Akao, K

Isaakidis, P

Raguenaud, Marie-Eve

Seitaboth, S

Te, V

Zachariah, R

English

MSF Field Research

XVII INTERNATIONAL
AIDS CONFERENCE
3-8 August 2008 | Mexico City
Poster Exhibition 
Track B - Natural History  
 
THPE0101 - Early mortality (pre and post antiretroviral treatment) amongst children with HIV/AIDS enrolled 
in two programs in Cambodia  
 
M.-E. Raguenaud1, P. Isaakidis1, V. Te2, S. Seitaboth3, K. Akao3, R. Zachariah4 
  
1Médecins Sans Frontières OCB, Phnom Penh, Cambodia, 2Donkeo Referral Hospital, MoH, Takeo, Cambodia, 3Angkor 
Hospital for Children, Siem Reap, Cambodia, 4Médecins Sans Frontières OCB, Brussels, Belgium 
  
Background: There is very limited documented information on the significance of early mortality (death within the first 
6 months) among children enrolled within HIV/AIDS programs in resource-limited settings.  
Among children in two routine programme settings in Cambodia, we determined a) the incidence of early mortality prior-to 
and after initiating ART and b) assessed risk factors associated with early mortality.  
Methods: Retrospective cohort and Cox-regression analysis of routine data from Donkeo Referral Hospital, Takeo and 
Angkor Hospital for Children, Siem Reap, Cambodia, since 2003 and 2004.  
Results: A total of 1495 children were included in the analysis of whom 413 (27%) were aged <18 months, 445 (30%) 18-
59 months and 637 (43%) 5-14 years. The median interval between being considered "eligible for ART" and actually 
"initiating ART" was 4.5 months (138 days): 25% of ART eligible children were still not initiated on ART at 9 months 
after enrolment.  
There were a total of 70 (61%) deaths that occurred within the first 6 months after enrolment, of which 83% occurred 
in children not yet started on ART. Overall mortality rate was 4.8/100 person-years (95% CI, 4.0-5.8). 295 children were 
lost to follow up. Early mortality rate was 8 fold higher among children who had not yet started ART compared to those 
placed on treatment. Among children < 5 years, active tuberculosis was a significant risk factor for early death after 
adjusting for CD4%, WHO stage, sex, and year of admission.  
Conclusions: There is a high early mortality among children enrolled within two program settings in Cambodia and these 
rates were eight-fold higher among children not yet initiated on ART compared to those placed on treatment. Reasons 
for treatment initiation delays and causes of death need to be further investigated and urgent measures to promptly 
initiate ART in eligible children should be taken.    
Presenting author email: msfb-phnom-penh-med@brussels.msf.org 

Early mortality (pre and post antiretroviral treatment) amongst children with HIV/AIDS enrolled in two programs in Cambodia

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