title: Pathology and causes of death in a series of human immunodeficiency virus-positive and -negative pediatric referral hospital admissions in Botswana.
abstract: BACKGROUND
  Little is known about causes of death among children seriously affected by the AIDS epidemic in southern African countries.
  
  
  METHODS
  Autopsies were performed on 47 children 1 month to 13 years of age in Francistown, Botswana, between July 1997 and July 1998.
  
  
  RESULTS
  Median age was 10 months; 68% were HIV-positive. The leading cause of death was respiratory infection, accounting for 29 of 35 (83%) deaths among HIV-positive and 8 of 12 (67%) deaths among HIV-negative children. Among HIV-positive children, Pneumocystis carinii pneumonia (PCP) was responsible for 31% of all deaths and for 48% of deaths in infants < or =1 year. Among children < or =2 years with cough and dyspnea, age < or =1 year, interstitial infiltrate and HIV positivity were highly predictive of PCP (sensitivity, 100%; specificity, 63%).
  
  
  CONCLUSIONS
  Respiratory disease accounted for most deaths in HIV-positive children. Children < or =1 year who are known or suspected to be HIV-positive and who have cough, dyspnea and pulmonary infiltrates should be treated presumptively for PCP.
authors.affiliation: BOTUSA Project, Gaborone, Botswana.
authors.forename: Naseem A
authors.initials: NA
authors.lastname: Ansari
authors.forename: Ally H
authors.initials: AH
authors.lastname: Kombe
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Kenyon
authors.forename: Loeto
authors.initials: L
authors.lastname: Mazhani
authors.forename: Nancy
authors.initials: N
authors.lastname: Binkin
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Gebrekristos
authors.forename: Samabyawo
authors.initials: S
authors.lastname: Nyirenda
authors.forename: Sebastian B
authors.initials: SB
authors.lastname: Lucas
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000401:mortality* / Q000473:pathology*; D000293:Adolescent; D001902:Botswana / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission; D011237:Predictive Value of Tests; D012141:Respiratory Tract Infections / Q000150:complications / Q000401:mortality* / Q000473:pathology*; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000401:mortality / Q000473:pathology