Analysis of Morbidity and Mortality Factors among HIV-Infected Children in the Communal Medical Centres of the Municipality of Ratoma

Abstract

Introduction: The objective of this study was to analyse the morbidity and mortality factors of HIV-infected children. Material and Methods: This was a 10-year retrospective study from 1 January 2012 to 31 December 2021. All children aged 0-15 years with a positive HIV serological test or PCR under antiretroviral treatment and having a medical file were followed up in the two CMCs of the Ratoma commune. Results: We collected 183 records of HIV-infected children on antiretroviral treatment. The median age was 3 years with extremes of 2 months and 15 years. More than half (60.1%) were <5 years old. More than half of the children (65.1%) were at WHO clinical stage (3 and 4). 60.8% had anemia with a median hemoglobin level of 10.7 g/dl. Respiratory diseases (39.34%) were the most common morbid events. Almost half (44.3%) were alive and followed up, 17.5% died, 23.5% lost to follow-up and 14.8% transferred. Anemia (18.75%) was the most common cause of death. Maternal non-education (p = 0.001), very low income (p = 0.0001), clinical screening (p = 0.0003), severe immunodepression (p = 0.002), tuberculosis (p = 0.007), clinical stage 3 (p = 0.0001) were the main risk factors associated with deaths. Conclusion: The application of the new WHO recommendations for medical management, which require early initiation of antiretroviral treatment, the improvement of PMTCT performance and the promotion of systematic screening are necessary to reduce the morbidity and mortality of HIV-infected children in our context.