Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

BACKGROUND:The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV-related oral lesions in paediatric Nigerian patients on HAART with those not on HAART.MATERIALS AND METHODS: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross-sectional study over a 2-year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P-value of <0.05 was considered significant.RESULTS:A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm(3), 913 cells/mm(3) and 629 cells/mm(3) for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56-1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54-0.94; P=0.024) and HIV-gingivitis (OR=0.59; 95% CI=0.46-0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV-periodonttitis (OR=0.60; 95% CI=0.51-0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31-5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62-2.06).CONCLUSION: HIV-related Oral lesions are frequently seen in HIV-infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV-gingivitis

Effect of instructions about the method of urine collection and storage on the isolation rate of urinary bacteria in children

A study of 65 children (29males and 36females) and aged between four weeks and 15years with significant bacteriuria was undertaking over a six month period to determine the effects of instruction received about the methods of urine collection and storage on the prevalence of urinary tract infection. The commonest clinical presentation was fever (64.6). Only 22(35.4) of the patients had specific symptoms suggestive of urinary tract infections. The instructions about urine collection were given to 48(73.8) care givers. This instruction was given by the attending doctors (84). Despite the explanation; 15(23.1) of the patients collected the urine samples wrongly and 44(67.7) stored the samples for longer than one hour. Significant bacteriuria was more prevalent in 74.2of patients who submitted their urine samples more than one hour after collection. Communication skill is important and should be emphasized in the trainings of health workers in procedure on the patients

Childhood diabetes mellitus in Kano, North West, Nigeria

There is paucity of literature on childhood diabetes mellitus from developing countries and especially North west Nigeria and this has made it pertinent for documentation of the features of the disease in a major regional referral centre. The study was designed to describe the clinical presentation and outcome of childhood diabetes mellitus. Retrospective review of hospital records of paediatric patients managed for diabetes at Aminu Kano Teaching Hospital; Kano. Nigeria between January 1999 and December 2006. The age; sex; presenting features; complications; laboratory features and outcome of the patients were retrieved from the hospital records. During the years under review eleven out of 3;585 admissions were managed for Type 1 diabetes mellitus giving a prevalence rate of 3.1/1000. Male to female ratio was 1:0.6. The mean age at presentation was 10 4.5years most of the patients (72.7) belonged to the lower socio-economic classes IV and V. The duration of symptoms ranged from 6 58days with a mean of 24 22.8days. The patients presentedwith urinary tract infections (36.4); malaria (27.3) and recurrent boils (18.2). Three (27.3) of the patients had polyuria and polydypsia while only one (91) patient had polyphagia and weight loss. The mean random blood glucose on admission was 28.5 7.9mmo/L (16.9 39.2mmo/L) Four patient presented with diabetic Keloacidosis. Two patients (18.2) were discharged against medical advice while 1(9.1) patient died. Childhood Diabetes Mellitus; remains relatively uncommon in Nigeria

Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria

Background: Nephrotic syndrome is a common childhood renal disorder; the prevalence of Urinary tract infection (UTI) in these patients is high. The increased prevalence of UTI are due to immunoglobulin loss; defective T cell function; presence of ascites and relative malnutrition. Objective: The study is to evaluate the prevalence of UTI ; its etiological agents; antibiotics; sensitivity pattern and the outcome in children with nephrotic syndrome. Methods: A prospective study of all patients with diagnosis of nephrotic syndrome from January 2003 to December 2006. Urine specimen were routinely obtained by clean catch method following careful preparation urethral orifices. The specimens were processed immediately. Five millimeters (5mml) loopful of the sample were inoculated on a blood agar and CLED agar plates. Identification of the organism to species level was by using stokes disc diffusion technique. Results : Forty two patients were studied. The mean age and SEM for males was 8.2 + 0.5 years and females with 7.9 + 0.8years. The age range was two to fifteen years UTI was caused predominantly by Staphylococcus aureus in 67.9; Klebsiella species (17.9) and Pseudomonas (14.2). There was high invitro resistance of these organisms to nalidixic acid and ampicillin but sensitive to cefotaxime; ceftriazone and ciprofloxacin. Conclusion: It is recommend that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate

A Seven - Year Review of Accidental Kerosene Poisoning in Children at Aminu Kano Teaching Hospital

Background: Accidental ingestion of kerosene is a potential source of morbidity and mortality in children. The objectives of the study are to determine to magnitude of the problem and proffer feasible solutions to reduce the frequency of occurrence. Methodology: The medical records of all cases of kerosene poisoning admitted into Paediatric Medical Ward and Emergency Paediatric Unit were identified and relevant data extracted and analysed. Results: Kerosene poisoning constituted 55 (1.2) of cases of all paediatric admissions within the period (Jan 1999 Dec 2005). The study showed that children 4 months to 8 years were affected with peak age of 18 months. Thirty-four (61.8) of the cases were aged below 2 years which conforms to findings in earlier studies in Nigeria. Main clinical feature was cough with difficulty in breathing in 52 (94.5) of cases. Others features noted were central nervous system involvement (14.5); vomiting (20); and fever 16 (29.1). There were 3 deaths giving the mortality of 5.5. Conclusion: The study has revealed that kerosene poisoning is a significant cause of morbidity and mortality. Government policies that will enhance the standard of living of people and education of parents/care givers are the identified imperatives for reduction of the problem

Outcome of delivery among HIV positive mothers at Aminu Kano teaching hospital; Kano

BACKGROUND: If a HIV positive mother delivers in a health facility; interventions can be effected to reduce the risk of transmission of HIV to the baby. The study was done to evaluate the interventions offered to HIV positive women who delivered at Aminu Kano Teaching Hospital (AKTH) Kano. METHOD: Retrospective review of the case records of all HIV positive patients that delivered at AKTH over a 27 month period (October 2003 to December 2005) was used. RESULTS: There were 4922 deliveries out of which 125 were HIV positive; giving a prevalence rate of 2.54. Most (75.2) of the patients received Nevirapine alone in labour; 20.8 received a combination of antiretroviral drugs while 4 received none because their records were not available. Majority (88) of the patients had spontaneous vaginal delivery; 10.4 by elective CS and 1.6 by emergency CS. There was no maternal death but 3.2 of the babies were stillbirths. All the babies received a single dose of Nevirapine. Most (96) mothers chose exclusive breast milk substitute. CONCLUSION: HIV positive mothers need to deliver in health facilities to receive the full compliment of care they deserve. Highly Active Antiretroviral therapy (HAART) should be introduced; as it is more effective for PMTCT

Outcome of Delivery among HIV Positive Mothers at Aminu Kano Teaching Hospital

BACKGROUND: If a HIV positive mother delivers in a health facility; interventions can be effected to reduce the risk of transmission of HIV to the baby. The study was done to evaluate the interventions offered to HIV positive women who delivered at Aminu Kano Teaching Hospital (AKTH) Kano. METHOD: Retrospective review of the case records of all HIV positive patients that delivered at AKTH over a 27 month period (October 2003 to December 2005) was used. RESULTS: There were 4922 deliveries out of which 125 were HIV positive; giving a prevalence rate of 2.54. Most (75.2) of the patients received Nevirapine alone in labour; 20.8received a combination of antiretroviral drugs while 4received none because their records were not available. Majority (88) of the patients had spontaneous vaginal delivery; 10.4by elective CS and 1.6by emergency CS. There was no maternal death but 3.2of the babies were stillbirths. All the babies received a single dose of Nevirapine. Most (96) mothers chose exclusive breast milk substitute. CONCLUSION: HIV positive mothers need to deliver in health facilities to receive the full compliment of care they deserve. Highly Active Antiretroviral therapy (HAART) should be introduced; as it is more effective for PMTCT

Outcome of Delivery among HIV Positive Mothers at Aminu Kano Teaching Hospital

BACKGROUND: If a HIV positive mother delivers in a health facility; interventions can be effected to reduce the risk of transmission of HIV to the baby. The study was done to evaluate the interventions offered to HIV positive women who delivered at Aminu Kano Teaching Hospital (AKTH) Kano. METHOD: Retrospective review of the case records of all HIV positive patients that delivered at AKTH over a 27 month period (October 2003 to December 2005) was used. RESULTS: There were 4922 deliveries out of which 125 were HIV positive; giving a prevalence rate of 2.54. Most (75.2) of the patients received Nevirapine alone in labour; 20.8received a combination of antiretroviral drugs while 4received none because their records were not available. Majority (88) of the patients had spontaneous vaginal delivery; 10.4by elective CS and 1.6by emergency CS. There was no maternal death but 3.2of the babies were stillbirths. All the babies received a single dose of Nevirapine. Most (96) mothers chose exclusive breast milk substitute. CONCLUSION: HIV positive mothers need to deliver in health facilities to receive the full compliment of care they deserve. Highly Active Antiretroviral therapy (HAART) should be introduced; as it is more effective for PMTCT