title: Clinical predictors of HIV infection in hospitalized children aged 2-18 months in Harare, Zimbabwe.
abstract: BACKGROUND
  In Africa without antiretroviral treatment more than half of the HIV infected children die by 2 years. The recommended HIV virological testing for early infant diagnosis is not widely available in developing countries therefore a presumptive diagnosis is made in infants presenting with symptoms suggestive of HIV disease.
  
  
  OBJECTIVE
  To identify presenting signs and symptoms predictive of HIV infection in hospitalized children aged between 2- 18 months at Harare Hospital, Zimbabwe.
  
  
  METHODS
  In a cross sectional study the baseline clinical information was collected and HIV infection confirmed using DNA PCR. Multiple logistic regression analysis was used to identify significant predictors of symptomatic HIV infection. Diagnostic parameters (sensitivity, specificity) and their 95% confidence intervals were calculated.
  
  
  RESULTS
  355 children with an overall median age of 6 months (IQR: 3, 10.5 months) of whom 203 (57.2%) were HIV DNA PCR positive. Clinical signs independently predictive of HIV infection were cyanosis, generalized lymphadenopathy, oral thrush, weight for age z-score <-2 and splenomegaly. The sensitivity of these signs ranged from 43-49% with a higher specificity (ranging from 72.3-89.5%).
  
  
  CONCLUSIONS
  Clinical identification using individual signs for probable HIV infection in hospitalized children below 18 months would provide an opportunity for early diagnosis, treatment.
authors: Department of Paediatrics, University of Zimbabwe, College of Health Sciences, Zimbabwe. knathoo@mweb.co.zw
authors: K J
authors: KJ
authors: Nathoo
authors: S
authors: S
authors: Rusakaniko
authors: O
authors: O
authors: Tobaiwa
authors: H A
authors: HA
authors: Mujuru
authors: I
authors: I
authors: Ticklay
authors: L
authors: L
authors: Zijenah
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015030:Zimbabwe / Q000453:epidemiology
keywords: HIV; clinical predictors; hospitalized children
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