       Document 0748
 DOCN  M9490748
 TI    AIDS orphans in Kinshasa, Zaire: incidence and socioeconomic
       consequences.
 DT    9411
 AU    Ryder RW; Kamenga M; Nkusu M; Batter V; Heyward WL; Project SIDA,
       Department of Public Health, Kinshasa, Zaire.
 SO    AIDS. 1994 May;8(5):673-9. Unique Identifier : AIDSLINE MED/94338605
 AB    OBJECTIVE: To determine the incidence, morbidity, mortality, and
       socioeconomic consequences of becoming an AIDS orphan (a child with an
       HIV-1-seropositive mother who has died) in Kinshasa, Zaire. DESIGN: A
       longitudinal cohort study was undertaken between 1986 and 1990. Within
       this cohort, a nested case-control study of AIDS orphans was performed.
       AIDS orphan cases were children with an HIV-1-seropositive mother who
       had died. Two groups of control children were identified. The first
       group of control children were age-matched children with
       HIV-1-seropositive mothers who were alive at the time of death of the
       AIDS orphan case mother. The second group of control children were
       children with HIV-1-seronegative mothers who were also alive at the time
       of death of the AIDS orphan case mother. SETTING: Obstetric ward and
       follow-up clinic at two large municipal hospitals in Kinshasa, Zaire.
       PARTICIPANTS: A total of 466 HIV-1-seropositive women, their children,
       and the fathers of these children; 606 HIV-1-seronegative women, their
       children, and the fathers of these children. MAIN OUTCOME MEASURES: AIDS
       orphan incidence, HIV-1 vertical transmission rate, morbidity, mortality
       and socioeconomic indicators of the consequences of becoming an AIDS
       orphan. RESULTS: The AIDS orphan incidence rate was 8.2 per 100
       HIV-1-seropositive women-years of follow-up. Vertical transmission of
       HIV-1 was higher in AIDS orphan cases (41%) than in control children
       with HIV-1-seropositive mothers (26%; P < 0.05). Among children without
       vertically acquired HIV-1 infection, morbidity rates and indices of
       social and economic well-being were similar in AIDS orphans and control
       children. Five out of 26 (19%) AIDS orphan cases died during follow-up,
       compared with three out of 52 (6%) control children (P < 0.05).
       CONCLUSION: During a 3-year follow-up period, children with
       HIV-1-seropositive mothers had a considerable risk of becoming an AIDS
       orphan. However, the presence of a concerned extended family appeared to
       minimize any adverse health and socioeconomic effects experienced by
       orphan children.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY  Adolescence  Adoption
       Adult  Case-Control Studies  Child  *Child of Impaired Parents  Child
       Rearing  Child, Preschool  Cohort Studies  *Family Health  Female  Human
       HIV Infections/CONGENITAL/EPIDEMIOLOGY/TRANSMISSION  *HIV-1  Incidence
       Infant  Infant, Newborn  Male  Parity  Pregnancy  Pregnancy
       Complications, Infectious/EPIDEMIOLOGY  Risk  Socioeconomic Factors
       Urban Population  Zaire/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

