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[2002 - 2014年河南省受艾滋病病毒暴露儿童的死亡风险及相关因素研究]

[Study on the risk of mortality and associated factors among HIV-exposed children in Henan province, 2002-2014].

作者信息

Wang Q, Ma N, Si H, Ma Y M, Li N, Nie Y G, Sun D Y, Wang Z

机构信息

Institute of STD and AIDS Prevention and Control, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.

Henan Provincial Academy of Medical Science.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Dec 10;38(12):1629-1633. doi: 10.3760/cma.j.issn.0254-6450.2017.12.009.

Abstract

To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014. A follow-up program was set up when infants as 1, 3, 6, 9, 12, 18 month olds. Data regarding the HIV-exposed children and their mothers were collected, including service of PMTCT, antiviral therapy, incidence of infectious disease and survival status of infants. Univariate and multivariate logistic regression models were used to explore the risk factors. A total number of 1 705 HIV-infected infants were reported from 2002 to 2014. Among them, 1 536 infants (90.09%) were still alive when they were at one and a half years old, with another 58 (3.40%) lost to follow up and 111 (6.51%) infants were dead. The cumulative mortality rates in HIV-exposed children, newborn, and HIV-exposed infants were 67.39‰, 23.07‰, and 57.01‰, respectively. No statistical significance was found on the decreasing tendency of mortality in different years. The leading cause of death was noticed as pneumonia, with a proportion of 32.43%, followed by suspected AIDS. Early diagnosis had not been made in infants. Low-birth weight (=4.97, 95%: 3.12-7.92) seemed to be a risk factor. Early detection in pregnancy (= 0.46, 95%: 0.26-0.80) and HARRT provided to children (=0.25, 95%: 0.15-0.42) were recognized as protective factors. The mortality of HIV-exposed children were high, which called for the development of programs on early infant diagnosis and HARRT. Measures should be taken to prevent pneumonia and other infectious diseases, together with nutrition support and monitor program on growth.

摘要

为调查2002年至2014年河南省受艾滋病病毒感染儿童的生存状况及相关危险因素。当婴儿1、3、6、9、12、18月龄时建立随访项目。收集受艾滋病病毒感染儿童及其母亲的数据,包括预防母婴传播服务、抗病毒治疗、传染病发病率和婴儿生存状况。采用单因素和多因素逻辑回归模型探索危险因素。2002年至2014年共报告1705例感染艾滋病病毒的婴儿。其中,1536例婴儿(90.09%)在一岁半时仍存活,另有58例(3.40%)失访,111例(6.51%)婴儿死亡。受艾滋病病毒感染儿童、新生儿和受艾滋病病毒感染婴儿的累积死亡率分别为67.39‰、23.07‰和57.01‰。不同年份死亡率的下降趋势无统计学意义。主要死亡原因是肺炎,占32.43%,其次是疑似艾滋病。婴儿未进行早期诊断。低出生体重(=4.97,95%:3.12-7.92)似乎是一个危险因素。孕期早期检测(=0.46,95%:0.26-0.80)和为儿童提供高效抗逆转录病毒治疗(=0.25,95%:0.15-0.42)被认为是保护因素。受艾滋病病毒感染儿童的死亡率较高,这需要制定早期婴儿诊断和高效抗逆转录病毒治疗项目。应采取措施预防肺炎和其他传染病,同时提供营养支持和生长监测项目。

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