Comparative Assessment of Serum Selenium Status in HIV-Infected and Non-infected Children: A Pilot Study in a Tertiary Hospital in Nigeria.

Background Selenium is an essential micronutrient that plays a crucial role in a wide range of physiological processes, including immune responses. Selenium deficiency has been recognized as an associated factor in the progression of HIV to advanced HIV disease and/or mortality. Although selenium supplementation has been shown to reduce hospitalizations and improve cellular immunity, the evidence remains mixed. This study aimed to determine the prevalence of selenium deficiency and its relationship with HIV disease markers in HIV-infected children at the Lagos University Teaching Hospital. Methodology This is a cross-sectional, comparative, pilot study of plasma concentrations of selenium in HIV-infected (n = 30) and non-infected (n = 20) children enrolled in the pediatric HIV clinic of the Lagos University Teaching Hospital, Lagos, Nigeria, from May 2019 to May 2021. HIV-infected children were on stable antiretroviral therapy (ART) with an undetectable viral load. The serum concentration of selenium was measured using the automated atomic absorption spectrophotometer (hydride generation method). Logistic regression was used to study the effect of selenium status on the levels of HIV disease markers (CD4 count, viral load, weight, opportunistic infections) in the study participants. Results The median age of all participants was nine (4-12) years, with 74% being boys. The mean selenium concentrations were lower in HIV-infected children (91.1 ± 12.0 µg/L) compared to the comparison group without HIV (147.8 ± 4.9 µg/L) (p = 0.001). After controlling for age, ART duration, markers of HIV infection, and other potentially confounding variables, participants with selenium deficiency had approximately 11-fold odds of increased hospital admissions (adjusted odds ratio = 10.57, 95% confidence interval = 1.58 to 70.99; p = 0.015). Conclusions In this study, selenium concentrations were significantly lower in HIV-infected children than in the HIV-negative comparison group. Lower serum selenium concentrations were associated with increased hospitalizations. Although our findings suggest the potential need for selenium supplementation for children living with HIV in Nigeria, further studies are warranted to determine the safety and efficacy of selenium supplementation in this key population.

Awareness and practice of cord blood donation by pregnant women in Lagos Nigeria: Practice implication for future cord blood transplantation in Nigeria.

Background: Poor awareness remains a substantial limitation to harnessing the benefits of umbilical cord blood (UCB) in sub-Saharan Africa. The aim of this study was to determine the level of awareness and factors influencing intention to donate cord blood to blood bank among antenatal clinic attendees at a tertiary hospital in Nigeria. Methods: We conducted a questionnaire-based cross-sectional study of 400 women attending the antenatal clinic of a tertiary hospital in Lagos, Nigeria, between February and June 2018. The data were analyzed using Stata version 13; comparisons were conducted with Chi-square, Student's t-test, and Mann-Whitney U-test. Univariable and multivariable binary logistic regression was conducted with "willingness to donate" as the outcome variable. Results: Majority (n = 287/331 [86.2%, 95% confidence interval [CI]: 76.4-84.9]) of the participants had some knowledge of UCB, almost half intended future donation of UCB (n = 161/333, [48.3%, 95% CI: 42.9-53.6]). Based on our findings, factors such as religion (P = 0.001), education (P = 0.03), information from health-care provider (P < 0.001) appear to influence awareness, and the decision to donate UCB. Conclusion: Although the awareness of the clinical uses of UCB is very limited in Nigeria, the intent to participate in UCB donation is high. Factors such as religion, education, and prior information about UCB donation by health-care providers have been identified in this study to have an influence on the decision to donate UCB.

RésuméContexte: La faible sensibilisation demeure une limitation substantielle à l'exploitation des avantages du sang de cordon ombilical (UCB) en Afrique subsaharienne. Le but de cette étude était de déterminer le niveau de sensibilisation et les facteurs influençant l'intention de donner du sang de cordon à une banque de sang parmi Les participants à une clinique prénatale dans un hôpital tertiaire au Nigéria. Méthodes: Nous avons mené une étude transversale basée sur un questionnaire auprès de 400 femmes fréquentant la clinique prénatale d'un hôpital tertiaire à Lagos, au Nigeria, entre février et juin 2018. Les données ont été analysées à l'aide de Stata version 13; des comparaisons ont été effectuées avec le chi carré, le test t de Student et le test U de Mann-Whitney. Binaire univariable et multivariable une régression logistique a été effectuée avec la "volonté de donner" comme variable de résultat. Résultats: Majorité (n = 287/331 [86,2%, confiance à 95% intervalle [IC]: 76,4­84,9]) des participants avaient une certaine connaissance de l'UCB, près de la moitié des dons futurs prévus de l'UCB (n = 161/333, [48,3%, IC à 95%: 42,9-53,6]). Des facteurs tels que la religion (P = 0,001), l'éducation (P = 0,03), les informations fournies par le prestataire de soins de santé (P <0,001) ont influence la sensibilisation et la décision de faire un don d'UCB. Conclusion: Bien que la connaissance des utilisations cliniques de l'UCB soit très limitée au Nigéria, la l'intention de participer au don UCB est élevée. Facteurs tels que la religion, l'éducation et les informations préalables sur le don d'UCB par les soins de santé les prestataires ont été identifiés dans cette étude comme ayant une influence sur la décision de faire un don d'UCB.

Prevalence of insulin resistance among patients attending the HIV clinic in a Nigerian tertiary hospital.

BACKGROUND: Insulin Resistance(IR) is increasing in Africans as well as among the Human Immunodeficiency Virus(HIV) infected population for several reasons which include the viral infection itself and the use of Highly active antiretroviral therapy (HAART). This present study assessed the prevalence of IR among HIV infected population and the imminent effect of the disease and therapy on patients. METHODS: This cross sectional study was conducted in Lagos among 266 HIV infected participants and 130 HIV Negative controls aged 18-80 years. Questionnaires were administered and fasting venous blood samples collected for plasma glucose and insulin. Homeostatic Model Assessment (HOMA-IR) and Quantitative Insulin Check Index (QUICKI) indices were used to establish Insulin Resistance using a cut off of >2 and <0.339 respectively. RESULTS: Insulin resistance was prevalent in 24.1% of HIV-infected participants based on a HOMA-IR and 21.1% using QUICKI compared to 8.5% and 4.6% in the HIV uninfected controls (p<0.001). A prevalence of 25.8% was found among the HAART exposed group compared to 10% among the HAART naïve group (p=0.056) using HOMA-IR while QUICKI results showed 22.5% and 10% respectively (p=0.115). CONCLUSION: This study established a significantly high prevalence of IR among HIV infected patients and a higher but non-significant prevalence among the HAART exposed group. Close monitoring of patients is recommended to reduce the risk of developing Diabetes Mellitus. Further research work is needed to identify ways of lowering the prevalence of IR in HIV infected persons.