ABSTRACT
Aim: To determine the abnormalities in total cholesterol (TC) levels and the potential risk factors in ART–naive, HIV-infected Nigerian children. Study Design: A retrospective and cross-sectional study. Place and Duration of Study: Paediatric antiretroviral therapy (ART) clinic of the Federal Medical Centre, Makurdi, between June 2010 and June 2012. Methods: Electronic data of 429 HIV-infected ART-naive children, aged 1–15 years, including 223 males and 206 females, were analysed to get the relevant information for the study. Abnormal un-fasted TC levels and the association with potential risk factors were tested in bivariate regression analyses. Abnormal lipid level was defined as hypercholestrolaemia when the TC was>200mg/dL and hypocholesterolaemia when TC was ˂160mg/dl. Normal TC was value between 160 and 200mg/dl. P-value less than 0.05 was significant. Results: The median age was 5.00 years with an interquartile range of 3.0 to 8.0 years. The TC ranged from 32 to 196 mg/dl with a mean value of 116±34.98mg/dl. Hypocholesterolaemia was the prominent finding in 88.3% (379/429) of the children. Hypercholestrolaemia was not found (0%). In bivariate analyses, no factor was found to significantly impact on hypocholesterolaemia, although a greater proportion of hypocholesterolaemia was seen in children: within 2-15 years age group (92.1%, 349/379); male gender (52.0%): HIV/AIDS stages 1&2 (82.6%); CD4 count>200 cell/mm3(81.5%); viral load>10,000 copies/ml (69.1%); hemoglobin˂10g/dl (61.7%); stunting (55.4%, 102/207) and undernourishment with body mass index (BMI)˂18.5 (83.7%, 164/222). Multivariate analysis was not done. Conclusion: A high prevalence of hypocholesterolaemia was found among the ARTnaive, HIV-infected Children, in Makurdi. The study could serve as a stimulus for our centre and other paediatric ART programmes in Nigeria to undertake an elaborate lipid profile of HIV infected children at diagnosis and on follow-up on ART.
ABSTRACT
Aims: To determine the prevalence, the pattern of usage and the predictors of complementary and alternative medicine (CAM) among children on highly active antiretroviral therapy (HAART). Study Design: Prospective, Cross-sectional and quantitative. Place and Duration of Study: Paediatric antiretroviral clinic of the Federal Medical Centre, Makurdi, Benue State, Nigeria, February 2012 to December 2012. Methodology: Researchers administered structured questionnaire to 409 (102 men and 307 women) consecutively consented caregivers (CGs) whose children had been on HAART for not less than 6 months in order to fulfill the objectives of the study. Results: 79.2% (324/409) of children used CAM as reported by their CGs. The three most commonly used CAM products were herbal concoctions containing majorly Bitter leaves (317/324, 97.8%), Ugu leaves/roots (282, 87.0%) and Neem tree leaves/bark (270, 83.3%). CGs also largely administered CAM whose contents were unknown (250, 77.2%). The use of Anointed water (255, 78.7%) and Anointed Oil (245, 75.6%) were also common. Animal products including Elephant skin (12, 3.7%), Elephant bone (10, 3.1%) and Snake bone (8, 2.5%) were also acknowledged. Spiritual healing was the most sought-for practice, seen among 252 (77.8%) CGs. 3.7% (12/324) of the CGs had disclosed the use of CAM to their primary physicians. Multivariate logistic regression analyses showed that: the use of CAM by CGs (AOR; 33.79, 95%CI; 8.049-141.856, P=.000); when the child on HAART is of a male gender (AOR; 2.142, 95%CI; 1.230-3.730, P=.007); fathers as CGs compared to mothers (AOR; 1.698, 95%CI;1.180-2.443, P=.004); CGs with no formal education compared to when CG attained a post-secondary level of education (AOR; 1.498, 95%CI; 1.127-1.990, P=.005), remained independently associated with the use of CAM in children. Conclusions: CAM use is common in Nigerian children on HAART. Concerted efforts should be put in place to encourage disclosure among CGs. Identified harmful CAMs should be discouraged.