The pattern of mucocutaneous disorders in HIV infected children attending care and treatment centres in dar es salaam

Abstract

Human Immunodeficiency Vims (HIV) infects millions of people worldwide. It

causes severe immunodeficiency resulting in a greater susceptibility to infections,

inHammatory disorders and tumorous conditions. HIV/AIDS is associated with a

wide range of mucocutaneous disorders, some of which are used in staging of the

disease. Patterns of mucocutaneous disorders in children could be modified by the

various drugs the patient is taking, especially the Antiretrovirals (ARVs). There is

lack of information about the magnitude of the problem in Dar es Salaam.

Objective

To determine the pattern of mucocutaneous disorders in HIV infected children aged

0 to 17 years attending Care and Treatment Centres (CTC) at Muhimbili National

Hospital (MNffI and the Municipal Hospitals in Dar es Salaam.

Study design and Setting

Cross sectional descriptive study at CTCs at MNfI and the three Municipal Hospitals

in Dar es Salaam; Ilala Temeke and Mwananyamala.

Methodology

Data was collected using a structured questionnaire. A complete dermatological

examination was carried out in daylight. Investigations such as skin biopsy, skin

scrapings and CD4+ count were taken. Data was analysed using Statistical Package

for Social Science (SPSS) program version 10.0. Chi-square and Fisher exact

statistical test were used to determine association between variables and p-value of less than or equal to 0.05 was considered statistically sigmficaut.Results

A total of 347 children were recruited into the study, of these 52% were males and

48% were females. Mucocutaneous disorders were found in 294 (85%) HIV infected

children. There was no gender difference in the occurrence of mucocutaneous

disorders except for non infectious inflammatory dermatoses in which males were

more affected (p=O.02). The most frequently encountered dermatoses were infections

followed by non infectious inflammatory dermatoses. All types of mucocutaneous

disorders were more prevalent in advanced stage of the disease. Children with severe

irnmunosupression had significantly increased viral and fungal cutaneous infections

(p=0.01). Most children (75%) with mucocutaneous disorders were using ART.

However, there was no statistical significant in the distribution of types of

mucocutaneons disorders between those on ART and those not on ART.

Conclusion and Recommendation

Mucocutaneous disorders are common in HIV infected children despite the use of

ART. These disorders are more common when HIV infection advances and the

immune function deteriorate. Therefore, comprehensive care and management of

HIV infected children should emphasize on mucocutaneous disorders. Health care

providers need to be on the look to identify various types of mucocutaneous

disorders, as they may be a pointer of HIV infection as well as an indication of