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坦桑尼亚五岁以下儿童死亡率与孕产妇艾滋病毒感染状况:利用艾滋病指标调查数据对2003年至2012年期间的趋势进行分析

Under-five mortality and maternal HIV status in Tanzania: analysis of trends between 2003 and 2012 using AIDS Indicator Survey data.

作者信息

Arunda Malachi Ochieng, Choudhry Vikas, Ekman Björn, Asamoah Benedict Oppong

机构信息

International Master Programme in Public Health, Faculty of Medicine, Lund University, CRC, Jan Waldenströms gata 35, 205 02 Malmö, Sweden;

Social Medicine and Global Health, Department of Clinical Sciences, Malmo, Lund University, Sweden.

出版信息

Glob Health Action. 2016 Jun 20;9:31676. doi: 10.3402/gha.v9.31676. eCollection 2016.

Abstract

BACKGROUND

Mortality among children under five remains a significant health challenge across sub-Saharan Africa. HIV/AIDS is one of the leading contributors to the relatively slow decline in under-five mortality in this region. In Tanzania, HIV prevalence among under-five children is high and 90% of all infections are due to mother-to-child transmission.

OBJECTIVES

The study aimed to examine the association between maternal HIV-positive status and under-five mortality in Tanzania. It also aimed to estimate the proportions and trends of under-five mortality attributable to maternal HIV/AIDS in Tanzania between 2003 and 2012.

DESIGN

Binomial logistic regression was used to analyze cross-sectional survey data from the Tanzania AIDS Indicator Surveys to examine the association between maternal HIV positivity and under-five mortality between 2003 and 2012.

RESULTS

After controlling for confounders, the adjusted odds ratios were 1.5 (95% CI 1.1-1.9) in 2003-2004, 4.6 (95% CI 2.7-7.8) in 2007-2008, and 2.4 (95% CI 1.2-4.6) in 2011-2012. The maternal HIV-attributable mortality risk percent of under-five children was 3.7 percent in 2003-2004, 11.3 percent in 2007-2008 and 5.6% in 2011-2012.

CONCLUSION

Maternal HIV positivity is associated with under-five mortality in Tanzania, making maternal HIV serostatus a relevant determinant of whether a child will survive up to five years of age or not. The impact of maternal HIV/AIDS attributable mortality risk has a significant contribution to the overall under-five mortality in Tanzania. The continued monitoring of HIV and mortality trends is important for policy development and design of interventions.

摘要

背景

在撒哈拉以南非洲地区,五岁以下儿童的死亡率仍然是一项重大的健康挑战。艾滋病毒/艾滋病是该地区五岁以下儿童死亡率下降相对缓慢的主要原因之一。在坦桑尼亚,五岁以下儿童的艾滋病毒感染率很高,所有感染中有90%是母婴传播所致。

目的

该研究旨在探讨坦桑尼亚母亲艾滋病毒呈阳性状态与五岁以下儿童死亡率之间的关联。它还旨在估计2003年至2012年期间坦桑尼亚五岁以下儿童因母亲感染艾滋病毒/艾滋病所致死亡的比例和趋势。

设计

采用二项逻辑回归分析坦桑尼亚艾滋病指标调查的横断面调查数据,以研究2003年至2012年期间母亲艾滋病毒呈阳性与五岁以下儿童死亡率之间的关联。

结果

在控制混杂因素后,2003 - 2004年调整后的优势比为1.5(95%置信区间1.1 - 1.9),2007 - 2008年为4.6(95%置信区间2.7 - 7.8),2011 - 2012年为2.4(95%置信区间1.2 - 4.6)。2003 - 2004年五岁以下儿童因母亲感染艾滋病毒所致的死亡风险百分比为3.7%,2007 - 2008年为11.3%,2011 - 2012年为5.6%。

结论

在坦桑尼亚,母亲艾滋病毒呈阳性与五岁以下儿童死亡率相关,这使得母亲的艾滋病毒血清学状态成为儿童能否活到五岁的一个相关决定因素。母亲感染艾滋病毒/艾滋病所致死亡风险对坦桑尼亚五岁以下儿童的总体死亡率有重大贡献。持续监测艾滋病毒和死亡率趋势对于政策制定和干预措施设计很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d36f/4916291/5b2103a253d7/GHA-9-31676-g001.jpg

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