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HIV infection in malnourished children in Harare, Zimbabwe
I M Ticklay1, K J Nathoo, S Siziya
1Division of Paediatrics, Harare Hospital.
Insights
Human immunodeficiency virus (HIV) infection significantly impacts childhood malnutrition. HIV-infected malnourished children presented with marasmus and specific clinical signs like pneumonia and oral thrush, highlighting the epidemic's effect on nutritional health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood malnutrition is a significant global health concern.
- The Human Immunodeficiency Virus (HIV) epidemic has a profound impact on child health, particularly in developing regions.
- Understanding the interplay between HIV infection and malnutrition in children is crucial for effective interventions.
Purpose of the Study:
- To compare socio-demographic, nutritional, and clinical features of HIV-infected and uninfected children with malnutrition.
- To identify clinical indicators predictive of HIV infection in malnourished children.
- To assess the prevalence of HIV among malnourished children admitted to Harare Hospital.
Main Methods:
- A descriptive study involving 140 children (aged >15 months) admitted to Harare Hospital.
- Children were categorized as HIV seropositive or seronegative.
- Data collected included socio-demographic information, nutritional status (marasmus, kwashiorkor), and presenting clinical features.
Main Results:
- Of 140 children, 68 (48.6%) were HIV seropositive. Socio-demographic features were similar between groups.
- Marasmus and marasmic kwashiorkor were more prevalent in HIV-infected children (p=0.001).
- Pneumonia, generalized lymphadenopathy, chronic discharging ears, and oral thrush were significantly more frequent in HIV-infected children (p<0.01).
Conclusions:
- HIV infection is highly prevalent among malnourished children, underscoring the epidemic's impact on childhood nutritional morbidity.
- Clinical signs such as marasmus, generalized lymphadenopathy, oral thrush, and discharging ears are significant predictors of HIV infection in this population.
- Early identification and management of HIV in malnourished children are essential to mitigate adverse health outcomes.
Abstract:
A descriptive study was undertaken to compare the pattern of socio-demographic features, nutritional profile and presenting features of HIV infected and uninfected children with malnutrition. A total of 140 children aged above 15 months admitted to the paediatric wards, Harare Hospital from December 1993 to February 1994 were studied. Sixty eight (48.6%) children were found to be HIV seropositive and 72 negative. The socio-demographic features were similar in both groups. Marasmus and marasmic kwashiorkor were predominant in the HIV infected children, whilst the majority (64%) of the children in the HIV uninfected group had kwashiorkor (p = 0.001). Pneumonia, lymphadenopathy, chronic discharging ears and oral thrush were significantly more frequent in the HIV infected than in the non HIV infected children (p < 0.01). Factors predictive of HIV infection were marasmus (OR 2.72, 95% CI 1.04-8.10), generalised lymphadenopathy (OR 2.77, 95% CI 1.16-6.64), oral thrush (OR 2.72, 95% CI 1.16-6.37) and discharging ears (OR 6.05, 95% CI 1.89-19.42) with a sensitivity of 57.6% (95% CI 45.7%-69.5%), specificity of 71.4% (95% CI 60.8% 82.0%). The high prevalence of HIV infection among the malnourished children emphasises the impact of the HIV epidemic on childhood nutritional morbidity.