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Title: | Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015 | Authors: | Remera, Eric Chammartin, Frederique Nsanzimana, Sabin Forrest, Jamie Ian Smith, Gerald E. Mugwaneza, Placidie Malamba, Samuel S. SEMAKULA, Muhammed Condo, Jeanine U. Ford, Nathan Riedel, David J. Nisingizwe, Marie Paul Binagwaho, Agnes Mills, Edward J. Bucher, Heiner |
Issue Date: | 2021 | Publisher: | BMJ PUBLISHING GROUP | Source: | BMJ Global Health, 6 (5) (Art N° e004398) | Abstract: | Introduction Child mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda. Methods We used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother's HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother's HIV status. Results In total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1-2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality. Conclusions This study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span. | Notes: | Remera, E (corresponding author), Rwanda Biomed Ctr, Inst HIV Dis Prevent & Control, City Of Kigali, Rwanda.; Remera, E (corresponding author), Swiss Trop & Publ Hlth Inst, Basel, Switzerland.; Remera, E (corresponding author), Univ Basel, Basel, Switzerland.; Remera, E (corresponding author), Univ Hosp Basel, Basel Inst Clin Epidemiol & Biostat, Dept Clin Res, Basel, Switzerland.; Remera, E (corresponding author), Univ Global Hlth Equ, Kigali, Rwanda. ericremera@gmail.com |
Keywords: | child health;maternal health;AIDS;HIV | Document URI: | http://hdl.handle.net/1942/37110 | ISSN: | 2059-7908 | e-ISSN: | 2059-7908 | DOI: | 10.1136/bmjgh-2020-004398 | ISI #: | WOS:000763937700003 | Rights: | Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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