Ochigbo Sunday Oteikwu, Torty Chimaeze, Anah Maxwell
Faculty of Medicine, Department of Paediatrics, University of Calabar, Calabar, Nigeria.
Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria.
Pan Afr Med J. 2019 Apr 11;32:179. doi: 10.11604/pamj.2019.32.179.16837. eCollection 2019.
Early diagnosis and treatment of paediatric HIV is key as mortality of untreated patients is very high in the first two years of life, and reaches 80% by four years. Case finding efforts for children especially outside Prevention of mother-to-child transmission (PMTCT) is inadequate. Targeting siblings of index HIV-exposed and infected children is an important way of improving identification and enrolment into care thereby reducing paediatric mortality. The study therefore aimed to determine the prevalence of HIV infection among siblings of HIV positive children in care in Calabar.
This descriptive cross-sectional study was conducted among children aged six weeks to 15 years who are siblings of HIV positive children receiving care. Parental consent and child assent were obtained, the children were tested for HIV at their homes irrespective of their prior test results. Ethical clearance certificates were obtained from the health institutions.
Siblings of 401 index patients were tested for HIV, four were positive giving a prevalence rate of 1%. Three hundred and sixty-seven 367(91.5%) had been tested previously while 34(8.5%) never had HIV test. Among the siblings who were HIV positive, 1(0.3%) was a male while 3(0.7%) were females. There were more HIV positive siblings in the 11-15 years age group.
All the four HIV positive siblings were from the lower socioeconomic class (p=0.022). The routine screening of siblings of HIV positive children should be sustained with focus on adolescents from the lower socioeconomic class. This will improve early identification and enrolment into care thereby reducing paediatric mortality.
小儿艾滋病的早期诊断和治疗至关重要，因为未经治疗的患者在生命的头两年死亡率非常高，到四岁时死亡率达到80%。针对儿童的病例发现工作，尤其是在母婴传播预防（PMTCT）项目之外的工作，是不够充分的。将感染艾滋病毒的儿童的兄弟姐妹作为目标人群，是改善识别和护理登记从而降低儿童死亡率的重要途径。因此，本研究旨在确定卡拉巴尔接受护理的艾滋病毒阳性儿童的兄弟姐妹中艾滋病毒感染的患病率。
本描述性横断面研究在年龄为六周至15岁、为接受护理的艾滋病毒阳性儿童的兄弟姐妹的儿童中进行。获得了家长的同意和儿童的同意，无论他们之前的检测结果如何，这些儿童都在家中接受了艾滋病毒检测。从卫生机构获得了伦理批准证书。
对401名索引患者的兄弟姐妹进行了艾滋病毒检测，4人呈阳性，患病率为1%。其中367人（91.5%）之前接受过检测，而34人（8.5%）从未进行过艾滋病毒检测。在艾滋病毒呈阳性的兄弟姐妹中，1名（0.3%）为男性，3名（0.7%）为女性。11至15岁年龄组的艾滋病毒阳性兄弟姐妹更多。
所有四名艾滋病毒阳性的兄弟姐妹都来自社会经济地位较低的阶层（p=0.022）。应持续对艾滋病毒阳性儿童的兄弟姐妹进行常规筛查，重点关注社会经济地位较低阶层的青少年。这将改善早期识别和护理登记，从而降低儿童死亡率。
