Voluntary counseling and testing in the pediatric ward of mzuzu central hospital, Northern Malawi

Objectives: A voluntary counseling and testing (VCT) program to screen for human immunodeficiency virus (HIV) has been implemented in areas of high HIV prevalence; however, such services are not readily available to children in the clinics of sub-Saharan Africa. The objective of this study was to investigate the relationship between the clinical symptoms of children and HIV infection status. Methods: A cross-sectional study of children and their caregivers was conducted at a clinic in northern Malawi, a country with a high prevalence of HIV infection. A total of 85 (48.6%) pediatric patients and 82 (46.7%) caregivers were recruited in the study. The HIV VCT services were provided based on the principle of three C's (consent, counseling, and confidential). Results: The prevalence rates of HIV infection were 16.5% for children and 25.9% for their caregivers. In those children, 74.0% and 65.3% of HIV infections may be attributable to malnutrition and sepsis, respectively. Caregivers were mainly motivated to accept the VCT service or agree to have their children receive the test because they wanted to know their own HIV status (81.7%) and the status of their children (78.0%). Conclusion: When a child shows symptoms of malnutrition and sepsis, the clinic should recommend VCT to caregivers in order to help them learn about their own as well as their child's HIV status. After discussing factors that affect the advantages, disadvantages, limitations, and acceptability of offering routine VCT services, it is concluded that a standard approach to identify HIV infections in hospitalized children is urgently needed.