Incidence of Ventilator-associated pneumonia in the critical care unit at Kenyatta National Hospital, a public tertiary care hospital

Abstract

Background: Human Immunodeficiency virus infected children are highly susceptible to opportunistic infections of the respiratory system which are the most common cause of morbidity and mortality. The chest radiograph is the most frequently requested examination for the evaluation of respiratory disease. Its applications include screening, diagnosis and monitoring response to medication of respiratory illnesses.Objective: To determine the prevalence of abnormal chest radiograph findings among HIV infected children. Design: Prospective cross-sectional descriptive study Setting: Kenyatta National Hospital and Mbagathi Level 5 Nairobi County hospital Subjects: The chest radiographs and clinical history of 123 HIV infected children below 15 years were studied between November 2014 and February 2015. Results: The age range of the children was 1-15 years with a median age of 24 months. The male: female ratio was 1:1.02. Normal chest radiographs were found in 54/123 (44%) while 69/123 (56%) had abnormal chest radiographic findings. Pulmonary opacities were identified in the majority of patients with abnormal chest radiographs (67%) while almost 51% showed lymphadenopathy. In the pulmonary opacities, “other infiltrate’’ (61%) was found to be more common than consolidation (39%). Pleural effusions were not common while cavitary lesions and pneumothorax were not identified. There was no significant association between the radiographic findings and the children’s age and sex. The findings of this study correlated well with similar studies in Africa. Conclusion: HIV infected children especially those below the age of 5 years, are highly susceptible to chest infections. This was seen in the high prevalence of cough and severe respiratory distress as well as the significant number of abnormal chest radiograph findings. The high prevalence of ‘other infiltrate’ in this study may indicate that the causative pathogen may not respond to standard antibiotic regimes; and further clinical studies to confirm this are required.