
2015 Sando et al.; licensee BioMed Central.

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