Children and Hiv/AIDS in SOUTH AFRICA

Children and HIV /AIDS in South Africa Has the child lost weight ?-- check for possible HIV infection

The definition for AIDS Wasting Syndrome is 10 body weight loss

It is crucial to remember in pediatric patients , that this can amount to as little as a 1 kilogram (kg ) weight loss

As soon as weight loss , for any reason , is noted , a full assessment should be done

Remember that the downward slope for weight loss is a slippery one and can be hard to reverse in small children Oral Thrush Infants and children

who have HIV are more likely to develop a condition of the mouth called thrush

Caused by the overgrowth of the Candida albicans fungus , commonly known as yeast Infection is seen on the tongue and the inside of the cheeks

Appears as white patches on the inside of the mouth that look like left over milk Oral Thrush Quite painful , causing the child to have difficulty eating and drinking

May result in bleeding if the patches are scraped off

A bland diet may be easier for the child to tolerate

Thrush can occur in babies with a normal immune system or normal CD4 counts

Thrush is treated with a liquid medication called Nystatin

Parotid Enlargement Approximately 10 of HIV-positive children examined have parotid swelling of various degrees

Unilateral or bilateral diffuse , soft swelling of the parotid salivary glands

Often causes a dry mouth (xerostomia

Accompanied by pain

Parotid Enlargement Benign lymphoepithelial lesions of the parotid gland associated with HIV infection results from the involvement of intra-parotid lymph nodes by persistent generalized lymphadenopathy

Various treatments for benign lymphoepithelial cysts of the parotid gland - simple aspiration to surgical resection , pharmacotherapy , or radiotherapy

Correct identification of salivary lymphoid infiltrates has important implications for the prognosis and patient management Cotrimoxazole Prophylaxis The low-cost antibiotic

Reduced mortality in children with HIV by 40

Treatment costs about US 0 .03 a day , or about US 10 a year per child

4 million children younger than age 15 years could benefit from treatment with co-trimoxazole

Administer once daily on every day of week

Begin at 6 weeks in all infants of HIV positive mothers Cotrimoxazole Prophylaxis Counsel and Support mother /caretaker Counseling is identified as a key element in the management of a child with HIV /AIDS infection

Support mother /caretaker in identifying ways of meeting the baby 's micronutrient needs

Demonstrate the preparation of the foods the mother /caretaker has chosen

Stress the importance of using clean water and clean containers for replacement feeding Counsel and Support mother /caretaker Ensure that each child has a Child Health Card Assess children for complete and up-to-date immunization Counsel mothers /caretakers about importance of taking their children for monthly growth promotion and monitoring Nutritional counseling should be given to all mothers / caretakers Advise the mother /caretaker to take the child for regular follow up to ensure the child completes immunization Competition...