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Mortality among HIV-infected paediatric patients in Barbados
1Department of Paediatrics, Queen Elizabeth Hospital, Martindales Road, St Michael, Barbados, West Indies. cedwards@sunbeach.net
Insights
High mortality in pediatric HIV/AIDS patients in Barbados was observed, with lower respiratory infections being a key cause of death. The study highlights the urgent need for improved resources and anti-retroviral therapy access for these children.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Acquired Immunodeficiency Syndrome (AIDS) is a leading cause of death in children in developing nations.
- Understanding pediatric HIV mortality patterns is crucial for targeted interventions.
Purpose of the Study:
- To review mortality patterns in Human Immunodeficiency Virus (HIV)-infected pediatric patients in Barbados.
- To analyze causes of death and hospitalization trends over a 15-year period.
Main Methods:
- Retrospective analysis of hospitalization records for HIV-infected children (<16 years) who died.
- Data extraction on hospitalizations, duration, and causes of death from a specific database.
Main Results:
- 39 deaths (65%) occurred among 60 diagnosed HIV-infected children.
- Mortality was highest in infants (<1 year) and during 1989-1995; no patients received anti-retroviral therapy.
- Lower respiratory tract infections, gastroenteritis, and septicaemia were primary causes of death.
Conclusions:
- A high mortality rate persists among pediatric HIV/AIDS patients in Barbados.
- Lower respiratory tract infections significantly contribute to mortality.
- Improved resources, particularly anti-retroviral therapy, are essential for managing pediatric HIV/AIDS.
Abstract:
Since the onset of the HIV epidemic, AIDS has become the leading cause of mortality in the paediatric age group in many developing countries. The main objective of this study was to review the mortality in HIV-infected paediatric patients in Barbados. It is a retrospective analysis of the hospitalization course of HIV-infected paediatric patients aged < 16 years who died during a 15-year period of surveillance. Using a specific database, information pertaining to number and duration of hospitalizations, and cause of death were analyzed. There were 39 (65%) deaths among 60 HIV-infected patients diagnosed during the period of study. Twenty-one (54%) were male and 18 (46%) were female. Twenty-seven (69%) case records were retrieved for analysis. The highest mortality (56%) was among patients aged < 1 year and between 1989 and 1995. Hospitalizations averaged three per patient. No patient received anti-retroviral therapy. Nineteen (70%) patients died during hospitalization on the paediatric ward. Lower respiratory tract infections suspected to be Pneumocystis carinii, gastroenteritis and septicaemia were the most frequent diagnoses at the time of death. The annual mortality ranged between 0 and 1.7 (mean 0.7) per 1000 live births. The overall mortality rate was high among HIV-infected paediatric patients, with lower respiratory tract infections being implicated as a major contributing cause of death. Results of this study definitely indicate a need for improved resources in the management of paediatric HIV/AIDS cases, especially focussing on the availability and administration of anti-retroviral therapy.