Paediatric HIV/AIDS in Ile-Ife, Nigeria.
OBJECTIVE
To determine the clinical features, modes of transmission and outcome of HIV infection in children.


METHODS
A descriptive study involving prospective HIV antibody screening.


METHODS
Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, a referral centre.


METHODS
Four hundred and one consecutive children aged three days to 17 years presenting with features of immunosuppression from January 1996 to October 2001.


METHODS
HIV seroprevalence and outcome in infected children.


RESULTS
Twenty percent of the children studied were HIV seropositive. More females than males were HIV seropositive (p = 0.004). The probable mode of infection was vertical in 66, blood transfusion in 12 and sexual contacts in four; two children whose mothers were HIV seropositive had previously been transfused with unscreened blood. Of the presenting clinical features, weight loss or failure to thrive, persistent diarrhoea, and skin diseases were highly sensitive and specific with high positive predictive values. Marasmus was the only type of protein energy malnutrition seen in the infected children. Seven patients were discharged against medical advice and 26 were lost to follow up. Thirty seven (46.3%) died within four months of diagnosis mainly from pneumonia and septicaemia. Four patients are still being followed up and only one is receiving antiretroviral drugs.


CONCLUSIONS
HIV infection is a cause of morbidity and mortality in Nigerian children and the main mode of infection is vertical. The presence of any combination of persistent diarrhoea, weight loss/failure to thrive and skin manifestations should arouse suspicion and could be used as a screening test for symptomatic HIV infection in Nigerian children.
Adejuyigbe
E A
EA
Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria. ebunadejuyigbe@hotmail.com
Oyelami
O
O
Onayemi
O
O
Durosinmi
M A
MA
D000293:Adolescent; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006679:HIV Seropositivity; D015528:HIV Seroprevalence; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010372:Pediatrics; D011446:Prospective Studies; D017678:Sex Distribution