progression of hiv aids in children attending ampath clinics in w kenya n.
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PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA. Prof. Ayaya SO, Dr Nyandiko WM Dr Vreeman RC, Prof. Rotich JK IeDEA PI meeting, Zanzibar. BACKGROUND. AMPATH - 10YRS Incubation period AIDS Survival Time Impact of AMPATH. OBJECTIVES.

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PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA


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progression of hiv aids in children attending ampath clinics in w kenya

PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA

Prof. Ayaya SO, Dr Nyandiko WM

Dr Vreeman RC, Prof. Rotich JK

IeDEA PI meeting, Zanzibar

background
BACKGROUND
  • AMPATH - 10YRS
  • Incubation period
  • AIDS Survival Time
  • Impact of AMPATH
objectives
OBJECTIVES
  • Determine the incubation period and its associated factors
  • Determine AIDS Survival Time and its associated factors
methodology
METHODOLOGY
  • Study subjects : HIV infected children aged 14 yrs and below
  • Setting: AMPATH clinics in WESTERN Kenya
  • Design : retrospective analysis of prospectively collected data
  • Analysis : regression analysis and Kaplan Meier Survival Curves
results i demographic data
RESULTS IDemographic data
  • Total of 5792 children included
  • Age ≤ 2 yrs 1093 (19%)
  • Female sex 2954 (51%)
  • Ever on ARVs 3232 (56%)
  • Orphans 1702 (29.39%)
results ii
RESULTS II

AT ENROLMENT:

  • HAZ severe (<3SD) 1230 (33.27%)
  • WAZ severe(<3SD) 808 (21.64%)
  • CDC class C 1134(19.92%)
  • AIDS 3630(62.67%)
results iii
RESULTS III

ADHERENCE

  • Perfect ARV adherence 2271(68.82%)
  • Perfect clinic adherence 1435(26.34%)
results iv
RESULTS IV

OUTCOMES

  • Time from diagnosis to ADE :

Mean 217 days

Median 112 days

  • Time from ADE to death/LTFU

Mean 201 DAYS

Median 117 days

results v
RESULTS V
  • Factors associated with incubation period(HIV to ADE) AGE ≤ 2 YRS

CDC stage at diagnosis (HR=1.8, CI 1.05-2.45)

Non-clinic adherence (HR=0.9, CI 1.05-2.45)

Never on ARV (HR=.41, CI 0.27-0.62)

results vi
RESULTS VI

FACTORS ASSOCIATED WITH HIV TO ADE > 2 YRS

CD4% at diagnosis (HR=0.9, CI .93-.95)

CDC stage C at diagnosis(HR=5.4, CI 3.98-7.22)

Non MTRH CLINIC (hr=.8, CI .66-.94)

Never on ARV (HR=.36, CI .29-.66)

results vii
RESULTS VII

Factors associated with HIV to ADE age ≤ 2 yrs

CD 4% at diagnosis

CDC at diagnosis

Non-clinic adherence(HR=1.6, CI 1.05-2.45)

Never on ARV (HR=0.41, CI .27-.62)

results viii
RESULTS VIII
  • FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≤ 2 yrs)

Nearest CD4 at ADE )

EVER ON ARV )(HR=9.2, CI 3.9-21.1)

results ix
RESULTS IX

FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≥ 2yrs)

  • Nearest CD 4 at ADE) ( HR=7.3, CI 4.1-13)
  • Ever on ARV )
conclusions i
CONCLUSIONS I
  • Incubation period was short
  • AIDS survival time was short
  • Factors associated with incubation period were:

CDC stage at diagnosis

Non- clinic adherence

never on ARV

conclusions ii
CONCLUSIONS II

CD 4%

Non MTRH clinic

  • Factors associated with AIDS Survival time were:

Nearest CD4 to ADE

Ever on ARV

acknowledgements
ACKNOWLEDGEMENTS
  • Dean SOM MU
  • Dean IUMC
  • USAID-AMPATH
  • MU-IU PRWG
  • IEDEA EA
  • JOE MAMLIN