title: Prevalence of persistent microalbuminuria and associated factors among HIV infected children attending a Tertiary Hospital in Northern Tanzania: a cross sectional, analytical study.
abstract: BACKGROUND
  Human Immunodeficiency Virus (HIV) infection is a significant cause of paediatric morbidity and mortality especially in Sub-Saharan Africa. It affects the kidney by injuring the glomerular and tubular epithelial cells causing leakage of albumin in urine. Microalbuminuria is known to be an early indicator of kidney injury including HIVAN. The purpose of this study was to identify the prevalence and factors associated with microalbuminuria among HIV infected children receiving care and treatment at Kilimanjaro Christian Medical Centre (KCMC).
  
  
  METHODS
  We conducted a cross sectional hospital based analytical study at KCMC from December 2012 to April 2013. It involved children who are HIV infected attending child centred family care clinics (CCFCC). Patients' demographic and clinical characteristics were extracted from the file; physical examination performed. Urine samples were analysed for by HemoCue Albumin 201 system analyzer. Statistical package for social sciences (SPSS) version 16.0 was be used to process and analyze the data.
  
  
  RESULTS
  Three hundred thirty HIV-infected children under 18 years were recruited during the study period. Mean age was 119.4 (5-218) months. Prevalence of microalbuminuria by using HemoCue Albumin 201 analyzer was 28.8% (n = 95). Presence of microalbuminuria was significantly associated with severity of HIV disease progression according to WHO disease stage (p = 0.0015) and CD4 count less than 350 cells/µL (p = 0.044).
  
  
  CONCLUSIONS
  The study has shown that microalbuminuria is common in HIV infected children. Early screening and treatment of microalbuminuria is important to minimize the risk of developing end stage kidney disease. Children with advanced HIV disease and those with CD4 count less than 350 cells/µL should be given priority for urinary albumin screening in a setting without routine screening for microalbuminuria.
authors.affiliation: Kilimanjaro Christian Medical University College, Tumaini University Makumira P.O. Box 2240, Moshi, Tanzania.
authors.forename: Ignatus Kissima
authors.initials: IK
authors.lastname: Mosten
authors.affiliation: Kilimanjaro Christian Medical University College, Tumaini University Makumira P.O. Box 2240, Moshi, Tanzania.
authors.forename: Bernadus Carolus
authors.initials: BC
authors.lastname: Hamel
authors.affiliation: Kilimanjaro Christian Medical University College, Tumaini University Makumira P.O. Box 2240, Moshi, Tanzania ; Department of Paediatrics and Child Health, Kilimanjaro Christian Medical Centre (KCMC), P. O. Box 3010, Moshi, Tanzania.
authors.forename: Grace Damas
authors.initials: GD
authors.lastname: Kinabo
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000150:complications*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D013636:Tanzania
keywords: HIV; HIV associated nephropathy (HIVAN); Microalbuminuria; children; proteinuria