Prevalence and risk factors for hepatitis c and human immunodeficiency virus co-infection among children in Enugu, Nigeria

Background: Hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV), are major public health challenges in the developing world especially sub-Saharan Africa. The aim of this study was to determine the prevalence and risk factors of Hepatitis C virus infection among children infected with HIV. Methods: This was a cross-sectional study conducted at the Paediatric HIV Clinic, UNTH, Enugu between July and December 2009. Antibodies to HCV were analyzed by newer generation rapid chromatographic immunoassay method using the Chromatest one step HCV test kit. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 15 statistical software. The chi squared test was used to test for significant association of categorical variables. A p-value of <0.05 was accepted as significant. Results: One hundred and eighteen children HIV-infected children, aged between eighteen months to fifteen years were included in the data analysis. Eight of the HIV infected subjects were positive for HCV, giving an HIV-HCV co-infection prevalence of 6.8%. Co-infection was more prevalent among males and in those in age group 11-15 years. Blood transfusion, irrespective of frequency (p<0.015), and injections for immunization (p<0.049) were the significant risk factors noted Conclusion: There is need for strengthening of existing preventive strategies against HCV and HIV infections such as screening of donor blood and safe injection practices in our locality

Prevalence of Human Immunodeficiency Virus Transmission among Transfused Children with Sickle Cell Anemia in Enugu Nigeria

Background: There are a number of routes for human immuno-deficiency virus (HIV) transmission in children. Blood transfusion-related HIV is still common in developing countries like Nigeria especially among high risk children such as those who require repeated blood transfusions. Aim: The aim of this study was to find the prevalence of HIV among transfused children with sickle cell anemia in Enugu. Subjects and Methods: This is a descriptive cross-sectional study conducted at the Sickle Cell Clinic of the University of Nigeria Teaching Hospital; Enugu Sixty-nine transfused children with SCA were enrolled after obtaining consent from their caregivers and assent from older children. Non transfused children matched for age; sex; and social status with the subjects served as control. Voluntary counseling and testing were then provided. Relevant data were obtained using pretested questionnaire. Statistical Package for Social Science (SPSS) version 11 (Chicago; IL) was used for data analysis. The chi-square was used to test for significant association of categorical variables and a P-value of less than 0.05 accepted as significant. Results: HIV antibodies were found in 2.9 (2/69) of the subjects and in 1.6 (1/64) of the control (P = 0.604). All the infected individuals among the subjects were males; had only been transfused once and were from the lower socioeconomic class. The only infected child from the control group was a 7-year-old male and he probably acquired it through vertical transmission since the mother also tested positive to HIV antibody. Conclusions: Blood transfusion is still a risk factor for HIV transmission among children with sickle cell anemia in Nigeria. Strategies that will ensure improved blood transfusion safety at health facilities need to be strengthened

Practice of Asthma Management among Doctors in South-East Nigeria

The major role of airway inflammation in childhood asthma has been recognised for more than a decade; and anti-inflammatory drugs now form the mainstay of treatment. In order to optimise treatment and achieve a better outcome; different guidelines have been introduced for asthma management. Examining the practice of the medical practitioners who manage asthma will help establish the gaps and provide informed advice on the current national and international guidelines. Our objective was to investigate the appropriate treatment of acute bronchial asthma by medical practitioners in south-east Nigeria. Two hundred and eighty-five doctors were interviewed using a structured questionnaire. Evaluation for differences in asthma management by doctors with different years of practice and heath facilities was carried out. Results were analysed with Epi info version 3.5. We concluded that management based on newer trends in childhood asthma management and adherence to management guidelines is less common among doctors that work in non-tertiary health facilities and among doctors that graduated more than 15 years ago or less than 5 years ago. This needs to be improved for optimal management of these patients. The need for regular continuing medical education for all doctors cannot be over emphasised

Some Behavioural Risk Factors for Intestinal Helminthiasis in Nursery and Primary School Children in Enugu; South Eastern Nigeria

The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. Design: A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. Setting: This study was carried out in the research laboratory of the Federal Ministry of Health; National Arbovirus and Vector Research Centre; Enugu. Method: Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis . Results: The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (X2 = 75.77; df = 2; p = 0.001) and with different habits of washing fruits before eating ( X2 = 52.79; df = 2; p = 0.001) among the pupils. Also; the rate of helminthic infection varied significantly with the source of drinking water (X2 = 55.12; df = 3; p = 0.01); water boiling habits (X2 = 40.89; df = 2; p = 0.001); use of footwear after school hours (X2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (X2 = 80.25; df = 3; p = 0.001) also significantly influenced the rate of helminthic infection. Conclusion: Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic habits which are obvious risk factors for intestinal helminthiasis

Demographic and Sociocultural Characteristics of Sickle Anaemia Children with Positive Hepatitis B Surface Antigenaemia in a Tertiary Health Facility in Enugu

Hepatitis B virus infection is contracted through contact with body fluid of infected persons. Patientswith sickle cell anaemia (SCA); a common haematological disorder inNigeria; have tendencies to visit traditional healerswho administer scarifications and ritualmarks thatmay expose themtoHBVinfection. To determine the demographic and socio-cultural characteristics of children with SCA infected withHBVat theUniversity ofNigeriaTeachingHospital Enugu. Two hundred and twenty one children aged 6months to 17years with SCA were recruited consecutively from October 2004 to April 2005. They were screened for HBsAg using ELISA method. There was no statistically difference in hepatitis B surface antigenaemia among different age group (P=0.907). Social class did not significantly influence the prevalence of HBsAg among subjects (p=0.887). socio-cultural practices like circumcision and scarification did not influence the prevalence of HBsAg; (p=0.636) (p=0.771) respectively. Significantly highernumber of people fromlowest socioeconomic class practice scarification (p=0.0001). Demographic and sociocultural factors do not appear to influence the prevalence of HBsAg among childrenwith SCAinEnugu;Nigeria. Sickle cell anaemia; Hepatitis B surface antigenaemia; Demographic; Sociocultural characteristic

Sociodemographic Differences in the Distribution of Hepatitis C Virus Antibodies among Children with Sickle Cell Anemia in Enugu; South East Nigeria

Background:Hepatitis C virus (HCV) has become an important cause of chronic liver disease and liver cancer worldwide. A study of the sociodemographic differences in the distribution of HCV antibodies (Anti-HCV) among those at risk will broaden knowledge of the problem among patients in this part of the country. Objective: To determine the sociodemographic differences in the distribution of HCV antibodies among transfused children with sickle cell anaemia (SCA) in Enugu and compare it with their non- transfused counterparts. Methodology: The study was conducted among two hundred and sixty-nine children with SCA attending the paediatrics sickle cell clinic at University of Nigeria Teaching Hospital (UNTH) Enugu; 136 transfused SCA patients as subjects and 133 age and sex matched non-transfused SCA as controls were studied. Results: There was no statistically significant difference in the age and sex distribution of the anti-HCV positive subjects and controls P 0.05. Majority of the subjects (66.7) and control (71.4) who tested positive were in lower socio-economic class. Conclusion: HCV infection is not uncommon in children with SCA. There is no significant difference in the sociodemographic characteristics of the HCV positive subjects and controls

Effect of Social Class and Area of Domicile on the Prevalence of Intestinal Helminthiasis in Nursery and Primary School Children in Enugu

Objective:The primary objective of the study was to determine the effect of social class and area of domicile on the prevalence of helminthiasis in nursery and primary school children in Enugu.Subjects and method: This was a cross-sectional study in which stool samples were obtained from 460 nursery and primary school children from different social classes and different areas of domicile and analysed for intestinal helminthiasis using the Kato Katz method.Results: One hundred and sixty-six (36.1) of the 460 children studied lived in the urban area; 215 (46.7) lived in the semi-urban area and 79 (17.2) lived in the urban slum area. The prevalence of intestinal helminthic infection was lowest in children living in urban areas (10.2) and highest in those in urban slums (48.4). There was a significant relationship between residential abode or area of domicile and prevalence of helminthic infection (?2 = 59.54; df = 2; p = 0.001).The prevalence of intestinal helminthic infection was highest in the lower class (50.9); lowest in the upper class (9.7) and intermediate in the middle class (21.7). This trend was statistically significant (?2 = 65.06; df = 2; p = 0.001). Conclusion: It is concluded that the prevalence of intestinal helminthiasis is affected by both areas of domicile and social class of children. Hence; intervention by the government to create better areas of domicile and to improve the social class of its populace will reduce the prevalence of intestinal helminthiasis