Associations with HIV status in children with diarrhoea in Cape Town, South Africa

Abstract

Diarrhoea and HIV are two of the biggest public health problems in children in Africa. Various patient characteristics namely; socio-demographic/-economic, clinical, health-seeking behaviour, and feeding practices were compared in children with diarrhoea who were HIV-infected, HIV-exposed or HIV-negative. Data were collected prospectively for the period April 2002 - April 2003 on children ≥6 weeks and ≤2 years old admitted to the Diarrhoeal Rehydration Unit at the Red Cross War Memorial Children's Hospital. Of the 350 patients enrolled, HIV status was known for 135 (38.6%): 27 (20%) were HIV-infected, 47(34.8%) were HIV-exposed and the remainder HIV-negative. No significant differences were found between the three groups for any of the socio-demographic or socio-economic determinants analysed. A significant difference (p=0.048) was observed between groups for health-seeking behaviour with more HIV infected patients (29.6%)having sought a traditional healer before allopathic care. HIV-infected patients had more recurrent diarrhoea (p=0.001), were more often severely malnourished (p=0.002), were transferred more often to a long stay ward for prolonged care (p<0.001) and were less likely to be breastfed (p=0.005). The association with HIV-infected patients and seeking a traditional healer for healthcare could be due to a wide range of socio-cultural confounders, and requires further exploration.