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

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 H...

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Autores principales: Sando, David, Spiegelman, Donna, Machumi, Lameck, Mwanyika-Sando, Mary, Aris, Eric, Muya, Aisa, Jackson, Elizabeth, Baernighausen, Till, Hertzmark, Ellen, Chalamilla, Guerino, Fawzi, Wafaie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379717/
https://www.ncbi.nlm.nih.gov/pubmed/25881135
http://dx.doi.org/10.1186/s12879-015-0875-2
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author Sando, David
Spiegelman, Donna
Machumi, Lameck
Mwanyika-Sando, Mary
Aris, Eric
Muya, Aisa
Jackson, Elizabeth
Baernighausen, Till
Hertzmark, Ellen
Chalamilla, Guerino
Fawzi, Wafaie
author_facet Sando, David
Spiegelman, Donna
Machumi, Lameck
Mwanyika-Sando, Mary
Aris, Eric
Muya, Aisa
Jackson, Elizabeth
Baernighausen, Till
Hertzmark, Ellen
Chalamilla, Guerino
Fawzi, Wafaie
author_sort Sando, David
collection PubMed
description 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.
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spelling pubmed-43797172015-04-01 Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania Sando, David Spiegelman, Donna Machumi, Lameck Mwanyika-Sando, Mary Aris, Eric Muya, Aisa Jackson, Elizabeth Baernighausen, Till Hertzmark, Ellen Chalamilla, Guerino Fawzi, Wafaie BMC Infect Dis Research Article 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. BioMed Central 2015-03-26 /pmc/articles/PMC4379717/ /pubmed/25881135 http://dx.doi.org/10.1186/s12879-015-0875-2 Text en © Sando et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sando, David
Spiegelman, Donna
Machumi, Lameck
Mwanyika-Sando, Mary
Aris, Eric
Muya, Aisa
Jackson, Elizabeth
Baernighausen, Till
Hertzmark, Ellen
Chalamilla, Guerino
Fawzi, Wafaie
Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title_full Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title_fullStr Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title_full_unstemmed Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title_short Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania
title_sort time trends of baseline demographics and clinical characteristics of hiv infected children enrolled in care and treatment service in dar es salaam, tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379717/
https://www.ncbi.nlm.nih.gov/pubmed/25881135
http://dx.doi.org/10.1186/s12879-015-0875-2
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