Paediatric palliative care is an emerging subspecialty that focuses on achieving the best possible quality of life for children with life-limiting conditions and also for their families. It is a response to the suffering and unique needs of such children. Globally there is limited documented data available on the palliative care needs of children with HIV. A retrospective review of data of all the HIV exposed and positive children who were admitted to the ward from January to December 2012 was done to document their palliative care needs.A total of 243 children were admitted to the ward during the stated period. Of these, 139 (57.2%) were female and 104 (42.8%) were male. Among them 131 (54%) were aged five years and below whereas 112 (46%) were above five years. Some of the identified palliative care needs documented included physical needs: pneumonia 46 (19%), severe acute malnutrition 38 (16%), mild and moderate acute malnutrition 23 (9.6%), and respiratory tract infections 22 (9.3%). Social needs: poor social support 21 (41%), financial instability 16 (31%), and child neglect 4 (8%). Psychological needs: antiretroviral treatment (ART) counselling 127 (36%), HIV counselling and testing for the child and family 63 (18%), adherence support 53 (15%), and others 11 (3%). Spiritual needs: discontinuing ART because of belief in spiritual healing 18 (81%), loss of hope because of severe ill health 1 (5%), and others 3 (14%).These results emphasise the need for palliative care in children with HIV even in the era of ART. The needs identified are in keeping with studies done elsewhere and are similar to the palliative care needs of children with other life-limiting illnesses such as cancer.ConclusionHIV positive and exposed children plus their families have vast palliative care needs and a holistic approach is the key in their management.

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Background: Staphylococcus aureus is a major cause of purulent inflammations. The range of staphylococcal infections varies and includes skin infections, endocarditis, deep-seated abscesses, osteomyelitis, necrotizing pneumonia, and other diseases, some of which are lethal. This ability is provided by virulence factors, including toxins, especially pore-forming agents such as the Panton-Valentine leukocidin (PVL) and gamma-hemolysin (Hlg). The aim of our study was to determinate the prevalence of PVL and Hlg genes among S. aureus isolates recovered in the microbiological laboratory of the Karaganda State Medical University, Kazakhstan.Methods & Materials: From 2011 to 2013, 41 stains of S. aureus were isolated from patients with skin and soft tissue infections from different hospitals of Central Kazakhstan. Bacterial identification was performed using MALDI-TOF (Microflex, Bruker). Additional species identification was checked with PCR amplification of nuc gene. PVL and Hlg genes were detected by PCR, according to (Lina, Piemont et al., 1999).Results: Investigation of 41 Staphylococcus aureus cultures, identified with MALDI mass spectrometry, showed that the presence nuc gene were in 39 stains. PCR analysis of all 41 S. aureus isolates indicated that 19 (46,3%) carried genes for PVL synthesis. At the same time the proportion of staphylococcus with Hlg gene was 21.9%. The stains of S. auresus with simultaneous presence PVL and Hlg genes were detected in 9.8% cases. Conclusion:Our study revealed that Panton-Valentine leukocidine (PVL) and gamma-hemolysin (Hlg) genes are carried by an almost half (46.3%) and slightly more than one-fifth (21.9%) of S. aureus isolates recovered from patients with purulent infections skin and soft tissue. Every tenth (9.8%) isolate of S.aureus had two genes of toxins, simultaneously. As it has shown that patients with PVL positive invasive infections stayed significantly longer in hospital than patients with PVL negative invasive infections (Cupane, Pugacova et al., 2012).