HIV infection in severely malnourished children in Kumasi, Ghana: a cross-sectional prospective study
Identifieur interne : 000269 ( Pmc/Curation ); précédent : 000268; suivant : 000270HIV infection in severely malnourished children in Kumasi, Ghana: a cross-sectional prospective study
Auteurs : Serwah Bonsu Asafo-Agyei [Ghana] ; Sampson Antwi [Ghana] ; Samuel Blay Nguah [Ghana]Source :
- BMC Pediatrics [ 1471-2431 ] ; 2013.
Abstract
The Human Immunodeficiency Virus (HIV) epidemic has adversely affected the nutritional status and mortality of children in Africa. This study assessed the disease burden, predictive clinical features and outcomes for children with severe acute malnutrition (SAM) and concomitant HIV infection.
This was a cross-sectional prospective study of children with SAM aged between 3 months and 13 years admitted to the nutritional rehabilitation unit (NRU) of Komfo Anokye Teaching Hospital. Socio-demographic, anthropometric and clinical data were documented and HIV serostatus established with 2 rapid HIV antibody tests and Enzyme-linked immunosorbent assay, if indicated. HIV viral polymerase chain reaction testing was not available at the time of the study. Logistic regression analyses were used to identify significant clinical predictors of HIV seropositivity.
Sixty-seven (27.2%, 95% CI = 21.8-33.3%) of the 246 study children had positive HIV antibody results. Uptake of provider-initiated HIV testing and counselling was 100%. Amongst children aged 18 months and over, the HIV seroprevalence was 28.3% (30/106). HIV seropositivity was strongly associated with prolonged fever, cough and diarrhoea; oral thrush, generalised lymphadenopathy and pulmonary tuberculosis (p value < 0.001 for all parameters). The presence of ≥ 3 of the first 5 aforementioned parameters was highly specific (98.3-100%) for HIV seropositivity in study children. HIV seropositivity was also significantly associated with cough, vomiting, lethargy/altered consciousness, skin rash and hepatomegaly (p value < 0.05 for all parameters). Overall mortality rate was 17.5%, with HIV seropositive children having a significantly higher mortality rate (37.8% versus 10.1%; p value < 0.001) and a lower rate of weight gain (2.4 g/kg/day versus 7.0 g/kg/day; p value < 0.001).
HIV testing was well accepted by parents/carers and should be offered in all NRUs. There was a high HIV seroprevalence among children with SAM and a significantly poorer outcome in mortality and weight gain. Some clinical features were identified to be predictive of HIV seropositivity and could be useful as indicators to prompt further investigation and/or referral in resource limited settings where HIV test kits are unavailable. This would aid in the early detection and comprehensive management of the HIV seropositive child with SAM.
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DOI: 10.1186/1471-2431-13-181
PubMed: 24206638
PubMed Central: 3828476
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">HIV infection in severely malnourished children in Kumasi, Ghana: a cross-sectional prospective study</title><author><name sortKey="Asafo Agyei, Serwah Bonsu" sort="Asafo Agyei, Serwah Bonsu" uniqKey="Asafo Agyei S" first="Serwah Bonsu" last="Asafo-Agyei">Serwah Bonsu Asafo-Agyei</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea></affiliation></author><author><name sortKey="Antwi, Sampson" sort="Antwi, Sampson" uniqKey="Antwi S" first="Sampson" last="Antwi">Sampson Antwi</name><affiliation wicri:level="1"><nlm:aff id="I2">School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea></affiliation></author><author><name sortKey="Nguah, Samuel Blay" sort="Nguah, Samuel Blay" uniqKey="Nguah S" first="Samuel Blay" last="Nguah">Samuel Blay Nguah</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24206638</idno><idno type="pmc">3828476</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828476</idno><idno type="RBID">PMC:3828476</idno><idno type="doi">10.1186/1471-2431-13-181</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000270</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000270</idno><idno type="wicri:Area/Pmc/Curation">000269</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000269</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">HIV infection in severely malnourished children in Kumasi, Ghana: a cross-sectional prospective study</title><author><name sortKey="Asafo Agyei, Serwah Bonsu" sort="Asafo Agyei, Serwah Bonsu" uniqKey="Asafo Agyei S" first="Serwah Bonsu" last="Asafo-Agyei">Serwah Bonsu Asafo-Agyei</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea></affiliation></author><author><name sortKey="Antwi, Sampson" sort="Antwi, Sampson" uniqKey="Antwi S" first="Sampson" last="Antwi">Sampson Antwi</name><affiliation wicri:level="1"><nlm:aff id="I2">School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea></affiliation></author><author><name sortKey="Nguah, Samuel Blay" sort="Nguah, Samuel Blay" uniqKey="Nguah S" first="Samuel Blay" last="Nguah">Samuel Blay Nguah</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Pediatrics</title><idno type="eISSN">1471-2431</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The Human Immunodeficiency Virus (HIV) epidemic has adversely affected the nutritional status and mortality of children in Africa. This study assessed the disease burden, predictive clinical features and outcomes for children with severe acute malnutrition (SAM) and concomitant HIV infection.</p></sec><sec><title>Methods</title><p>This was a cross-sectional prospective study of children with SAM aged between 3 months and 13 years admitted to the nutritional rehabilitation unit (NRU) of Komfo Anokye Teaching Hospital. Socio-demographic, anthropometric and clinical data were documented and HIV serostatus established with 2 rapid HIV antibody tests and Enzyme-linked immunosorbent assay, if indicated. HIV viral polymerase chain reaction testing was not available at the time of the study. Logistic regression analyses were used to identify significant clinical predictors of HIV seropositivity.</p></sec><sec><title>Results</title><p>Sixty-seven (27.2%, 95% CI = 21.8-33.3%) of the 246 study children had positive HIV antibody results. Uptake of provider-initiated HIV testing and counselling was 100%. Amongst children aged 18 months and over, the HIV seroprevalence was 28.3% (30/106). HIV seropositivity was strongly associated with prolonged fever, cough and diarrhoea; oral thrush, generalised lymphadenopathy and pulmonary tuberculosis (p value < 0.001 for all parameters). The presence of ≥ 3 of the first 5 aforementioned parameters was highly specific (98.3-100%) for HIV seropositivity in study children. HIV seropositivity was also significantly associated with cough, vomiting, lethargy/altered consciousness, skin rash and hepatomegaly (p value < 0.05 for all parameters). Overall mortality rate was 17.5%, with HIV seropositive children having a significantly higher mortality rate (37.8% versus 10.1%; p value < 0.001) and a lower rate of weight gain (2.4 g/kg/day versus 7.0 g/kg/day; p value < 0.001).</p></sec><sec><title>Conclusions</title><p>HIV testing was well accepted by parents/carers and should be offered in all NRUs. There was a high HIV seroprevalence among children with SAM and a significantly poorer outcome in mortality and weight gain. Some clinical features were identified to be predictive of HIV seropositivity and could be useful as indicators to prompt further investigation and/or referral in resource limited settings where HIV test kits are unavailable. This would aid in the early detection and comprehensive management of the HIV seropositive child with SAM.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Antwi, S" uniqKey="Antwi S">S Antwi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Beisel, Wr" uniqKey="Beisel W">WR Beisel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Angami, K" uniqKey="Angami K">K Angami</name></author><author><name sortKey="Reddy, Sv" uniqKey="Reddy S">SV Reddy</name></author><author><name sortKey="Singh, Ki" uniqKey="Singh K">KI Singh</name></author><author><name sortKey="Singh, Nb" uniqKey="Singh N">NB Singh</name></author><author><name sortKey="Singh, Pi" uniqKey="Singh P">PI Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bachou, H" uniqKey="Bachou H">H Bachou</name></author><author><name sortKey="Tyllesk R, T" uniqKey="Tyllesk R T">T Tylleskär</name></author><author><name sortKey="Downing, R" uniqKey="Downing R">R Downing</name></author><author><name sortKey="Tumwine, Jk" uniqKey="Tumwine J">JK Tumwine</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ticklay, Im" uniqKey="Ticklay I">IM Ticklay</name></author><author><name sortKey="Nathoo, Kj" uniqKey="Nathoo K">KJ Nathoo</name></author><author><name sortKey="Siziya, S" uniqKey="Siziya S">S Siziya</name></author><author><name sortKey="Brady, Jp" uniqKey="Brady J">JP Brady</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kessler, L" uniqKey="Kessler L">L Kessler</name></author><author><name sortKey="Daley, H" uniqKey="Daley H">H Daley</name></author><author><name sortKey="Malenga, G" uniqKey="Malenga G">G Malenga</name></author><author><name sortKey="Graham, S" uniqKey="Graham S">S Graham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Prazuck, T" uniqKey="Prazuck T">T Prazuck</name></author><author><name sortKey="Tall, F" uniqKey="Tall F">F Tall</name></author><author><name sortKey="Nacro, B" uniqKey="Nacro B">B Nacro</name></author><author><name sortKey="Rochereau, A" uniqKey="Rochereau A">A Rochereau</name></author><author><name sortKey="Traore, A" uniqKey="Traore A">A Traore</name></author><author><name sortKey="Sanou, T" uniqKey="Sanou T">T Sanou</name></author><author><name sortKey="Malkin, Je" uniqKey="Malkin J">JE Malkin</name></author><author><name sortKey="Apaire Marchais, V" uniqKey="Apaire Marchais V">V Apaire-Marchais</name></author><author><name sortKey="Masson, D" uniqKey="Masson D">D Masson</name></author><author><name sortKey="Dublanchet, A" uniqKey="Dublanchet A">A Dublanchet</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Amadi, B" uniqKey="Amadi B">B Amadi</name></author><author><name sortKey="Kelly, P" uniqKey="Kelly P">P Kelly</name></author><author><name sortKey="Mwiya, M" uniqKey="Mwiya M">M Mwiya</name></author><author><name sortKey="Mulwazi, E" uniqKey="Mulwazi E">E Mulwazi</name></author><author><name sortKey="Sianongo, S" uniqKey="Sianongo S">S Sianongo</name></author><author><name sortKey="Changwe, F" uniqKey="Changwe F">F Changwe</name></author><author><name sortKey="Thomson, M" uniqKey="Thomson M">M Thomson</name></author><author><name sortKey="Hachungula, J" uniqKey="Hachungula J">J Hachungula</name></author><author><name sortKey="Watuka, A" uniqKey="Watuka A">A Watuka</name></author><author><name sortKey="Walker Smith, J" uniqKey="Walker Smith J">J Walker-Smith</name></author><author><name sortKey="Chintu, C" uniqKey="Chintu C">C Chintu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Madec, Y" uniqKey="Madec Y">Y Madec</name></author><author><name sortKey="Germanaud, D" uniqKey="Germanaud D">D Germanaud</name></author><author><name sortKey="Moya Alvarez, V" uniqKey="Moya Alvarez V">V Moya-Alvarez</name></author><author><name sortKey="Alkassoum, W" uniqKey="Alkassoum W">W Alkassoum</name></author><author><name sortKey="Issa, A" uniqKey="Issa A">A Issa</name></author><author><name sortKey="Amadou, M" uniqKey="Amadou M">M Amadou</name></author><author><name sortKey="Tchiombiano, S" uniqKey="Tchiombiano S">S Tchiombiano</name></author><author><name sortKey="Pizzocolo, C" uniqKey="Pizzocolo C">C Pizzocolo</name></author><author><name sortKey="Huber, F" uniqKey="Huber F">F Huber</name></author><author><name sortKey="Diallo, S" uniqKey="Diallo S">S Diallo</name></author><author><name sortKey="Abdoulaye Mamadou, R" uniqKey="Abdoulaye Mamadou R">R Abdoulaye-Mamadou</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mutanga, Jn" uniqKey="Mutanga J">JN Mutanga</name></author><author><name sortKey="Raymond, J" uniqKey="Raymond J">J Raymond</name></author><author><name sortKey="Towle, Ms" uniqKey="Towle M">MS Towle</name></author><author><name sortKey="Mutembo, S" uniqKey="Mutembo S">S Mutembo</name></author><author><name sortKey="Fubisha, Rc" uniqKey="Fubisha R">RC Fubisha</name></author><author><name sortKey="Lule, F" uniqKey="Lule F">F Lule</name></author><author><name sortKey="Muhe, L" uniqKey="Muhe L">L Muhe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baggaley, R" uniqKey="Baggaley R">R Baggaley</name></author><author><name sortKey="Hensen, B" uniqKey="Hensen B">B Hensen</name></author><author><name sortKey="Ajose, O" uniqKey="Ajose O">O Ajose</name></author><author><name sortKey="Grabbe, Kl" uniqKey="Grabbe K">KL Grabbe</name></author><author><name sortKey="Wong, Vj" uniqKey="Wong V">VJ Wong</name></author><author><name sortKey="Schilsky, A" uniqKey="Schilsky A">A Schilsky</name></author><author><name sortKey="Lo, Y R" uniqKey="Lo Y">Y-R Lo</name></author><author><name sortKey="Lule, F" uniqKey="Lule F">F Lule</name></author><author><name sortKey="Granich, R" uniqKey="Granich R">R Granich</name></author><author><name sortKey="Hargreaves, J" uniqKey="Hargreaves J">J Hargreaves</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sadler, K" uniqKey="Sadler K">K Sadler</name></author><author><name sortKey="Kerac, M" uniqKey="Kerac M">M Kerac</name></author><author><name sortKey="Collins, S" uniqKey="Collins S">S Collins</name></author><author><name sortKey="Khengere, H" uniqKey="Khengere H">H Khengere</name></author><author><name sortKey="Nesbitt, A" uniqKey="Nesbitt A">A Nesbitt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fergusson, P" uniqKey="Fergusson P">P Fergusson</name></author><author><name sortKey="Tomkins, A" uniqKey="Tomkins A">A Tomkins</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Fergusson, P" uniqKey="Fergusson P">P Fergusson</name></author><author><name sortKey="Chinkhumba, J" uniqKey="Chinkhumba J">J Chinkhumba</name></author><author><name sortKey="Grijalva Eternod, C" uniqKey="Grijalva Eternod C">C Grijalva-Eternod</name></author><author><name sortKey="Banda, T" uniqKey="Banda T">T Banda</name></author><author><name sortKey="Mkangama, C" uniqKey="Mkangama C">C Mkangama</name></author><author><name sortKey="Tomkins, A" uniqKey="Tomkins A">A Tomkins</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Excler, Jl" uniqKey="Excler J">JL Excler</name></author><author><name sortKey="Standaert, B" uniqKey="Standaert B">B Standaert</name></author><author><name sortKey="Ngendandumwe, E" uniqKey="Ngendandumwe E">E Ngendandumwe</name></author><author><name sortKey="Piot, P" uniqKey="Piot P">P Piot</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ulasi, To" uniqKey="Ulasi T">TO Ulasi</name></author><author><name sortKey="Ebenebe, J" uniqKey="Ebenebe J">J Ebenebe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yeung, S" uniqKey="Yeung S">S Yeung</name></author><author><name sortKey="Wilkinson, D" uniqKey="Wilkinson D">D Wilkinson</name></author><author><name sortKey="Escott, S" uniqKey="Escott S">S Escott</name></author><author><name sortKey="Gilks, Cf" uniqKey="Gilks C">CF Gilks</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berggren Palme, E" uniqKey="Berggren Palme E">E Berggren Palme</name></author><author><name sortKey="Gudeta, B" uniqKey="Gudeta B">B Gudeta</name></author><author><name sortKey="Bruchfeld, J" uniqKey="Bruchfeld J">J Bruchfeld</name></author><author><name sortKey="Muhe, L" uniqKey="Muhe L">L Muhe</name></author><author><name sortKey="Giesecke, H" uniqKey="Giesecke H">H Giesecke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jeena, Pm" uniqKey="Jeena P">PM Jeena</name></author><author><name sortKey="Pillay, P" uniqKey="Pillay P">P Pillay</name></author><author><name sortKey="Pillay, T" uniqKey="Pillay T">T Pillay</name></author><author><name sortKey="Coovadia, Hm" uniqKey="Coovadia H">HM Coovadia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cotton, Mf" uniqKey="Cotton M">MF Cotton</name></author><author><name sortKey="Schaaf, Hs" uniqKey="Schaaf H">HS Schaaf</name></author><author><name sortKey="Hesseling, Ac" uniqKey="Hesseling A">AC Hesseling</name></author><author><name sortKey="Madhi, Sa" uniqKey="Madhi S">SA Madhi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Osterbauer, B" uniqKey="Osterbauer B">B Osterbauer</name></author><author><name sortKey="Kapisi, J" uniqKey="Kapisi J">J Kapisi</name></author><author><name sortKey="Bigira, V" uniqKey="Bigira V">V Bigira</name></author><author><name sortKey="Mwangwa, F" uniqKey="Mwangwa F">F Mwangwa</name></author><author><name sortKey="Kinara, S" uniqKey="Kinara S">S Kinara</name></author><author><name sortKey="Kamya, Mr" uniqKey="Kamya M">MR Kamya</name></author><author><name sortKey="Dorsey, G" uniqKey="Dorsey G">G Dorsey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chinkhumba, J" uniqKey="Chinkhumba J">J Chinkhumba</name></author><author><name sortKey="Tomkins, A" uniqKey="Tomkins A">A Tomkins</name></author><author><name sortKey="Banda, T" uniqKey="Banda T">T Banda</name></author><author><name sortKey="Mkangama, C" uniqKey="Mkangama C">C Mkangama</name></author><author><name sortKey="Fergusson, P" uniqKey="Fergusson P">P Fergusson</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Pediatr</journal-id><journal-id journal-id-type="iso-abbrev">BMC Pediatr</journal-id><journal-title-group><journal-title>BMC Pediatrics</journal-title></journal-title-group><issn pub-type="epub">1471-2431</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24206638</article-id><article-id pub-id-type="pmc">3828476</article-id><article-id pub-id-type="publisher-id">1471-2431-13-181</article-id><article-id pub-id-type="doi">10.1186/1471-2431-13-181</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>HIV infection in severely malnourished children in Kumasi, Ghana: a cross-sectional prospective study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Asafo-Agyei</surname><given-names>Serwah Bonsu</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>sbasafoagyei@gmail.com</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Antwi</surname><given-names>Sampson</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>kantwisampson@gmail.com</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Nguah</surname><given-names>Samuel Blay</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>sbnguah@gmail.com</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff><aff id="I2"><label>2</label>School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</aff><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>9</day><month>11</month><year>2013</year></pub-date><volume>13</volume><fpage>181</fpage><lpage>181</lpage><history><date date-type="received"><day>17</day><month>1</month><year>2013</year></date><date date-type="accepted"><day>31</day><month>10</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2013 Asafo-Agyei et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Asafo-Agyei et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2431/13/181"></self-uri><abstract><sec><title>Background</title><p>The Human Immunodeficiency Virus (HIV) epidemic has adversely affected the nutritional status and mortality of children in Africa. This study assessed the disease burden, predictive clinical features and outcomes for children with severe acute malnutrition (SAM) and concomitant HIV infection.</p></sec><sec><title>Methods</title><p>This was a cross-sectional prospective study of children with SAM aged between 3 months and 13 years admitted to the nutritional rehabilitation unit (NRU) of Komfo Anokye Teaching Hospital. Socio-demographic, anthropometric and clinical data were documented and HIV serostatus established with 2 rapid HIV antibody tests and Enzyme-linked immunosorbent assay, if indicated. HIV viral polymerase chain reaction testing was not available at the time of the study. Logistic regression analyses were used to identify significant clinical predictors of HIV seropositivity.</p></sec><sec><title>Results</title><p>Sixty-seven (27.2%, 95% CI = 21.8-33.3%) of the 246 study children had positive HIV antibody results. Uptake of provider-initiated HIV testing and counselling was 100%. Amongst children aged 18 months and over, the HIV seroprevalence was 28.3% (30/106). HIV seropositivity was strongly associated with prolonged fever, cough and diarrhoea; oral thrush, generalised lymphadenopathy and pulmonary tuberculosis (p value < 0.001 for all parameters). The presence of ≥ 3 of the first 5 aforementioned parameters was highly specific (98.3-100%) for HIV seropositivity in study children. HIV seropositivity was also significantly associated with cough, vomiting, lethargy/altered consciousness, skin rash and hepatomegaly (p value < 0.05 for all parameters). Overall mortality rate was 17.5%, with HIV seropositive children having a significantly higher mortality rate (37.8% versus 10.1%; p value < 0.001) and a lower rate of weight gain (2.4 g/kg/day versus 7.0 g/kg/day; p value < 0.001).</p></sec><sec><title>Conclusions</title><p>HIV testing was well accepted by parents/carers and should be offered in all NRUs. There was a high HIV seroprevalence among children with SAM and a significantly poorer outcome in mortality and weight gain. Some clinical features were identified to be predictive of HIV seropositivity and could be useful as indicators to prompt further investigation and/or referral in resource limited settings where HIV test kits are unavailable. This would aid in the early detection and comprehensive management of the HIV seropositive child with SAM.</p></sec></abstract><kwd-group><kwd>Malnutrition</kwd><kwd>HIV</kwd><kwd>AIDS</kwd><kwd>SAM</kwd><kwd>PITC</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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