Dermatology Quality of Life Impairments among Newly Diagnosed HIV/AIDS-Infected Patients in the University of Ilorin Teaching Hospital (Uith), Ilorin, Nigeria.

The study sought to describe the quality-of-life impairments in newly diagnosed HIV/AIDS-infected adult patients with cutaneous lesions. This was a hospital-based, cross-sectional, descriptive study of 160 newly diagnosed HIV/AIDS-infected adult patients attending the HIV/AIDS clinic of University of Ilorin Teaching Hospital (UITH). Systemic random sampling technique was used in recruiting respondents for the study. The Dermatology Life Quality Index (DLQI) was used to gauge the quality-of-life impairments. The study showed high prevalence of cutaneous lesions in HIV/AIDS-infected patients. Majority of the respondents (83.7%) scored more than 10 in DLQI score. This signifies that the skin lesions had large negative effects on their quality of life. The assessment of the impact of dermatoses on patients' quality of life is important for clinical management. It is pertinent to detect patients at higher risk of experiencing worse quality of life in order to treat them holistically.

Prevalence and pattern of cutaneous lesions in relationship to CD4 cell counts among newly diagnosed HIV patients in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.

BACKGROUND: Oral lesions are among the earliest clinical manifestation of HIV infection. In developing countries like Nigeria, were sophisticated diagnostic apparatus used to monitor the immunologic status of HIV/AIDS patients is not readily available, early recognition of the commonest and specific HIV-related oral lesions can be used for diagnosis so that prompt treatment can be provided to reduce morbidity. OBJECTIVES: To assess the prevalence and spectrum of oral lesions in relationship to CD4 cell counts among newly diagnosed HIV patients in University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara State, Nigeria. METHODS: This was a hospital based, cross sectional, descriptive study of 160 newly diagnosed adult patients attending the HIV/AIDS clinic of UITH, Ilorin. The study protocol was approved by the Ethics committee of the UITH. Informed consent from all the patients was also obtained prior to data collection. All the HIV patients were treatment naïve. A questionnaire guided interview and clinical oral assessment were used. RESULTS: The prevalence of oral lesions was 31%. The commonest oral lesion was of fungal origin (53.1%) followed by viral (36.7%). Oral lesions of inflammatory origin (6.7%) were relatively rare while those of bacterial origin (4.1%) were not very common. None of the oral lesions detected was of neoplastic origin. Most of the oral lesions occurred when the CD4 cell counts were less than 200 cells/µl. CONCLUSION: Oral lesions are common in people with HIV with very low CD4 cell counts (≤ 200 cells/µl). Oral Candidiasis is the commonest lesion in Ilorin, Kwara State, Nigeria.

Otologic and audiological evaluation among HIV patients in Ilorin, Nigeria.

BACKGROUND: HIV infection is the highest cause of death worldwide and presenting eventually with ENT regions. OBJECTIVE: This study is to determine the prevalence of hearing loss and hearing patterns among adults Nigerians with HIV and causal relationships between CD4+ counts with the degree of hearing impairments. METHODS: This prospective study was carried out among all consecutive HIV positive patients attending the clinic at the University of Ilorin teaching hospital (U.I.T.H.), Ilorin, Nigeria between January and July, 2008. They all had audiological assessments with a pure tone audiometer within the frequency range 250 to 8,000 Hz to determine their hearing thresholds together with their CD+ counts estimations. RESULTS: 89 were evaluated in the age range of 18 to 56 years (Mean 36.4 years, SD of 8.82) and the modal age group was 21-39 years (59.6%), 40-56 years (38.2%).There were 51 males (57.3%) and 38 females (42.7%) with a male/female ratio of 1.3:1.0. Otological symptoms included tinnitus (15.7%), vertigo (15.7%), otalgia (14.6%) and hard of hearing (10%). Examinations showed bilateral serous Otitis media (glue ear) in 58 patients (65.1%) with no affectation of the facial nerves. PTA showed mixed, conductive and SNHL in 32 patients (36%), 20 patients (22.5%), 9 patients (10.1%) respectively and only 15(16.9%) had normal hearing thresholds. The CD4+ counts ranged between 12 to 616. CD4 counts with hearing loss mostly < 300mm3. CONCLUSION: The prevalence of hearing loss is 87% among HIV infected patients, mostly mixed HLwith causal relationships between reduced CD4+ counts of less than 300/mm3 with severity of hearing loss. The hearing loss can interfere with the communication and specific knowledge vital to the development of best practices towards ensuring the inclusion of hearing impaired in HIV/AIDS prevention and treatment programmes.

Prevalence of dermatophytosis among primary school children in Oke-Oyi community of Kwara state.

BACKGROUND: Dermatophytic infections have been known to impact negatively on health and well-being of children. This study was undertaken to determine the prevalence, clinical types as well as the etiologic organisms of dermatophyte infection among primary school children aged 5-16 years in Oke-Oyi community in Kwara state. MATERIALS AND METHODS: A 4-months descriptive cross-sectional survey was carried out among 602 children aged 5-16 years in Oke-Oyi community, in Kwara state. RESULTS: The prevalence of clinically suspected dermatophytoses lesion was 29.9% (180/602). Dermatophyte accounted for 5.0% (30/602) on Sabouraud dextrose agar culture, while non-dermatophyte molds represent majority of isolate i.e., 15.4% (93/602). Tinea capitis is the commonest clinical type, followed by Tinea coporis and then Tinea pedis. Multiple infections are noted in nine respondents. Three species of dermatophytes belonging to only two of the three genera of dermatophytes were responsible for human infection in the area studied, of which Trichophyton mentagrophyte is the commonest, followed by Microsporum audouinii and Trichophyton verucossum. Among the non-dermatophytes, Aspergillus fumigatus and Candida albicans predominate. CONCLUSION: This study demonstrates that the prevalence of dermatophytoses in the school studied was significant. Control efforts should target this vulnerable group to reduce its prevalence.

Prevalence of dermatophytosis among primary school children in Oke-Oyi community of Kwara state

Background: Dermatophytic infections have been known to impact negatively on health and well-being of children. This study was undertaken to determine the prevalence; clinical types as well as the etiologic organisms of dermatophyte infection among primary school children aged 5-16 years in Oke-Oyi community in Kwara state. Materials and Methods: A 4-months descriptive cross-sectional survey was carried out among 602 children aged 5-16 years in Oke-Oyi community; in Kwara state. Results: The prevalence of clinically suspected dermatophytoses lesion was 29.9(180/602). Dermatophyte accounted for 5.0(30/602) on Sabouraud dextrose agar culture; while non-dermatophyte molds represent majority of isolate i.e.; 15.4(93/602). Tinea capitis is the commonest clinical type; followed by Tinea coporis and then Tinea pedis. Multiple infections are noted in nine respondents. Three species of dermatophytes belonging to only two of the three genera of dermatophytes were responsible for human infection in the area studied; of which Trichophyton mentagrophyte is the commonest; followed by Microsporum audouinii and Trichophyton verucossum. Among the non-dermatophytes; Aspergillus fumigatus and Candida albicans predominate. Conclusion: This study demonstrates that the prevalence of dermatophytoses in the school studied was significant. Control efforts should target this vulnerable group to reduce its prevalence

Effect of highly active antiretroviral therapy on CD4 count and weight in AIDS patients seen at the UITH, Ilorin.

OBJECTIVE: To determine the response on treatment-naïve HIV/AIDS patients to the Highly Active Antiretroviral Therapy (HAART) in terms of CD4 Count and Weight gain over a period of 2 1/2 years. METHODS: Patients with Acquired Immunodeficiency Syndrome (AIDS) were recruited under the Federal Government Highly Active Antiretroviral Therapy (HAART) programme at the University of Ilorin Teaching Hospital. The treatment regimen included Lamivudine, Starvudine and Nevirapine. The patients' responses were evaluated with respect to CD4 count and weight over the period of treatment. The diagnosis of HIV/AIDS was made on the basis of reactivity with two different ELISA reagents, and CD4 count was done with Dynal T4 Quant method. The weights (kg.) of the patients were taken at monthly visit. RESULTS: The duration of treatment for the patients analysed ranged from 1 month to 14 months. Analysis of CD4 count was possible in 105 patients. The mean post treatment CD4 count and weight were significantly higher than the pre-treatment values (p < 0.001 and p < 1.01) respectively. There were significant positive correlations (p < 0.05 and p < 0.001) between increases in CD4 count and weight respectively, and duration of treatment. In eight (8) patients, CD4 Count reduced or remained the same in spite of treatment. CONCLUSION: The HAART regime is associated with increase in CD4 Count and weight gain. While increases in CD4 Count and weight correlated with duration of therapy, there was no correlation between CD4 Count increase and weight gain.