Abstract:
HIV is a prominent infection in society and its health implications are seen in the
paediatric wards daily. Despite its multi-system effect on the body, it particularly
results in many respiratory infections. Effective understanding of the disease profile
and management of patients with HIV relies on correct statistics and proper use of
resources.
Since the introduction of anti-retrovirals in 2004 in South Africa, the impact of
HIV/AIDS on respiratory disease needs to be re-evaluated. The purpose of the study
is to understand the disease profile of children with HIV/AIDS with regard to the
presence of respiratory conditions with which they present, the need for chest
physiotherapy and their health status.
Of the 125 patients recruited in this study 55% were boys, average age was 20.55
months (SD= 23.64), average length of hospital stay of 2 ½ weeks (mean=18.76,
SD=19.19), 80% discharged and 9.6% died. The most common respiratory
conditions presented included bacterial pneumonia (66.4%), tuberculosis (48%) and
pneumocystis jirovecii pneumonia (23.2%). The least common condition was
lymphoid interstitial pneumonitis (4.8%). Two thirds of the children (68.8%)
presented with a high burden of disease. Physiotherapy treatment was indicated for
96% of the patients mainly due to excess secretions and poor air entry. About forty
percent (40.8%) of children were taking anti-retrovirals with an average length of use
of 9.81 months (SD=11.61). Three out of four (75%) mothers were not involved in a
PMTCT program. The analysis of immune status revealed a mean CD4 percentage
17.33% (SD=10.96), CD4 absolute 631.36 cell/mm3 (SD=610.36) and viral load 2.6
million copies /ml (SD=9.08 million copies/ml).
A higher burden of disease was related to the use of anti-retrovirals, a lower
immunity, female patients, longer length of hospital stay and incidences of mortality
occuring at later periods of hospital stay. Results of this study highlight the characteristics of respiratory disease burden
among children with HIV in a South African setting in a post HAART era.
