title: Time trends of baseline demographics and clinical characteristics of HIV infected children enrolled in care and treatment service in Dar es Salaam, Tanzania.
abstract: BACKGROUND
  Few studies have described time-based trends of clinical and demographic characteristics of children enrolling in HIV and AIDS care and treatment services. We present findings of a study that explored time-based trends of baseline characteristics among children enrolling into 26 public HIV care facilities in Dar es Salaam, Tanzania.
  
  
  METHODS
  Children enrolled between October 2004 and September 2011 was included in these analyses. The year of enrollment was used as the primary predictor of interest, and log linear and linear regressions model were used to analyze dichotomous and continuous variables respectively. P-values under 0.05 were considered significant.
  
  
  RESULTS
  Among the 6,579 children enrolled, the proportion with advanced disease at enrollment increased from 35% to 58%, mean age increasing from 5.0 to 6.2 years (p < 0.0001), proportion of children less than 2 years decreased from 35% to 29%. While the median hemoglobin concentration rose from 9.1 g/dl to 10.3 g/dl (P <0.0001), proportion with a history of past TB dropped from 25% to 12.8% (P < 0.0001). Over time, health centers and dispensaries enrolled more children as compared to hospitals (P < 0.0001). Temeke district, which has the lowest socioeconomic status among the three districts in Dar es Salaam, had a significant increase in enrollment from 22% to 25% (P = 0.02).
  
  
  CONCLUSIONS
  We found that as time progressed, children were enrolled in care and treatment services at an older age sicker status as evidenced by increase in mean age and more advanced disease stage at first contact with providers. We recommend more efforts be focused on scaling up early HIV infant diagnosis and enrollment to HIV care and treatment.
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. dsando.tz@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Sando
authors.affiliation: Harvard T.H. Chan School of Public Health (HSPH), P.O. Box 79810, Dar es Salaam, Tanzania. stdls@hsph.harvard.edu.
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. lmachumi@mdh-tz.org.
authors.forename: Lameck
authors.initials: L
authors.lastname: Machumi
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. mmwanyika.sando@gmail.com.
authors.forename: Mary
authors.initials: M
authors.lastname: Mwanyika-Sando
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. arisea@yahoo.com0.
authors.forename: Eric
authors.initials: E
authors.lastname: Aris
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. aisamuya@gmail.com.
authors.forename: Aisa
authors.initials: A
authors.lastname: Muya
authors.affiliation: Harvard T.H. Chan School of Public Health (HSPH), P.O. Box 79810, Dar es Salaam, Tanzania. ejackson@hsph.harvard.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jackson
authors.affiliation: Harvard T.H. Chan School of Public Health (HSPH), P.O. Box 79810, Dar es Salaam, Tanzania. tbaernig@hsph.harvard.edu.
authors.forename: Till
authors.initials: T
authors.lastname: Baernighausen
authors.affiliation: Harvard T.H. Chan School of Public Health (HSPH), P.O. Box 79810, Dar es Salaam, Tanzania. stleh@channing.harvard.edu.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hertzmark
authors.affiliation: Management and Development for Health (MDH), P.O. Box 79810, Dar es Salaam, Tanzania. gchalamilla@gmail.com.
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.affiliation: Harvard T.H. Chan School of Public Health (HSPH), P.O. Box 79810, Dar es Salaam, Tanzania. mina@hsph.harvard.edu.
authors.forename: Wafaie
authors.initials: W
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000480:Alkynes; D000554:Ambulatory Care Facilities; D019380:Anti-HIV Agents / Q000627:therapeutic use; D048588:Benzoxazines / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007223:Infant; D019259:Lamivudine / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D019829:Nevirapine / Q000627:therapeutic use; D012720:Severity of Illness Index; D013636:Tanzania / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine; C098320:efavirenz