HIV Infection Presenting in Older Children and Adolescents: A Case Series from Harare, Zimbabwe

HIV in adolescents in sub-Saharan Africa

“…Increasingly, these long-term survivors are presenting for care [55]. In countries with early onset severe epidemics, there is a substantial but largely hidden epidemic among these young people [4].…”

Undiagnosed HIV Infection among Adolescents Seeking Primary Health Care in Zimbabwe

“…tures suggesting long-standing HIV infection are an increasingly prominent cause of adolescent morbidity in countries such as Zimbabwe, which has been severely affected since early in the HIV epidemic [6][7][8]. We recently reported that hospitalized adolescents in Harare had a high burden of HIV infection, with an adult spectrum of opportunistic infections plus severe complications of untreated pediatric HIV infection, such as chronic lung disease and growth failure [9].…”

Increased risk of HIV-infection among school-attending orphans in rural Zimbabwe

“…Whilst the possibility of long-term survival following mother-to-child transmission among some of the HIV positive orphans cannot be dismissed (Ferrand et al, 2007;Marston, Zaba, Salomon, Brahmbhatt, & Bagenda, 2005), other research has shown that the proportion of vertically infected children who survive to adolescence in the absence of treatment, is likely to be quite low even for those children who are slow progressors (Brahmbhatt et al, 2006;Crampin et al, 2003;Ferrand et al, 2007;Schim van der Loeff et al, 2003;Stover et al, 2008;Zaba et al, 2005). There are a number of factors that suggest that the higher risk of HIV amongst these orphans is more likely the result of sexual acquisition than vertical transmission.…”

“…Surviving mothers tend to be more committed to securing their children's education than surviving fathers , and, as was also seen here, paternal orphans are more likely to remain with their surviving parent and within the extended family safety net than those children who have lost their mothers (Hosegood et al, 2007;Monasch & Boerma, 2004). One limitation with these data is that we are not able to assess the impact of orphanhood, and particularly maternal orphaning, on educational attainment as all participants were in school (Andrews et al, 2006;Bicego et al, 2003;Case & Ardington, 2006;Ferrand et al, 2007;Floyd et al, 2007;Foster & Williamson, 2000;Gregson et al, 2005;. Orphans attending school may be very different from orphans in the community, however by selecting school orphans and comparing them to schoolattending children we have controlled for a number of other socio-demographic and economic factors.…”