在CHAMPS网络中对与艾滋病毒相关的5岁以下死亡的死后鉴定:基于人口的死亡率监测
Inacio Mandomando1, Zachary J Madewell2, Portia C Mutevedzi3
1Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde INS, Marracuene, Maputo, Mozambique; ISGlobal, Barcelona, Spain; Global Health and Tropical Medicine, GHTM, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, Lisboa, Portugal.
The lancet. HIV
|February 27, 2026
概括
人类免疫缺陷病毒 (HIV) 显著导致儿童死亡率,特别是在高负担地区. 改善早期检测,治疗和母婴健康服务对于减少儿科死亡和实现全球艾滋病毒目标至关重要.
科学领域:
- 全球儿童健康 儿童健康
- 传染病流行病学 传染病流行病学
- 儿科死亡率研究儿童死亡率研究
背景情况:
- 尽管有预防工作,儿童艾滋病毒仍然是全球儿童死亡的关键原因.
- 儿童健康和死亡预防监测 (CHAMPS) 网络分析了因艾滋病毒而导致的死亡,以了解导致的因素.
- 焦点领域包括并发病,并发感染和医疗保健准入方面的差距.
研究的目的:
- 分析5岁以下儿童因艾滋病毒导致的死亡的原因和贡献因素.
- 确定与儿科艾滋病毒死亡率相关的并发病,并发感染和护理差距.
- 为减少艾滋病毒感染人口儿童死亡率的战略提供信息.
主要方法:
- 在七个CHAMPS站点 (2016-2024) 中对5岁以下死亡的前性描述性分析.
- 标准化验尸调查,包括最小侵入性组织采样,组织病理学和分子检测.
- 多学科小组对死亡原因的裁决和描述性统计分析.
主要成果:
- 艾滋病毒与3.2% (164/5200) 的5岁以下死亡因果链有关,在莫桑比克,肯尼亚,塞拉利昂,马里和南非的死亡率最高.
- 仅有58%的艾滋病毒病例有记录的死前诊断,而67%的人接受了抗逆转录病毒治疗.
- 常见的并发病包括下呼吸道感染 (52%),败血症 (43%) 和消耗综合征 (55%),频繁的同时感染,如细胞大脑病毒和Klebsiella pneumoniae.
结论:
- 儿科艾滋病毒是高负担地区5岁以下死亡率的主要驱动因素,常常由同时感染和营养不良加剧.
- 低的诊断和治疗率突出显示了大量错过的护理机会.
- 加强早期检测,治疗和母婴健康服务对于减少死亡率和实现全球艾滋病毒目标至关重要.
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