Prevalence and pattern of bacteraemia among HIV-infected under -five children in a tertiary hospital in Kano, Nigeria

Abstract

Background: Bacteraemia is an invasive bacterial disease of childhood that is associated with serious complications and high mortality especially in immunocomprised HIV infected children.

Aim: To determine the prevalence and pattern of bacteraemia among HIV-infected Under-five children.

Design: It was a prospective cross -sectional study

Subjects and Methods: One hundred and thirty four febrile HIVinfected children were recruited from the outpatient departments and emergency room of a tertiary hospital to determine the presence of bacteraemia, the etiologic agent and antibiotics susceptibility. An automated (BACTEC) incubator was used to detect bacteraemia, subcultures were done and identification and antibiotic susceptibility tests were done using standard laboratory procedures. Sociodemographic and clinical data were obtained using a proforma and data analysis was done using SPSS version 17.0 for windows.

Results: The prevalence of bacteraemia in HIV-infected children was 14.2% (19/134). Salmonella typhi and Staphylococcus aureus were the predominant isolates, each accounting for 21% of all cases of bacteraemia. Most (81.3%) of the subjects were on HAART and its use had no effect on rate of bacteraemia. Fourteen (73.7%) and 12(63.2%) of the isolates were sensitive to ciprofloxacin and ceftriaxone respectively. Sensitivities to ampicillin, cloxacillin and co-trimoxazole were 0.0%, 5.3% and 5.3% respectively.

Conclusion: Bacteraemia is a significant health problem among HIV-infected under-five children despite the high rate of HAART use. Treatment adherence should be strengthened among this population. There is need for improvement in personal and food hygiene, environmental sanitation and possibly introducing typhoid vaccine among under-five HIV-infected children.

Keywords: bacteraemia, underfive, human immunodeficiency virus/acquired immune deficiency syndrome, prevalence, highly active antiretroviral therapy