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El cumplimiento de los objetivos internacionales en la supervivencia infantil y el VIH / SIDA
Neff Walker1, Bernhard Schwartländer, Jennifer Bryce
1Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, 1211 Geneva, Switzerland. walkern@unaids.org
Lancet (London, England)
|July 31, 2002
Resumen
El virus de la inmunodeficiencia humana y el síndrome de inmunodeficiencia adquirida (VIH/SIDA) aumentaron significativamente la mortalidad de menores de 5 años en el África subsahariana entre 1990 y 1999. Si bien el VIH / SIDA es una preocupación creciente, otras enfermedades asesinas de niños también requieren atención para cumplir con los objetivos mundiales de reducción de la mortalidad.
Área de la Ciencia:
- Salud global La salud global.
- Epidemiología La epidemiología.
- La pediatría es la medicina de los niños.
Sus antecedentes:
- Los esfuerzos para reducir la mortalidad de menores de 5 años han dado resultados mixtos en la última década.
- El virus de la inmunodeficiencia humana y la epidemia del síndrome de inmunodeficiencia adquirida (VIH / SIDA) a menudo se citan como una razón para el estancamiento del progreso.
- Este estudio investiga el impacto del VIH/SIDA en las tendencias de mortalidad de menores de 5 años en el África subsahariana.
Objetivo del estudio:
- Estimar la mortalidad de menores de 5 años atribuible al VIH en 39 países de África subsahariana.
- Comparar la mortalidad atribuible al VIH con la mortalidad total de menores de 5 años entre 1990 y 1999.
- Evaluar el papel del VIH/SIDA en la reversión de las tendencias de mortalidad infantil.
Principales métodos:
- Utilizó un proceso de estimación en cuatro pasos utilizando datos de sero-prevalencia del VIH de la clínica prenatal.
- Estimó el número de niños nacidos de madres infectadas por el VIH.
- Las tasas de transmisión calculadas de madre a hijo y la mortalidad subsiguiente de menores de 5 años, ajustadas por causas concurrentes.
Principales resultados:
- Se estima que 330.000 niños menores de 5 años murieron de infección por el VIH en África subsahariana en 1999.
- La infección por el VIH representó el 7,7% de las muertes de menores de 5 años en 1999, frente al 2% en 1990.
- Cinco países superaron las 30 muertes por VIH atribuibles a menores de 5 años por cada 1000, y otros 16 entre 10 y 25 por cada 1000.
Conclusiones:
- El VIH / SIDA es un contribuyente significativo y creciente a la mortalidad de menores de 5 años en África.
- El VIH/SIDA por sí solo no explica el estancamiento o la inversión de las tendencias de la mortalidad infantil en muchas naciones africanas.
- El fortalecimiento de los sistemas de salud para abordar otras enfermedades infantiles importantes junto con el VIH / SIDA es crucial para lograr los objetivos internacionales de reducción de la mortalidad.
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