Anthropometric measurements of HIV-infected children aged one to five years in a tertiary hospital in Lagos Nigeria

Objectives: To determine the association between HIV infection and anthropometric measures (weight, height, midupper arm circumference and head circumference) of children aged one to five years.Method: A cross sectional descriptive study using structured questionnaire and measurement of weight, height, head and midupper arm circumference of 846 infected children and matched controls.Results: The mean weights of the controls were significantly higher than those of the infected children at all age groups (p<0.005) while, the controls were significantly taller than the infected children after 49months (p=0.019). The controls had bigger arm than the infected (p=<0.029) while the head circumference was also significantly higher in the controls (p=<0.033) with the difference being more in the children aged less than 3 years.Conclusion: HIV infection has a profound association with growth being earliest on the head size, followed by weight and then height.Keywords: HIV, children, weight, height, MUAC, head circumferenc

Serum And Red Cell Folate Levels Of Paediatric Sicklers In Painful And Anaemic Crises

Patients with sickle cell anaemia aged between one and ten years had their Red Cell Folate (RCF) and Serum Folate (SF) levels analysed. They comprised 32 sicklers in painful crises and 30 sicklers in anaemic crises all of whom were already on daily 5mg folic acid supplementation. The mean RCF of 208.0nmol/L in sicklers in painful crises was significantly high compared to the mean value of 154.4nmo1/L in the control (P0.05; while their mean SF (2.1nmo1/L) was significantly lower than that of the control. On the basis of these findings, it is suggested that the practice of supplementing the sicklers with daily 5mg folic acid should continue, and it should be given twice daily in the case of anaemic crises. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 202-20

Right Sided Hernia of Bochdalek: A Case Report

Congenital diaphragmatic hernias (CDH) of the foramen of Bochdalek are commonly reported in newborn Caucasian children; in contrast, they are rarely seen in African children. We report a case of right-sided Bochdalek's hernia that presented after the neonatal period and was successfully managed at the Lagos University Teaching Hospital. The seeming rarity of this lesion in African children may really represent a low incidence or it may be due to underdiagnosis as a result of the paucity of prenatal diagnostic and perinatal support services. Nigerian Journal of Paediatrics Vol.31(2) 2004: 59-6

Differential Cell Count of Bone Marrow Aspirates in Steady-state Sickle Cell Anaemia Patients

Background: Megaloblastic arrest of the bone marrow is one of the causes of anaemic crises in patients with sickle cell anaemia. The diagnosis of this condition will require that the reference level of megaloblastosis during steady state be properly documented. Objectives:To document a reference differential cell count in the bone marrow aspirates of patients with sickle cell anaemia and determine the level of megaloblastosis that can be regarded as indicating megaloblastic crisis in such patients. Design: Systematic counting of haematopoietic cells in the bone marrow of children with confirmed Hb phenotype SS who are in steady state. Subjects and Methods: The subjects were 11 of 68 children with sickle cell anaemia attending the paediatric outpatient clinic at the Lagos University Teaching Hospital, Lagos, in respect of whom parental consent for bone marrow aspiration was obtained. About 4.5 ml of blood was obtained from the antecubital vein of each child, for full blood count. Bone marrow was aspirated from the posterior superior iliac spine. Slides were stained with MayGrünwald-Giemsa stain. Proportions of erythroid, myeloid, lymphoid and megakaryocytic cells out of 250 nucleated bone marrow cells were determined. Results: Steady state mean packed cell volume (PCV) was 0.2 ± 0.017 L/L. The mean reticulocyte count was 5.9 percent (95% CI, 5.3 – 7.0%) and the mean cell volume was 91.8 ± 2.7 fl. Erythroid precursors constituted 34.5 percent of the total nucleated bone marrow cells (NBMC). Of these, polychromatic and orthochromatic erythroid blasts predominated, constituting 49 and 36percent respectively, of total erythroid precursors. Polychromatic and orthochromatic megaloblasts constituted 16.5percent (95% CI, 7-25%) of total NBMC or 47.8 percent of erythroid precursors. The myeloid erythroid ratio was 1:1. The reference range of megaloblasts was 8-26 percent of the NBMC. Conclusion: Patients with sickle cell anaemia in steady-state may show megaloblastic bone marrow changes even with routine folate supplements. Megaloblastic crisis should not be diagnosed until megaloblasts are in excess of 26 percent of the total NBMC. Nigerian Journal of Paediatrics2003;30:54-5

Guidelines for the management of HIV/AIDS in infants and older children in Lagos University Teaching Hospital

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 8-1

Prevalence of Skin Diseases in Children with Human Immunodeficiency Syndrome Infection in Paediatric HIV Clinic of A Tertiary Hospital in Nigeria.

Background: HIV infection/AIDS being a multi-systemic disease affects the skin at various stages in course of the illness. A knowledge of the common skin diseases associated with HIV infection can lead to early detection, appropriate staging and commencement of appropriate care in the infected patients.Objective: The study was to document the prevalence and pattern of skin diseases in children with HIV infection seen at the Paediatric department of a tertiary centre in Nigeria.Methods: HIV positive children attending the PEPFAR HIV clinic of Lagos University Teaching Hospital, Nigeria were examined for the presence of skin lesions. Anthropometric measurements were also obtained. Blood samples were taken for CD4+ cell count, viral load and full blood count.Results: Two hundred and fourteen (214) patients were studied, consisting of 107 HIV infected children and 107 uninfected children as controls. Skin lesions were observed in 89 (83%) of the HIV infected patients, while only 72 uninfected controls had skin lesions. (p = 0.035). The predominant skin disease in the HIV infected children was Pruritic papular eruption (PPE) with a frequency of 25.9%, followed by fungal infections (24.6%). Herpes zoster was found only in HIV infected children (p = 0.041). There was a strong correlation between the degree of immunosuppression (as reflected by the value of age dependent CD4+ cell count/CD4+ percentage) and the prevalence of skin disease in the HIV infected patients. The presence of pruritic papular eruptions and Herpes zoster was associated with advanced immunosuppression.Conclusion: Skin diseases are common in HIV infection in our environment. Early detection of HIV infection can be made in the presence of skin diseases like Pruritic papular eruption and Herpes zoster.Keywords: HIV, kin diseases, prevalence, children, Nigeri