Validation of a new clinical case definition for paediatric HIV infection, Bloemfontein, South Africa
Joubert, G.; Schoeman, C.J.; Bester, C.J.
Journal of Tropical Pediatrics 51(6): 387
2005
ISSN/ISBN: 0142-6338 PMID: 15890723 DOI: 10.1093/tropej/fmi029Document Number: 260353
Following a study conducted in 2000, evaluating the WHO clinical case definition for paediatric human immunodeficiency virus (HIV) in Bloemfontein, South Africa, anew case definition was proposed, namely that HIV is suspected in a child who has had at least 2 of the following 4 signs: marasmus, hepatosplenomegaly, oropharyngeal candidosis, and generalized lymphadenopathy. The case definition was found to have a sensitivity of 63.2% and a specificity of 96%. In 2002, a study was conducted to investigate the association of cardiovascular abnormalities with HIV infection. The study was also conducted in the general paediatric wards at Pelonomi Hospital, Bloemfontein. Information regarding the 4 elements of the proposed case definition was added to the questionnaire. In the original study (n=201), splenomegaly and hepatosplenomegaly had similar sensitivities and specificities, 42.0% and 41.2%, and 92.2% and 94.0%, respectively. In the validation study (n=202); splenomegaly instead of hepatosplenomegaly was noted. Using the original data, the new case definition had a sensitivity of 63.2% and a specificity of 96.0%; corresponding values using the validation data set were 75.9% and 73.0%, respectively.