title: Burden and cost of inpatient care for HIV-positive paediatric patients--status in the Cape Town metropole during the second week of March 1999. Paediatric HIV Census Group.
abstract: OBJECTIVE
  To determine the burden of the HIV epidemic on paediatric inpatient facilities in the teaching hospitals of the Cape metropole and tributaries to these hospitals.
  
  
  METHODS
  Second- and third-level hospitals.
  
  
  METHODS
  During the second week of March 1999 a multicentre collaborative census was performed of all paediatric beds in the teaching hospitals of Cape Town and all facilities draining to and from them.
  
  
  RESULTS
  One hundred and six HIV-infected patients were identified from a total of 1,264 beds. Thirty-nine children were in second-level beds or in a long-term residential facility. Fifty-six children were in second-level beds designated for acute care, and occupied 12% of all such beds. Ten children were in beds designated for the care of tuberculosis. Thirty-two (56%) of the acute admissions were for gastro-enteritis, and 13 (23%) were for pneumonia. In 10 children (18% of all admissions) recognised complications of HIV infection were direct causes of admission. For 29 children (35% of all admissions) the current admission was the first; the remainder had had a mean of 2.4 previous admissions. Fourteen children (25%) had received oxygen, and 26 (46%) had received intravenous therapy. Mean lifetime hospitalisation cost per infected child was calculated to be R19,712. The projected cost of a local initiative to reduce mother-to-child transmission is between R8,326 and R10,806 per vertical infection prevented.
  
  
  CONCLUSIONS
  The inpatient burden of HIV-infected children in Cape Town reflects an early stage of the epidemic. Compared with projected lifetime hospitalisation cost for infected children, an intervention to reduce vertical transmission cost would be cost effective.
authors.affiliation: Department of Paediatrics and Child Health, University of Cape Town.
authors.forename: P
authors.initials: P
authors.lastname: Roux
authors.forename: L
authors.initials: L
authors.lastname: Henley
authors.forename: M
authors.initials: M
authors.lastname: Cotton
authors.forename: B
authors.initials: B
authors.lastname: Eley
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data; D002648:Child; D015362:Child Nutrition Disorders / Q000821:virology; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000635:transmission; D017721:Hospital Costs; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008427:Maternal Health Services / Q000191:economics; D011247:Pregnancy; D013019:South Africa / Q000453:epidemiology