Prevalence and route of transmission of undiagnosed human immunodeficiency virus infection among children using provider-initiated testing and counselling strategy in Ido-Ekiti, Nigeria: a cross-sectional study

Introduction: ninety-one percent of global Human Immunodeficiency Virus (HIV) infection in children occurs in sub-Saharan Africa. Provider Initiated Testing and Counselling (PITC) Strategy is a means of reducing missed opportunities for HIV exposed or infected children. The present study determined the prevalence of HIV infection using PITC Strategy among children seen at the Paediatric Emergency Unit of Federal Medical Centre (FMC), Ido-Ekiti, and the possible route of transmission. Methods: cross-sectional study on prevalence of HIV infection using PITC model. 530 new patients whose HIV serostatus were unknown and aged 15 years or below were recruited consecutively and offered HIV testing. Serial algorithm testing for HIV infection using Determine HIV-1/2 and Uni-Gold rapid test kits was adopted. Seropositive patients younger than eighteen months had HIV Deoxyribonucleic Acid Polymerase Chain Reaction (HIV DNA PCR) test for confirmation.Results: twenty-four (4.5%) of the 530 patients were confirmed to have HIV infection; of whom 19(79.2%) were less than 18 months of old; with age range of five to 156 months. Fifteen (62.5%) of the infected children were females; likewise, the gender specific infection rate was higher (%) among the females compared with (%) among the males. Two of the HIV infected children's mothers were late, while the remaining 22 mothers (%) were HIV seropositive. Mother-To-Child-Transmission was the most likely route of transmission in the children. Conclusion: PITC strategy is vital to the early diagnosis and effective control of HIV infection in children. However, this cannot be totally effective if PMTCT is not optimized

Vestibulo-otologic Events in Drug-resistant Tuberculosis Patients on Medications.

Aims: This study aims to document the onset, types and factors associated with vestibulo-otologic (VO) events among patients on treatment for drug resistant Tuberculosis (DRTb). Study Design: This is a prospective study of patients with drug resistant Tuberculosis who were admitted for the intensive phase of treatment with injectable medications. Place and Duration of Study: The study was carried out at drug resistant Tuberculosis (DRTb) centre, Sacred Heart Hospital, Lantoro, Abeokuta, Nigeria between October 2013 and December 2014. Methodology: Patients with complaints referable to VO effects of medications were recruited into the study. Clinical evaluation included the type, onset and duration of the vestibular or otologic events. Further information were retrieved from the patients case note records which included age, sex, retroviral status, weight on admission and height, from where the body mass index (BMI) was calculated. Data analyses were performed using SPSS version 20. Results: A total of 121 patients comprising of 80 male and 41 female patients. Modal age group distribution for all patients was the group 21-40 years (72.7%), while the mean age ±SD was 32.9±13.7 years. The duration of treatment ranged from 12 to 20 weeks, mean ±SD= 14±3.4 weeks. VO events occurred in 40.5%, vestibular events alone were in 27.3% while otologic events alone occurred in 33.1%. The VO events were noticed between 6-19 weeks of treatment (mean ±SD= 11.1±4.7 weeks). Dizziness/imbalance were the most common vestibular while tinnitus was the most common otologic event. Among the patients with VO events, 13/46=28.3%, had repeat pure tone audiometry, and 7 (15.2%) met audiometric criteria for ototoxicity. Conclusion: Vestibulo-otologic events were common among DRTb patients in Nigeria. The major complaints started around 11 weeks on medication. Factors associated with the VO events were female gender, being underweight and retroviral positive.