The Influence of Human Immuno-Deficiency Virus (HIV) Infection on Orphaned Neonates

ABSTRACT

This retrospective study from January to December 1999 reports 74 orphaned neonates admitted at the special care unit in Dar-es-Salaam; Tanzania. The commonest causes of maternal death were Anemia; Edema-Proteinuria-Hypertension -Gestosis (EPH Gestosis); Acquired Immuno-deficiency syndrome (AIDS); tuberculosis and postpartum hemorrhage (PPH). There was a very high association of maternal AIDS and tuberculosis with maternal deaths. The overall mortality rates were not significantly different between the orphans whose mothers had AIDS and those whose serostatus was unknown. However among the 3 infants who died from HIV sero-positive group; the mean age was 20 days(14-29days); while those with unknown serostatus the mean age was 28 days. HIV negative infant was twice more likely to be accepted in the orphanage. Failure to thrive was 3.5 fold more common among HIV positive infants. Diarrhea was conversely more common among babies whose HIV unknown statusWhile 20 out of 42 (47) discharged infants from among the HIV unknown serostatus were taken by the biological father; only 5 out of 18 (28) were taken by the father among HIV positive/AIDS group. There are no appropriate counseling sessions and there is lack of follow-up; especially for those discharged home. There was a 35 fold higher risk of tuberculosis and HIV co-morbidity whereby 18 out of 25 (72) mothers who were diagnosed to have AIDS had tuberculosis as well. Among the mothers with unknown serostatus; only 1 out of 49 (2) had tuberculosis. Thus; AIDS and tuberculosis both contribute to the maternal deaths. We speculate that tuberculosis in HIV pregnant mothers is associated with a more a rapid downhill course and mortality. There is a need to address this matter urgently. Moreover; there is a need to have a coordinated community based care for these orphans and their caretakers