Department of Statistics, Dire Dawa University, Dire Dawa, Ethiopia.
Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.
Sci Rep. 2022 Apr 27;12(1):6867. doi: 10.1038/s41598-022-10880-y.
The main objective of this study was to identify variables jointly affected for CD4 count and hazard time to death of HIV-infected children under ART at Felege Hiwot Referal and Specialized Hospital. A retrospective cohort study design was conducted on 202 HIV-infected children under ART whose follow-ups were from January 2014 up to December 2018. The descriptive statistics revealed that about 25.2% of HIV-infected children under ART in the study period(Jaunary 2014-December 2018) died and 74.8% were censored. The estimated association parameter in the joint model was - 0.8339 and statistically significant (p value = 0.025). There was a negative relationship between the two response variables namely CD4 count and the risk for death on HIV-positive children under treatment. The level of education of children's parents, level of disclosure of the disease, baseline CD4 count, functional status, and adherence level were statistically and significantly affected for the two response variables, CD4 count and risks for the death of children. Separate and joint models have been compared interims of standard error and the joint model had a small standard error as compared to the separate models. The small standard errors in joint models indicate that the joint model was better in detecting variables that affected the two responses in this regard. Health-related education should be conducted to parents of children for easy recovery of CD4 count and for reducing risks for the death of children.
本研究的主要目的是确定共同影响接受抗逆转录病毒疗法（ART）的 HIV 感染儿童 CD4 计数和死亡风险时间的变量。对 202 名接受 ART 的 HIV 感染儿童进行了回顾性队列研究，随访时间为 2014 年 1 月至 2018 年 12 月。描述性统计显示，研究期间（2014 年 1 月至 2018 年 12 月）约有 25.2%的接受 ART 的 HIV 感染儿童死亡，74.8%被删失。联合模型中的估计关联参数为-0.8339，具有统计学意义（p 值=0.025）。在接受治疗的 HIV 阳性儿童中，两个反应变量（即 CD4 计数和死亡风险）之间存在负相关关系。儿童父母的受教育程度、疾病披露程度、基线 CD4 计数、功能状态和依从水平对两个反应变量 CD4 计数和儿童死亡风险均有统计学和显著影响。分别和联合模型之间的比较是根据标准误差进行的，与单独模型相比，联合模型的标准误差较小。联合模型中的小标准误差表明，在检测影响这两个反应的变量方面，联合模型表现更好。应向儿童的父母提供与健康相关的教育，以方便 CD4 计数的恢复，并降低儿童死亡的风险。
