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a Mpilo Central Hospital, Bulawayo, Zimbabwe: Department
of Paediatrics, b Department of
Pathology
Correspondence to: and reprint requests to: Dr M O Ikeogu, Department of Paediatrics, Mpilo Central Hospital, PO Box 2096, Bulawayo, Zimbabwe.
Accepted 3
September 1996
Over a 10 month period 184 children, aged 5 years or less, who
died at home had their nutritional status and HIV serostatus established; necropsies were also carried out. The HIV antibody test
was positive in 122/184 (66%). Of the HIV seropositive children Pneumocystis carinii pneumonia was present in 19 (16%),
cytomegalovirus pneumonia in nine (7%), and lymphoid interstitial
pneumonitis in 11 (9%). Opportunistic infection was therefore seen in
28/122 (23%) of the seropositive cases but in none of the seronegative cases. Tuberculosis was present in 8/184 (4%): 6/122 (5%) in HIV seropositive and 2/62 (3%) in seronegative children. Lung aspirate showed positive bacterial isolates in 106/122 (86%) of HIV
seropositive and 46/62 (74%) of seronegative children with Gram
negative organisms predominating in both groups. Malnutrition was
common and affected 106/184 (58%); positive growth was obtained in 98 (92%) of the malnourished children irrespective of their HIV
serostatus. Malnutrition was significantly associated with bacterial
lung infection after adjustment for the confounding effect of HIV
status. No association was found between HIV serostatus and bacterial
lung infection that could not be attributed to malnutrition at the time
of death. The importance of adequate nutrition in reducing the risk of
bacterial infection in HIV infected children is apparent.
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