在埃塞俄比亚西北部接受高效抗逆转录病毒治疗的 HIV 感染儿童中贫血的发生率及其预测因素：一项多中心回顾性随访研究。
Incidence of anaemia and its predictors among HIV-infected children receiving highly active antiretroviral treatment in North-West Ethiopia: a multicentre retrospective follow-up study.
机构信息
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
出版信息
BMJ Open. 2024 Sep 12;14(9):e083939. doi: 10.1136/bmjopen-2024-083939.
BACKGROUND
Anaemia is one of the most common problems in HIV-infected patients associated with increased HIV progression, decreased functional capacity, survival and quality of life. For better interventions, up-to-date information concerning anaemia among HIV-infected children less than 5 years of age on antiretroviral therapy (ART) is vital. Thus, this study aims to determine the predictors of anaemia among HIV-infected children less than 5 years of age receiving ART in North-West Ethiopia.
DESIGN
An institution-based retrospective follow-up study was conducted.
STUDY SETTING
Amhara region Comprehensive Specialized Hospitals, North-West Ethiopia.
PARTICIPANTS
In total, we examined 460 HIV-infected children less than 5 years of age who had followed highly active antiretroviral treatment from 2010 to 2020.
OUTCOME MEASURES
The outcome measures were median time to detection of anaemia, the incidence and the effects of cotrimoxazole preventive therapy (CPT), ART adherence, tuberculosis (TB), WHO clinical stage and wasting on anaemia.
RESULTS
The overall follow-up time was 9234 person-months of observation. The incidence density of anaemia was 8.34 per 1000 person-months of observation (95% CI 6.67 to 10.43). The cumulative survival probability of children after the last months of follow-up was 0.54. The independent predictors of anaemia were not receiving CPT (adjusted HR (AHR)=4.44; 95% CI 2.48 to 7.93), poor adherence to ART (AHR=2.46; 95% CI 1.37 to 4.42), TB (AHR=3.40; 95% CI 1.72 to 6.72), severe WHO clinical stage (AHR=3.03; 95% CI 1.40 to 6.58) and severe wasting (AHR=1.98; 95% CI 1.08 to 3.64).
CONCLUSION AND RECOMMENDATION
The incidence rate of anaemia was high and it was provoked by predictors like CPT, ART adherence, TB, WHO clinical stage and wasting. Therefore, it is necessary to emphasise for these predictors.
背景
贫血是与 HIV 进展、功能能力下降、生存和生活质量降低相关的 HIV 感染者中最常见的问题之一。为了更好的干预，了解在抗逆转录病毒治疗（ART）下，五岁以下感染 HIV 的儿童的贫血最新信息至关重要。因此，本研究旨在确定在埃塞俄比亚西北部接受 ART 的五岁以下感染 HIV 的儿童贫血的预测因素。
设计
基于机构的回顾性随访研究。
研究地点
阿姆哈拉地区综合专科医院，埃塞俄比亚西北部。
参与者
我们共检查了 460 名五岁以下接受高效抗逆转录病毒治疗的 HIV 感染儿童，这些儿童从 2010 年至 2020 年接受了治疗。
结果测量
结果测量包括贫血检测的中位时间、发生率以及复方新诺明预防疗法（CPT）、ART 依从性、结核病（TB）、世界卫生组织临床分期和消瘦对贫血的影响。
结果
总的随访时间为 9234 人月的观察期。贫血的发病率密度为每 1000 人月 8.34 例（95%CI 6.67 至 10.43）。最后几个月随访后儿童的累积生存率为 0.54。贫血的独立预测因素包括未接受 CPT（调整后的 HR（AHR）=4.44；95%CI 2.48 至 7.93）、ART 依从性差（AHR=2.46；95%CI 1.37 至 4.42）、TB（AHR=3.40；95%CI 1.72 至 6.72）、严重的世卫组织临床分期（AHR=3.03；95%CI 1.40 至 6.58）和严重消瘦（AHR=1.98；95%CI 1.08 至 3.64）。
结论和建议
贫血的发生率很高，并且由 CPT、ART 依从性、TB、世卫组织临床分期和消瘦等预测因素引起。因此，需要强调这些预测因素。
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