{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:10:14Z","timestamp":1791213014259,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2011,4,7]],"date-time":"2011-04-07T00:00:00Z","timestamp":1302134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> To describe the contribution of paediatric HIV and of HIV co\u2010infections to admissions to a hospital in Moshi, Tanzania, using contemporary laboratory methods.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> During 1\u2003year, we enrolled consecutively admitted patients aged \u22652\u2003months and &lt;13\u2003years with current or recent fever. All patients underwent standardized clinical history taking, a physical examination and HIV antibody testing; standard aerobic blood cultures and malaria film were also done, and hospital outcome was recorded. Early infant HIV diagnosis by HIV\u20101 RNA PCR was performed on those aged &lt;18\u2003months. HIV\u2010infected patients also received serum cryptococcal antigen testing and had their CD4\u2010positive T\u2010lymphocyte count and percent determined.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> A total of 467 patients were enrolled whose median age was 2\u2003years (range 2\u2003months\u201313\u2003years); Of those patients, 57.2% were female and 12.2% were HIV\u2010infected. Admission clinical diagnosis of HIV disease was made in 10.7% and of malaria in 60.4%. Of blood cultures, 5.8% grew pathogens; of these 25.9% were <jats:italic>Salmonella enterica<\/jats:italic> (including 6 <jats:italic>Salmonella<\/jats:italic> Typhi) and 22.2%<jats:italic>Streptococcus pneumoniae. Plasmodium falciparum<\/jats:italic> was identified on blood film of 1.3%. HIV infection was associated with <jats:italic>S.\u00a0pneumoniae<\/jats:italic> (odds ratio 25.7, 95% CI 2.8, 234.0) bloodstream infection (BSI), but there was no evidence of an association with <jats:italic>Escherichia coli<\/jats:italic> or <jats:italic>P.\u00a0falciparum<\/jats:italic>; <jats:italic>Salmonella<\/jats:italic> Typhi BSI occurred only among HIV\u2010uninfected participants. The sensitivity and specificity of an admission clinical diagnosis of malaria were 100% and 40.3%; and for an admission diagnosis of bloodstream infection, they were 9.1% and 86.4%, respectively.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold>  <jats:italic>Streptococcus pneumoniae<\/jats:italic> is a leading cause of bloodstream infection among paediatric admissions in Tanzania and is closely associated with HIV infection. Malaria was over\u2010diagnosed clinically, whereas invasive bacterial disease was underestimated. HIV and HIV co\u2010infections contribute to a substantial proportion of paediatric febrile admissions, underscoring the value of routine HIV testing.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2011.02774.x","type":"journal-article","created":{"date-parts":[[2011,4,7]],"date-time":"2011-04-07T23:34:39Z","timestamp":1302219279000},"page":"830-837","source":"Crossref","is-referenced-by-count":75,"title":["Invasive bacterial and fungal infections among hospitalized HIV\u2010infected and HIV\u2010uninfected children and infants in northern Tanzania"],"prefix":"10.1111","volume":"16","author":[{"given":"John A.","family":"Crump","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib O.","family":"Ramadhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Morrissey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levina 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