Constraints and prospects in the management of pediatric HIV/AIDS.
BACKGROUND
Pediatric HIV/AIDS is increasing in Nigeria through mother-to-child transmission. Lack of diagnostic facility and affordability of therapy are major constraints. These factors were examined in Lagos University Teaching Hospital (LUTH) between 1996 and 2002.


METHODS
Case records of pediatric HIV/AIDS patients were examined for age, sex, mode of diagnosis, associated illnesses, treatment outcome and socioeconomic and HIV status of the parents.


RESULTS
Out of 124 cases confirmed to have HIV/AIDS, 56.5% were aged <18 months and 89.5% had > or =4 clinical features at presentation. There was an increasing trend in the number of cases from 1996 to 2002. Diagnosis was by WHO clinical criteria as no polymerase chain reaction (PCR), was done and only 12.1% had CD4+ count done. The commonest associated illness was tuberculosis (25.8%). Only 20.2% were placed on antiretroviral drugs during the period. Mothers were significantly younger than fathers (P<0.05) and were more likely to be HIV positive. High rate of discharges against medical advice and default from follow-up occurred.


CONCLUSIONS
Pediatric HIV/AIDS is on the increase at LUTH, and mothers were more HIV infected than fathers. The prohibitive cost of drugs prevented most patients from receiving therapy.
Temiye
Edamisan O
EO
Department of Paediatrics, College of Medicine of University of Lagos (CMUL), Nigeria. edatemiye2000@yahoo.co.uk
Akinsulie
Adebola O
AO
Ezeaka
Chinyere V
CV
Adetifa
Ifedayo M O
IM
Iroha
Edna O
EO
Grange
Adenike O
AO
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors
D019380:Anti-HIV Agents