Little K E, Bland R M, Newell M L
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, UCL, London, UK.
Trop Med Int Health. 2008 Sep;13(9):1098-110. doi: 10.1111/j.1365-3156.2008.02130.x. Epub 2008 Jul 28.
The successes achieved in paediatric disease management in well-resourced countries in recent years highlight the vast divide between the care options, and ultimately survival, between developed and developing areas of the world. Using an extensive literature review, we quantify recent achievements in terms of improved survival and quality of life, and examine current evidence of the effects of treatment on the survival and morbidity of HIV-infected children in developing countries. When provided with the same care as their counterparts in developed countries, children in developing countries show similar improvements in survival and general health, with 1-year survival rates exceeding 90% in many African settings. Despite the challenges of providing comprehensive packages of care in resource-limited settings, there is an urgent need to scale up prevention and treatment of HIV infections in children, focussing on strengthening Prevention of Mother-to-Child Transmission programmes in order to reduce the numbers of infants who are infected in addition to reducing morbidity and mortality among their mothers.
近年来，资源丰富国家在儿科疾病管理方面取得的成功凸显了世界发达地区和发展中地区在护理选择以及最终生存率方面的巨大差距。通过广泛的文献综述，我们量化了近期在提高生存率和生活质量方面取得的成就，并审视了目前关于治疗对发展中国家感染艾滋病毒儿童的生存和发病率影响的证据。当发展中国家的儿童获得与发达国家儿童相同的护理时，他们在生存和总体健康方面也会有类似的改善，在许多非洲地区，1岁儿童的生存率超过90%。尽管在资源有限的环境中提供全面护理套餐存在挑战，但迫切需要扩大儿童艾滋病毒感染的预防和治疗，重点是加强预防母婴传播项目，以减少感染婴儿的数量，同时降低其母亲的发病率和死亡率。
