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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905
EISSN: 1680-6905
Vol. 12, No. 3, 2012, pp. 259-267
Bioline Code: hs12043
Full paper language: English
Document type: Research Article
Document available free of charge

African Health Sciences, Vol. 12, No. 3, 2012, pp. 259-267

 en Clinical predictors of HIV infection in hospitalized children aged 2 - 18 months in Harare, Zimbabwe
Nathoo, KJ; Rusakaniko, S; Tobaiwa, O; Mujuru, HA; Ticklay, I & Zijenah, L

Abstract

Background: In Africa without antiretroviral treatment more than half of the HIV infected children die by 2 years. The recommended HIV virological testing for early infant diagnosis is not widely available in developing countries therefore a presumptive diagnosis is made in infants presenting with symptoms suggestive of HIV disease.
Objectives: To identify presenting signs and symptoms predictive of HIV infection in hospitalized children aged between 2- 18 months at Harare Hospital, Zimbabwe.
Methods: In a cross sectional study the baseline clinical information was collected and HIV infection confirmed using DNA PCR. Multiple logistic regression analysis was used to identify significant predictors of symptomatic HIV infection. Diagnostic parameters (sensitivity, specificity) and their 95% confidence intervals were calculated.
Results: 355 children with an overall median age of 6 months (IQR: 3, 10.5 months) of whom 203 (57.2%) were HIV DNA PCR positive. Clinical signs independently predictive of HIV infection were cyanosis, generalized lymphadenopathy, oral thrush, weight for age z-score <-2 and splenomegaly. The sensitivity of these signs ranged from 43-49% with a higher specificity (ranging from 72.3-89.5%).
Conclusion: Clinical identification using individual signs for probable HIV infection in hospitalized children below 18 months would provide an opportunity for early diagnosis, treatment.

Keywords
clinical predictors, HIV, hospitalized children

 
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