Mortality and Health Outcomes in HIV-Infected and HIV-Uninfected Mothers at 18–20 Months Postpartum in Zomba District, Malawi
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{"title"=>"Mortality and Health Outcomes in HIV-Infected and HIV-Uninfected Mothers at 18-20 Months Postpartum in Zomba District, Malawi", "type"=>"journal", "authors"=>[{"first_name"=>"Megan", "last_name"=>"Landes", "scopus_author_id"=>"23397501800"}, {"first_name"=>"Monique", "last_name"=>"van Lettow", "scopus_author_id"=>"8215062500"}, {"first_name"=>"Richard", "last_name"=>"Bedell", "scopus_author_id"=>"34568161000"}, {"first_name"=>"Isabell", "last_name"=>"Mayuni", "scopus_author_id"=>"16307556300"}, {"first_name"=>"Adrienne K.", "last_name"=>"Chan", "scopus_author_id"=>"37121626600"}, {"first_name"=>"Lyson", "last_name"=>"Tenthani", "scopus_author_id"=>"37762235500"}, {"first_name"=>"Erik", "last_name"=>"Schouten", "scopus_author_id"=>"8935125600"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84866040220", "doi"=>"10.1371/journal.pone.0044396", "sgr"=>"84866040220", "isbn"=>"1932-6203", "pmid"=>"22973443", "issn"=>"19326203", "pui"=>"365608689"}, "id"=>"22f0245e-7cec-3178-9237-7e8033e920eb", "abstract"=>"BACKGROUND Maternal morbidity and mortality among HIV-infected women is a global concern. This study compared mortality and health outcomes of HIV-infected and HIV-uninfected mothers at 18-20 months postpartum within routine prevention of mother-to-child transmission of HIV (PMTCT) services in a rural district in Malawi. METHODS A retrospective cohort study of mother-child dyads at 18-20 months postpartum in Zomba District. Data on socio-demographic characteristics, service uptake, maternal health outcomes and biometric parameters were collected. RESULTS 173 HIV-infected and 214 HIV-uninfected mothers were included. HIV-specific cohort mortality at 18-20 months postpartum was 42.4 deaths/1000 person-years; no deaths occurred among HIV-uninfected women. Median time to death was 11 months post-partum (range 3-19). Women ranked their health on a comparative qualitative scale; HIV-infected women perceived their health to be poorer than did HIV-uninfected women (RR 2.4; 95% CI 1.6-3.7). Perceived maternal health status was well correlated with an objective measure of functional status (Karnofsky scale; p<0.001). HIV-infected women were more likely to report minor (RR 3.8; 95% CI 2.3-6.4) and major (RR 6.2; 95% CI 2.2-17.7) signs or symptoms of disease. In multivariable analysis, HIV-infected women remained twice as likely to report poorer health [adjusted OR (aOR) 2.3; 95% CI 1.4-3.6], as did women with low BMI (aOR 2.1; 95% CI 1.1-4.0) and scoring lowest on the welfare scale (aOR 2.0; 95% CI 1.1-3.8). CONCLUSIONS HIV-infected women show increased mortality and morbidity at 18-20 months postpartum. In our rural Malawian operational setting, where there is documented under-application of ART and poor adherence to PMTCT services, these results support attention to optimizing maternal participation in PMTCT programs.", "link"=>"http://www.mendeley.com/research/mortality-health-outcomes-hivinfected-hivuninfected-mothers-1820-months-postpartum-zomba-district-ma-5", "reader_count"=>32, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>3, "Student > Master"=>6, "Other"=>1, "Student > Bachelor"=>3, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>3, "Student > Master"=>6, "Other"=>1, "Student > Bachelor"=>3, "Professor"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>4, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>2, "Arts and Humanities"=>1, "Business, Management and Accounting"=>2, "Psychology"=>1, "Social Sciences"=>7, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Social Sciences"=>{"Social Sciences"=>7}, "Psychology"=>{"Psychology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "reader_count_by_country"=>{"Malawi"=>1, "Tanzania"=>1, "Switzerland"=>2}, "group_count"=>4}

Scopus | Further Information

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