The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis

Adetokunboh, Olatunji; Awotiwon, Ajibola; Ndwandwe, Duduzile; Uthman, Olalekan A.; Wiysonge, Charles Shey

doi:10.1080/21645515.2019.1599676

Cited by 3 publications

(3 citation statements)

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“…Of note, 13% of the 10 to 24‐year‐old age group had not yet initiated ART. Our results suggest that even in the setting of treat‐all policies, there remains a substantial burden of WHO‐4 and WHO‐3 events associated with poor HIV‐related immune status, in particular among younger children, and highlights the need to implement or re‐inforce strategies to reduce preventable infectious diseases in this population [36,37].…”

Section: Discussionmentioning

confidence: 99%

Time‐varying age‐ and CD4‐stratified rates of mortality and WHO stage 3 and stage 4 events in children, adolescents and youth 0 to 24 years living with perinatally acquired HIV, before and after antiretroviral therapy initiation in the paediatric IeDEA Global Cohort Consortium

Desmonde

Neilan

Musick

et al. 2020

J. Intern. AIDS Soc.

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Introduction: Evaluating outcomes of paediatric patients with HIV provides crucial data for clinicians and policymakers. We analysed mortality and clinical events rates among children, adolescents, and youth with perinatally acquired HIV (PHIV) aged 0 to 24 years stratified by time-varying age and CD4, before and after antiretroviral therapy (ART), in the paediatric IeDEA multiregional collaboration (East, West, Central and Southern Africa, Asia-Pacific, and Central/South America and the Caribbean). Methods: ART-na€ ıve children with HIV enrolled before age 10 (proxy for perinatal infection) at IeDEA sites between 2004 and 2016, with ≥1 CD4 measurement during follow-up were included. We estimated incidence rates (IR) and 95% confidence intervals (95% CI) of mortality and first occurrence of WHO-4 and WHO-3 events, excluding tuberculosis, during person-years (PY) spent within different age (<2, 2 to 4, 5 to 9, 10 to 14, 15 to 19, 20 to 24) and CD4 (percent when <5 years [<15%, 15% to 24%, ≥25%]; count when ≥5 years [<200, 200 to 499, ≥500 cells/µL]) strata. We used linear mixed models to predict CD4 evolution, with trends modelled by region. Results: In the pre-ART period, 49 137 participants contributed 51 966 PY of follow-up (median enrolment age: 3.9 years). The overall pre-ART IRs were 2.8/100 PY (95% CI: 2.7 to 2.9) for mortality, 3.3/100 PY (95% CI: 3.0 to 3.5) for first occurrence of a WHO-4 event, and 7.0/100 PY (95% CI: 6.7 to 7.4) for first occurrence of a WHO-3 event. Lower CD4 and younger age strata were associated with increased rates of both mortality and first occurrence of a clinical event. In the post-ART period, 52 147 PHIVY contributed 207 945 PY (ART initiation median age: 4.5 years). Overall mortality IR was 1.4/ 100 PY (95% CI: 1.4 to 1.5) and higher in low CD4 strata; patients at each end of the age spectrum (<2 and >19) had increased mortality post-ART. IRs for first occurrence of WHO-4 and WHO-3 events were 1.3/100 PY (95% CI: 1.2 to 1.4) and 2.1/100 PY (95% CI: 2.0 to 2.2) respectively. These were also associated with lower CD4 and younger age strata. Conclusions: Mortality and incidence of clinical events were highest in both younger (<2 years) and older (>19 years) youth with PHIV. Scaling-up services for <2 years (early access to HIV diagnosis and care) and >19 years (adolescent-and youth-focused health services) is critical to improve outcomes among PHIVY.

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Section: Discussionmentioning

confidence: 99%

Time‐varying age‐ and CD4‐stratified rates of mortality and WHO stage 3 and stage 4 events in children, adolescents and youth 0 to 24 years living with perinatally acquired HIV, before and after antiretroviral therapy initiation in the paediatric IeDEA Global Cohort Consortium

Desmonde

Neilan

Musick

et al. 2020

J. Intern. AIDS Soc.

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“…First, there were a significant number of research articles published on this topic, with 672 out of the 675 articles retrieved being research articles. This highlights the importance of studying VPDs in children in sub-Saharan Africa, which is likely due to the high burden of VPDs in our region [ 15 ]. Second, the average growth rate of research publications was 4.71%, indicating a steady increase in research output on this topic over the years.…”

Section: Discussionmentioning

confidence: 99%

Systematic Mapping of Research on Vaccine-Preventable Diseases in Children in Sub-Saharan Africa: A Decennial Scientometric Analysis

Iwu,

Iwu-Jaja,

Jaca

et al. 2023

Vaccines

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Vaccine-preventable diseases (VPDs) remain a significant public health challenge, particularly in sub-Saharan Africa. The high burden of VPDs in this region necessitates the need for continued investigation and intervention. This paper presents a bibliometric analysis of research on VPDs in children in sub-Saharan Africa in the last 10 years to capture the current state of research in the field. This study used a systematic search for articles published between 2013 and 2022 in the Web of Science Core Collection database and, subsequently, scientometric techniques for data analyses and interpretation. Annual scientific production of publications on the research of VPDs in children in sub-Saharan Africa increased from 2013 to 2019 and then gradually declined. South Africa had the most VPD studies (n = 148; 16.2%), followed by Nigeria, Ghana, Kenya, The Gambia, Malawi, Ethiopia, and the Republic of Congo. The Vaccine journal published the most. The Pan African Medical Journal was the most frequent destination journal based in Africa. The commonly studied pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Research productivity increased exponentially in the pre-COVID era and declined in the past two years, so more VPD research in this region is needed.

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“…A better understanding of waning immunity to HBV, measles, and rubella in HIV-infected children, as well as the need for booster doses, is needed [28]. Increasing the body of evidence on vaccine-preventable diseases in HIVinfected children is even more relevant for healthcare workers and policymakers in high endemicity areas; Olatunji et al showed that the disease burden can be effectively reduced through immunization programs and improvement of cART coverage in children [29]. A retrospective cohort study by Shen et al reviewed vaccination coverage in Chinese HIV-exposed children, identifying an early infancy diagnosis of HIV and having mothers with better education, as factors associated with highter probability of being vaccinated, while most of the deceased children in the cohort were not vaccinated [6].…”

Section: Discussionmentioning

confidence: 99%

Protection of Vaccine Preventable Diseases in a Population of HIV-Infected Children: A 3 Years Prospective Study

et al. 2021

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Human Immunodeficiency Virus (HIV) infected children have a 30–70% chance of being incompletely immunized and may not respond serologically with the same magnitude or durability as uninfected children. The aim of the study was to describe the rate of protective antibodies titre and the persistence of the response against four recommended vaccinations in HIV infected children and adolescents. A two-phase observational study was performed in which protective IgG antibodies to measles, mumps, rubella and hepatitis B were determined and monitored for 12 and 24 months, in 26 perinatally HIV-infected children. The rate of protection for rubella and hepatitis B was significantly lower in the HIV group compared to the control group (92% vs. 65% for rubella and 78.4% vs. 45.4% for hepatitis B; p < 0.05). Children who received primary vaccination after initiating combination antiretroviral therapy (cART) had a higher rate of response. Seronegative patients who received a booster dose of vaccine had a good immunological response. HIV infection is associated with a lower response to vaccines against rubella and hepatitis. The beginning of cART before vaccination may be associated with a better response. The evaluation of the serological response is crucial in children with HIV infection in order to evaluate the protection of vaccine preventable diseases.

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The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis

Abstract: Please refer to published version for the most recent bibliographic citation information. If a published version is known of, the repository item page linked to above, will contain details on accessing it.

Cited by 3 publications

References 104 publications

Time‐varying age‐ and CD4‐stratified rates of mortality and WHO stage 3 and stage 4 events in children, adolescents and youth 0 to 24 years living with perinatally acquired HIV, before and after antiretroviral therapy initiation in the paediatric IeDEA Global Cohort Consortium

Time‐varying age‐ and CD4‐stratified rates of mortality and WHO stage 3 and stage 4 events in children, adolescents and youth 0 to 24 years living with perinatally acquired HIV, before and after antiretroviral therapy initiation in the paediatric IeDEA Global Cohort Consortium

Systematic Mapping of Research on Vaccine-Preventable Diseases in Children in Sub-Saharan Africa: A Decennial Scientometric Analysis

Protection of Vaccine Preventable Diseases in a Population of HIV-Infected Children: A 3 Years Prospective Study

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