Review of Children with AIDS in Kinshasa, Zaire

To gain knowledge about how acquired immunodeficiency disease (AIDS) is manifested in older children 52 seropositive children ages 2-12 years (mean age 6.4 years) admitted to Zaires Mama Yemo Hospital with clinical signs of AIDS were studied. All 52 children exhibited significant weight loss; 99% were below the 10th percentile weight for age and 86% were below the 3rd percentile. 50 children (95%) gave a history of chronic fever and 34 (65%) had respiratory infections. 31 children (60%) had hepatomegaly and 13 (25%) had splenomegaly. Chronic diarrhea was noted in about half these children. 15 (29%) had generalized lymphadenopathy. Opportunistic infections--most commonly oral candidiasis and cutaneous mycosis--were identified in 27 children (52%). Finally neurological complications chiefly convulsions were observed in 25% of the children. Boys were twice as susceptible to convulsions than girls. The average duration of hospitalization was 25 days. 12 children (23%) died during hospitalization. 8 of these deaths were associated with pulmonary infections (largely interstitial pneumonitis) and 4 were associated with neurological complications (convulsions). Hospitalization blood transfusions for malaria or sickle cell disease and the receipt of injections appeared to be the major risk factors in this group of children.