Background: In Africa without antiretroviral treatment more than half of the HIV infected children die by 2 years. The
recommended HIV virological testing for early infant diagnosis is not widely available in developing countries therefore a
presumptive diagnosis is made in infants presenting with symptoms suggestive of HIV disease.
Objectives: To identify presenting signs and symptoms predictive of HIV infection in hospitalized children aged between
2- 18 months at Harare Hospital, Zimbabwe.
Methods: In a cross sectional study the baseline clinical information was collected and HIV infection confirmed using DNA
PCR. Multiple logistic regression analysis was used to identify significant predictors of symptomatic HIV infection. Diagnostic
parameters (sensitivity, specificity) and their 95% confidence intervals were calculated.
Results: 355 children with an overall median age of 6 months (IQR: 3, 10.5 months) of whom 203 (57.2%) were HIV
DNA PCR positive. Clinical signs independently predictive of HIV infection were cyanosis, generalized lymphadenopathy,
oral thrush, weight for age z-score <-2 and splenomegaly. The sensitivity of these signs ranged from 43-49% with a higher
specificity (ranging from 72.3-89.5%).
Conclusion: Clinical identification using individual signs for probable HIV infection in hospitalized children below 18
months would provide an opportunity for early diagnosis, treatment.