Prevalence and pattern of bacteraemia among HIV-infected under-five children in a tertiary hospital in Kano, Nigeria

Background: Bacteraemia is an invasive bacterial disease of childhood that is associated with serious complications and high mortality especially in immunocomprised HIV infected children.Aim: To determine the prevalence and pattern of bacteraemia among HIV-infected Under-five children.Design: It was a prospective cross -sectional study.Subjects and Methods: One hundred and thirty four febrile HIVinfected children were recruited from the outpatient departments and emergency room of a tertiary hospital to determine the presence of bacteraemia, the etiologic agent and antibiotics susceptibility. An automated (BACTEC) incubator was used to detect bacteraemia, subcultures were done and identification and antibiotic susceptibility tests were done using standard laboratory procedures. Sociodemographic and clinical data were obtained using a proforma and data analysis was done using SPSS version 17.0 for windows. Results: The prevalence of bacteraemia in HIV-infected children was 14.2% (19/134). Salmonella typhi and Staphylococcus aureus were the predominant isolates, each accounting for 21% of all cases of bacteraemia. Most (81.3%) of the subjects were on HAART and its use had no effect on rate of bacteraemia. Fourteen (73.7%) and 12(63.2%) of the isolates were sensitive to ciprofloxacin and ceftriaxone respectively. Sensitivities to ampicillin, cloxacillin and co-trimoxazole were 0.0%, 5.3% and 5.3% respectively.Conclusion: Bacteraemia is a significant health problem among HIV-infected under-five children despite the high rate of HAART use. Treatment adherence should be strengthened among this population. There is need for improvement in personal and food hygiene, environmental sanitation and possibly introducing typhoid vaccine among under-five HIV-infected children

Perception and knowledge of mothers on causes and treatment of rickets associated knee deformity in Ile-Ife, Osun State, Nigeria

This descriptive cross-sectional community-based study was carried out in Ile-Ife; Nigeria to assess the knowledge of mother's on the aetiology of rickets associated knee deformities and the cultural perception of its treatment. Data collection was done using interviewer based semi structured questionnaires. A total of 464 questionnaires were administered with a response rate of 86.9. Over half (59.8; N=241) and 36.5(147) of the mothers were aware of children with knee deformity and rickets; respectively. Ninety-one (22.6) mothers had the correct knowledge and perception of the true meaning of rickets. Rickets associated knee deformity aetiology was wrongly perceived to be mainly hereditary (53.8); cancer (50.9) and bone infection (48.1). Very low proportions of mothers had correct knowledge on the causes of rickets such as inadequate exposure to sunshine (21.3) or inadequate intake of calcium (21.1). The knowledge of aetiology of rickets was influenced by education (P0.02); skilled occupation (P0.0001) and the previous birth of a child with knee deformity from rickets (P0.001). The mother's cultural perceptions of treatment for childhood rickets associated knee deformities was significantly affected by age (P0.001); education; (P0.001); skilled occupation (P0.000); history of knee deformity (P0.04) and mothers with children diagnosed to have knee deformity (P0.004). Lack of finance; poor compliance to treatment; too long treatment periods; lack of information on where to seek for treatment and unaffordable treatment were among the important factors affecting completeness of treatment of knee deformity due to rickets. In conclusion; the awareness of mothers about rickets in Nigeria is still very low. It is a major reason for late presentation or complete failure to seek for adequate treatment of the knee deformity due to rickets. Increase and sustain public health enlightenment programmes are necessary for prevention. Health policy should incorporate free surgical fees for the established knee deformity to encourage community participation in the management of the condition

Pyogenic meningitis in Ilesa, Nigeria.

This study was conducted in 124 children with meningitis to review the etiology, antimicrobial susceptibility and outcome of disease in a Nigerian tertiary health facility. Of these, 97 (78.27%) were culture positive; in the rest 27(21.8%), diagnosis was based on Gram staining of the CSF. Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus and Escherichia coli were isolated in 33.9%, 33.9%, 5.6%, 2.4%, and 2.4% samples respectively. All the isolates had 100 percent; sensitivity to both ceftriaxone and ciprofloxacin while the sensitivities to penicillin and ampicillin were remarkably low. The mortality was 33/124 (26.6%) while 16/ 91 (17.6%) of the survivors had various neurologic sequelae.