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Journal of Tropical Pediatrics Advance Access published online on September 6, 2008
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmn076
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Sensitivity of Paediatric AIDS Score vs. WHO Case Classification in Indian Children—A Retrospective Study*

Tanushree Banerjeea, Tripti Pensib and Dipankar Banerjeec

aDepartment of Statistics, University of Delhi, New Delhi-110007, India
bDepartment of Paediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi-110001, India
cDepartment of Neurology, Institute of Human Behaviour and Allied Sciences, Dilshad Garden, New Delhi-110095, India

Correspondence: Tanushree Banerjee, Department of Statistics, University of Delhi, A-123 Vikaspuri, New Delhi 110018, India. E-mail <banerjee_tanushree{at}rediffmail.com>


  Abstract

This study was conducted at the Department of Paediatrics, Dr Ram Manohar Lohia Hospital, to test the statistical significance of existing World Health Organization (WHO) clinical case definition (CCD) for diagnosis of AIDS in areas where diagnostic resources are limited. A total of 360 cases between 18 months and 12 years of age satisfying WHO case definitions of AIDS were included in study group. Our study detected 16.66% (60) of HIV incidence in children visiting the paediatrics outpatient clinic. Twenty percent of cases manifested three major and two minor signs, which had sensitivity of 73.33%; specificity, 90.66% and positive predictive value (PPV), 61.11%. Stepwise logistic analysis identified weight loss, chronic fever >1 month and total lymphocyte count <1500 cells mm–3 as important predictors. Eighty-six cases (23.89%) showed two major and two minor signs with sensitivity and specificity of 86.66 and 88.66%, respectively. Thus a CCD based on 13 clinical signs/symptoms was proposed for paediatric AIDS with better sensitivity and PPV than the WHO case definition but with almost similar specificity.

Key Words: acquired immunodeficiency syndrome • clinical case definition • human immunodeficiency virus • India • predictive values

*The abstract of this study was accepted for poster presentation at the 4th International AIDS Society (IAS) Conference, Sydney, Australia, 22–25 July 2007.


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