The purpose of the study was to describe the probability of HIV infection with a given clinical manifestation (listed below) in this population of children. Children admitted with one or more of the target signs or symptoms were tested for HIV. The study was quite small, with only 115 children tested and 23 positive for HIV. Oral thrush and generalized dermatitis were the most specific sign while generalized lymphadenopathy was the most sensitive. See below for a table of the significant results.

Sandeep B. Bavdekar and Rinku Agarwal, Clinically Directed Selective Screening for HIV Infection in Hospitalized Children. Indian Pediatrics 2005; 42:1191-1197

Target features: children with one or more of these were tested: chronic diarrhea, severe malnutrition, persistent cough, generalized lymphadenopathy, oral thrush, hepatomegaly, repeated common infections, generalized dermatitis, chronic parotid swelling, recurrent bacterial infection, disseminated tuberculosis and/ or PCP pneumonia.

Only the three features in the following table were significantly (p < 0.05) related to HIV positivity. However, the study had low power so should not be interpreted to mean that the other features were unrelated. Notably, over 91% of the positive children had more than one positive finding (median three findings).

Comment: Although these findings are for children in India. they seem to fit with what we're observing at Evangel. When I trained in the mid 1980s, palpating the fontanelle of an infant was called "the pediatrician's handshake" because we did it so instinctively and immediately. Now I find myself palpating the axillary lymph nodes instead. This limited study provides some data to back that up (although it looked at generalized rather than axillary adenopathy).

Average user rating

   (0 vote)