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. 2018 Aug:73:10-17.
doi: 10.1016/j.ijid.2018.05.012. Epub 2018 May 28.

The role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0-59 months in Manhiça District, Rural Mozambique

Sozinho Acácio  1 , Tacilta Nhampossa  1 , Llorenç Quintó  2 , Delfino Vubil  3 , Charfudin Sacoor  3 , Karen Kotloff  4 , Tamer Farag  4 , Nasrin Dilruba  4 , Eusebio Macete  1 , Myron M Levine  4 , Pedro Alonso  5 , Inácio Mandomando  1 , Quique Bassat  6
Affiliations

The role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0-59 months in Manhiça District, Rural Mozambique

Sozinho Acácio et al. Int J Infect Dis. 2018 Aug.

Abstract

Background: Diarrhea is an important health problem among HIV-infected patients. This study evaluated the role of HIV in the epidemiology, etiology, and severity of diarrheal disease among children.

Methods: The Global Enteric Multicenter Study enrolled children with moderate-to-severe diarrhea (MSD) and less-severe diarrhea (LSD) between December 2007 and November 2012. One to three controls for MSD cases and one per LSD case were enrolled and matched by age, sex, and neighborhood. All children were tested for HIV. Clinical data, anthropometric data, and stool samples were collected. Follow-up was performed at 60 days.

Results: Two hundred and fourteen MSD cases and 418 controls, together with 349 LSD cases and 214 controls were tested. HIV prevalence was 25% among MSD cases (4% for matched controls) and 6% among LSD cases (6% among matched controls). HIV-infected children were more likely to have MSD (odds ratio 5.6, p<0.0001). Mortality rates were higher among HIV-infected children than among the uninfected (34 vs. 5 per 1000 child-weeks at risk; p=0.0039). Cryptosporidium, Giardia, and enteroaggregative Escherichia coli (aatA only) were more prevalent among HIV-infected MSD cases than among uninfected ones.

Conclusion: HIV is an important risk factor for MSD. The high mortality rate implies that children with MSD should be screened for HIV and managed accordingly.

Keywords: Children; Etiology; HIV; Less-severe diarrhea; Moderate-to-severe diarrhea; Mortality.

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Figures

Figure 1
Figure 1
Study profile: HIV counseling and testing among moderate-to-severe diarrhea (MSD) and less-severe diarrhea (LSD) cases and their matched controls.
Figure 2
Figure 2
Survival at the 60-day follow-up home visit according to HIV status among moderate-to-severe diarrhea (MSD) cases.
See this image and copyright information in PMC

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