Peripheral neuropathy in HIV-infected children attending care and treatment clinic, at Muhimbili National Hospital, Dar es Salaam: a cross sectional study

• Published in: BMC neurology 2021-08, Vol.21 (1), p.314-314, Article 314
• Main Authors: Amiji, Insiyah A, Naburi, Helga E, Kija, Edward, Mumburi, Livin P
• Format: Article
• Language: English
• Subjects: Adolescent; African languages; Age; Ankle; Antiretroviral agents; Antiretroviral therapy; Body mass index; Care and Treatment; CD4 antigen; Child; Child, Preschool; Children; Complications and side effects; Cross-Sectional Studies; Disease prevention; Female; HIV; HIV infection in children; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Hospitals; Human immunodeficiency virus; Humans; Infections; Isoniazid; Male; Pain; Pediatric research; Pediatrics; Peripheral nerve diseases; Peripheral Nervous System Diseases - epidemiology; Peripheral Neuropathy; Public health; Reflexes; Risk factors; Statistics; Tanzania - epidemiology; Variables
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-021-02335-0

Peripheral neuropathy (PN) is a neurological complication of untreated Human Immunodeficiency Virus (HIV) infection or exposure to certain antiretroviral drugs. In Tanzania where HIV is a major public health problem, the burden of HIV associated peripheral neuropathy has not yet been well defined in children.Thisstudy investigated the prevalence and associated factors for peripheral neuropathy among children living with HIV, attending Care and Treatment Clinic (CTC) at Muhimbili National Hospital (MNH). A cross-sectional study was conducted among 383 HIV positive children aged 5 to 18 years at MNH, CTC in Dar es Salaam between October to December 2019. All participants provided written assent/consent. Structured questionnaires designed for this study was used to collect data and screening for peripheral neuropathy was done on each participant using the Pediatric modified Total Neuropathy Score (Ped m TNS) that includes subjective and objective assessment. A score of 5 or greater on the Ped m TNS was used to define peripheral neuropathy. Data analysis was done using SPSS Version 23. The prevalence of peripheral neuropathy among HIV infected children was 14.1 % (95 % CI (10.8 - 18 %). Common neuropathic symptoms were numbness, tingling sensation, reduced ankle reflexes and reduced sensation to light touch and pain that was limited to the toes. Low CD4 cell count (OR = 12.21; 95 % CI3.75-39.66; p = 0.0001), high viral load (OR = 10.54; 95 % CI 3.19-34.77; p = 0.0001), ART regime containing NRTI plus PI (OR = 3.93; 95 % CI 1.43- 10.74; p = 0.01) and the last exposure to isoniazid more than 6 months ago (OR = 3.71; 95 % CI 1.57-8.77; p = 0.003) were independent predictors for peripheral neuropathy. Peripheral neuropathy is common among HIV infected children attending CTC at MNH and its frequency increases with advanced disease. The choice of ART regimen and other drugs for treating comorbid conditions should carefully be evaluated.