The prevalence and characteristics of cardiovascular disorders in children infected with Human immunodeficiency virus type 1 (HIV-1) at Muhimbili National Hospital.

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University of Dar es Salaam
Introduction and review of Literature The prevalence and characteristics of HIV cardiac disorders vary from one area to another and these have seldom been elucidated in African children. The cardiac disorders include disturbances of rhythm, pericardial effusions, cardiomyopathies, endocarditis, arteriopathies and other cardiac disease. Study objective To determine the prevalence and characteristics of cardiovascular disorders infected with Human Immunodeficiency Virus type 1 (HIV-1). Study design A cross-sectional comparative hospital based study. Setting The study was conducted in the General Paediatric wards and General paediatric outpatient elinics of Muhimbili National Hospital (MNH) in Dar es Salaam, from April 2001 to January 2002. Subjects A total of 280 children aged between 18 months to 7 years who were admitted in the wards or seen at outpatient clinic, were recruited for the study. Methodology All children aged between 18 months to 7 years attending paediatric outpatient clinics or admitted to MNII medical Paediatric wards whose parents/ guardians consented the study and for HIV testing were enrolled for study. A thorough history and physical examination was done on recruitment. All children who tested negative for HIV infection formed the comparable group. Both groups were further subjected to cardiovascular assessment including chest X-Ray, Electrocardiogram and echocardiogram. Main outcome measures The main outcome measures were the magnitude and characteristics of cardiovascular disorders among the two studied groups. Results The overall prevalence of cardiovascular disorders was 83/280 (29.6%). The prevalence of cardiovascular disorders in HIV infected children was higher at 36/78 (46.2%) compared to 47/202 (23.3%) in HIV uninfected children. The difference was statistically significant in the two studied groups, p=0.00017. The common cardiac disorders strongly associated with HIV- infected children were; pericardial effusion 26.9%, Left ventricular dysfunction 24.7%, cardiomyopathy 24.4% and tachycardia 20.5%. Conclusions and Recommendations 1. Cardiovascular disorders are common among HIV-I infected children at MNH. 2. Echocardiogram was the most important tool in diagnosing cardiac disorders. 3. Cardiac disorders in HIV-I positive children were similar to those reported in other centres. 4. It is recommended that a thorough cardiovascular evaluation including Echocardiogram should be done in HIV infected children so as to diagnose cardiac disorders easily and ofer better management.
Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RA644.25.K82)
Aids (Disease), Cardiovascular system, Diseases, Children, Immunologic diseases
Kubhoja, S.D.M.