Outcome in a paediatric cohort receiving ART in Addis Abeba, Ethiopia

Abstract

Aim: To evaluate pediatric AntiRetroviral Treatment (ART) treatment in a resource-limited setting.

Methods: Data from a paediatric ART cohort at the All African Leprosy and Rehabilitation Centre, Addis Abeba, were analysed. Outcome measures included survival, age, gender, WHO stage, weight, regimen and CD4 cell count.

Results: From April 2005 to December 2008, 482 children initiated ART. Median age was 5.9 years (IQR 3.7-9.8), and median CD4 cell count was 236 cells per mm3. Median follow-up was 16 months (IQR=6-24 month). Among those followed for 24 months (n=188), 160 children were still receiving treatment, six had dropped out, eight had been transferred out, and 13 (7.5%) had died (4.0 deaths per 100 person-years). Mortality was highest in the first 6 months resulting in a 4.3% mortality rate. Lower age and immune suppression (low CD4) were associated with mortality, while sex, drug regimen, tuberculosis at treatment initiation, application of stavudine and/or zidovudine were not.

Conclusion: ART treatment of children in resource-limited settings is possible as demonstrated by low attrition. The high proportion of malnourished children and children admitted at late stage of the disease calls for attention. Efforts to enrol more children and at an earlier stage of the disease should be promoted.