HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

AIMS: To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. METHODS: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. RESULTS: Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. CONCLUSIONS: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

Blood pressure values in healthy term newborns at a tertiary health facility in Enugu, Nigeria.

BACKGROUND: Blood pressure (BP) is a reflection of hemodynamic variables. It is an important vital sign and indicator of clinical stability. Accurate measurement of this physiological signal is essential for the optimal management of the ill infant. An increase in the awareness of hypertension among neonates has resulted to increased ability to diagnose neonates with the disease. OBJECTIVES: This study aimed to determine BP values in apparently healthy term newborns in the first 48 h of life and evaluate the factors affecting BP at birth. METHODS: Three hundred and ten healthy appropriate for gestational age term newborns were consecutively recruited. BP measurements were determined using the oscillometric technique with the neonate supine after an appropriate size cuff was applied on the right arm. The monitor (Dinamap 8100) is switched on while the cuff inflation and deflation is automatically done by the instrument with subsequent display of the BP values on the screen. BP measurements were taken at age 0-24 h and 25-48 h. Their weight was measured with infant's weighing scale, and data analyzed with SPSS version 15. RESULTS: The mean systolic BP (SBP), diastolic and mean arterial BP at 0-24 h were 63.3 ± 5.5 mmHg, 36.8 ± 5.3 mmHg and 46.4 ± 5.2 mmHg respectively. There was a positive correlation between birth weight and SBP at birth. No significant correlation was found between BP and gender, mode of delivery or maternal age. CONCLUSION: This study provides current normative BP values that can be used in neonatal Intensive Care Unit.

Disseminated Histoplasmosis in a 13-year-old girl: a case report.

BACKGROUND: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune-compromised individuals such as those with acquired immuno-deficiency syndrome. OBJECTIVE: To describe a case of disseminated histoplasmosis in an adolescent girl. METHOD: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. RESULT: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. CONCLUSION: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-year-old girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.

Mothers' perception of excessive crying in infancy in south eastern Nigeria.

BACKGROUND: Excessive infant crying, though usually benign, can be very troublesome to parents with unwanted consequences on the child. Previous reports had shown cultural and racial differences in it's perception by mothers. We undertook this study to determine the prevalence of excessive crying in our area of practice and also determine associated factors. METHOD: This was a cross sectional, questionnaire based descriptive study on mothers' perception of their infants' crying. Subjects were mother/infant pairs attending the well baby clinics at the Institute of Child Health, University of Nigeria Teaching Hospital, Enugu, Mother of Christ Specialist Hospital, Enugu and the Ebonyi State University Teaching Hospital, Abakaliki. RESULT: Four hundred and eighty mother/infant pairs participated in the study. Seven point nine percent of the mothers reported excessive crying in their infants. There was no significant diurnal variation in the rate of excessive crying among these infants. Educated mothers (P = 0.008) reported excessive crying less frequently than the uneducated ones. Other maternal and infants demographic factors did not have any influence on mothers' perception of excessive crying in their infants. CONCLUSION: Excessive crying among infants is more commonly perceived by uneducated mothers. This group should be identified and counselled about excessive crying to prevent untoward consequences.