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M9490748.TXT
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1994-09-24
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Document 0748
DOCN M9490748
TI AIDS orphans in Kinshasa, Zaire: incidence and socioeconomic
consequences.
DT 9411
AU Ryder RW; Kamenga M; Nkusu M; Batter V; Heyward WL; Project SIDA,
Department of Public Health, Kinshasa, Zaire.
SO AIDS. 1994 May;8(5):673-9. Unique Identifier : AIDSLINE MED/94338605
AB OBJECTIVE: To determine the incidence, morbidity, mortality, and
socioeconomic consequences of becoming an AIDS orphan (a child with an
HIV-1-seropositive mother who has died) in Kinshasa, Zaire. DESIGN: A
longitudinal cohort study was undertaken between 1986 and 1990. Within
this cohort, a nested case-control study of AIDS orphans was performed.
AIDS orphan cases were children with an HIV-1-seropositive mother who
had died. Two groups of control children were identified. The first
group of control children were age-matched children with
HIV-1-seropositive mothers who were alive at the time of death of the
AIDS orphan case mother. The second group of control children were
children with HIV-1-seronegative mothers who were also alive at the time
of death of the AIDS orphan case mother. SETTING: Obstetric ward and
follow-up clinic at two large municipal hospitals in Kinshasa, Zaire.
PARTICIPANTS: A total of 466 HIV-1-seropositive women, their children,
and the fathers of these children; 606 HIV-1-seronegative women, their
children, and the fathers of these children. MAIN OUTCOME MEASURES: AIDS
orphan incidence, HIV-1 vertical transmission rate, morbidity, mortality
and socioeconomic indicators of the consequences of becoming an AIDS
orphan. RESULTS: The AIDS orphan incidence rate was 8.2 per 100
HIV-1-seropositive women-years of follow-up. Vertical transmission of
HIV-1 was higher in AIDS orphan cases (41%) than in control children
with HIV-1-seropositive mothers (26%; P < 0.05). Among children without
vertically acquired HIV-1 infection, morbidity rates and indices of
social and economic well-being were similar in AIDS orphans and control
children. Five out of 26 (19%) AIDS orphan cases died during follow-up,
compared with three out of 52 (6%) control children (P < 0.05).
CONCLUSION: During a 3-year follow-up period, children with
HIV-1-seropositive mothers had a considerable risk of becoming an AIDS
orphan. However, the presence of a concerned extended family appeared to
minimize any adverse health and socioeconomic effects experienced by
orphan children.
DE Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY Adolescence Adoption
Adult Case-Control Studies Child *Child of Impaired Parents Child
Rearing Child, Preschool Cohort Studies *Family Health Female Human
HIV Infections/CONGENITAL/EPIDEMIOLOGY/TRANSMISSION *HIV-1 Incidence
Infant Infant, Newborn Male Parity Pregnancy Pregnancy
Complications, Infectious/EPIDEMIOLOGY Risk Socioeconomic Factors
Urban Population Zaire/EPIDEMIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).