Morbidity among HIV-1-infected mothers in Kenya: prevalence and correlates of illness during 2-year postpartum follow-up.
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2007Author
Walson, JL
Brown, ER
Otieno, PA
Mbori-Ngacha, DA
Wariua, G
Obimbo, EM
Bosire, RK
Farquhar, C
Wamalwa, D
John-Stewart, GC
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Background: Much of the burden of morbidity affecting women of childbearing age in sub-Saharan Africa occurs in the context of HIV-1 infection. Understanding patterns of illness and determinants of disease in HIV-1–infected mothers may guide effective interventions to improve maternal health in this setting. Methods: We describe the incidence and cofactors of comorbidities affecting peripartum and postpartum HIV-1–infected women in Kenya. Women were evaluated by clinical examination and standardized questionnaires during pregnancy and for up to 2 years after delivery. Results: Five hundred thirty-five women were enrolled in the cohort (median CD4 count of 433 cells/mm3) and accrued 7736 person-months of follow-up. During 1-year follow-up, the incidence of upper respiratory tract infections was 161 per 100 person-years, incidence of pneumonia was 33 per 100 person-years, incidence of tuberculosis (TB) was 11 per 100 person-years, and incidence of diarrhea was 63 per 100 person-years. Immunosuppression and HIV-1 RNA levels were predictive for pneumonia, oral thrush, and TB but not for diarrhea; CD4 counts <200 cells/mm3 were associated with pneumonia (relative risk [RR] = 2.87, 95% confidence interval [CI]: 1.71 to 4.83), TB (RR = 7.14, 95% CI: 2.93 to 17.40) and thrush. The risk of diarrhea was significantly associated with crowding (RR = 1.86, 95% CI: 1.19 to 2.92) and breast-feeding (RR = 1.71, 95% CI: 1.19 to 2.44). Less than 10% of women reported hospitalization during 2-year follow-up mortality risk in the cohort was 1.9% and 4.8% for 1 and 2 years, respectively. Conclusion: Mothers with HIV-1, although generally healthy, have substantial morbidity as a result of common infections, some of which are predicted by immune status or by socioeconomic factors. Enhanced attention to maternal health is increasingly important as HIV-1–infected mothers transition from programs targeting the prevention of mother-to-child transmission to HIV care clinics.
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http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/50014http://www.ncbi.nlm.nih.gov/pubmed/17667334
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372412/
Citation
C., DRWAMALWADALTON, MBORI- PROFNGACHADOROTHYA, ELIZABETH DROBIMBO. 2007. Morbidity among HIV-1-infected mothers in Kenya: prevalence and correlates of illness during 2-year postpartum follow-up. J Acquir Immune Defic Syndr . 2007 Oct 1; 46 ( 2 ): 208-15 . PMID: 17667334 [PubMed - indexed for MEDLINE] Walson JL, Brown ER, Otien. J Acquir Immune Defic Syndr . 2007 Oct 1; 46 ( 2 ): 208-15 .. : Kisipan, M.L.Publisher
University of Nairobi
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- Faculty of Health Sciences (FHS) [10387]