The risk of pre-ART attrition among children was also lower in 2012 (AsHR=0.4, 95% CI: 0.3 to 0.6) but higher among those missing a CD4 cell count (AsHR=2.0, 95% CI: 1.4 to 2.7), those with severe malnutrition (AsHR=1.4, 95% CI: 1.0 to 1.9) and children enrolled from outpatient clinics (AsHR=1.6, 95% CI: 1.1 to 2.2) (Supplementary Table 2). This evidence concerns the gene CD4 and malnutrition.