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Review of epidemiology of HIV-1 infection in children: Zaire experience.

The seroprevalence of HIV in children at the Pediatrics Dept. of the Mama Yemo Hospital a 530 pediatric bed hospital in Kinshasa Zaire is reviewed from 1984-1990: it remained stable from 11-12% in in-patients and 3-5% in out-patients during this period. Although the 1st verified case of pediatric AIDS In Kinshasa was documented in 1983 the 1st case of pediatric cryptococcal meningitis appeared in 1977. A seroprevalence study of 368 children 2-14 years old from November 1984-May 1985 found 11% HIV+. 12% of 258 hospitalized infants were HIV+ from June-August 1985. In November 1988 1110 children newborn to 14 years of age attended the pediatric emergency room: 5% were HIV+ overall 12.6% of infants <6 months and 4.1% of older children were positive. Blood transfusions for malaria and Sickle cell and multiple injections but not vaccinations were common in seropositive children. One intervention being taken in this Dept. is to limit blood transfusions in pediatric patients unless hemoglobin levels are below 5 g/dl. 6% of pregnant women were HIV positive indicating that vertical transmission is common. The socioeconomic costs of pediatric AIDS and high since the average hospital stay was 24 days costing 4 times the average monthly income. The average mortality was 23% funerals cost 11 times the monthly income. HIV seroprevalence by ELISA is the only reliable way to diagnose AIDS in African children in whom the clinical definition of AIDS i.e. diarrhea fever failure to thrive and respiratory infections are common. The author proposed from these seroprevalence data that HIV had stabilized in Zaire in the 1970s.