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Under-five mortality and maternal HIV status in Tanzania: analysis of trends between 2003 and 2012 using AIDS
Malachi Ochieng Arunda1, Vikas Choudhry2, Björn Ekman2
1International Master Programme in Public Health, Faculty of Medicine, Lund University, CRC, Jan Waldenströms gata 35, 205 02 Malmö, Sweden; arundamalachi@gmail.com.
Background:
Mortality among children under five remains a significant health challenge across sub-Saharan Africa. HIV/AIDS is one of the leading contributors to the relatively slow decline in under-five mortality in this region. In Tanzania, HIV prevalence among under-five children is high and 90% of all infections are due to mother-to-child transmission.
Objectives:
The study aimed to examine the association between maternal HIV-positive status and under-five mortality in Tanzania. It also aimed to estimate the proportions and trends of under-five mortality attributable to maternal HIV/AIDS in Tanzania between 2003 and 2012.
Design:
Binomial logistic regression was used to analyze cross-sectional survey data from the Tanzania AIDS Indicator Surveys to examine the association between maternal HIV positivity and under-five mortality between 2003 and 2012.
Results:
After controlling for confounders, the adjusted odds ratios were 1.5 (95% CI 1.1-1.9) in 2003-2004, 4.6 (95% CI 2.7-7.8) in 2007-2008, and 2.4 (95% CI 1.2-4.6) in 2011-2012. The maternal HIV-attributable mortality risk percent of under-five children was 3.7 percent in 2003-2004, 11.3 percent in 2007-2008 and 5.6% in 2011-2012.
Conclusion:
Maternal HIV positivity is associated with under-five mortality in Tanzania, making maternal HIV serostatus a relevant determinant of whether a child will survive up to five years of age or not. The impact of maternal HIV/AIDS attributable mortality risk has a significant contribution to the overall under-five mortality in Tanzania. The continued monitoring of HIV and mortality trends is important for policy development and design of interventions.
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