To review the pediatric care and treatment program at Massey Street Children Hospital, in Lagos, Nigeria a retrospective analysis of medical records focusing on health services, survival and retention in care. Methods: The analysis covered a cohort of children initiated on antiretroviral therapy (ART) from 2005 to 2011. In this population, pediatric HIV care was defined as initiating ART between ages 0 and 14 years.\nTreatment initiation and follow-up were according to the Nigerian national guidelines for pediatric ART,\nwhich are based on World Health Organization guidelines adapted to our local context. The primary\nendpoint was mortality measured as cumulative survival. Other outcomes of interest included ââ?¬Å?loss to\nfollow-upââ?¬Â, ââ?¬Å?transferred outââ?¬Â, and ââ?¬Å?stopped treatmentââ?¬Â.\nResults: Mean (SD) age at ART initiation was 51 (39) months in female children and 52 (42) months in\nmale children. After seven years of ART care, 64 % of the 660 study children were retained in care and on\ntreatment, 16 % were lost to follow-up, 10 % were dead, and 9 % had discontinued HIV care at this facility\nfor other reasons. World Health Organization disease stage, CD4 count, age, and year of ART initiation were\nhighly predictive of mortality, while anemia at baseline was not statistically significantly associated.\nConclusions: Overall study results suggest a viable pediatric HIV program exists at the study facility. Retention\nrates were lowest for the earliest cohort of infected children, which implies long-term challenges. Mother-to-child\ntransmission programs need to be dynamic to stem the scourge of pediatric HIV in Nigeria.
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