Publication:

Social characteristics associated with outcome of paediatric human immunodeficiency virus admissions

Background Information on social characteristics in human immunodeficiency virus (HIV) infected Nigerian children is scarce. The association between social characteristics such as single parenthood, low socio-economic status, polygamy and lack of parental education on the outcome of paediatric HIV admissions has been under studied.

Methods Information was obtained from the case notes of HIV infected children between the year 2006 and 2012 at a Nigerian tertiary hospital. Details of the information extracted include socio-demographics, diagnoses and outcome of management. Data was analysed with the SPSS 18 software.

Results Fifty (1.73%) of the total 2897 paediatric admissions were due to HIV disease. The mean age of the children studied was 3.7±2.9years and the 50 children were made up by 27 boys and 23 girls, giving a male to female ratio of 1:0.9. The mean age of the mothers and fathers were 28.7 and 36.7 years respectively. Pneumonia, septicaemia and tuberculosis accounted for more than 60% of admissions. Five (10.0%) children were from the upper, 12 (24.0%) from the middle and 33 (766.0%) from the lower socioeconomic classes. Twenty-four parents (couples) were both sero-positive for HIV and 7 discordant. Nineteen (38.0%) could not be classified because the status of the father was unknown. Of the 7 sero-discordant parents, 3 sero-negative fathers neglected their families. Thirty-nine children were from monogamous homes, nine from polygamous and two were raised by single parents. There were two discharges against medical advice and eleven deaths. The average number of siblings of the children studied was 2.57±2.1. Mortalities on admission were significantly associated with, parental financial constraints and the admitted HIV infected child having more than one sibling (p<0.05).

Conclusions It was concluded that appropriate interventions to manage these associations will most likely improve the outcome of admissions. Strategies of improving disclosure and prevention of negative outcome of disclosures, such as family neglect in sero-discordant couples also need to be identified.