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J Int AIDS Soc. 2014 Apr 22;17:18818. doi: 10.7448/IAS.17.1.18818. eCollection 2014.

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

Collaborators (207)

Zannou DM, Ahouada C, Akakpo J, Ahomadegbé C, Bashi J, Gougounon-Houéto A, Azon-Kouanou A, Houngbé F, Sehonou J, Koumakpaï S, Alihonou F, d'Almeida M, Hodonou I, Hounhoui G, Sagbo G, Tossa-Bagnan L, Adjide H, Drabo J, Bognounou R, Dienderé A, Traore E, Zoungrana L, Zerbo B, Sawadogo AB, Zoungrana J, Héma A, Soré I, Bado G, Tapsoba A, Yé D, Kouéta F, Ouedraogo S, Ouédraogo R, Hiembo W, Gansonré M, Messou E, Gnokoro JC, Koné M, Kouakou GM, Bosse CA, Brou K, Assi AI, Chenal H, Hawerlander D, Soppi F, Minga A, Abo Y, Yoboue JM, Eholié SP, Amego MD, Andavi V, Diallo Z, Ello F, Tanon AK, Koule SO, Anzan KC, Guehi C, Aka EA, Issouf KL, Kouakou JC, N'Gbeche MS, Pety T, Avit-Edi D, Kouakou K, Moh M, Yao VA, Folquet MA, Dainguy ME, Kouakou C, Méa-Assande VT, Oka-Berete G, Zobo N, Acquah P, Kokora MB, Eboua TF, Timité-Konan M, Ahoussou LD, Assouan JK, Sami MF, Kouadio C, Renner L, Goka B, Welbeck J, Sackey A, Owiafe SN, Wejse C, Silva ZJ, Paulo J, Rodrigues A, Silva Dd, Medina C, Oliviera-Souto I, Østergaard L, Laursen A, Sodemann M, Aaby P, Fomsgaard A, Erikstrup C, Eugen-Olsen J, Maïga MY, Diakité FF, Kalle A, Katile D, Traore HA, Minta D, Cissé T, Dembelé M, Doumbia M, Fomba M, Kaya AS, Traoré AM, Traoré H, Toure AA, Dicko F, Sylla M, Berthé A, Traoré HC, Koïta A, Koné N, Coulibaly ST, Traoré M, Traoré N, Ajayi S, Alim G, Dapiap S, Otu, Igbinoba F, Benson O, Adebamowo C, James J, Obaseki, Osakede P, Olasode J, Seydi M, Sow PS, Diop B, Manga NM, Tine JM, Bassabi CC, Sy HS, Ba A, Diagne A, Dior H, Faye M, Gueye RD, Mbaye AD, Patassi A, Kotosso A, Kariyare BG, Gbadamassi G, Komi A, Mensah-Zukong KE, Pakpame P, Lawson-Evi K, Atakouma Y, Takassi E, Djeha A, Ephoévi-gah A, Djibril Sel-H, Dabis F, Bissagnene E, Arrivé E, Coffie P, Ekouevi D, Jaquet A, Leroy V, Lewden C, Sasco AJ, Amani D, Azani JC, Balestre E, Bessekon S, Bohossou F, Gilbert C, Karcher S, Gonsan JM, Carrou JL, Lenaud S, Nchot C, Malateste K, Yao AR, Siloué B, Clouet G, Dosso M, Doring A, Kouakou A, Rabourdin E, Rivenc J, Anglaret X, Ba B, Becquet R, Essanin JB, Ciaranello A, Datté S, Desmonde S, Diby JS, Gottlieb GS, Horo AG, Kangah SN, Malvy D, Meless D, Mounkaila-Harouna A, Ndondoki C, Shiboski C, Tchounga B, Thiébaut R, Wandeler G.

Author information

1
Service Pédiatrie Centre Hospitalier, Universitaire Gabriel Toure, Bamako, Mali.
2
Inserm, Centre Inserm U897 - Epidémiologie - Biostatistiques, University of Bordeaux, Bordeaux, France; University of Bordeaux, ISPED, Centre Inserm U897 - Epidémiologie - Biostatistiques, Bordeaux, France; Sophie.Desmonde@isped.u-bordeaux2.fr.
3
Service Pédiatrie, Centre National Hospitalier Universitaire, Cotonou, Bénin.
4
Hopital pour Enfants Albert Royer, Dakar, Sénégal.
5
Service Pédiatrie, Hopital Général de Gaulle, Ouagadougou, Burkina Faso.
6
Korle Bu Teaching Hospital, Accra, Ghana.
7
Inserm, Centre Inserm U897 - Epidémiologie - Biostatistiques, University of Bordeaux, Bordeaux, France; University of Bordeaux, ISPED, Centre Inserm U897 - Epidémiologie - Biostatistiques, Bordeaux, France.

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.

KEYWORDS:

Africa; HIV; hospitalization; infectious diseases; morbidity; paediatrics

PMID:
24763078
PMCID:
PMC3999943
[Indexed for MEDLINE]
Free PMC Article
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