Journal of Tropical Pediatrics Advance Access originally published online on December 9, 2008
Journal of Tropical Pediatrics 2009 55(3):170-176; doi:10.1093/tropej/fmn106
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Morbidity in HIV-1-Infected Children Treated or Not Treated with Highly Active Antiretroviral Therapy (HAART), Abidjan, Côte d’Ivoire, 2000–04*
aService de Pédiatrie du CHU de Caremeau, Nîmes, France
bProgramme Enfant Yopougon/PACCI, Abidjan, Côte d'Ivoire
cCeDReS/PACCI, Abidjan, Côte d’Ivoire
dService de Pédiatrie, CHU de Treichville, Abidjan, Côte d'Ivoire
eUMR_145, Institut de Recherche pour le Développement (IRD)/Université Montpellier 1, Montpellier, France – CReCSS, Aix en Provence, France
Correspondence: Dr Carsten Walenda, 8bis, rue de St Gilles, 30 000 Nîmes, France. Tel: +33 6 75 32 20 75; Fax: +33 4 66 68 37 23. E-mail: <walendac{at}yahoo.com>.
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Abstract |
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Background: In the 2008 UNAIDS epidemic update, 33 million people worldwide were estimated infected with HIV, including 2.2 million children. In Côte d’Ivoire, 480 000 adults and 60 000 children were HIV-infected. Studies in developed countries have shown an improvement of children's morbidity under HAART treatment.
Objective: The objective of this study is to describe and compare morbidity in relation to evolution of the disease in HIV-1-infected children in Côte d’Ivoire, according to symptoms and the presence or absence of HAART treatment.
Methodology: A total of 273 HIV-1-infected children from age 18 months to 18 years were included from October 2000 until December 2003. Follow-up was continued until 30 September 2004. The study population was divided in three groups. Group 1 included symptomatic children treated under HAART. Group 2 included asymptomatic children who did not need HAART treatment. Group 3 included children who met criteria to be treated at inclusion but were not treated.
Principal Findings: The three most common diseases in Group 1 before treatment were bronchitis, diarrhoea and ear nose and throat (ENT) diseases. Under treatment, the three most common diseases in Group 1 were bronchitis, ENT diseases and diarrhoea. The three most occurring diseases in Group 2 were bronchitis, ENT diseases and skin infectious diseases. The three most occurring diseases in Group 3 were bronchitis, diarrhoea and ENT diseases.
Conclusions: The incidence of diseases was significantly lower among asymptomatic children than among symptomatic untreated children (p < 0.0001). The morbidity found in symptomatic children who received treatment was similar to that encountered in asymptomatic children. The main reason for death in all of the groups was tuberculosis.
*This article has partially been presented at the ADELF congress for epidemiology in tropical countries, Ouidah, Benin, 23–25 January 2007.
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