Clinical spectrum of human immunodeficiency virus disease in children in a West African city

Km, Vetter; Djomand, Gaston; Zadi, F; Diaby, Lacina; Brattegaard, K.; Timite, Marguerite; Andoh, J.; Ja, Adou; Km, De Cock

doi:10.1097/00006454-199605000-00011

Cited by 57 publications

(17 citation statements)

References 9 publications

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“…Seroprevalence surveys of all paediatric admissions to major urban hospitals in Zambia and Co Ã te d'Ivoire have found that children with an admission diagnosis of malnutrition are more likely to be HIV-infected than children with other common admission diagnoses. 13,14 The ® nding that marasmus is particularly associated with HIV infection is also consist- ent with these earlier studies from the region. 6,10± 12 Severe wasting is a recognized feature of paediatric AIDS in African cohort studies of perinatally infected children.…”

Section: Discussionsupporting

confidence: 72%

The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

Kessler

Daley

Malenga

et al. 2000

Annals of Tropical Paediatrics

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A study was undertaken in a central nutritional rehabilitation unit in southern Malawi to assess the impact of HIV infection on clinical presentation and case fatality rate. HIV seroprevalence in 250 severely malnourished children over 1 year of age was 34.4% and overall mortality was 28%. HIV infection was associated significantly more frequently with marasmus (62.2%) than with kwashiorkor (21.7%) (p < 0.0001). Breastfed children presenting with severe malnutrition were significantly more likely to be HIV-seropositive (p < 0.001). Clinical and radiological features were generally not helpful in distinguishing HIV-seropositive from HIV-seronegative children. The case fatality rate was significantly higher for HIV-seropositive children (RR 1.6 [95% CI 1.14-2.24]). The increasing difficulties of managing the growing impact of HIV infection on severely malnourished children in Malawi are discussed in the context of reduced support for nutritional rehabilitation units.

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Section: Discussionsupporting

confidence: 72%

The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

Kessler

Daley

Malenga

et al. 2000

Annals of Tropical Paediatrics

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“…64,65 Anemia prevalence among HIV-infected children varies with underlying conditions, but is usually high, ranging from 12% to 94%. [66][67][68] Moreover, anemia is a prognostic factor for negative outcomes such as progression to AIDS and early death; 66,69 thus, controlling preventable causes of anemia could also help reduce the burden of HIV-related morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania.

Villamor

Mbise²,

Spiegelman³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. The associations of hemoglobin, hematocrit, and packed cell volume with socioeconomic factors, malaria, human immunodeficiency virus (HIV) infection, and nutritional status were examined among 687 children admitted to hospital with pneumonia participating in a double blind, placebo-controlled trial of vitamin A supplementation. Children were randomized to receive 2 doses of vitamin A (200,000 IU) or placebo at baseline, and additional doses at 4 and 8 months after discharge from hospital. Hemoglobin levels were measured at enrollment and, on a subset of 161 children, during follow-up. At baseline, hemoglobin concentration was positively associated with the number of possessions in the household, maternal level of education and quality of water supply, and inversely related to malaria infection after controlling for potential confounding variables. Children infected with HIV experienced a significant fall in mean hemoglobin levels over time. The risk of developing severe anemia (Ͻ 7 g/ dL) during follow-up was lower for children who were breastfed for longer than 18 months as compared to those with less than 6 months of breastfeeding (adjusted prevalence ratio ϭ 0.14, 95% confidence interval [CI]ϭ 0.02, 0.93; P ϭ 0.04), and higher for children over two years of age as compared to 6 to 11 months-old infants (adjusted prevalence ratio ϭ 8.11, 95% CI ϭ 1.2, 55.8; P ϭ 0.03). Children with repeated diagnoses of malaria had 4.1 times the risk of developing severe anemia than did children without the diagnosis (95% CI ϭ 1.3, 13.5; P ϭ 0.02). Vitamin A supplements were associated with an overall nonsignificant reduction of 14% in the risk of developing severe anemia (adjusted prevalence ratio ϭ 0.86, 95% CI ϭ 0.37, 1.99; P ϭ 0.73). We conclude that malaria, HIV infection, low socioeconomic status, and short duration of breastfeeding are strong and independent determinants of adverse hematologic profiles in this population.

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“…14 HIV infected children progress more rapidly than adults in the development of immune dysfunction and resultant illness by Kathleen A , et al 15 The highest incidence of AIDS occurs in the first year of life and almost all cases are due to perinatal infection.…”

Section: Frommentioning

confidence: 99%

Clinical profile of human immunodeficiency virus infection in children: an interesting prospective study

Deshmukh¹,

Mogre²,

et al. 2016

Int J Contemp Pediatr

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Background: HIV infection has become a pandemic affecting both industrialized & developing countries. The increase in pediatric HIV infection has had a substantial impact on childhood mortality both in industrialized countries and developing countries. It is believed that this study will motivate research worker to work for further improvement of the disease, clinical presentation, diagnostic measures and management in already existing health care delivery system in a tertiary care centre in the tribal area and which may lead to even better survival and quality of life for these children. With the above background, the study is taken up to find the clinical profile of HIV infection in pediatric population in the study area. Methods: The current hospital based prospective study was carried out in the department of pediatrics, Shri V. N. Government Medical College, Yavatmal (Maharashtra), India from 1st January 2011 to 30th June 2012. 108 cases of HIV attending the pediatric OPD and IPD were included in the study. Importance of test was explained to the parents. HIV was diagnosed by using Standard Protocol. All those who were positive by ELISA, confirmed it by repeat test after 3 months. Western blot was not possible due to non availability of kits. Confirmations of all infections were done as per strategies suggested by WHO. Due to non-availability of specific but expensive test like PCR, p24 antigen assay or HIV Culture, children of PPTCT positive mother were tested on follow up after 18 month age to determine whether the transmission was vertical. Results: Majority (60.18%) cases in this study are below 5 years of age. Maximum cases 33(30.55%) were between 5-10yrs of age and 5 cases (4.62%) were below 18 months. Males 69(63.88%) outnumbered females 39(36.11%) with M: F ratio of 1.76:1. In the present study predominant route of transmission of HIV to the child was by perinatal (vertical) transmission (98.15%). Maximum 64(59.25%) were home delivered cases followed by 29(26.85%) normal hospital delivered and 6(5.55%) LSCS/instrumental delivered cases. In present study 60(55.55%) severe malnutrition (Group III and IV) was the most common examination finding. Of the total 108 cases enrolled in the study, 75 cases had regular follow up for 250 times and 33 cases did not follow up. Majority of follow ups were for respiratory complaints (23.20%) and fever (17.60%). Only 7.20% patients came for follow up were asymptomatic. Most of the follow up were for OI's. In this study, 108 cases of the study group visited 250 times in our hospital. Out of these 90 cases had 212 episodes of OI's and 18 cases had no evidence of OI's. Conclusions: HIV infection is an unpredictable disease in infants, children and adolescent which involves multiple organ system and is characterized by progressive clinical deterioration and ultimate development of severe immune dysfunction with opportunistic infections and secondary cancers resulting in a chronic and very complex illness. HIV infected infant and children now survive to adolescen...

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Clinical spectrum of human immunodeficiency virus disease in children in a West African city

Cited by 57 publications

References 9 publications

The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania.

Clinical profile of human immunodeficiency virus infection in children: an interesting prospective study

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