RESUMO
Background: HIV-infected children are surviving into adolescence and adulthood due to the effectiveness of highly active antiretroviral therapy (HAART) but they now have to cope with living with a chronic disease. Health-related quality of life (HRQOL) has been shown to be an invaluable tool in assessing health outcome in chronic health conditions including HIV. Little is known about the HRQOL of HIV-infected children in both developing and developed countries. The study aimed at assessing the HRQOL of Nigerian children with HIV infection and compare it with that of healthy children in Uyo. Methods: A cross-sectional study of 211 HIV-infected children aged 2 to 15 years and 211 age, sex and social class-matched HIV-uninfected children with their caregivers was conducted at the University of Uyo Teaching Hospital, Uyo for a duration of nine months from October 2016 to July 2017. A generic version of the Pediatric Quality of Life Inventory (PedsQL 4.0) was used to measure their HRQOL. Results: From both self and proxy reports, there was no significant difference in the mean total HRQOL score of HIV-infected children and that of HIV-uninfected children. Conclusions: HRQOL of HIV-infected children in Uyo, Akwa Ibom state was good and comparable to that of HIV-uninfected children. Assessment of HRQOL should be incorporated into routine antiretroviral therapy ART programmes as a measure of the outcome of disease management. This will further help to identify needs and direct interventions for holistic care of these vulnerable children.
RESUMO
Objective: Management of pleural fluid collection not due to trauma increases workload of the paediatric thoracic surgeons; while delay or inappropriate treatment worsens the prognosis of the disease. This study aimed at assessing the outcome of therapeutic tube thoracostomy in non-traumatic paediatric pleural fluid collections and identifying factors responsible for treatment failure with tube thoracostomy. Design: Prospective analysis of socio-demographic characteristics; clinical features; clinical diagnosis; radiological diagnosis; and bacteriological diagnosis including bacteria cultured with sensitivity pattern; also treatment offered including tube thoracostomy with duration of tube thoracostomy and length of hospitalisation; indication for additional surgical procedure with type; and outcome of treatment of 30 paediatric patients with non-traumatic pleural fluid collection. Results: Thirty paediatric patients with various causes of non-traumatic pleural fluid collection in 34 pleural spaces were analysed. Their ages ranged between six months and 16 years (mean = 6.5 years) and M:F ratio of 2:1. Pleural effusion and empyema thoracis accounted for 46 and 40 with staphylococcus aureus and streptococcus pneumoniae cultured in 10 each and a high negative culture rate of 46; which was higher with age. The parents of 40 of the patients belonged to social class 3. Success rate of tube thoracostomy was 86 in unilateral cases; 50 in bilateral cases and 81 in all cases. Alternative treatment with thoracotomy and decortications gave a success rate of 100. Conclusion: Thoracotomy with decortication is superior to tube thoracostomy in paediatric non-traumatic pleural fluid collection and should be chosen as the primary treatment option when there is bilateral disease; chronicity; loculated effusion; thickened pleural membranes or trapped lung
Assuntos
Países em Desenvolvimento , Hospitalização , Sepse , ToracostomiaRESUMO
Background: Behavioural problems among schoolchildren can pose a burden on families and society. Objective: To determine the prevalence and pattern of behavioural problems among children living in Uyo, a town in South-South Nigeria. Methods: A cross-sectional study was carried out among 572 pupils from six primary schools selected randomly from private and government schools in Uyo. Pupils with a normal IQ were selected using a systematic sampling method. The Rutter behavioural scale for teachers (B2) was completed by their teachers, and that for parents (A2) was completed by the parents. Student's t-test was used to compare pairs of means, frequencies were compared using the chi-square test, and p<0.05 was taken as significant. Results: According to the teachers' scale 132 pupils (23.1%) had scores within the range indicating behavioural problems, compared with 103 pupils (18.0%) on the parents' scale. This was statistically significant (Ï2=19.8, p=0.001). Pupils in government and private schools had mean scores of 7.4 (standard deviation (SD) 6.41) and 5.12 (SD 6.26) and 7.29 (SD 5.84) and 6.96 (SD 5.76), respectively. Behavioural problems were more common among children in government schools and among those in the lower socio-economic class. Boys had significantly higher mean scores than girls, and both scales showed more boys to be disturbed. Antisocial behaviour was commonest among boys and older children. Conclusion: There is a high prevalence of behavioural problems among primary school children in Uyo, with a predominance of antisocial behaviour. The government needs o provide appropriate services to deal with this state of affairs