title: Otorhinolaryngological findings and hearing in HIV-positive and HIV-negative children in a developing country.
abstract: The otorhinolaryngological (ORL) manifestations of Human Immunodeficiency virus (HIV) are common, but remain poorly characterized among children of Sub-Saharan Africa, where 90% of new pediatric infections occur. Our objective was to compare ORL findings and hearing in HIV-positive and -negative children of Luanda, Angola, using a comparative study of 78 outpatients from the HIV polyclinic and of 78 age- and sex-matched controls in a pediatric hospital with interview, general and ORL examination, brainstem auditory evoked potentials, and at age >5 years pure tone open-air audiometry. ORL pathology emerged in 92% of HIV-positive and 78% (p = 0.02) of control children. HIV-associated ORL findings comprised dental caries (56 vs. 32%; p = 0.0009), cervical lymphadenopathy >1 cm (45 vs. 10%; p < 0.0001), facial skin lesions (32 vs. 5.1%; p < 0.0001), chronic suppurative otitis media (26 vs. 3.8%; p = 0.0002), dry tympanic membrane perforations (9 vs. 1%; p = 0.03), tonsils of Mallampati score 0-1 (87 vs. 64%; p = 0.0009), and bilateral hearing loss of >25 dB (13 vs. 1%; p = 0.009). Other HIV-associated characteristics included ear pain (44 vs. 27%; p = 0.006), earlier otorrhea episodes (34 vs. 17%; p = 0.004), tuberculosis (29 vs. 2.6%; p < 0.0001), and pneumonia (22 vs. 2.6%; p = 0.0003). ORL pathology appeared usual in both HIV-positive and -negative children. However, the overall high frequency and severity of the findings among the HIV-positive children require regular inclusion of the ORL area in these children's clinical evaluation.
authors: Medical Faculty, Helsinki University, Helsinki, Finland. anni.taipale@fimnet.fi
authors: Anni
authors: A
authors: Taipale
authors: Tuula
authors: T
authors: Pelkonen
authors: Marko
authors: M
authors: Taipale
authors: Irmeli
authors: I
authors: Roine
authors: Luis
authors: L
authors: Bernardino
authors: Heikki
authors: H
authors: Peltola
authors: Anne
authors: A
authors: Pitkäranta
mesh_terms: D000810:Angola / Q000453:epidemiology; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006678:HIV; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology; D006309:Hearing / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies