Trend of HIV-seropositivity among children in a tertiary health institution in the Niger Delta Region of Nigeria

The objective of the study was to investigate the recent trends and magnitude of pediatric HIV-infection in the Niger Delta of Nigeria. It is a descriptive study of 1,559 consecutively recruited children (0-16 years), in whom laboratory requests for HIV screening were made, and seen in the Pediatrics Department of the University of Port Harcourt Teaching Hospital between January 1999 to December 2004 were evaluated for HIV –infection. The overall prevalence obtained was 25.8%. HIV-1 constituted the predominant viral serotype (97.6%) compared to HIV-2 (2.4%). The peak HIV seropositivity occurred in pediatrics 6-8 years. There was no statistically significant difference in prevalence rate based on gender (OR = 1, p = 0.98). Children with clinical diagnosis of bronchopneumonia, neonatal sepsis, septicemia and pulmonary tuberculosis had higher prevalence of HIV seropositivity. There is a trend of increasing HIV prevalence from 1999 to 2004 (χ2 for trend= 6.23, p = 0.39). History of previous blood transfusion was not significantly associated with HIV positivity (OR = 0.94, p = 0.94). This study shows that, in spite of the anti HIV campaign, there is a high prevalence of HIV among children attending tertiary health institution in the Niger Delta of Nigeria and the trend is increasing over the last 5 years. This calls for a re-intensified effort on health education and risk control programme, provision of antiretroviral regimen to prevent mother-to-child transmission of HIV, provision of supportive environment for voluntary counseling and confidential testing of pregnant women coupled with the provision of pediatric antiretroviral therapy to reduce HIV-related mortality and morbidity of HIV-infected Nigerian children. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 80-8

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer