15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10308)

Kekitiinwa AR, Kalyesubura I, Bakeera SK, Namale A, Musoke P
Mulago hospital, Kampala, Uganda

BACKGROUND: The Paediatric Infectious Disease Clinic is a specialized AIDS clinic established in 1985. Currently, it serves 1200 active clients providing primary care, prevention and treatment of opportunistic infections, counseling and nutritional support. Less than 10% of the children receive antiretroviral therapy.

METHODS: In July 2003, 1010 children were assessed using WHO and CDC HIV staging. Information on demographic features, current illness, drug treatment, HIV status, and nutritional status was collected. HIV ELISA was performed for children above18 months while DNA PCR on those below. CD4% was done for HIV infected children. Data was analyzed using EPI 2000.

RESULTS: To date, 53% of clients are female. 71% are >5years of age, while only 5%<1 yr. Mean age is 87 months. The commonest presenting illness was wasting with "failure to thrive" (42%): 12% had Kaposis sarcoma and 20% had tuberculosis. The mean CD4% was 13. Severe immune suppression (CD4 %< 15) was present in 50% of children<1 year, 36% 1-5yrs and 39% over 6years. Overall, 73% had moderate to severe suppression thus requiring ART. Using the WHO classification, 62% had moderate to severe immunosuppression and this was comparable to CDC's 63%. The mean baseline CD4% for clients on ART was 3.5. The percentage of children that had CD4% less than 15 and went from CD4 15 to 25% will be calculated.

CONCLUSION: There is an urgent need to provide ART to over 70% of children attending this clinic. WHO and CDC classification were fairly comparable in predicting those who had moderate to severe suppression using the immunological staging.

040711
B10308

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