HIV infection, tuberculosis and workload in a general paediatric ward

Aim. To describe the impact of HIV infection and tuberculosis on the workload of a general paediatric ward at Red Cross War Memorial Children's Hospital in 2007. Methods. Prospective descriptive surveillance of the patient composition of a general paediatric ward over a 1-year period. Results. Median bed occupancy was 96.4%, and 66.7% of all patients hospitalised to the ward were less than 12 months old. Of all the admitted children, 27.6% had HIV infection, and 16.7% had tuberculosis (TB). Dual HIV and TB infection was present in 10.3% of all patients. Of all the children requiring high care, 23.1% were HIV infected. Approximately 50% of all children with HIV infection were on antiretroviral therapy. The annualised nurse-to-patient ratios were 1 registered nurse per 2.7 patients, and 1 professional nurse per 5.0 high-care patients. Fifty-six children died while in hospital, of whom 34 (60.7%) were HIV infected. Pneumonia was the main cause of death in both HIV-infected and uninfected children. Conclusion. Despite prevention of mother-to-child-transmission intervention and paediatric antiretroviral treatment programmes, HIV infection and TB contribute substantially to the general paediatric workload at the hospital. Work associated with specific nursing functions should be quantified so that patient/nurse ratios may be optimised.