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

Abstract

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.

Incidence of Pneumonia and Predictors Among Human Immunodeficiency Virus Infected Children at Public Health Institutions in the Northwest Part of Ethiopia: Multicenter Retrospective Follow-Up Study

“…5 Acute and chronic respiratory illnesses are the most common presenting complaint of morbidity in HIV-infected children. 6 HIV-infected children are 6.5 times more at risk of hospitalization and at higher risk of death from pneumonia when compared to HIV-uninfected children, especially in African countries. 7 In the highest HIV burden countries in sub-Saharan Africa, 60% of pneumonia deaths occur in HIVinfected children.…”

Spirometry practice and the impact of a phase 1 training workshop among health workers in southern Nigeria: a cross-sectional study

“…The burden of respiratory diseases in Nigeria is enormous [1] with varying published prevalence of respiratory illnesses that have lung-function complications. These include pneumonia and its various complications, tuberculosis [2], asthma [3], chronic obstructive pulmonary disease (COPD) [4] as well as diseases that have lung-related co-morbidities like sickle cell anemia (SCA) [5], and HIV [6] which have attendant restrictive (interstitial) or obstructive residual effects on the lung. Furthermore, associated environmental inhalations that affect the lung, such as environmental tobacco smoke exposure [7], use of biomass fuels for cooking [8], gas flaring activities, and air pollution [9] also abound in Nigeria.…”