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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pneumocystis pneumonia in South African children with and without human immunodeficiency virus infection in the era of highly active antiretroviral therapy
Pediatric Infectious Disease Journal, Volume 29, No. 6, Year 2010
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Description
Background: Pneumocystis pneumonia (PCP) is a major cause of hospitalization and mortality in human immunodeficiency virus (HIV)-infected African children. Aim: The aim of this study was to investigate the incidence and outcome of PCP in South African children living in a high HIV-prevalence area in the context of a free, available antiretroviral therapy program. Methods: Sequential children hospitalized with hypoxic pneumonia were prospectively enrolled from November 2006 to August 2008. Sociodemographic, historical, clinical, and outcome data were collected. A nasopharyngeal aspirate and lower respiratory tract sample (induced sputum or bronchoalveolar lavage) were submitted for PCP immunofluorescence. Lower respiratory tract samples were also investigated for bacterial, mycobacterial, and viral pathogens. Results: A total of 202 children were enrolled; 124 (61.4%) were HIV-infected; 34 (16.8%) were HIV-exposed but uninfected and 44 (21.8%) were HIV-unexposed. Among HIV-exposed children, 70 (44.3%) had participated in the Prevention of Mother to Child Transmission program, but only 18.4% were taking trimethoprim- sulfamethoxazole prophylaxis. PCP occurred in 43 children (21.3%) of whom 33 (76.7%) were HIV-infected. The case fatality of children with PCP was higher than those without PCP (39.5% vs. 21.4%; relative risk, 1.85; 95% confidence interval, 1.15-2.97; P = 0.01). Conclusions: PCP is a common cause of hypoxic pneumonia and mortality in HIV-infected South African infants. Underuse of the Prevention of Mother to Child Transmission program and failure to institute trimethoprim-sulfamethoxazole prophylaxis in HIV-exposed children identified through the program are important obstacles to reducing PCP incidence. Copyright © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Morrow, Brenda M.
South Africa, Cape Town
University of Cape Town
Hsaio, Nei Yuan
South Africa, Cape Town
University of Cape Town
Zampoli, Marco
South Africa, Cape Town
University of Cape Town
South Africa, Cape Town
Red Cross War Memorial Children's Hospital
Whitelaw, Andrew C.
South Africa, Cape Town
University of Cape Town
Zar, Heather J.
South Africa, Cape Town
University of Cape Town
South Africa, Cape Town
Red Cross War Memorial Children's Hospital
Statistics
Citations: 54
Authors: 5
Affiliations: 2
Identifiers
Doi:
10.1097/INF.0b013e3181ce871e
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study