HIV infection, tuberculosis and workload in a general paediatric ward

Abstract

Aim: To describe the impact of HIV infection and tuberculosis on the workload of a general paediatric ward at Red Cross War Memorial Children’s Hospital in 2007.

Methods: Prospective descriptive surveillance of the patient composition of a general paediatric ward over a 1 year period.

Results: Median bed occupancy was 96.4%, and 66.7% of all patients admitted to the ward were < 12 months old. Of all admitted children, 27.6% had HIV infection, 16.7% had tuberculosis (TB) and 10.3% had HIV-TB co-infection. Of all children requiring high care, 23.1% were HIV-infected. Approximately 50% of all children with HIV infection were on antiretroviral therapy. The annualised nurse-to-patient ratios were 1 nurse per 2.7 patients and 1 registered nurse per 5.0 high care patients. Fifty six children died during admission; 34 (60.7%) were HIV-infected. Pneumonia was the main cause of death in both HIV-infected and uninfected children.

Conclusion: Despite the existence of prevention of mother-to-child transmission intervention and paediatric antiretroviral treatment programmes throughout the Western Cape, HIV infection and TB continues to contribute substantially to the general paediatric workload at the hospital. Work associated with specific nurse functions should be quantified so that patient-nurse ratios may be optimised.