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Home >> Publications >> Reasons for hospitalization in HIV-infected children in West Africa.

Publication

Author(s):

Dicko F, Desmonde S, Koumakpai S, Dior-Mbodj H, Kouéta F, Baeta N, Koné N, Akakpo J, Signate Sy H, Ye D, Renner L, Lewden C, Leroy V; Pediatric IeDEA West Africa Working Group.

Pub Title:

Reasons for hospitalization in HIV-infected children in West Africa.

Pub Date:

Apr 22 2014

Pub Region(s):

West Africa

Journal:

Title: 
JIAS- Journal of the International AIDS Society
Link: 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999943/

PubMed: 24763078
Pub PDF: PDF icon 24763078.pdf

Abstract
INTRODUCTION:
Current knowledge on morbidity and mortality in HIV-infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV-infected children in West Africa (IeDEA West Africa collaboration).

METHODS: We performed a six-month prospective multicentre survey from April to October 2010 in five HIV-specialized paediatric hospital wards in Ouagadougou, Accra, Cotonou, Dakar and Bamako. Baseline and follow-up data during hospitalization were recorded using a standardized clinical form, and extracted from hospitalization files and local databases. Event validation committees reviewed diagnoses within each centre. HIV-related events were defined according to the WHO definitions.

RESULTS: From April to October 2010, 155 HIV-infected children were hospitalized; median age was 3 years [1-8]. Among them, 90 (58%) were confirmed for HIV infection during their stay; 138 (89%) were already receiving cotrimoxazole prophylaxis and 64 children (40%) had initiated antiretroviral therapy (ART). The median length of stay was 13 days (IQR: 7-23); 25 children (16%) died during hospitalization and four (3%) were transferred out. The leading causes of hospitalization were WHO stage 3 opportunistic infections (37%), non-AIDS-defining events (28%), cachexia and other WHO stage 4 events (25%).

CONCLUSIONS: Overall, most causes of hospitalizations were HIV related but one hospitalization in three was caused by a non-AIDS-defining event, mostly in children on ART. HIV-related fatality is also high despite the scaling-up of access to ART in resource-limited settings.

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Citation:

Dicko F, Desmonde S, Koumakpai S, Dior-Mbodj H, Kouéta F, Baeta N, Koné N, Akakpo J, Signate Sy H, Ye D, Renner L, Lewden C, Leroy V; Pediatric IeDEA West Africa Working Group. Reasons for hospitalization in HIV-infected children in West Africa. J Int AIDS Soc. 2014 Apr 22;17:18818. doi: 10.7448/IAS.17.1.18818. eCollection 2014. PubMed PMID: 24763078; PubMed Central PMCID: PMC3999943.