Causes of Hospital re-administrations of HIV / AIDS children at Dr George Mukhari hospital during the year 2003

Abstract

Introduction HIV/AIDS is major cause of child mortality and an increase in the number of sick children presenting to health services worldwide (UNICEF 2008). A significant number of children live with HIV/AIDS in South Africa. Research indicates that in poor resourced countries, there is an increase in the prevalence of hospital admissions and re-admissions among HIV infected children as compared to developed countries. Research data on hospital admissions, treatment and care of HIV positive children South Africa is limited. Objectives This study was therefore initiated to determine the demographic and clinical causes of HIV positive children admitted and readmitted at the paediatric ward of Dr George Mukhari Hospital (DGMH), South Africa in the year 2003. Methods This was mainly a descriptive quantitative study using medical records of HIV infected children admitted and readmitted in the paediatric ward of DGMH from 1st January to 31st December 2003. A full census of all the records of children admitted in the two paediatric wards was carried out. Descriptive and inferential statistics were used to analyze data. Results The study comprised 74 children, 28 (37.8%) female and 48 (62.2%) males. The average mean of initial admission length of hospital stay was 12.3 days and (SD = 12.1) days. The different diagnoses were classified in accordance with World Health Organization (WHO) Clinical Staging of HIV disease for infants and children with established HIV infection. Out of a total of 581 initial admissions, 74 (12.7%) children were readmitted. The mean interval days between the discharge date and readmission date was 9.8 days (SD = 7.0 days) and 94.6% of the readmissions occurred within the first two weeks of discharge date. Second readmission decreased by 75.3% as only 18 patients were readmitted. A further 95.9% decrease in the third readmission was noted with only 3 patients getting readmitted. iv The commonest causes of admission with HIV were broncho-pneumonia, gastro-enteritis, vomitting, oral thrush, immunosuppression with symptoms like fever,cough, respiratory distress. Causes of readmissions were broncho-pneumonia, oral thrush, diarrhoea, vomitting, immunosuppression, pulmonary tuberculosis, wasting and failure to thrive, dehydration associated with symptoms like fever, cough, respiratory distress and upper respiratory distress. Conclusion The rate of readmission was (12.7%) and majority of the readmitted children were in the 0- 2-year age group. The study results show a high prevalence of diseases of the respiratory system with a high frequency of broncho-pneumonia and a high prevalence of diseases of the digestive system with a high frequency of gastro-enteritis. The average mean of the initial hospital admission stay was 12.3 days, which was significantly higher than other studies previously conducted. The probable reason for a long hospital stay could be the high prevalence of co-infections among the children admitted.