Prevalence of Pneumocystis Carinii Pneumonia Human Immunodefficiecy Virus Seropositin infants and young children admitted with pneumonia at the Kenyatta National Hospital
Abstract
Background: Pneumocystis carmu pneumonia (PCP) is one of the most
common opportunistic infections in children with immunosuppresion due to
HIV infection. PCP is hence an important factor in morbidity and mortality
in paediatric HIV infection. Most centers are however unable to undertake
confirmatory diagnosis for PCP hence the need to establish factors in favour
of empiric therapy.
Objective: To determine the prevalence of PCP in HIV seropositive children
admitted with severe pneumonia at KNH and study the general mortality
outcome of these children with pneumocystis carinii pneumonia.
Design: Cross-sectional study.
Setting: Kenyatta National Hospital, a 1,890 - bed referral hospital in
Nairobi, Kenya.
Subjects: HIV seropositive children admitted with severe pneumonia aged
between 2 and 24 months.
Method: Induced sputum from the study subjects was tested for PCP by
indirect immunofluorescent assay technique and examined for cysts of P
carinii
Results: A total of 130 children were studied. PCP was positive in 18 (14%)
of the subjects while 78% of the children with PCP died within 48hrs. or
admission. There were more deaths in patients with PCP 8S compared to
those without PCP and this difference had a significant trend (p=O.OOO, OR
15.16; 95%C1 4.53 - 50.77).
Conclusion PCP is common in HIV seropositive children admitted with
severe pneumonia at KNH and early case fatality is high among them.
Recommendations: In children admitted with severe pneumonia the HIV
status should be determined at admission in order to enable identify HIV
exposed infants and empirically treat them for pneumocystis carinii
pneumonia.
Citation
Master Of Medicine In Paediatrics Of The University Of Nairobi, 2004Publisher
University of Nairobi. Department of Paediatrics)