Prevalence of Pubertal Delay in Paediatric Human Immunodeficiency Virus Infection

Research Article

Austin J HIV/AIDS Res. 2022; 8(1): 1053.

Prevalence of Pubertal Delay in Paediatric Human Immunodeficiency Virus Infection

Kan KM1*, Muyele H1, Monono N2, Fomenky C1, Chiabi A1 and Mah E3

¹Department of Clinical Sciences, Faculty of Health Sciences, The University of Bamemda, Cameroon

²Department of Paediatrics, Faculty of Health Sciences, University of Buea, Cameroon

³Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon

*Corresponding author: Kan KM, Department of Clinical Sciences, Faculty of Health Sciences, The University of Bamenda, North West Region, Cameroon

Received: October 04, 2022; Accepted: November 04, 2022; Published: November 11, 2022


Background: In Cameroon, Paediatric HIV occurs in 7 per 500,000 people living with HIV. HIV infection can result in impaired sexual development and delayed puberty. There are few studies on the impact of HIV on puberty.

Aim: To determine prevalence of pubertal delay in paediatric population infected with Human Immunodeficiency Virus (HIV) on antiretroviral therapy.

Methods: This was a cross-sectional descriptive study that assessed puberty using the Marshall and Tanner staging system in 120 HIV positive children aged 8-18years, at the Bamenda Regional Hospital treatment Centre from February to May 2022. Data obtained included sex, age, tanner stage of development and age at puberty.

Results: Of 120 participants included, the majority 64(53.3%) were girls. The median (IQR) age was 13.9(11.1-15.8) and 71(59.2%) were aged =13years. Sixty-three (52.5%) participants were in Tanner stage 1-2 and the prevalence of pubertal delay was 12.7%. Median age at puberty in years was thelarche: 12.5(9.9-14.4), adrenarche: 13.2(11.8-14.6), menarche: 14(13-14) in girls and gonadarche: 12.9(11.6-14.4), adrenarche: 13.3(11.4-14.4) in boys.

Conclusion: About 13% of HIV infected children on ART experience pubertal delay with a prevalence rate of 12.7%.

Keywords: Puberty; Human immunodeficiency virus; Paediatrics


Human Immunodeficiency Virus (HIV) in the paediatric population contributes to the high burden of infection in children aged 1-14 years and accounts for 1.7 million cases and 150,000 new infections annually with the Sub-Saharan Africa most affected [1]. In Cameroon, paediatric HIV occurs in 7 percent of 500,000 people who are living with HIV [2]. Morbidity and mortality from thisinfection is high and results in multi-systemic involvement including the endocrine system. Onset of puberty heralds sexual development and is enhanced by sex hormones bringing about body changes and selfimage. HIV infection results in impaired physical growth, wasting and resultant hypofunction of hypothalamic-pituitary gonadal axis resulting in impaired sexual development and delayed puberty [3-11]. Delayed puberty refers to lack of features of pubertal development by the age of 13 years in females and 14 years in males [13,14]. There are few studies on impact HIV on puberty and in Cameroon there is limited data on puberty in the paediatric HIV population, hence the necessity of this study to determine the prevalence of pubertal delay in a paediatric HIV infected population on Antiretroviral Therapy (ART) at a treatment centre in Cameroon.


Study Design and Setting

This was a hospital-based cross-sectional descriptive study over a 4 months period, carried out in the paediatric treatment centre of the Bamenda Regional Hospital (BRH); a second-level reference health institution for the North West Region of Cameroon. This facility follows up over 500 children aged between 0-19 years living with HIV and receiving Antiretroviral Therapy (ART) of which 250 are aged 8-18 years.

Study Population

Children aged 8-18 years who were HIV infected and followed up at the paediatric treatment centre of BRH whose parent or guardian consented to the study and who gave assent to participate in the study were included while those with chronic illnesses or genetic abnormalities such as sickle cell disease, congenital heart disease, chronic renal failure, diabetes, inflammatory bowel diseases, paediatric malignancies, genetic diseases (Downs syndrome, Turners syndrome) were excluded.

Ethical Consideration

Ethical clearance was obtained from the Institutional Review Board of the Faculty of Health Sciences, University of Bamenda and administrative authorization was also gotten from the North West Regional delegation for public health and the Bamenda Regional Hospital. Informed consent from the caregivers and assent from the children.

Study Procedure

Data Collection

Socio-demographic data was obtained in a structured preformed questionnaire and records of the physical examination to demonstrate features of sexual maturity. Sexual maturation was assessed by physical examination with the aid of graphic representations of the Marshall and Tanner staging system. This staging system grades pubertal development via assessment of external primary and secondary sexual characteristics in the subjects on a 5point ordinal scale in both boys and girls that ranges from 1 (pre pubertal) to 5 (adult like) for female breast, male genitalia and pubic hair for both males and females. Female participants were asked about their age at attainment of menarche.

Data Analysis and Management

Data obtained was entered into the software statistical package for social sciences (SPSS) version 26.0 for analysis. Quantitative variables were expressed as mean ± SD for normal distribution and medians and Interquartile Range (IQR) for non-normal or skewed distribution. Categorical variables were expressed as frequency and percentages.


General Characteristics of Study Participants

Table I highlights the socio-demographics of the 120 enrolled participants consisting of 64 (53.3%) female and 56 (46.7%) male with a female to male ratio of 1.1.Most of the subjects were above 13 years (59.2%) followed by those aged [10-13] years constituting 28.3% while those aged 8 to less than 10 years were the minority.