Effect of nutritional and HIV status on bacteraemia in Zimbabwean children who died at home.

From July 1992 to May 1993 a study was performed of the relationship between bacteraemia, nutritional status and HIV status in 212 out of 334 consecutive infants and children aged 0-5 years, who had died at home in Bulawayo, Zimbabwe. The remaining 122 children were excluded because the time period between death and arrival at the hospital was over 3 h. A pathogen was isolated from 92 (43%) children and Klebsiella species were most commonly isolated. A positive HIV-1 serology was found in 122 (58%) children and 110 (52%) children were malnourished. Malnutrition was significantly associated with bacteraemia at death after adjustment for the confounding effect of age and HIV status (odds ratio 4.28; 95% CI 2.27-8.07; P < 0.001). No association was found between either HIV serostatus or proven HIV infection and bacteraemia, which could not be attributed to nutritional status. Conclusion. Bacteraemia, in particular with Gram-negative bacteria, is an important cause of death in malnourished children in Zimbabwe regardless of their HIV-1 antibody status.