TITLE:
Late Diagnosis of HIV Infection in Children: Prevalence and Outcome
AUTHORS:
Aymar Pierre Gildas Oko, Antoinette Géraldine Olandzobo, Gaston Ekouya-Bowassa, Mamadou Ildevert Cyriaque Ndjobo, Lucie Ollandzobo, Nelly Pandzou-Guembo, Letitia Lombet, Jeysse Pierre Yoleine Poathy, Steve Vassili Missambou-Mandilou, Aurore Mbika-Cardorelle, Georges Marius Moyen
KEYWORDS:
Late Diagnosis, HIV Infection, Prevalence, Mortality, Child, Brazzaville
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.7 No.4,
December
15,
2017
ABSTRACT: Background: Late diagnosis of HIV infection is an important cause of death in
children. Objectives: To determine the prevalence of late diagnosed HIV
infection in children, describe the socio-demographic characteristics and to
analyze outcome of these children. Methods: From January 2015 to October
2016, we carried out a prospective analytical study in the pediatric departments
of University Teaching Hospital of the Brazzaville. Late diagnosed HIV children
were selected for this work. Data analysis was performed in univariate and
multivariate with Epi Info 7.2.1. Results: Of the 6058 hospitalized
children, 103 (1.7%) were selected, 57.3% were boys; the median age was 21.9
months (IQR, 17.8 - 76.7 months). Children of low socio-economic status accounted for 68.0%,
those motherless: 43.7%. None of the children were tested for HIV before
hospitalization. Mothers had a low education level in 60.2% of cases and were unaware of prevention of
mother-to-child transmission (PMTCT): 60.3%. Children mostly showed
signs of stages 4 (49.5%), and 3 (31.1%) of HIV infection, immunodeficiency was
severe for 68.0% of children. Children discharged from the hospital accounted
for 62.1% of which 15.53% against medical advice. The case fatality rate was
37.9%. The risk factors for death in univariate analysis were: age = 8.66), maternal death (OR = 17.93),
severe malnutrition (OR = 66.07), clinical stages 4 (OR = 66.07) and severe
immunodeficiency (OR = 17.37). The main pathologies responsible for death were respiratory infections (38.5%) and diarrheal diseases
(30.8%). Conclusion: Improvement of PMTCT program effectiveness, universal
access to early detection and antiretroviral therapy for infants are needed to reduce the number of late diagnosed
HIV-children and therefore HIV-related morbidity and mortality.