HIV-1 seroprevalence among paediatric admissions at the University Teaching Hospital (UTH) - Lusaka

Abstract

The seroprevalence of human immunodeficiency virus type l(HIV-l) among paediatric admissions were studied at the University Teaching Hospital (UTH) Lusaka, Zambia during the period from 22nd November to 15th December, 1995. This was at a time when the number of admissions to the department of Paediatrics and Child Health were highest. The admission rate on average at this time of the year is 2,000 children per month. This busy period usually starts from the month of October to February each year. The study was a cross sectional survey, evaluating disease presentation among HIV-1 positive and HIV-1 negative children admitted to the department. The children were enrolled to the study using a systematic sampling method around the clock at the outpatient department. A standardized questionnaire was administered to every fifth child admitted. A consent was sought from the accompanying adult to recruit the child and test the child for HIV. Blood for laboratory tests including HIV test was collected. During the period of the study 2011 children were admitted to hospital out of which three hundred and three (303) joined the study. The overall HIV-1 seroprevalence for the study group was 30.4 percent while that for the children aged 18 months and more was 27.8 percent. There was no sex difference in the HIV-1 seroprevalence. Educational levels of the mothers was used as a proxy to determine socio-economic status of the children. The mothers who had secondary school education and higher were categorized as belonging to a group of high socio-economic class while those who had no formal education or primary school education belonged to the low socio-economic class. There was a high HIV-1 seroprevalence in children whose mothers had secondary school education or higher as compared to children born to mothers with primary school education or none. This means HIV seropositivity was more common in children from high socio-economic class than from those of low socio-economic class. The illnesses that were seen in the study period were Respiratory tract infection, Protein energy malnutrition, Malaria, Gastro-enteritis, Measles and Anaemia. RTI and Anaemia were seen more in the children who were HIV-1 seropositive than in the HIV-1 seronegative group. The mortality rate in the HIV-1 seropositive children was 15.6 percent as compared to 9.3 percent .in the HIV-1 seronegative children. The illnesses that were associated with death in both HIV seropositive and HIV seronegative children were RTI, PEM, G/E, Malaria and Measles. The main cause of death in children who were HIV-1 seropositive was RTI while PEM caused more death for those who were HIV-1 seronegative. Postmortems were not carried out to confirm the causes of death in these children.