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Background: The clinical manifestations of HIV infection vary widely among infants, children, and adolescent. So there is a need to study the mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children. Methods: Observational analytic cross sectional study. The children who were HIV positive (confirmed by ELISA for HIV-1 and HIV-2), and attending the OPD of ART Centre and SN Children Hospital, Allahabad during period of one year. The study population consisted of 47 patients, belonging to both sexes and age of 18 months to 19 years. Detailed history was taken and full clinical examination done in all cases. CD4 count was estimated at the time of presentation. Results: Predominant mode of transmission in our study was vertical and it was present in 95% cases. Fever was the most common presenting complaint and was present in 28 (59.57%) cases. The most common clinical sign was pallor in our study, present in 37 cases (78.72%) followed by lymphadenopathy 34 (72.34%). On the basis of WHO clinical staging, most of the patients in our study were found in stage 2 .On the basis of immunological staging, 51% had no evidence of immunosuppression (stage1), 18 (38.3%) had mild to advanced immunosuppression (stage 2 and 3) and 5 (10.63%) patients were severely immunosuppressed (stage 4). Conclusion: In HIV infected children predominant mode of transmission is vertical. Fever and pallor are common clinical manifestations. Most of the patients are found in WHO clinical stage 2 and immunological stage 1.
RESUMO
OBJECTIVE: The present study was conducted prospectively to determine i) the length of postnatal hospital stay of healthy newborns and determine the factors facilitating their early discharge (< 48 h) and ii) the frequency and causes of re-hospitalization following early discharge, in a tertiary care hospital. METHODS: Length of hospital stay was recorded for healthy newborns. Factors facilitating Early discharge were determined by both univariate and multivariate (multiple logistic regression) analyses. Of all newborns discharged within 48 h, every third case was called for a follow-up visit 72 hrs later and examined for any medical problem and need of re-hospitalization. RESULTS: A total of 1134 babies were enrolled, of which 861 (76.2%) were discharged at or before 48 hours. The overall mean (SD) length of hospital stay was 46.4 (45.8) h. Factors contributing to early discharge included vaginal delivery (RR: 30.2; 95% CI: 19.0, 47.9; P<0.001), absence of pre-existing maternal disease or obstetric complication (RR: 4.32; 95% CI: 2.27, 8.22; P < 0.001), and birth weight of > 2.5 kg (RR: 1.91; 95% CI: 1.27, 2.89; P = 0.002). Of the 280 neonates called for follow-up, 193 reported. Of these, 61 (31.6%) were normal. Neonatal jaundice was the most frequent problem seen in 105 (54.4%) children on follow-up. Only 16 (8.3%) newborns needed re-hospitalization; the most common indication being neonatal jaundice (n=9). CONCLUSION: Most of the children in our set-up are being discharged within 48 hrs. Early discharge is governed primarily by maternal indications. A follow-up visit after 72 hr is important to assess the need of re-hospitalization in healthy newborns discharged within 48 hrs of birth.