The University of Southampton
University of Southampton Institutional Repository

The long-term impact of HIV and orphanhood on the mortality and physical well-being of children in rural Malawi

Crampin, Amelia C., Floyd, Sian, Glynn, Judith R., Nyondo, Andrew, Khondowe, Masiya M., Njoka, Chance L., Kanyongoloka, Huxley, Ngwira, Bagrey, Zaba, Basia and Fine, Paul E.M. (2003) The long-term impact of HIV and orphanhood on the mortality and physical well-being of children in rural Malawi AIDS: Official Journal of the International AIDS Society, 17, (3), pp. 389-397. (doi:10.1097/01.aids.0000042939.55529.a8).

Record type: Article


Objective: To assess the influence of maternal HIV status and orphanhood on child mortality and physical well-being.
Design: Retrospective cohort study with > 10 years of follow-up.
Methods: From population-based surveys in Karonga District, Malawi in the 1980s, 197 individuals were identified as HIV-positive. These individuals and 396 HIV-negative individuals matched for age and sex, and their spouses and offspring, were sought in 1998-2000.
Results: All but 11 of the index individuals were traced, identifying 2520 offspring; of these, 1106 offspring were included in analyses. Among those with HIV-positive mothers, mortality was 27% [95% confidence interval (CI), 17-38] in infants (1-30 days), 46% (95% CI, 34-58) in those under 5 years and 49% (95% CI, 38-61) in those under 10 years. The corresponding figures for those with HIV-negative mothers were 11% (95% CI, 8-13), 16% (95% CI, 13-19) and 17% (95% CI, 14-20). Death of HIV-positive mothers, but not of HIV-negative mothers or of fathers, was associated with increased child mortality. Among survivors who were still resident in the district, neither maternal HIV status nor orphanhood was associated with stunting, being wasted, or reported ill-health.
Conclusions: Mortality in children under 5 years is much higher in children born to HIV-positive mothers than in those born to HIV-negative mothers. With 10% of pregnant women HIV-positive, we estimate that approximately 18% of under-5 deaths in this population are attributable to HIV. Most of the excess is attributable to vertical transmission of HIV. Our findings suggest that, in terms of physical well-being, the extended family in this society has not discriminated against surviving children whose parents have been ill or have died as a result of HIV/AIDS.

Full text not available from this repository.

More information

Published date: 2003


Local EPrints ID: 34241
ISSN: 0269-9370
PURE UUID: 5f037975-c5b3-402d-9bcc-7c7302d2ef65
ORCID for Sian Floyd: ORCID iD

Catalogue record

Date deposited: 17 May 2006
Last modified: 17 Jul 2017 15:50

Export record



Author: Amelia C. Crampin
Author: Sian Floyd ORCID iD
Author: Judith R. Glynn
Author: Andrew Nyondo
Author: Masiya M. Khondowe
Author: Chance L. Njoka
Author: Huxley Kanyongoloka
Author: Bagrey Ngwira
Author: Basia Zaba
Author: Paul E.M. Fine

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.