Department of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Indian J Pediatr. 2010 Jun;77(6):627-31. doi: 10.1007/s12098-010-0076-3. Epub 2010 Jun 8.
To determine the prevalence of orphanhood among HIV positive children and to compare their social and demographic and clinical characteristics with that of HIV-positive non-orphans.
From February 2008 through March 2009, data was collected from 148 children registered at the antiretroviral (ART) clinic of a tertiary care hospital in Delhi, on their demographic profile, HIV status of parents, orphan status and cause of parental death, mode of transmission of the infection, current caregiver, school enrollment and clinical and immunologic parameters of HIV infection at presentation.
The prevalence of orphanhood was 49.3%. Majority of the orphans were paternal orphans. The primary caregiver was either the surviving parent or extended family members. The orphans were older at presentation and had shorter mean duration of follow-up. They lagged behind the non-orphans in immunisation, nutritional status, school enrollment and attendance and socioeconomic status. They presented more frequently with severe immunosuppression and had a higher prevalence of opportunistic infections. There was no significant difference between the orphans and the non-orphans in the WHO clinical stage of presentation and adherence to ART.
The prevalence of orphanhood among the HIV-positive children is high. Although extended family is a cornerstone for care of HIV-positive orphans, these families are overwhelmed by the added responsibility of these children. Larger community-based studies are needed to determine the true magnitude of orphanhood and to evolve methods to socially and financially support the families taking care of these children.
确定艾滋病毒阳性儿童中孤儿的流行率，并比较其社会人口学和临床特征与艾滋病毒阳性非孤儿的特征。
2008 年 2 月至 2009 年 3 月，从德里一家三级保健医院的抗逆转录病毒（ART）诊所收集了 148 名登记在册的儿童的数据，内容包括他们的人口统计学概况、父母的艾滋病毒状况、孤儿身份和父母死亡原因、感染传播方式、目前的照顾者、入学情况以及就诊时艾滋病毒感染的临床和免疫参数。
孤儿的患病率为 49.3%。大多数孤儿是父亲一方的孤儿。主要照顾者是健在的父母或大家庭成员。孤儿就诊时年龄较大，随访时间平均较短。他们在免疫接种、营养状况、入学和出勤率以及社会经济地位方面落后于非孤儿。他们更频繁地出现严重免疫抑制，机会性感染的患病率更高。孤儿和非孤儿在就诊时的世界卫生组织临床分期和对 ART 的依从性方面没有显著差异。
艾滋病毒阳性儿童中的孤儿患病率较高。尽管大家庭是照顾艾滋病毒阳性孤儿的基石，但这些家庭因要承担这些孩子的额外责任而不堪重负。需要进行更大规模的基于社区的研究，以确定孤儿的真实规模，并制定方法为照顾这些孩子的家庭提供社会和经济支持。
