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Late Diagnosis of HIV Infection in Children: Prevalence and Outcome

Open Journal of Pediatrics 2017年第4期7卷 331-344页

作者： 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 Department of Pediatrics Teaching Hospital Center (THC) of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Hospital Center of Loandjili Pointe-Noire Congo

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 < 12 months (OR = 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.

关键词： Late Diagnosis HIV Infection Prevalence Mortality Child Brazzaville

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