Child mortality according to maternal and infant HIV status in Zimbabwe

Edmore Marinda, Jean H. Humphrey, Peter J. Iliff, Kuda Mutasa, Kusum J. Nathoo, Ellen G. Piwoz, Lawrence H. Moulton, Peter Salama, Brian J. Ward, Henry Chidawanyika, John Hargrove, Agnes Mahomva, Florence Majo, Lucie Malaba, Michael Mbizvo, Faith Mzengeza, Kusum Nathoo, Mary Ndhlovu, Robert Ntozini, Lidia PropperPhilipa Rambanepasi, Andrea Ruff, Naume Tavengwa, Lynn Zijenah, Claire Zunguza, Partson Zvandasara

Research output: Contribution to journalArticle

Abstract

BACKGROUND: HIV causes substantial mortality among African children but there is limited data on how this is influenced by maternal or infant infection status and timing. METHODS: Children enrolled in the ZVITAMBO trial were divided into 5 groups: those born to HIV-negative mothers (NE, n = 9510), those born to HIV-positive mothers but noninfected (NI, n = 3135), those infected in utero (IU, n = 381), those infected intrapartum (IP, n = 508), and those infected postnatally (PN, n = 258). Their mortality was estimated. RESULTS: Two-year mortality was 2.9% (NE infants), 9.2% (NI), 67.5% (IU), 65.1% (IP), and 33.2% (PN). Between 8 weeks and 6 months, mortality in IU infants quintupled (from 309 to 1686/1000 c-y). The median time from infection to death was 208, 380, and >500 days for IU, IP, and PN infants, respectively. Among NI children, advanced maternal disease was predictive of mortality. Acute respiratory infection was the major cause of death. CONCLUSIONS: Perinatally infected infants are at particular risk of death between 2 and 6 months: cotrimoxazole prophylaxis and early pediatric HAART should be scaled up. Uninfected infants of infected mothers have at least twice the mortality risk of infants born to uninfected mothers: all HIV-exposed infants should be targeted with child survival interventions. HIV-positive mothers with more advanced disease are not only more likely to infect their infants, but their infants are more likely to die, whether infected or not: provision of antiretroviral treatment to pregnant and lactating women is an urgent need for both mothers and their children.

Original languageEnglish (US)
Pages (from-to)519-526
Number of pages8
JournalPediatric Infectious Disease Journal
Volume26
Issue number6
DOIs
StatePublished - Jun 2007

Keywords

  • Child mortality
  • HIV
  • Maternal HIV status
  • Time of infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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  • Cite this

    Marinda, E., Humphrey, J. H., Iliff, P. J., Mutasa, K., Nathoo, K. J., Piwoz, E. G., Moulton, L. H., Salama, P., Ward, B. J., Chidawanyika, H., Hargrove, J., Mahomva, A., Majo, F., Malaba, L., Mbizvo, M., Mzengeza, F., Nathoo, K., Ndhlovu, M., Ntozini, R., ... Zvandasara, P. (2007). Child mortality according to maternal and infant HIV status in Zimbabwe. Pediatric Infectious Disease Journal, 26(6), 519-526. https://doi.org/10.1097/01.inf.0000264527.69954.4c