Pediatric HIV infection is rapidly emerging as a problem among children in India. As per HIV/AIDS sentinel surveillance data, Uttar Pradesh comes in group-III(1), showing low prevalence of HIV infection. Several factors make Agra a specially vulnerable area from the point of view of HIV transmission. Agra, being major tourist destination, is well connected by major highways and rail-routes to major cities. This also increases the likelihood of transmission to a significant degree.

This prospective study was conducted among hospitalized children between November 2001 and March 2003 at Department of Pediatrics. S.N. Medical College, Agra. For this study 120 children from 18 months to 12 years of age, suspected of having HIV/AIDS as per WHO criteria for diagnosis of AIDS in children in developing countries, were studied(2). Children below 18 months were not included in our study because of diagnostic difficulties. After taking consent from their parents, all these children were examined and screened for HIV infection. Diagnosis of HIV infection was confirmed by three positive ELISA tests i.e. three different ELISA on same sera, according to WHO strategy-III(3).

Out of total 120 children screened, 10 cases turned out to be HIV positive, showing the prevalence of 8.3% in high likelihood hospitalized children in this area. A similar study from Aligarh, Uttar Pradesh by Lahiri et al.(4) showed prevalence less then 1% in high risk hospitalized children. The high prevalence of 8.3% among high risk hospitalized children in our study is in sharp contrast to their observation. A study from Mumbai has shown prevalence as high as 15% among clinically suspected hospitalized children(5).

Most common route of infection in affected children was perinatal in eight (80%) followed by blood transfusion in one(10%). Mode of transmission in one case could not be determined. Sexual route was the most common route of infection in parents of affected children, as history suggestive of sexual promiscuity was obtained in 87.5% of these parents. Evaluation of awareness level revealed that 36.7% fathers and 63.2% mothers of total screened children had never heard of AIDS till the time of diagnosis. This lack of awareness is probably the most important cause for such a high prevalence of HIV transmission in this area. At this stage, we feel that, a more practical and planned approach is needed to increase disease awareness and penetrability of health services, so that the rapid spread of this deadly disease could be halted in time.

Sanjay Verma,
R. Bhatia,
Department of Pediatrics,
S.N. Medical College, Agra, U.P.
E-mail: [email protected]

1. National AIDS Control Organization. Country Scenario 2001-2002. Ministry of Health and Family Welfare. Government of India, New Delhi, 2003.

2. World Health Organization. Acquired Immunodeficiency Syndrome (AIDS). WHO/CDC case definition for AIDS. Wkly Epid Rec 1986; 61: 69-76.

3. Ministry of Health and Family Welfare, National AIDS Control Organization. HIV testing manual for strategies of HIV testing, Government of India, New Delhi: 2000; pp. 59-61.

4. Lahiri S, Shahab T, Malik A, Alam S. HIV seropositivity in hospitalized children with high clinical likelihood of AIDS. Indian Pediatr 2002; 39: 372-375.

5. Agarwal M, Koppikar GV, Ghildial R, Charvakar M, Joshi SM, Lahiri K. Seropositivity rate for HIV infection in hospitalized children on selective screening. Indian Pediatr 2001; 38: 267-271.