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Paediatric HIV/AIDS in Abakaliki
Abstract
Background: The increasing prevalence of HIV infection in Nigeria makes it desirable to document the clinical features of the disease in environments where there are often limited financial resources for HIV testing.
Objectives: The study was aimed at determining the mode of transmission, clinical presentation, and outcome of HIV infection in children admitted with clinical manifestations suspicious of HIV infection. It was also to examine whether the WHO clinical case definition for paediatric AIDS in Africa could help predict the infection in the local community.
Method: A retrospective review of 342 patients aged between one month and 15 years, who were admitted and screened for suspected HIV infection between January 2000 and September 2001, was carried out.
Results: Forty-six (13.7 percent) of the 342 patients were confirmed positive. However, adequate clinical data was obtained in only 31 patients. Vertical transmission was a significant source of infection in these children (p<0.05) having been documented in 21 (67.7 percent) of the 31 patients, while four (12.9 percent) were probably infected through blood transfusion. The main clinical features in HIV positive children at presentation were persistent and/or recurrent fever (90.3 percent), progressive weight loss (83.9 percent), chronic diarrhoea (67.7 percent), persistent cough (64.5 percent), generalized lymphadenopathy (51.6 percent), dermatitis (48.4 percent), and oral candidiasis (41.9 percent). Only 54.8 percent of the HIV positive patients presented with features corresponding to the WHO case definition of paediatric AIDS in Africa. Seven patients died (22.6 percent) and 19 patients were lost to follow up. Pneumonia constituted a significant morbidity (64.5 percent) as well as the commonest (57.1 percent) cause of death.
Conclusion: The WHO clinical case definition for paediatric AIDS in Africa was poorly sensitive and poorly specific in this study. In view of this, HIV screening is of vital importance in the diagnosis of AIDS. Prevention of vertical transmission through the prophylactic use of anti-retroviral therapy in pregnancy may be the most powerful tool against HIV infection in the community.
Key Words: HIV/AIDS, paediatric age group
Nigerian Journal of Paediatrics Vol.30(4) 2003: 128-134
Objectives: The study was aimed at determining the mode of transmission, clinical presentation, and outcome of HIV infection in children admitted with clinical manifestations suspicious of HIV infection. It was also to examine whether the WHO clinical case definition for paediatric AIDS in Africa could help predict the infection in the local community.
Method: A retrospective review of 342 patients aged between one month and 15 years, who were admitted and screened for suspected HIV infection between January 2000 and September 2001, was carried out.
Results: Forty-six (13.7 percent) of the 342 patients were confirmed positive. However, adequate clinical data was obtained in only 31 patients. Vertical transmission was a significant source of infection in these children (p<0.05) having been documented in 21 (67.7 percent) of the 31 patients, while four (12.9 percent) were probably infected through blood transfusion. The main clinical features in HIV positive children at presentation were persistent and/or recurrent fever (90.3 percent), progressive weight loss (83.9 percent), chronic diarrhoea (67.7 percent), persistent cough (64.5 percent), generalized lymphadenopathy (51.6 percent), dermatitis (48.4 percent), and oral candidiasis (41.9 percent). Only 54.8 percent of the HIV positive patients presented with features corresponding to the WHO case definition of paediatric AIDS in Africa. Seven patients died (22.6 percent) and 19 patients were lost to follow up. Pneumonia constituted a significant morbidity (64.5 percent) as well as the commonest (57.1 percent) cause of death.
Conclusion: The WHO clinical case definition for paediatric AIDS in Africa was poorly sensitive and poorly specific in this study. In view of this, HIV screening is of vital importance in the diagnosis of AIDS. Prevention of vertical transmission through the prophylactic use of anti-retroviral therapy in pregnancy may be the most powerful tool against HIV infection in the community.
Key Words: HIV/AIDS, paediatric age group
Nigerian Journal of Paediatrics Vol.30(4) 2003: 128-134
