Impact of HIV on childhood morbidity and mortality among underfive chilren hospitalised at the University Teaching Hospital (UTH), Lusaka

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Sinyinza, Fredrick
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Zambia is among countries in the Sub-Saharan African with high HIV seroprevalence Rates. In spite an increased awareness campaign concerning the dangers of HIV/AIDS and its prevention, the infection has continued to spread. The current impact of the HIV infection on childhood morbidity and mortality is not well known, particularly in developing countries. The mode of transmission in the adult population of the Sub-Saharan region is mainly heterosexual. The commonest mode of transmission in children is by vertical transmission. The main objective of the study therefore was to look at the impact of HIV on childhood morbidity and mortality among under five children hospitalized at the University Teaching Hospital children's wing. The study was conducted in 1999 between August and October. This was a descriptive cross sectional study involving children aged between two months and five years admitted to the hospital during this period, parents/guardians of children in the study were interviewed and HIV voluntary counseling and testing services were provided. Only those children whose parents consented to a blood test for the presence of HIV antibodies were enrolled on to the study .The information obtained was recorded by using a standard questionnaire. The study revealed that most of parents were willing to know the HIV serostatus of their children as demonstrated by the 83% acceptance rate. The seroprevalence rate was 40% for children aged above I8 months (confirmed infection), and 38% for those aged below 18 months (suspected infection). The Maternal blood was not tested for HIV antibodies due to financial constraints. The magnitude of HIV infection in non-Hospitalised children still remains unknown. The leading causes of admission in HIV positive children were Protein Energy Malnutrition, Tuberculosis, Pneumonia and Diarrhea Diseases. These diseases were also the common causes of admissions in HIV negative children although the morbidity was higher in the former. The common causes of death in HIV positive children were PEM, Pneumonia, and Diarrhoea Disease. Although they were also among the common causes of death in HIV negative children, the mortality rate was much higher in HIV positive children. The overall mortality rates were 22% for HIV positive children and 14% for HIV negative children. The study has also reviewed that most of the HIV positive children had a history of having lost a sibling in their family, probably due to HIV related morbidity. In conclusion, in order to reduce the impact of HIV infection on childhood morbidity and mortality, there is need to step up more aggressive interventions so that mother to child transmission of HIV can be greatly reduced. At the time of the study the overall HIV seroprevalence rate in the community was 19.7 %.
Diseases , HIV/AIDS -- Zambia