Demographic and clinical profile of HIV infected children

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Indian J Med Res 129, January 2009, pp 42-49

Demographic & clinical profile of HIV infected children accessing

care at Tambaram, Chennai , India

S. Rajasekaran, L. Jeyaseelan*, K. Raja & N. Ravichandran

Government Hospital for Thoracic Medicine, Tambaram Sanatorium, Chennai &

*Department of Biostatistics,

Christian Medical College , Vellore , India

Background & objectives: Human immunodeficiency virus (HIV) is severely

affecting the poorly educated and economically disadvantaged in Indian society.

When children start developing clinical

manifestations, needing treatment, they have to travel long distances for

accessing care and support at tertiary institutions.

This places an extra burden on patients, who are already struggling to cope with

their illness. Sufficient data are needed for the government to evolve

appropriate policy for providing

care to the children affected with HIV. We undertook this study to present the

socio-demographic characteristics, signs and symptoms, clinical profile,

distance travelled and follow up pattern of HIV

positive children who accessed care for the first time in a referral hospital at

Chennai , India .

Methods: Electronic medical records from patients diagnosed with HIV between

2002 and 2004 at the Government Hospital for Thoracic Medicine (GHTM) in

Tambaram (Chennai) in India were analyzed to

understand care-seeking behaviours. Demographic variables such as age, sex,

education and occupation, data on clinical manifestations were examined together

with geographic information.

Results: At GHTM 1,768 new paediatric patients accessed care from 2002 to 2004.

Children aged less than 5 yr were 49.9 per cent; 1115 children had (63%)

tuberculosis. Significantly, 14.9 and 20.6 per

cent children had extra-pulmonary TB and disseminated TB respectively. Lower

respiratory infection (15.8%), Pneumocystis carinii pneumonia (15.20%),

oral/oesophageal candidiasis (13.5%), wasting (6.1%) and diarrhoeal disorders

(3.5%) were the common clinical manifestations. In all 47 per cent children

traveled between 200-400 km from home and 14 per cent travelled over 400 km.

Interpretation & conclusion: Our findings showed that tuberculosis should be

regarded as the indicator disease for HIV infection in children, especially when

they have clinical manifestations of progressive, non pulmonary and disseminated

disease. The primary and secondary health care centres should have the trained

capacity to diagnose and treat HIV disease and opportunistic infections so as

the children to have much needed care and support nearer to their residence.

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A copy of the full text of this article is available from the editor.