OBJECTIVE: To define a clinical profile indicative of HIV infection in a population of severely malnourished children in Burkina Faso. A total of 433 children (average age, 19 months) were recruited at the Sanou Souro National Hospital, Bobo Dioulasso, Burkina Faso. RESULTS: Sixty-three per cent presented with marasmus, 13% with kwashiorkor and 24% with both forms of malnutrition. The prevalence of HIV infection in children aged over 12 months was 13.8%, with a marked predominance of HIV-1 (95.8%). Mother-to-child transmission was proven in 77% of the cases; in 10% of the observed paediatric AIDS cases, transmission may have occurred through multi-injections with contaminated equipment. Marasmus was the form of malnutrition most frequently associated with HIV (P < 0.001); its severity was exacerbated by HIV infection. Adenopathy (P < 0.0001), oral candidiasis (P < 0.0006), skin disorders (P < 0.01) and hepatomegaly (P = 0.01) appeared to be significantly related to HIV infection. Discriminant analysis revealed that the presence of adenopathies was the strongest indicator symptom of HIV infection. Multivariate analysis revealed that a clinical profile of marasmus, adenopathies and oral candidiasis (specificity, 82%) was indicative of HIV infection in this population. The short-term clinical prognosis was poor and usually led to the death of the child when seropositive (P < 0.001). CONCLUSIONS: Among children exhibiting severe malnutrition, HIV-positive children are distinguished by a high horizontal transmission rate, a high specific clinical profile and a very poor prognosis.
OBJECTIVE: To define a clinical profile indicative of HIV infection in a population of severely malnourished children in Burkina Faso. A total of 433 children (average age, 19 months) were recruited at the Sanou Souro National Hospital, Bobo Dioulasso, Burkina Faso. RESULTS: Sixty-three per cent presented with marasmus, 13% with kwashiorkor and 24% with both forms of malnutrition. The prevalence of HIV infection in children aged over 12 months was 13.8%, with a marked predominance of HIV-1 (95.8%). Mother-to-child transmission was proven in 77% of the cases; in 10% of the observed paediatric AIDS cases, transmission may have occurred through multi-injections with contaminated equipment. Marasmus was the form of malnutrition most frequently associated with HIV (P < 0.001); its severity was exacerbated by HIV infection. Adenopathy (P < 0.0001), oral candidiasis (P < 0.0006), skin disorders (P < 0.01) and hepatomegaly (P = 0.01) appeared to be significantly related to HIV infection. Discriminant analysis revealed that the presence of adenopathies was the strongest indicator symptom of HIV infection. Multivariate analysis revealed that a clinical profile of marasmus, adenopathies and oral candidiasis (specificity, 82%) was indicative of HIV infection in this population. The short-term clinical prognosis was poor and usually led to the death of the child when seropositive (P < 0.001). CONCLUSIONS: Among children exhibiting severe malnutrition, HIV-positive children are distinguished by a high horizontal transmission rate, a high specific clinical profile and a very poor prognosis.
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Keywords:
Acquired Immunodeficiency Syndrome; Africa; Africa South Of The Sahara; Age Factors; Burkina Faso; Child; Demographic Factors; Developing Countries; Diseases; Epidemiology; Examinations And Diagnoses; French Speaking Africa; Health; Hiv Infections; Infant; Malnutrition; Measurement; Nutrition Disorders; Physical Examinations And Diagnoses; Population; Population Characteristics; Prevalence; Public Health; Research Methodology; Research Report; Signs And Symptoms; Viral Diseases; Western Africa; Youth
Authors: Munyaradzi P Mapingure; Sia Msuya; Nyaradzai E Kurewa; Marshal W Munjoma; Noel Sam; Mike Z Chirenje; Simbarashe Rusakaniko; Letten F Saugstad; Sake J de Vlas; Babill Stray-Pedersen Journal: J Int AIDS Soc Date: 2010-11-16 Impact factor: 5.396
Authors: Cécile Alexandra Peltier; Christine Omes; Patrick Cyaga Ndimubanzi; Gilles François Ndayisaba; Sara Stulac; Vic Arendt; Olivier Courteille; Narcisse Muganga; Kizito Kayumba; Jef Van den Ende Journal: PLoS One Date: 2009-04-24 Impact factor: 3.240