ABSTRACT
Background:Untreated maternal Human Immunodeficiency Virus (HIV) infection is associated with adverse pregnancy outcome including preterm birth, low birth weight, and mother-to-child transmission of the virus. This study aimed to compare the pregnancy outcome between HIV infected mothers who received ART in pregnancy and those who were ART-naïve. Methods:A cross-sectional study of HIV-infected mothers who brought their infants for follow up between November 2007 and May 2017 at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.Relevant information obtained include: time of diagnosis, antiretroviral therapy (ART) regimen and when it was commenced, gestational age at delivery and birthweight of child, mode of delivery, infant feeding option and ARV prophylaxis. Infection status of the infant was determined by DNA PCR at 6weeks of age. Based on when ART was commenced, mothers were grouped into three [(HAART experienced (HE) if ART was started before pregnancy, HAART in pregnancy (HIP) and HAART naive (NH) if no HAART was taken in pregnancy].Main outcome measures were rates of prematurity, low birth weight, mean birth weight, birth defects and mother-to-child transmission Result:A total of 1,640 HIV-exposed infants were seen (716(43.6%) in HE, 360(22.0%) in HIPand 564(34.4%) in NH groups). There were 825(50.3%) males and 815(49.7%) females. Zidovudine/Lamivudine and Nevirapine/Efavirenz was the most frequently used combined ART in 724 (67.3%) mothers. The mean birthweight was 3.12±0.38Kg; range 1.2 –5.7Kg (3.11±0.58Kg in HE; 3.13±0.53Kg in HIP; 3.18±0.74Kg in NH) Table 3. A hundred and eighty (11.0%) babies were preterm [76(42.2%) in HE; 26(14.4%) in HIP; 78(43.3%) in NH](p=0.007), while 159(9.7%) were LBW [74(46.5%) in HE; 22(13.8%) in HIP; 63(39.6%) in NH](p=0.03). Fourteen (0.9%) babies had birth defects [5(35.7%) in HE; 9(64.3%) in HIP] (p=0.01). The commonest birth defects were neural tube defect 7(50%) and congenital heart defect 4(28.8%). Overall transmission rate was 21.4% [8% in the HE, 4.5% in HIP and 87.5% in NH groups] (p=0.001). The mean birth weights of uninfected babies were higher than their infected counterparts but was not significant (p>0.05).Conclusion:The benefits of early HAART in reducing mother-to-child transmissionmust be weighed against the risks of lower birthweight and potential teratogenic effects of drug exposure on the foetus
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Background:Malaria is a life threatening protozoan infection and children under 5 years are one of the most vulnerable group. Good malaria preventive practices among these group is key to reducing malaria burden and its associated mortality Objective:The aim of the study was to assess malaria preventive practices among under-five children in Rivers State, Nigeria. Materials and Methods:This was a cross sectional study carried out in public and private health facilities in Rivers state. Ethical approval for the study was obtained from the Research and Ethics committee of the University of Port Harcourt Teaching Hospital, while an informed written consent was obtained from the parents or caregivers of the participants. Stratified sampling method was used to select the health facilities and the subjects for the study. A pretested interviewer administered questionnaire was used to harvest relevant information on socio demographic characteristics of the subjects and informants and malaria preventive practices. Obtaineddata was analysed using SPSS version 22 and results are presented in prose and tables. Results:A total of 1138 children participated in the study constituting of 613 (53.9%) male and 525(46.1%) female giving a male: female ratio of 1.2:1. Mean age of participants was 1.74±1.08 years. Mothers, accounted for majority 1012 (88.9%) of the informants. Most of the informants had tertiary degree; 605 (53.4%) and 697 (61.8%) among mothers and fathers respectively. Among the occupations of fathers, public servants, civil servants and the self-employed were more represented, constituting 242 (21.4%), 200 (17.7%) and 149 (13.2%) respectively. Traders/business women, the self-employed and civil servants were most represented among the occupations of mothers in the study and these accounted for 444 (39.7%), 181 (16.2%) and 137 (12.3%) respectively. Malaria preventive practices included use of Insecticide-treated bed nets (ITNs), Indoor spraying of insecticide (modified IRS), use of antimalarial drugs, clearing of bushes/ disposal of containers where mosquitoes breed and use of mosquito repellent creams which constituted 605 (53.2%), 483 (42.4%), 133 (11.7%), 4 (0.4%) and 2 (0.2%) respectively; there were 512 (45.0%) children who slept under ITNs the previous night. Also, 970 (85.2%) had window nets installed in their homes. Protective window nets was also in place in the homes of 970 (85.2%) of the study participants. Among families that practiced use of ITNs, 110 (61.8%) were from the middle social class and 62 (34.8%) were from the upper social class, while 316 (52.2%) and 276 (45.6%) were from the upper and middle social class respectively among those that practised Indoor spraying of insecticide (IRS). Conclusion:Use of ITNs, modified IRS and use of anti malarials were the common malaria preventive practices among under-fives in Rivers state and these methods were more practiced among the middle and upper social class. Education on the integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be intensified
ABSTRACT
Background: Amblyopia is a common cause of visual impairment in children with uncorrected refractive errors, so screening and treatment should be carried out as early as possible to prevent permanent visual loss. Objective: To determine the prevalence of amblyopia among individuals less than 18years with refractive errors presenting to the Ophthalmology clinic of the University of Port Harcourt Teaching Hospital (UPTH). Methods: Children with refractive errors presenting at UPTH over a period of 2 years were studied. Their bio-data and relevant medical and ocular history were obtained. Their visual acuity was measured and standard ophthalmic examination was done for the anterior segment with a pen torch and slit lamp bio-microscope. The posterior segment was examined with Welch Allen direct ophthalmoscope. All the children in the study were refracted using the appropriate techniques. Result: A total of 306 children with refractive errors were studied, out of which 110 (36%) were males and 196 (64%) were females. Of these children, 204 (66.7%) had astigmatism, 68 (22.2%) had Myopia, 23(7.5%) had hypermetropia and 11(3.6%) had inconclusive refraction. Two hundred and seventy eight (90.8%) of these children with refractive errors had optimal correction by refraction while 17(5.6%) had developed amblyopia. All the children who had amblyopia were between 13 and 18years; five (29.5%) were males while twelve (70.5%) were females which is statistically significant (p=0.00001). Conclusion: The prevalence of amblyopia among children with refractive error is high and therefore early screening and intervention is important to prevent permanent visual loss.