The effect of HIV on morbidity and mortality in children with severe malarial anaemia.
The effect of HIV on morbidity and mortality in children with severe malarial anaemia.
复制标题
艾滋病毒对严重疟疾贫血儿童发病率和死亡率的影响。
DOI：
10.1186/1475-2875-6-143
复制
发表时间：
2007-10-31
期刊：
影响因子：
3
通讯作者：
Mermin, Jonathan
中科院分区：
文献类型：
--
作者：
Malamba, Samuel;Hladik, Wolfgang;Reingold, Arthur;Banage, Flora;McFarland, Willi;Rutherford, George;Mimbe, Derrick;Nzaro, Esau;Downing, Robert;Mermin, Jonathan
疟疾和艾滋病毒是撒哈拉以南非洲的常见死亡原因。评估了艾滋病毒感染对严重疟疾贫血儿童发病率和死亡率的影响。在乌干达坎帕拉的Mulago医院，作为前瞻性队列研究的一部分，对<5岁的儿童进行了随访，以评估输血相关的血源性病原体传播。所有儿童都被诊断为严重疟疾性贫血，需要输血。比较了HIV感染和未感染儿童输血后不同时间点的存活率。广义估计方程用于分析重复测量的发病率结果，调整混杂因素。在847名儿童中，78名（9.2%）感染了艾滋病毒。中位随访时间为162天（四分位距：111，169）。感染艾滋病毒的儿童更有可能在7天内死亡（风险比[HR] = 2.86，95%置信区间[CI] 1.30-6.29，P = 0.009）和28天内（HR = 3.70，95%CI 1.91-7.17，P < 0.001），输血后6个月内死亡的可能性更大（HR = 5.70，95%CI 3.54-9.16，P < 0.001）。HIV感染儿童在输血后28天内（发病率比（IRR）= 3.74，95% CI 1.41-9.90，P = 0.008）和6个月内（IRR = 2.66，95% CI 1.17 - 6.07，P = 0.02）因疟疾再次入院的频率高于HIV未感染儿童。患有严重疟疾贫血的艾滋病毒感染儿童的全因死亡率和与疟疾有关的死亡率高于未感染艾滋病毒的儿童。感染艾滋病毒和疟疾的儿童应得到积极治疗，并对其艾滋病毒疾病进行进一步评估，特别是复方新诺明预防和抗逆转录病毒治疗。
Malaria and HIV are common causes of mortality in sub-Saharan Africa. The effect of HIV infection on morbidity and mortality in children with severe malarial anaemia was assessed. Children <5 years old were followed as part of a prospective cohort study to assess the transfusion-associated transmission of blood-borne pathogens at Mulago Hospital, Kampala, Uganda. All children were hospitalized with a diagnosis of severe malarial anaemia requiring blood transfusion. Survival to different time points post-transfusion was compared between HIV-infected and uninfected children. Generalized estimating equations were used to analyse repeated measurement outcomes of morbidity, adjusting for confounders. Of 847 children, 78 (9.2%) were HIV-infected. Median follow-up time was 162 days (inter-quartile range: 111, 169). HIV-infected children were more likely to die within 7 days (Hazard ratio [HR] = 2.86, 95% Confidence interval [CI] 1.30–6.29, P = 0.009) and within 28 days (HR = 3.70, 95% CI 1.91–7.17, P < 0.001) of an episode of severe malarial anaemia, and were more likely to die in the 6 months post-transfusion (HR = 5.70, 95% CI 3.54–9.16, P < 0.001) compared to HIV-uninfected children. HIV-infected children had more frequent re-admissions due to malaria within 28 days (Incidence rate ratio (IRR) = 3.74, 95% CI 1.41–9.90, P = 0.008) and within 6 months (IRR = 2.66, 95% CI 1.17 – 6.07, P = 0.02) post-transfusion than HIV-uninfected children. HIV-infected children with severe malarial anaemia suffered higher all-cause mortality and malaria-related mortality than HIV-uninfected children. Children with HIV and malaria should receive aggressive treatment and further evaluation of their HIV disease, particularly with regard to cotrimoxazole prophylaxis and antiretroviral therapy.
登录
查看更多内容
DOI：
10.4269/ajtmh.1994.51.372
发表时间：
1994-09-01
影响因子：
3.3
作者：
ELHASSAN, IM;HVIID, L;THEANDER, TG
通讯作者：
THEANDER, TG
影响因子：
2.7
作者：
NIYONGABO, T;DELORON, P;BRELIVET, JC
通讯作者：
BRELIVET, JC
影响因子：
28.2
作者：
COLEBUNDERS, R;BAHWE, Y;PIOT, P
通讯作者：
PIOT, P
影响因子：
158.5
作者：
GREENBERG, AE;NSA, W;HASSIG, SE
通讯作者：
HASSIG, SE
影响因子：
158.5
作者：
MARSH, K;FORSTER, D;SNOW, R
通讯作者：
SNOW, R