Serum selenium status of HIV-infected children on care and treatment in Enugu, Nigeria

Objective. To compare the selenium status of HIV-infected and HIV-uninfected children. Methods. This was a hospital-based comparative study using a structured questionnaire in the quantitative research domain at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria. Seventy-four HIV-infected children were compared with 74 non-HIV-infected children (35 males and 39 females in each group). The outcome measure was the selenium status of the study participants. Results. The mean (standard deviation (SD)) weight-for-height z-score among the subjects was ­0.18 (1.53) compared with 0.05 (1.68) among the controls (p=0.457). The mean (SD) height-for-age z-score among the subjects was ­1.16 (1.44) compared with 0.06 (1.06) among the controls (p<0.001). Eighteen subjects (24.3%) compared with eight controls (11.4%) were selenium deficient (odds ratio 2.49; 95% confidence interval 1.00 - 6.18; p=0.044). Median CD4 counts of selenium-deficient and non-deficient subjects were 765.5 (range 409 - 1 489) and 694.0 (range 85 - 2 196) cells/µL, respectively (p=0.321). The proportions of selenium deficiency were 26.4% and 22.2% in the highly active antiretroviral therapy (HAART) and pre-HAART groups, respectively (p=0.565). Conclusion. There was a significant difference in the proportion of HIV-infected children who were selenium deficient compared with their uninfected counterparts

Prevalence and Risk Factors of Anaemia in Paediatric Patients in South-East Nigeria

Background. The causes of anaemia have regional variations; and further variation is expected among paediatric hospital patients. However; the prevalence of anaemia and its contributing risk factors among paediatric patients remain understudied in South-East Nigeria.Methods. The study involved 286 anaemic (haemoglobin (Hb) ?10 g/dL) and 295 non-anaemic preschool children attending a hospital outpatient department. A clinical research form was used to document demographic data; anthropometric measurements; disease details and packed cell volume. Common anaemia risk factors previously documented were studied. The prevalence rates of the independent variables were calculated and level of significance was determined; using ?2.Results. The prevalence of anaemia was 49.2; with the highest prevalence among children 12 months old (p

Clinical and Laboratory Profile of ARV Naive HIV Infected Children in the Era of Highly Active Anti-retroviral Therapy in Enugu, South-East Nigeria.

Background: HIV/AIDS is one of the most dynamic epidemic infectious diseases. An estimated 1000 children are newly infected with HIV every day, most of them in sub-Saharan Africa. They often present with various clinical and laboratory manifestations that complicates their management. Objectives: To determine the baseline clinical and laboratory features of HIV-infected children presenting at the University of Nigeria Teaching Hospital (UNTH) Ituku/Ozalla. Methods: Clinical and laboratory data were collected from HIV infected children seen at the Pediatric HIV Clinic of UNTH between July 1st 2010 and June 30th 2012. Clinical and immunological staging of the patients were done using the WHO criteria and data analysis was with SPSS version19. Results: Two hundred and ten children were enrolled into the study. The most common route of HIV infection was vertical transmission (95.2%). Common presenting clinical and laboratory data were: anaemia (92.9%), cough (76.2%), fever (63.3%), popular rash (62.9%) and poor weight gain (61.0%). Thirty-four children (16.2%) each had severe and moderate acute malnutrition while 92 children (43.8%) were stunted. Tuberculosis, hepatitis B and C co-infections were seen in 32.4%, 1.9% and 3.3% of the children respectively. Most of the patients had either a WHO clinical stage III (42.4%) or II (39.0%) disease. Severe immunosuppression based on CD4% or count was seen in more than half of the patients (59.1%). Conclusions: Anaemia was the most common clinical/laboratory finding; followed by cough. Although our patients were likely to present with WHO clinical 2 or stage 3 disease, severe immunological suppression was common.

Assessment of Clinical Features and Haematocrit Levels in Detection of Hypoxaemia in Sick Children

This cross-sectional study was to determine the prevalence of hypoxaemia among sick children in EnuguState University Teaching Hospital, Enugu, Nigeria and correlate it with clinical features and haematocrit levels.Ninety-two (92) sick children aged 2­48 months hospitalised at the teaching hospital were recruited after obtaining consent from their carers.The prevalence of hypoxaemia in this study, defined by oxygen saturation of less than 90%, was 13%, and was not dependent on age or sex. A higher proportion of subjects with hypoxaemia had tachypnoea (81.8%),compared with those without (18.2%) (χ² = 1.69; p=0.19).The sensitivity of using tachypnoea alone to predict hypoxaemia was 18.4% while the specificity was 92.3%.The presence of hypoxaemia predicted poor outcome 66.7% of those that died had hypoxaemia. The difference was statistically significant (χ2= 17.9; p=0.00).Tachypnoea had a poor sensitivity although good specificity in predicting hypoxaemia. Presence of hypoxaemia connotes poor prognosis. We recommend that finger pulse oximeters, which are cost effective,should be routinely available at hospitals in developing countries, so that hypoxaemia can be detected earlier and more intensive management instituted

Evaluation of Sexual Maturity among Adolescent Male Sickle Cell Anaemia Patients: the Usefulness of Testicular Volume Estimation

Use of Tanner stages i.e. Sexual Maturity Rating; (SMR); in evaluation of sexual maturity has gained widespread acceptance. Tanner staging assesses pubic hair growth and increase in genital sizes; the latter of which is best reflected by the increase in testicular size. Testicular volume increases is thought to be the most sensitive clinical indication of onset and progress of puberty. It has been argued that the initial stage of sexual development may be missed if testicular volume is not assessed. We explored usefulness of testicular volume estimation for assessing sexual maturity among adolescent male sickle cell anaemia (SCA) patients. Methods: We conducted a cross-sectional case-control study evaluating sexual maturation of male patients with sickle cell anaemia and those with HbAA genotype. Tanner staging and testicular volume assessment were both used as models for evaluating stages of sexual maturation among SCA patients and their normal counterparts matched for age and socioeconomic status. Results: SCA patients demonstrated delay in onset and completion of sexual maturation. Testicular volumes (TV) of subjects were smaller than those of controls but when related to stages of sexual maturity; there was no statistically significant difference between both groups. The correlation coefficients between various stages of sexual maturity and TV suggest strong associations. Conclusion: Testicular volume increase is shown as a reasonably good predictor of onset and progression of sexual maturity in both SCA subjects and their healthy controls

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