title: Minimizing the risk of non-vertical, non-sexual HIV infection in children--beyond mother to child transmission.
abstract: After witnessing an episode of poor injection safety in large numbers of children in a rural under-resourced hospital in Uganda, we briefly review our own experience and that of others in investigating HIV infection in children considered unlikely to be through commonly identified routes such as vertical transmission, sexual abuse or blood transfusion. In the majority of cases, parents are HIV uninfected. The cumulative experience suggests that the problem is real, but with relatively low frequency. Vertical transmission is the major route for HIV to children. However, factors such as poor injection safety, undocumented surrogate breast feeding, an HIV-infected adult feeding premasticated food to a weaning toddler, poor hygienic practice in the home and using unsterilised equipment for minor surgical or traditional procedures are of cumulative concern.
authors.affiliation: Division of Paediatric Infectious Diseases, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa. mcot@sun.ac.za
authors.forename: Mark F
authors.initials: MF
authors.lastname: Cotton
authors.forename: Barend J
authors.initials: BJ
authors.lastname: Marais
authors.forename: Monique I
authors.initials: MI
authors.lastname: Andersson
authors.forename: Brian
authors.initials: B
authors.lastname: Eley
authors.forename: Helena
authors.initials: H
authors.lastname: Rabie
authors.forename: Amy L
authors.initials: AL
authors.lastname: Slogrove
authors.forename: Angela
authors.initials: A
authors.lastname: Dramowski
authors.forename: Hendrik Simon
authors.initials: HS
authors.lastname: Schaaf
authors.forename: Shaheen
authors.initials: S
authors.lastname: Mehtar
mesh_terms: D001942:Breast Feeding; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous / Q000009:adverse effects; D008519:Medicine, Traditional; D011247:Pregnancy; D012307:Risk Factors; D012424:Rural Population; D013523:Surgical Equipment; D014454:Uganda / Q000453:epidemiology; D014886:Weaning