Research Article: Causes of Acute Hospitalization in Adolescence: Burden and Spectrum of HIV-Related Morbidity in a Country with an Early-Onset and Severe HIV Epidemic: A Prospective Survey

Date Published: February 2, 2010

Publisher: Public Library of Science

Author(s): Rashida A. Ferrand, Tsitsi Bandason, Praise Musvaire, Natasha Larke, Kusum Nathoo, Hilda Mujuru, Chiratidzo E. Ndhlovu, Shungu Munyati, Frances M. Cowan, Diana M. Gibb, Elizabeth L. Corbett, Glenda E. Gray

Abstract: Rashida Ferrand and colleagues show that HIV infection is the commonest cause of hospitalization among adolescents in a high HIV prevalence setting.

Partial Text: In industrialised countries trauma and behavioural disorders, such as substance abuse, obesity, and sexually transmitted infections account for most adolescent morbidity [1]. Chronic diseases, trauma, oncology, and mental disorders account for the majority of hospital admissions [2],[3]. In Africa, research on adolescent morbidity has been limited and has predominantly focused on reproductive health, reflecting the high incidence of sexually transmitted infections and obstetric problems among young people [4],[5].

The main finding of this study is that HIV is now the single most common cause of acute admission and in-hospital death among adolescents in Harare. HIV-infected adolescents were profoundly immunosuppressed, and the median CD4 count (51 cells/µl) was similar to that reported in other studies of hospitalised African adults in the pre-ART era [20],[21]. The spectrum of HIV-associated infections was also similar to that reported in African adults in the pre-ART era [15]. However, adolescents had an additional and heavy burden of chronic complications—such as growth failure and lung and cardiac disease—that have typically been reported in vertically HIV-infected children [22]–[24]. In this study, underlying chronic complications were associated with an increased risk of in-hospital death.



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