PDF(Pubmed)
Abstract：
Severe acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is no prior evidence. An institution-based retrospective cohort study was employed among 721 HIV-positive children from 1 January to 30 December 2021. Data were entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. Bi-variable and multivariable Cox-proportional hazard models were employed at 95 % confidence intervals to identify significant predictors for SAM. According to this result, the overall mean (±sd) age of the participants was found to be 9⋅83 (±3⋅3) years. At the end of the follow-up period, 103 (14⋅29 %) children developed SAM with a median time of 30⋅3 (13⋅4) months after ART initiation. The overall incidence density of SAM was found to be 5⋅64 per 100 child (95 % CI 4⋅68, 6⋅94). Children with CD4 counts below the threshold [AHR 2⋅6 (95 % CI 1⋅2, 2⋅9, P = 0⋅01)], disclosed HIV status [AHR 1⋅9 (95 % CI 1⋅4, 3⋅39, P = 0⋅03)] and Hgb level ≤10 mg/dl [AHR 1⋅8 (95 % CI 1⋅2, 2⋅9, P = 0⋅03)] were significant predictors for SAM. Significant predictors of acute malnutrition were having a CD4 count below the threshold, children who had previously reported their HIV status, and having haemoglobin <10 mg/dl. To ensure better health outcomes, healthcare practitioners should improve earlier nutritional screening and consistent counselling at each session of care.
摘要：
严重急性营养不良（SAM）影响多达50％的艾滋病毒感染儿童，尤其是那些居住在资源有限的医疗保健环境，如埃塞俄比亚。在随后的儿童随访期间，与抗逆转录病毒治疗（ART）后SAM发病率相关的因素，然而,没有先前的证据。一项基于机构的回顾性队列研究于2021年1月1日至12月30日在721名HIV阳性儿童中进行。使用Epi-Data版本3.1输入数据并导出至STATA版本14进行分析。在95%置信区间采用双变量和多变量Cox比例风险模型来确定SAM的重要预测因子。根据这个结果,参与者的总体平均（±sd）年龄为9·83（±3·3）岁。在随访期结束时，在ART开始后，103名（14·29％）儿童发展了SAM，中位时间为30·3（13·4）个月。SAM的总体发生率密度为每100名儿童5·64（95％CI4·68，6·94）。CD4计数低于阈值的儿童[AHR2·6（95％CI1·2，2·9，P=0·01）]，已披露的HIV状况[AHR1·9（95％CI1·4，3·39，P=0·03）]和Hgb水平≤10mg/dl[AHR1·8（95％CI1·2，2·9，P=0·03）]是SAM的重要预测因子。急性营养不良的重要预测因素是CD4计数低于阈值，以前报告过艾滋病毒状况的儿童，并且具有<10mg/dl的血红蛋白。为了确保更好的健康结果，医疗保健从业人员应在每次护理中改善早期营养筛查和一致的咨询。
