This is a cross-sectional analysis of causes of death ascertained through minimally invasive tissue sampling (MITS) in the Kenya Child Health and Mortality Prevention Surveillance site. We included decedents aged 28 days to less than 5 years, whose death was reported within 36 h, underwent MITS, and had HIV test results and causes of death determined. MITS specimens were tested using TaqMan Array Cards, culture, cytology, histopathology and immunohistochemistry and HIV PCR. A panel evaluated epidemiologic, clinical, verbal autopsy and laboratory data to assign causes of death using ICD-10 guidelines. Causes of death and etiological agents were stratified by HIV status. Nearly all HIV-infected decedents’ underlying cause of death was HIV disease, which was associated with malnutrition. Our findings underscore the need for strengthening early identification and management of HIV-infected children. Prevention, early diagnosis and treatment of malnutrition could be instrumental in improving the survival of HIV-infected and HIV-uninfected children.

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Causes of death in HIV-infected and HIV-uninfected children aged under-five years in western Kenya

Authors: Onyango, Dickens O.; Akelo, Victord; van der Sande, Marianne A.B.; Ridzon, Reneed; Were, Joyce A.; Agaya, Janet A.; Oele, Elizabeth A.; Wandiga, Stevee; Igunza, Aggrey K.; Young, Peter W.; Blau, Dianna M.; Joseph, Rachael H.; Yuen, Courtney M.; Zielinski-Gutierrez, Emily; Tippett-Barr, Beth A