Adejuyigbe E A, Odebiyi A I
Obafemi Awolowo University, Ile-Ife, Nigeria.
AIDS Care. 2006 Aug;18(6):537-43. doi: 10.1080/13548500500228698.
This prospective study compared the care and support provided for symptomatic HIV seropositive children of HIV serodiscordant parents (only the mother of the child is HIV infected) with children of seroconcordant parents (both parents are HIV infected) during admission and after discharge from a tertiary health institution in southwestern Nigeria. Information was collected from parents of eligible children by semi-structured questionnaires and observation of the children and their parents while on admission and at home. Of the 51 couples who met the study criteria, there were 27 seroconcordant couples and 24 serodiscordant couples. The children from serodiscordant couples were more frequently discharged against medical advice, abandoned, lost to follow-up, cared for by their mothers alone and were not up-to-date with their immunization schedule when compared with children from seroconcordant parents. These were statistically significant (p < 0.05). There was a higher mortality among these children and their mothers (p < 0.05). Paternal reasons for not providing adequate care for the children from serodiscordant parents included fear of being infected, doubt of child's paternity and waste of family resources on a 'child who is dying'. None of the children from both groups received support from governmental and non-governmental agencies. It is concluded that the care of sick HIV seropositive children of serodiscordant parents poses special challenges for clinicians working in Nigeria where there is no social support system.
这项前瞻性研究比较了在尼日利亚西南部一家三级医疗机构住院期间及出院后，为父母一方感染艾滋病毒（仅孩子的母亲感染艾滋病毒）的有症状艾滋病毒血清阳性儿童和父母双方均感染艾滋病毒的儿童所提供的护理与支持。通过半结构化问卷从符合条件儿童的父母那里收集信息，并在住院期间及在家中观察这些儿童及其父母。在符合研究标准的51对夫妇中，有27对父母双方均感染艾滋病毒的夫妇和24对父母一方感染艾滋病毒的夫妇。与父母双方均感染艾滋病毒的儿童相比，父母一方感染艾滋病毒的夫妇的孩子更频繁地不听从医嘱出院、被遗弃、失访、仅由母亲照顾，且未按时完成免疫接种计划。这些差异具有统计学意义（p < 0.05）。这些儿童及其母亲的死亡率更高（p < 0.05）。父母一方感染艾滋病毒的父母不为孩子提供充分护理的父方原因包括担心被感染、怀疑孩子的生父身份以及在“快要死去的孩子”身上浪费家庭资源。两组中的儿童均未得到政府和非政府机构的支持。研究得出结论，在没有社会支持系统的尼日利亚，照顾父母一方感染艾滋病毒的患病艾滋病毒血清阳性儿童对临床医生构成了特殊挑战。
