Population-level Mortality Associated with HIV Exposure in HIV-uninfected Infants in Botswana and South Africa: A Model-based Evaluation
- PMID: 30321432
- PMCID: PMC6703783
- DOI: 10.1093/tropej/fmy064
Population-level Mortality Associated with HIV Exposure in HIV-uninfected Infants in Botswana and South Africa: A Model-based Evaluation
Abstract
We aimed to quantify the contribution of excess mortality in HIV-exposed uninfected (HEU) infants to total mortality in HIV-uninfected infants in Botswana and South Africa in 2013. Population attributable fractions (PAFs) and excess infant deaths associated with HIV exposure in HIV-uninfected infants were estimated. Additionally, the Thembisa South African demographic model estimated the proportion of all infant mortality associated with excess mortality in HEU infants from 1990 to 2013. The PAF (lower bound; upper bound) of mortality associated with HIV exposure in HIV-uninfected infants was 16.8% (2.5; 31.2) in Botswana and 15.1% (2.2; 28.2) in South Africa. Excess infant deaths (lower bound; upper bound) associated with HIV exposure in 2013 were estimated to be 5.6 (0.5; 16.6)/1000 and 4.9 (0.6; 11.2)/1000 HIV-uninfected infants in Botswana and South Africa, respectively. In South Africa, the proportion of all infant (HIV-infected and HIV-uninfected) mortality associated with excess HEU infant mortality increased from 0.4% in 1990 to 13.8% in 2013.
Keywords: Botswana; HEU; HIV-exposed uninfected; South Africa; infant mortality.
© The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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References
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- Mahy M. What Is Needed for National and Global Monitoring of HEU Child Mortality. In International AIDS Society Conference Paris, France, 2017. http://programme.ias2017.org/Programme/Session/173/ (28 May 2018, date last accessed).
-
- South African National Department of Health. 2015 National Antenatal Sentinel HIV & Syphilis Survey Report. Pretoria, South Africa, 2017. www.doh.gov.za (12 July 2018, date last accessed).
-
- Brennan AT, Bonawitz R, Gill CJ, et al.A meta-analysis assessing all-cause mortality in HIV-exposed uninfected compared to HIV-unexposed uninfected infants and children. AIDS 2016;30:2351–60. - PubMed
-
- Le Roux SM, Abrams EJ, Nguyen K, et al.Clinical outcomes of HIV-exposed, HIV-uninfected children in sub-Saharan Africa. Trop Med Int Heal 2016;21:829–45. - PubMed