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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected children and infants in northern Tanzania
Tropical Medicine and International Health, Volume 16, No. 7, Year 2011
Notification
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Description
Objective To describe the contribution of paediatric HIV and of HIV co-infections to admissions to a hospital in Moshi, Tanzania, using contemporary laboratory methods. Methods During 1year, we enrolled consecutively admitted patients aged ≥2months and <13years with current or recent fever. All patients underwent standardized clinical history taking, a physical examination and HIV antibody testing; standard aerobic blood cultures and malaria film were also done, and hospital outcome was recorded. Early infant HIV diagnosis by HIV-1 RNA PCR was performed on those aged <18months. HIV-infected patients also received serum cryptococcal antigen testing and had their CD4-positive T-lymphocyte count and percent determined. Results A total of 467 patients were enrolled whose median age was 2years (range 2months-13years); Of those patients, 57.2% were female and 12.2% were HIV-infected. Admission clinical diagnosis of HIV disease was made in 10.7% and of malaria in 60.4%. Of blood cultures, 5.8% grew pathogens; of these 25.9% were Salmonella enterica (including 6 Salmonella Typhi) and 22.2%Streptococcus pneumoniae. Plasmodium falciparum was identified on blood film of 1.3%. HIV infection was associated with S. pneumoniae (odds ratio 25.7, 95% CI 2.8, 234.0) bloodstream infection (BSI), but there was no evidence of an association with Escherichia coli or P. falciparum; Salmonella Typhi BSI occurred only among HIV-uninfected participants. The sensitivity and specificity of an admission clinical diagnosis of malaria were 100% and 40.3%; and for an admission diagnosis of bloodstream infection, they were 9.1% and 86.4%, respectively. Conclusion Streptococcus pneumoniae is a leading cause of bloodstream infection among paediatric admissions in Tanzania and is closely associated with HIV infection. Malaria was over-diagnosed clinically, whereas invasive bacterial disease was underestimated. HIV and HIV co-infections contribute to a substantial proportion of paediatric febrile admissions, underscoring the value of routine HIV testing. © 2011 Blackwell Publishing Ltd.
Authors & Co-Authors
Crump, John A.
Unknown Affiliation
Ramadhani, Habib Omari
Unknown Affiliation
Morrissey, Anne B.
Unknown Affiliation
Msuya, Levina January
Unknown Affiliation
Yang, Lan Yan
Unknown Affiliation
Chow, Shein Chung
Unknown Affiliation
Morpeth, Susan Claire
Unknown Affiliation
Reyburn, Hugh G.
Unknown Affiliation
Njau, Boniface N.
Unknown Affiliation
Shaw, Andrea V.
Unknown Affiliation
Diefenthal, Helmut C.
Unknown Affiliation
Bartlett, John A.
Unknown Affiliation
Shao, John F.
Unknown Affiliation
Schimana, Werner
Unknown Affiliation
Cunningham, Coleen K.
Unknown Affiliation
Kinabo, Grace Damas
Unknown Affiliation
Statistics
Citations: 82
Authors: 16
Affiliations: 8
Identifiers
Doi:
10.1111/j.1365-3156.2011.02774.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Case-Control Study
Study Locations
Tanzania
Participants Gender
Female