Prevalence of Pneumocystis Carinii Pneumonia Human Immunodefficiecy Virus Seropositin infants and young children admitted with pneumonia at the Kenyatta National Hospital

Abstract

Background: Pneumocystis carmu pneumonia (PCP) is one of the most common opportunistic infections in children with immunosuppresion due to HIV infection. PCP is hence an important factor in morbidity and mortality in paediatric HIV infection. Most centers are however unable to undertake confirmatory diagnosis for PCP hence the need to establish factors in favour of empiric therapy. Objective: To determine the prevalence of PCP in HIV seropositive children admitted with severe pneumonia at KNH and study the general mortality outcome of these children with pneumocystis carinii pneumonia. Design: Cross-sectional study. Setting: Kenyatta National Hospital, a 1,890 - bed referral hospital in Nairobi, Kenya. Subjects: HIV seropositive children admitted with severe pneumonia aged between 2 and 24 months. Method: Induced sputum from the study subjects was tested for PCP by indirect immunofluorescent assay technique and examined for cysts of P carinii Results: A total of 130 children were studied. PCP was positive in 18 (14%) of the subjects while 78% of the children with PCP died within 48hrs. or admission. There were more deaths in patients with PCP 8S compared to those without PCP and this difference had a significant trend (p=O.OOO, OR 15.16; 95%C1 4.53 - 50.77). Conclusion PCP is common in HIV seropositive children admitted with severe pneumonia at KNH and early case fatality is high among them. Recommendations: In children admitted with severe pneumonia the HIV status should be determined at admission in order to enable identify HIV exposed infants and empirically treat them for pneumocystis carinii pneumonia.