Predictors of mortality in HIV-1 exposed uninfected post-neonatal infants at the Kenyatta National Hospital, Nairobi.
OBJECTIVE
To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants.


METHODS
Prospective cohort study.


METHODS
Kenyatta National Hospital, Nairobi, Kenya.


METHODS
Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age.


RESULTS
Sixteen infants died (post-neonatal mortality rate of 47/1000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0-13.2, p=0.05) and symptomatic maternal HIV-1 disease (RR=2.7, CI 0.9-7.7, p=0.06) were associated with infant mortality.


CONCLUSIONS
Prematurity, teenage motherhood and symptomatic HIV-1 maternal disease were important predictors for post-neonatal mortality in this cohort of HIV-1 exposed uninfected infants. These factors should be considered in monitoring and follow up in prevention of mother-to-child HIV-1 transmission (PMTCT) programs.
Gichuhi
C
C
Department of Clinical Pharmacology and Therapeutics, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya.
Obimbo
E
E
Mbori-Ngacha
D
D
Mwatha
A
A
Otieno
P
P
Farquhar
C
C
Wariua
G
G
Wamalwa
D
D
Bosire
R
R
John-Stewart
G
G
D000293:Adolescent; D000328:Adult; D001996:Bronchopneumonia / Q000401:mortality; D003968:Diarrhea, Infantile / Q000401:mortality; D005183:Failure to Thrive / Q000401:mortality; D005260:Female; D015658:HIV Infections; D015497:HIV-1; D006801:Humans; D007223:Infant; D007224:Infant Care; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors