Epidemiological, Clinical, Therapeutic and evolutionary Aspects of Children Living with HIV in Guédiawaye, Senegal

Abstract

Introduction: HIV infection in children is a major public health problem. The objective of this study carried out in the paediatric department of the Centre Hospitalier Roi Baudouin de Guédiawaye, was to evaluate the epidemiological, clinical, therapeutic and evolutionary aspects of a cohort of children with HIV over a 15-year period and to determine the factors associated with discontinuation of treatment and transition to second-line treatment. Patients and Methods: This was a descriptive and analytical cross-sectional study from August 2004 to December 2019 at the Centre Hospitalier Roi Baudouin de Guédiawaye. Through this study, age at diagnosis, current age, gender, orphan status, therapeutic aspects, status announcement and evolution were evaluated. A total of 129 patient records were studied over a 15-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019). HIV-positive children with profile I represented 93.8% and there was a male predominance with a sex ratio of 1.43. The current mean age of the children was 12.2 ± 4.5 and the median was 14 years. Fatherless and motherless children represented 24.0% and 20.2%, respectively, while both fatherless and motherless children represented 11.6%. The mean age at the start of ARV treatment was 7.6 ± 4.3 years and the median was 7.5 years. The mean age at the start of second-line treatment was 13.7 years with a standard deviation of 2.6 while the median was 13 years. AZT + 3TC + NVP was the most commonly used combination (29.5%) followed by TDF + FTC + NVP (26.2%). The mean age at treatment discontinuation was 13.3 ± 4.3 years while the median was 15 years. More than half of the children (57.0%)

Evaluation of Malnutrition in Infants Aged 0 - 59 Months in the Suburbs of Dakar

“…Almost half of the children were severely underweight (51.06%) and almost a quarter was moderately underweight (20.21%). These results differed from those of studies in Pikine-Dagoudane [20] and Guediawaye [14], where 11.8% and 5% of children were moderately chronically malnourished, 8.6% and 1% were severely chronically malnourished, 11.9% and 6% were moderately acutely malnourished, and 17.4% and 1% were severely wasted, respectively.…”

“…The prevalence of malnutrition was 62.77% for acute malnutrition, 41.49% for chronic malnutrition, and 71.27% for underweight. Our results are those obtained in a study carried out in Guediawaye, Senegal, in 2020, which showed a high prevalence of acute malnutrition (29.3%) compared with that of chronic malnutrition (20.4%) and underweight (25.5%) [14]. In terms of acute malnutrition, our results showed that 41.49% of the patients had severe acute malnutrition and 21.28% had moderate acute malnutrition.…”

“…The mean age of weaning was 15.50 ± 5.5 months for acute malnutrition and 14 ± 5.57 months for underweight. A study conducted in Guediawaye recorded an average weaning age of 19.7 ± 4.5 months but was not associated with undernutrition [14]. The child not being weaned is a risk factor associated with acute malnutrition and underweight.…”

“…In our study, the non-consumption of fruits, vegetables, and dairy products by a large number of malnourished children was a risk factor for acute malnutrition and underweight. In a study conducted in Pikine, only fruit non-consumption was associated with acute malnutrition [14]. The lack of animal products, fruits, and vegetables in the diet leads to a dietary deficiency in micronutrients.…”

“…The most represented age group was 12 -23 months. A study conducted in the district of Guediawaye in 2020 showed a high prevalence in the 6 -12-month age group [14]. This period of life is marked by dietary diversification; therefore, an inadequate and unbalanced diet at this age could cause malnutrition [15].…”