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Publication Type
Journal Article
Author, Analytic
Pierre, Russell B.; Steel-Duncan, J.C.; Evans-Gilbert, T.; Rodriguez, B.; Moore, Jacynth; Palmer, Paulette; Smikle, M. F.; Davis, Denver; Figueroa, J.P.; Christie, Celia D.C.
Author Affiliation, Ana.
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Article Title
Effectiveness of antiretroviral therapy in treating paediatric HIV/AIDS in Jamaica
Medium Designator
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Connective Phrase
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Journal Title
West Indian Medical Journal
Translated Title
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Reprint Status
Refereed
Date of Publication
2008
Volume ID
57
Issue ID
3
Page(s)
223-230
Language
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Connective Phrase
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Location/URL
http:; caribbean.scielo.org/scielo.php?script=sci_arttext&pid=S0043-31442008000300011&lng=en&nrm=
ISSN
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Notes
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Abstract
Background and Purpose: Paediatric HIV/AIDS remains a significant challenge in developing countries. We describe the effectiveness of interventions in HIV-infected children attending Paediatric Infectious Diseases Clinics in Jamaica. Methods: One hundred and ninety-seven HIV-infected children were followed prospectively in multicentre ambulatory clinics between September 1, 2002 and August 31, 2005, in the Kingston Paediatric and Perinatal HIV/AIDS Programme, Jamaica, and their outcomes described. Results: Median follow-up was 23 child-months (interquartile range [IQR] 1231) with 12 children (6.0%) lost to follow-up and deaths (n = 13) occurred at 4.64 per 100 child-years of follow-up. Median age was 5.0 years (IQR 2.28.1) and 32.1% had Centers for Disease Control and Prevention (CDC) category C disease at enrolment; 62% were ever on antiretroviral therapy (ART) with median duration of 15.4 months (IQR 5.525.5); 85% initiated ART with zidovudine/lamivudine/nevirapine. Mean weight-for-height 0.13 1.02 (mean difference -1.71 [95% Confidence interval (CI) -2.73, -0.69]; p = 0.001) and body mass index-for-age 0.05 1.11 (mean difference -1.11, [CI -1.79, -0.43]; p = 0.002); z scores increased after 24 months on ART; however, children remained stunted. Reductions in the incidence of hospitalizations (mean diff 30.95, [CI 3.12, 58.78]; p = 0.03) and in episodes of pneumonia, culture-positive sepsis and tuberculosis occurred in those on ART. Conclusions: A successfully implemented ambulatory model for paediatric HIV care in Jamaica has improved the quality of life and survival of HIV-infected children.....
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