Spectrum and outcome of clinical diseases in adults living with AIDS at the Ogun State University Teaching Hospital.

OBJECTIVES: To evaluate the changing frequency of HIV/AIDS amongst medical admissions as well as the spectrum and outcome of clinical diseases among these patients. DESIGN: Retrospective study. SETTING: Tertiary hospital in Nigeria. PARTICIPANTS: Two hundred and six People Living With AIDS (PLWA) admitted at the medical wards during the period 1992 to 2002. INTERVENTION: Treatment was symptomatic in all patients and where appropriate, specific treatment was administered for indicator diseases. Highly Active Anti-retroviral Therapy (HAART) was not used. MAIN OUTCOME MEASURES: Mortality within six months of diagnosis. RESULTS: PLWA constituted 4.2% of all medical admissions. The frequency increased from 0% in 1992 to 7.6% in 2001, and dropped to 5% by the year 2002. Seventy patients (34%) died within six months of diagnosis. RESULTS: This study has demonstrated an increasing frequency of HIV/AIDS amongst our medical in-patients from none in 1992 to 7.6% in 2001, and thereafter, a decline in 2002. We suspect that this decline could be a reflection of the health education on HIV, its increasing awareness and the widespread utilisation of effective control measures. Furthermore, the administration of highly active anti retroviral therapy (HAART) to a segment of PLWA in Sagamu by the community medicine department could be contributory. CONCLUSION: A community based study would be needed to assess the efficacy or otherwise of these current control measures. The advent of saliva and urine tests for HIV detection would ease specimen collection and increase compliance and participation at the community level.

Serial haemorheological changes in malnourished African children.

Malnutrition is a major cause of mortality and morbidity in the developing nations, and it is a problem which concerns about half of the worlds children. A total of 50 malnourished children were monitored along with 50 apparently healthy controls, aged 4-9 years for a period of four weeks after admission using haemorheological parameters as monitoring indices for recovery. The malnourished children had significant lower body weight, upper arm circumference and triceps skin fold thickness (P < 0.001). Plasma fibrinogen (PF), plasma viscosity (PV) and packed cell volume (PCV), were estimated. The PF (p < 0.001), PCV (P < 0.001) and PV (p < 0.001) values were significantly lower in the malnourished patients compared with controls. These parameters rose significantly throughout the four weeks of treatment. There was significant positive linear correlation between PCV vs fibrinogen (r = 0.665, P < 0.00137), PCV vs plasma viscosity (r = 0.575, P<0.00797), and fibrinogen vs plasma viscosity, (r = 0.581, P < 0.00718) in the malnourished patients. We suggest that rheological parameters could be a useful indices for monitoring response in African malnourished patients to treatment.