A Ten-year Review of Paediatric HIV/AIDS among Hospitalized Children in a Nigerian Teaching Hospital

Abstract

Summary Background: Regional differences which exist in the prevalence and clinical features of paediatric AIDS worldwide make it pertinent to document findings in our environment. Objectives: To document the prevalence and clinical features of AIDS in children hospitalized in a teaching hospital situated in South-western Nigeria. Design: Retrospective study. Methods: A review of hospital records of all children with AIDS admitted to Olabisi Onabanjo University Teaching Hospital, Sagamu, between January 1996 and December 2005 was made with a view to determining the prevalence and clinical features of the disease in the area served by the hospital. Results: Thirty three children were diagnosed with ADDS out of a total of 3061 hospitalized children; a prevalence rate of 1.08 percent. The prevalence increased, though not significantly, in the second half of the study period (x2= 3.67, p = 0.055). The male: female ratio was 1:1.4 and the age range was two months to 120 months with a mean of 17.4+ 23.2 months. Fourteen (42.4 percent) were infants, 15 (45.5 percent) pre-school children and four (12.1 percent) were school-aged children. A majority (93.9 percent) of the patients were infected with the HIV-1 strain, while the route of transmission was predominantly vertical. The main clinical features at presentation were chronic diarrhoea (69.7 percent), prolonged fever (63.6 percent), chronic cough (48.5 percent) and skin rashes (39.4 percent). Fifteen (45.5 percent patients had protein energy malnutrition which was mostly marasmic in type (73.3 percent). Most (57.6 percent) of the patients belonged to the low socio-economic class, but only four patients (12.1 percent) had associated pulmonary tuberculosis. The mean duration of hospital staywas 8.8 + 6.8 days. None of the patients received antiretroviral drug therapy. Mortality was 33.3 percent with septicaemia as the major cause. Conclusion: We observed a low prevalence of paediatric AIDS but the clinical features conformed to the WHO guidelines for its case definition. Lack of access to antiretroviral therapy contributed to the high rate of mortality..