RT Journal Article
SR Electronic
T1 Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e004398
DO 10.1136/bmjgh-2020-004398
VO 6
IS 5
A1 Eric Remera
A1 Frédérique Chammartin
A1 Sabin Nsanzimana
A1 Jamie Ian Forrest
A1 Gerald E Smith
A1 Placidie Mugwaneza
A1 Samuel S Malamba
A1 Muhammed Semakula
A1 Jeanine U Condo
A1 Nathan Ford
A1 David J Riedel
A1 Marie Paul Nisingizwe
A1 Agnes Binagwaho
A1 Edward J Mills
A1 Heiner Bucher
YR 2021
UL http://gh.bmj.com/content/6/5/e004398.abstract
AB Introduction Child mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda.Methods We used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother’s HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother’s HIV status.Results In total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1–2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality.Conclusions This study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.Data are available in a public, open access repository. Data used in this analysis was retrieved from open online source the Rwanda DHS 2005, 2010 and 2014–2015. These data are freely available upon request at MEASURE DHS website https://dhsprogram.com/data/available-datasets.cfm. The merged datasets used in this manuscript are available on request to the corresponding author.