HIV/AIDS and associated morbidity and mortality among hospitalised children in Kilifi, Kenya

Wamsele, Joyce; Kisenge, Rodrick

doi:10.4314/thrb.v8i2.14279

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…When analyzing for factors associated with HIV infection in this study it was found that, HIV-infected children were more likely to have lost a parent or both, present with cough, oral thrush, lymphadenopathy, acute malnutrition and stunting. These results are in line with those in previous studies describing the clinical presentation of HIV infection in children [ 5 , 13 , 14 , 18 – 22 ]. Hence, the presence of these associated factors should heighten the need to screen for HIV infection among children in settings where routine PITC services are not offered.…”

Section: Discussionsupporting

confidence: 93%

Prevalence and outcome of HIV infected children admitted in a tertiary hospital in Northern Tanzania

et al. 2022

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Background Provider Initiated Testing and Counseling (PITC) among hospitalized children have shown to increase the probability of identifying HIV-infected children and hence be able to link them to HIV care. We aimed at determining the prevalence, clinical characteristics and outcome of HIV-infected children admitted at Bugando Medical Centre (BMC) after active provision of PITC services. Methods A cross-sectional study with follow up at three months post enrollment was done. Children with unknown HIV status were tested for HIV infection as per 2012 Tanzanian algorithm. Questionnaires were used to collect demographic, clinical and follow up information. Data was statistically analyzed in STATA v13. Results A total of 525 children were enrolled in the study. Median [IQR] age was 28 [15–54] months. Males consisted of 60.2% of all the participants. HIV prevalence was 9.3% (49/525). Thirty-three (67.3%) of HIV-infected children were newly diagnosed at enrolment. Thirty-nine (79.6%) of all HIV-infected patients had WHO HIV/AIDS clinical stage four disease, 10 (20.4%) had WHO clinical stage three and none qualified in stage one or two. About 84% (41/49) of HIV infected children had severe immunodeficiency at the time of the study. Factors that were independently associated with HIV infection were, cough (OR 2.40 [1.08–5.31], p = 0.031), oral thrush (OR 20.06[8.29–48.52], p < 0.001), generalized lymphadenopathy (OR 5.61 [1.06–29.56], p = 0.042), severe acute malnutrition (OR 6.78 [2.28–20.12], p = 0.001), severe stunting (OR 9.09[2.80–29.53], p = 0.034) and death of one or both parents (OR 3.62 [1.10–11.87], p = 0.034). The overall mortality (in-hospital and post-hospital) was 38.8% among HIV-infected children compared with 14.0% in HIV-uninfected children. Within three months period after discharge from the hospital, 71.4% (25/35) of discharged HIV-infected children reported to have attended HIV clinic at least once and 60.0% (21/35) were on antiretroviral medications. Conclusion PITC to all admitted children identified significant number of HIV-infected children. Mortality among HIV-infected children is high compared to HIV-uninfected. At the time of follow up about 30% of discharged HIV-infected children did not attend to any HIV care and treatment clinics. Therefore effective efforts are needed to guarantee early diagnosis and linkage to HIV care so as to reduce morbidity and mortality among these children.

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Section: Discussionsupporting

confidence: 93%

Prevalence and outcome of HIV infected children admitted in a tertiary hospital in Northern Tanzania

et al. 2022

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“…Our prevalence could have been higher if subjects with severe malnutrition with diarrhoea were screened prevalence rates as high as 10-30% have been recorded in several studies in Nigeria 3,7,9,16,17 and up to 50% in Ken-ya6 , 18 . Most of these studies involved other morbidities other than acute watery diarrhoea as in our study 3,6,7,16,17,18. In a Zambian study that assessed children 5 years and below with diarrhoea and HIV only 25% had acute diarrhoea, the remaining being chronic diarrhoea 9 .…”

Section: Discussionmentioning

confidence: 72%

HIV Infection in hospitalized under-5 children with acute watery diarrhoea in Calabar, Nigeria.

Ntia¹,

Anah²,

Eyong³

et al. 2012

Nig. J. Paed.

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Background: The signs and symptoms of HIV/AIDS in children are not quite distinct because of similarities in clinical presentation between HIV infection and endemic tropical diseases. Diarrhoea, one of the cardinal symptoms of HIV/AIDS, is a common childhood disease. Objective: This study was conducted to find the prevalence of HIV infection among children admitted with acute watery diarrhoea in our diarrhoea treatment and training unit. Method: Consecutive children aged below 5 years admitted into the unit with diarrhoea were recruited. The children were examined. The parents were counseled before blood was taken for HIV screening. In addition, parents of children who were sero-positive for HIV were also screened. Results: One hundred and fifty-two who made the inclusion criteria were studied. Eight (5.3%) were sero-positive for HIV, five of them being males. None of these mothers had antenatal care and they were all delivered at either home or traditional attendants' homes. All were under weight and six of them presented with severe dehydration. These factors reached statistical significant differences between children who were sero-positive and those who were not. None of these eight patients died from acute watery diarrhoea but two of them eventually died from complications of persistent diarrhoea. Conclusion: Children with HIV may present with acute watery diarrhoea. Children with diarrhoea that are underweight with severe dehydration whose sero-status are not known should be screened for HIV.

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Pattern of respiratory diseases among human immunodeficiency virus-infected children in Enugu, Nigeria

Ayuk¹,

Ubesie²,

Iloh³

et al. 2019

Indian J Child Health

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Introduction: The lung is a major target for infectious and non-infectious complications of human immunodeficiency virus (HIV) infection. Objective: This study sought to assess the prevalence and pattern of respiratory diseases among HIV-infected children attending our pediatric HIV specialist clinic. Methods: A 10-year retrospective review of data on HIV-infected children seen at the Paediatric HIV clinic of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu. HIV diagnosis was made by HIV-DNA polymerase chain reaction testing and antibody testing depending on the age of the child. Diagnosis of pneumonia was made using the WHO pneumonia clinical algorithm while pulmonary tuberculosis(PTB) was diagnosed using clinical and radiological criteria. Data analyses were done with Statistical Package for the Social Sciences version 19 (Chicago, IL). Results: A total of 555 HIV-infected children were analyzed. There were 277 males (49.9%) with male to female ratio of 0.9–1. The cough was the most common complaint in 51.9% of the children. There were327 respiratory cases observed in 181 of 555 (34.7%) of the children. Using clinical symptoms, 65 of 327 (9.9%) of study participants had upper airway-related diseases with otitis media being most predominant (27/65; 41.5%); pneumonia was reported in 146 of 327 (45%) and PTB in 115 of 327 (35%). Total 124 of 181 children (72.5%) with respiratory infectionscompared to 18 of 287 (6.3%) without infections had an abnormal chest X-ray (CXR) (p<0.001). Identified risk factors for developing respiratory disease were low socio-economic status, being on second-line highly active antiretroviral therapy and having an abnormal CXR finding. Conclusions: Pneumonia and PTB are common in children with HIV. Chronic radiologicalchange is more common among HIV-infected children with clinical features of respiratory pathology. The need for close lung function monitoring in children with HIV is recommended for early detection of morbidity associated with these infections.

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HIV/AIDS and associated morbidity and mortality among hospitalised children in Kilifi, Kenya

Cited by 3 publications

References 8 publications

Prevalence and outcome of HIV infected children admitted in a tertiary hospital in Northern Tanzania

Prevalence and outcome of HIV infected children admitted in a tertiary hospital in Northern Tanzania

HIV Infection in hospitalized under-5 children with acute watery diarrhoea in Calabar, Nigeria.

Pattern of respiratory diseases among human immunodeficiency virus-infected children in Enugu, Nigeria

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