Abstract:
Introduction and review of Literature.
The prevalence and characteristics of HIV cardiac disorders vary from one area to
another, and these have seldom been elucidated in African children. The cardiac
disorders include disturbances of rhythm, pericardial effusions, cardiomyopathies,
endocarditis, arteriopathies and other cardiac diseases.
Study objective
To determine the prevalence and characteristics of cardiovascular disorders in children
infected with Human Immunodeficiency Virus type 1 (HIV-1).
Study design
A cross-sectional comparative hospital based study.
Setting
The study was conducted in the General Paediatric wards and General Paediatric
outpatient clinics of Muhimbili National Hospital (MNH) in Dar es Salaam, from April
2001 to January 2002.
Subjects
A total of 280 children aged between 18 months to 7 years who were admitted in the
wards or seen at outpatient clinic, were recruited for the study.
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Methodology
All children aged between 18 months to 7 years attending Paediatric outpatient clinics
or admitted to MNH medical Paediatric wards whose parents/guardians consented for
the study and for HN testing were enrolled for study.
A thorough history and physical examination was done on recruitment.
All children who tested positive for HN infection formed the study group.
Children who tested negative for HN infection formed the comparable group. Both
groups were further subjected to cardiovascular assessment including chest X-Ray,
Electrocardiogram and Echocardiogram.
Main outcome measures
The main outcome measures were the magnitude and characteristics of cardiovascular
disorders among the two studied groups.
Results
The overall prevalence of cardiovascular diso~ders was 83/280. (29.6%)
The prevalence of cardiovascular disorders in HIV infected children was higher at 36/78
(46.2%) compared to 47/202 (23.3%) in HN uninfected children.
The difference was statistically significant in the two studied groups, p=O.OOO 17.
The common cardiac disorders strongly associated with HN-infected children were;
pericardial effusion 26.9%, Left ventricular dysfunction 24.7%, cardiomyopathy 24.4%
and tachycardia 20.5%.
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Conclusions and Recommendations.
1. Cardiovascular disorders are common among HIV -1 infected children at MNH.
2. Echocardiogram was the most important tool in diagnosing cardiac disorders.
3. Cardiac disorders in HIV -1 positive children were similar to those reported in other
centres.
4.
It is recommended that a thorough c)diovascular evaluation including
Echocardiogram should be done in HIV infected children so as to diagnose
cardiac disorders easily and offer better management.
