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Published on: October 31, 2010

Paediatric HIV in central Sudan: high sero-prevalence and poor performance of clinical case definitions

Ahmed Abdalla Abbas1, Nour Elhouda Ata Alla Alla Gabo, Zahir Osman Eltahir Babiker

  • 1Faculty of Medicine, University of Medical Sciences and Technology, PO Box 12810, Khartoum, Sudan. ahmedabbas08@hotmail.com

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
|October 28, 2009
PubMed

Insights

Clinical case definitions (CCDs) for human immunodeficiency virus (HIV) screening in hospitalized children in Sudan showed poor performance. Improving access to HIV serology testing is recommended due to high HIV prevalence in this population.

Area of Science:

  • Paediatric infectious diseases
  • Clinical diagnostics
  • Epidemiology

Background:

  • Paediatric clinical case definitions (CCDs) are proposed screening tools for human immunodeficiency virus (HIV) in resource-limited settings.
  • The effectiveness of different CCDs in acutely hospitalized children requires evaluation.

Purpose of the Study:

  • To assess the performance of the World Health Organisation CCD (WHO-CCD), Bloemfontein CCD (B-CCD), and a modified B-CCD (MB-CCD) against HIV serology in hospitalized children.
  • To determine the HIV sero-prevalence in this paediatric population in central Sudan.

Main Methods:

  • A cohort study of 106 consecutive acute paediatric admissions was conducted over 3 months in a central Sudanese teaching hospital.
  • Performance metrics (sensitivity and specificity) of WHO-CCD, B-CCD, and MB-CCD were compared with HIV serology results.

Main Results:

  • CCDs demonstrated relatively high specificity: WHO-CCD (96.0%), B-CCD (88.0%), and MB-CCD (74.0%).
  • However, sensitivities were poor across all CCDs: WHO-CCD (16.7%), B-CCD (33.3%), and MB-CCD (66.7%).
  • The HIV sero-prevalence was notably high at 5.7%.

Conclusions:

  • Clinical case definitions performed inadequately for HIV screening in acutely hospitalized children in central Sudan when compared to serology.
  • There is a critical need to enhance access to accurate HIV serological diagnostic tools for children in this region.
  • The significant HIV sero-prevalence highlights challenges for public health policy and necessitates further investigation.
Abstract

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