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HIV infection among children and adolescents in Burundi, Cameroon, and the Democratic Republic of Congo

机译：布隆迪，喀麦隆和刚果民主共和国的儿童和青少年之间的艾滋病毒感染

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Evidence demonstrates a substantial HIV epidemic among children and adolescents in countries with long-standing generalized HIV epidemics, where availability of prevention of mother-to-child transmission services has historically been limited. The objective of this research was to explore factors associated with antiretroviral therapy (ART) initiation and morbidity among HIV-infected surviving children 2-17 years of age attending HIV programs in Central Africa. Programmatic data from 404 children attending HIV programs in Burundi, Cameroon, and the Democratic Republic of Congo (DRC) were included in our evaluation. Children were followed prospectively from 2008 to 2011 according to each clinic's standard of care. Diagnosis at a reference hospital was significantly associated with not having initiated ART (adjusted odds ratio, AOR=0.40; 95% confidence interval, CI, 0.24-0.67). Being seen at a clinic in Cameroon (AOR=0.45; 95%CI=0.24-0.85) and being in school were associated with decreased risk (AOR=0.55; 95%CI=0.31-0.96). Being ART-naive (AOR=1.88; 95%CI=1.20-2.94) and being diagnosed at a reference hospital (AOR=2.39; 95%CI=1.29-4.41) or other testing facility (AOR=2.86; 95%CI=1.32-6.18) were associated with increased risk of having a morbid event at the initial visit. In longitudinal analysis of incident morbidity, we found a decreased risk associated with attending clinics in Cameroon (adjusted hazard ratio, AHR=0.23; 95%CI=0.11-0.46) and the DRC (AHR=0.46; 95%CI=0.29-0.74), and an increased risk associated with being ART-naive (AHR=1.83; 95%CI=1.12-2.97). We found a high burden of HIV-related health problems among children receiving care in this setting. Children face significant barriers to accessing HIV services, and the HIV epidemic among surviving children in the Central African region has not been adequately evaluated nor addressed.
机译：证据证明了具有长期通知艾滋病毒流行病的儿童和青少年的大量艾滋病疫情，其中预防母婴传输服务历史上有限。本研究的目的是探讨与艾滋病毒感染的幸存小孩的抗逆转录病毒治疗（ART）引发和发病率的因素探讨了2-17岁，在中非的艾滋病毒计划。来自布隆迪，喀麦隆，喀麦隆和刚果民主共和国（DRC）的404名儿童学生的编程数据被列入我们的评估。根据每个诊所的护理标准，儿童从2008年到2011年开始。参考医院的诊断显着与未引发的技术有关（调整后的差距，AOR = 0.40; 95％置信区间，CI，0.24-0.67）。在喀麦隆的诊所（AOR = 0.45; 95％CI = 0.24-0.85）和在学校的临床上被看见，风险降低有关（AOR = 0.55; 95％CI = 0.31-0.96）。艺术 - 天真（AOR = 1.88; 95％CI = 1.20-2.94）并被诊断为参考医院（AOR = 2.39; 95％CI = 1.29-4.41）或其他测试设施（AOR = 2.86; 95％CI = 1.32-6.18）与在初次访问时具有病态事件的风险增加。在入射发病率的纵向分析中，我们发现与喀麦隆的诊所相关的风险降低（调节的危险比，AHR = 0.23; 95％CI = 0.11-0.46）和DRC（AHR = 0.46; 95％CI = 0.29-0.74 ），并且与艺术幼稚（AHR = 1.83; 95％CI = 1.12-2.97）相关的增加的风险。我们在此环境中收到护理的儿童中发现了艾滋病毒相关的健康问题的高负担。儿童面临着获得艾滋病毒服务的重要障碍，中非区域幸存儿童的艾滋病毒疫情尚未得到充分的评估，也没有得到充分的评估。

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