Conclusion et Recommandations
Les enfants infectés par le virus VIH ont
présenté un retard statural et pondéral et une
émaciation durant les douze mois d'étude.
Ils présentent tous un faible P/A,T/A, et P/T
malgré la mise sous traitement anti rétroviral qui ne semble pas
améliorer la croissance staturale, mais augmente le gain
pondéral.
D'où les recommandations suivantes:
F Aux personnels soignants : Renforcer
le dépistage volontaire du VIH chez les nouveau-nés et le suivi
de la croissance staturo pondérale des enfants nés de
mères séropositives.
F A la Faculté de Médecine et des
Sciences Biomédicales et à la Communauté
Scientifique : Encourager toute étude pouvant accroitre la
taille de l'échantillon d'un tel travail.
SUMMARY
Introduction and Objectives
Growth retardation is one of the main manifestations of HIV
infection as well as a risk factor for death in children. According to WHO, it
accounts for about 60% of all manifestations of HIV/AIDS in children. Many
studies carried out in children in different contexts in the United States and
Africa have shown that growth retardation is a sensitive indicator of disease
and a risk factor for death. The lack of studies in our milieu motivated us to
carry out this study.
The main objective was to compare the growth pattern in HIV
infected and non-infected children.
Methodology
The study was a prospective case-control study carried out in
the Mother and Child Centre of the Chantal Biya Foundation and in the
University Teaching Hospital from September 2008 to October 2009 on confirmed
HIV infected children of 6 weeks to 15 years. The study was
done on a sample of 39 infected cases and 39 non -infected controls and
followed up for a period of 12 months.
Results
The mean age of the infected children was 45.3 #177; 41.59
months and 44 #177; 40.68 months in the non-infected group but the difference
was not statistically significant.
The mean weight of the infected children was 13.57 #177; 8.82
kg compared to 17.03 #177; 8.04 kg in the non-infected group with a
statistically significant difference. The mean height was 94.04 #177; 61.22 cm
in the infected group compared to 98.1 #177; 24.9 cm in the non-infected, with
a statistically significant difference. The mean mid upper arm circumference
(MUAC) was 14.4 #177; 2.8 cm in the infected and 17.1 #177; 1.8 cm in the
non-infected group, and the difference was statistically significant.
The mean head circumference was 47.57 #177; 4.6 cm in the
infected children compared to 48.9 #177; 5.2 cm in the non-infected controls
with a statistically significant difference.
We noted that 20.5% of the infected children presented a
weight /height (WHZ) < - 2 against none in the non-infected group. The most
affected age group was that of the 26.5-27.5months, corresponding to the mean
age of 27 months with a mean z score of -5.4 in the infected children and the
difference was statistically significant. Concerning the evolution of the WHZ
scores over the 12 months follow-up period, they remained between - 1.9 and -
0.5 z score.
Most of the infected children (56.4%) had a weight/age (WAZ) z
score of < -2 compared to only 2.6% in the non-infected children. The most
affected age group was that corresponding to the mean age of 27 months with a
mean z score of - 5.9 in the infected children and the difference was
statistically significant. During the study period, the WAZ scores remained
between - 2.3 and -1.5, in the infected children, although all these children
were placed on antiretroviral therapy (ART) as they were all eligible for
treatment.
Concerning the height /age (HAZ) z scores, 51.3% of the
infected children had z scores < -2 with the most affected age group being
that of the 47.5 - 48.5 months (mean age 48months) and 126.5 - 127.5 months
(mean age 127months) with a mean HAZ of - 2.7. During the 12 months follow-up
period the HAZ scores, remained at between - 0.8 to - 1.8.
The age category of 27 months was the most affected in our
study sample, with a mean WAZ score of - 5.9 and a mean WHZ score of -5.4. On
the whole, the mean Z Scores for the various anthropometric indicators (WAZ,
HAZ and WHZ), were all low in the infected children compared to the
non-infected, on admission into the study and during the follow-up period.
No maternal factors significantly influenced growth of the
infected children.
Conclusion and Recommendations
HIV infected children manifested stunting, underweight and
wasting on admission and during the 12 months follow-up period.
They all had low WAZ, HAZ, WHZ scores despite antiretroviral
therapy which improved only the weight and not the height.
From these results, we recommended the following:
F To the Health Personnel : Strengthening
voluntary screening of the HIV in newborns and follow-up the weight and growth
of the children born from HIV-positive mothers.
F To the Faculty of Medicine and Biomedical Sciences
and the Scientific Community: Encourage any study that can increase
the size of the sample of such work.
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