Clinical spectrum of paediatric HIV in Nnewi, Nigeria.
BACKGROUND
HIV/AIDS is increasingly becoming a predominant cause of childhood morbidity and mortality in this part of the world.


METHODS
A descriptive, prospective study was carried out at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeast Nigeria, to ascertain the clinical features and probable modes of transmission of HIV infection in Children.


RESULTS
Out of 128 HIV -infected children, 53.1% were males and 46.9% females, giving a male: female ratio 1.1:1. They were aged from 3 months to 16 years, with a mean of 4.78 (+/- 3.97) years. Those in the 1-5 year age bracket made up 47.7%. The presumed route of infection was mother-to-child in 79.7% and blood transfusion in 16.4%. Majority (82.0%) presented with WHO clinical stage 3 disease and 55.7% were severely immunosuppressed. The most frequent clinical features were recurrent/persistent fever, persistent cough,weight loss/failure to thrive and generalised lymphadenopathy. There was co-infection with tuberculosis in 15.6% of patients. Eighteen patients (14.0%) were lost to follow up. Six children (4.7%) died during the period under review. They all presented in WHO stage 3 and 4. A hundred percent of the dead children had severe weight loss, 83.3% had generalized lymphadenopathy and recurrent or persistent fever respectively. Fifty percent presented with diarrhea and oral thrush. There was no gender difference in mortality. Mortality was highest among infants.


CONCLUSIONS
The high rate of vertical transmission of HIV reinforces the need for effective PMTCT interventions in reducing the incidence of HIV in children. A high index of suspicion and awareness of modes of presentation of HIV infection in children is needed for early diagnosis of those infected with HIV.
Ugochukwu
E F
EF
Department of Paediatrics Nnanmdi Azikiwe University Teaching Hospital PMB 5025, Nnewi, Anambra State, Nigeria. efugochukwu@yahoo.co.uk
D000293:Adolescent; D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D011446:Prospective Studies; D017678:Sex Distribution; D016019:Survival Analysis