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HIV infection among paediatric in-patients in Blantyre, Malawi

Sheryle R Rogerson1, Melissa Gladstone, Maria Callaghan

  • 1Department of Paediatrics, College of Medicine, University of Malawi, Malawi. sheryle.rogerson@rwh.org.au

Transactions of the Royal Society of Tropical Medicine and Hygiene
|July 15, 2004
PubMed

Insights

Human immunodeficiency virus (HIV) infection significantly increases hospital death risk in Malawian children. Early diagnosis and intervention are crucial for improving outcomes in pediatric HIV.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • HIV infection poses a significant threat to child survival globally.
  • Understanding the impact of HIV on pediatric hospital admissions and mortality is crucial for resource allocation and intervention strategies.

Purpose of the Study:

  • To determine the prevalence of HIV infection among children admitted to hospitals in Blantyre, Malawi.
  • To investigate the association between HIV infection and hospital admission characteristics, clinical presentation, and mortality.
  • To evaluate the utility of clinical symptoms and signs in diagnosing HIV in hospitalized children.

Main Methods:

  • A prospective study was conducted on children admitted to pediatric medical and surgical wards in Blantyre, Malawi.
  • HIV infection was diagnosed using serology, with PCR confirmation for infants under 15 months.
  • Data on demographics, clinical diagnoses, parental education, and outcomes were collected.

Main Results:

  • The prevalence of HIV infection was 18.9% (187/991) among admitted children, highest in infants under six months (32%).
  • HIV-infected children had a significantly higher mortality rate (almost 30%) compared to uninfected children (8.9%).
  • HIV was more prevalent in children with malnutrition, lower respiratory tract infections, and sepsis, but not strongly associated with malaria or surgical admissions.

Conclusions:

  • HIV infection is a major contributor to pediatric mortality in Malawi, accounting for over 40% of in-patient deaths.
  • Clinical diagnosis of HIV in children is unreliable, highlighting the need for routine testing.
  • Effective prevention and treatment strategies are essential to reduce the burden of pediatric HIV in high-prevalence settings.

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