ABSTRACT
BACKGROUND: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may result in significant life stressors, on both the infected children and their caregivers. METHODS: This included a hospital-based cross-sectional and comparative study. Subjects and controls who met the inclusion criteria were enrolled consecutively. Their socio-demographic variables were obtained and GHQ-28 was used to assess their psychosocial status. RESULTS: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled into this study. In total, 42 (27.3%) and 112 (72.7%) of the subjects were males and females, respectively, compared with 37 (24.0%) and 117 (76.0%) of the controls, respectively. The prevalence of psychosocial disorders among the subjects and controls was 39 and 2.6%, respectively (p < 0.001; odds ratio: 23.936). The patterns of psychosocial disorders among the caregivers of HIV-infected children were somatic symptoms (85%), anxiety/insomnia (80%), social dysfunction (63.3%) and severe depression (48.3%). CONCLUSION: There is a high prevalence of psychosocial disorders among caregivers of HIV-infected children.
Subject(s)
Caregivers/psychology , HIV Infections/congenital , Mental Disorders/epidemiology , Stress, Psychological/epidemiology , Adolescent , Adult , Anxiety/epidemiology , Case-Control Studies , Child , Child, Preschool , Cross-Sectional Studies , Depression/epidemiology , Female , HIV Infections/psychology , Humans , Male , Mental Health , Nigeria/epidemiology , Prevalence , Sleep Initiation and Maintenance Disorders/epidemiology , Stress, Psychological/complications , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of various inflammatory disorders since its discovery in 1940s. However, these useful drugs cause important side effects, such as impairment of glucose tolerance. We sought to determine the prevalence of steroid-induced impairment of glucose tolerance in pediatric patients on long-term steroid use. MATERIALS AND METHODS: A cross-sectional, descriptive and hospital-based study. Consenting subjects who met the inclusion criteria were screened with random glucometer measurements repeated twice. An average of both readings obtained from the initial measurement of their random blood glucose (RBG) and a repeat during the next clinic visit was taken as the RBG. RESULTS: Hundred patients were studied, 66 males/34 females. Subjects with nephrotic syndrome were 61 while 39 had asthma. Mean age of 10.13 years (range: 0.5-18 years); mean body mass index (BMI): 18.2 kg/m2 (range: 6.6 to 26.30 kg/m2 ). The subjects with nephrotic syndrome were on oral prednisolone while the asthmatics were on inhaled fluticasone, budesonide and oral methylprednisolone. Mean (range) duration of steroid use was 9.74 (0.5-72) months. Mean (range) RBG was 3.49 (3.3-7.5) mmol/L. None of the subjects showed abnormal RBG. However, the RBG was further categorized into low, moderate and high normal RBG. A positive correlation between longer duration of steroid use as well as high doses of both oral and inhaled steroids, and high normal RBG existed (P = .015). No statistically significant relationship existed between body mass index (BMI) percentile and RBG (P = .437). CONCLUSION: Low to moderate doses of oral and inhaled steroids should be used when indicated as they are associated with lesser risk of impairment of glucose tolerance in the pediatric population.
