Article Text
Abstract
The HIV/AIDS epidemic has placed increasing demands on limited paediatric intensive care services in developing countries. The decision to admit HIV infected children with Pneumocystis carinii pneumonia (PCP) into the paediatric intensive care unit (PICU) has to be made on the best available evidence of outcome and the ethical principles guiding appropriate use of scarce resources. The difficulty in confirming the diagnosis of HIV infection and PCP in infancy, issues around HIV counselling, and the variance in the outcome of HIV infected children with PCP admitted to the PICU in African studies compound this process. Pragmatic decision making will require evaluation of at least three ethical questions: are there clinical and moral reasons for admitting HIV positive children with PCP to the PICU, should more resources be committed to caring for HIV children who require the PICU, and how can we morally choose candidates for the PICU? Those working in the PICU in HIV endemic regions need to make difficult personal decisions on effective triage of admissions of HIV infected children with PCP based on individual case presentation, availability of resources, and applicable ethical principles.
- ART, antiretroviral treatment
- ELISA, enzyme linked immunosorbent antibody assay
- ICU, intensive care unit
- KEH, King Edward Hospital
- MTCT, mother-to-child transmission
- PCP, Pneumocystis carinii pneumonia
- PICU, paediatric intensive care unit
- HIV
- ICU
- children
- infection
- developing world
Statistics from Altmetric.com
Footnotes
Read the full text or download the PDF:
Other content recommended for you
- Short-term mortality and implementation of antiretroviral treatment for critically ill HIV-infected children in a developing country
- Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition
- The effect of HIV infection on paediatric bacterial meningitis in Blantyre, Malawi
- Aetiology and management of malnutrition in HIV-positive children
- Impact of HIV on mortality from acute lower respiratory tract infection in rural Zambia
- Respiratory morbidity from lymphocytic interstitial pneumonitis (LIP) in vertically acquired HIV infection
- Chest radiographic abnormalities in HIV-infected African children: a longitudinal study
- A retrospective study on the effects of colistin therapy in children with multidrug-resistant Gram-negative bacterial pathogens: impact of HIV status on outcome
- Impact of HIV-1 status on the radiological presentation and clinical outcome of children with WHO defined community-acquired severe pneumonia
- The impact of HIV and antiretroviral therapy on TB risk in children: a systematic review and meta-analysis