The Clinical Features of Paediatric HIV/AIDS at Presentation at the University of Abuja Teaching Hospital, Gwagwalada
Background: The reported geographical differences in the HIV-1 sub-type across the continent and the entire world makes it necessary to investigate whether the clinical presentation and outcome of such presentation can demonstrate differences in the multiple sub- type of HIV-1 infection. To determine whether the clinical presentations and outcome of HIV/AIDS in children in Abuja, Nigeria conforms with reports from elsewhere both within and outside the country. Method: A one- year prospective study of HIV infected children attending the University of Abuja Teaching Hospital (UATH), Gwagwalada, from November 2006 to October 2007,was carried out to determine the clinical presentation and outcome of such presentation in the area. Results: A total of 173 patients were diagnosed with signs and symptoms of HIV/AIDS and on antiretroviral therapy (ARVT). There were 90 (52.0%) males and 83 (48.0%) females giving a male to female ratio of 1.1:1. Less than 5 years constituted 81.5% of paediatric patients seen, with less than 2 years responsible for 52.0% of cases, and 11.8% being those between the ages of 10-15 years. The commonest presenting complains were that of recurrent fever (80.3%), progressive weight loss (77.5%), and persistent diarrhoea (69.1%). Chronic cough (62.2%) and skin rashes (52.7%) were equally common. While persistent diarrhoea, oral thrush, discharging ear, and failure to thrive were commoner in children less than two years, generalised lymphadenopathy, skin rashes and parotid swelling were commoner in older children. Mortality rate was found to be 3.5%, while WHO case definition for paediatric HIV/AIDS in African setting was found to be sensitive with low specificity and positive predictive value (PPV). Conclusion: Clinical presentation of paediatric HIV/AIDS appears similar with reports from other centers in spite of the wide variation in HIV-1 sub-types. Mortality was also found to be low. This was attributed largely to the availability of free antiretroviral drugs (ARVD), potent antibiotics and anti-fungal agents which were made freely available to HIV infected patients. The findings underscore the need for government to extend such services to HIV/AIDS patients across the country as a major way of reducing the sufferings of this scourge in children..
Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 433-438