RISK FACTORS TO HIV TRANSMISSION IN HIV POSITIVE UNDER-FIVES WITH DIARRHOEA
Authors: 1Peterside O, 1Kunle-Olowu O.E, 2Adesina A.F
Institutions: Department of Paediatrics and Child Health, 1Niger Delta University Teaching Hospital, Bayelsa State, 2Lagos State Hospital Management Board, Nigeria.
Background: HIV is of major public health importance in developing countries like Nigeria. The dominant mode of transmission in children is vertical, from mother to child. Other routes of infection are from parenteral exposure to blood and blood products, via sexual contact or re-use of unsterilized sharp objects.
Objectives: To determine the risk factors for HIV transmission in HIV positive under-fives.
Methods: Over a 6 month period, 342 under-fives attending the diarrhoea training unit of the University of Port-Harcourt Teaching Hospital were screened for HIV, using the double ELISA test. A self administered questionnaire exploring risk factors for HIV transmission was completed by the investigators. The mothers of the children found to be HIV positive were also tested for HIV with the same test kits.
General characteristics of study subjects
A total of 342 children less than five years of age who presented with diarrhoea at the DTU and CHEW of UPTH were recruited for the study. There were 201 (58.8%) males and 141 (41.2%) females, giving a male to female ratio of 1.4:1. The ages of the subjects ranged from one to 59 months with a mean age of 13.2 months. Table 1 shows the age and sex distribution.
Type of diarrhoea in the 33 HIV seropositive subjects
Among the HIV positive subjects, 19 (58.0%) had acute diarrhoea, 2 (6.0%) had persistent diarrhoea, 12 (36.0%) had chronic diarrhoea while 9 (27.3%) had dysentery
Thirty three of the 342 children tested positive giving an HIV prevalence rate of 9.6%.
Risk factors for HIV transmission in the 33 seropositive subjects
Three of the 33 seropositive children had lost their mothers. The mothers of the remaining 30 positive children also tested positive to HIV, giving a vertical transmission risk of 90.9%. Other risk factors were; injections from patent medicine dealers in 14 (42.4%), use of unsterilized instruments in 5 (15.2%) and a history suggestive of sexual abuse in 1 (3.0%). Table 2 shows the risk factors for HIV transmission.
Conclusion: vertical transmission is the overwhelming source of HIV infection in children. Efforts aimed at prevention of mother to child transmission of HIV should be intensified.