Frequency of Cryptococcal Meningitis in HIV-1 Infected Patients in North Central Nigeria

Background: Cryptococcal meningitis (CM) is the most common severe life threatening fungal infection in AIDS patients. It is an important cause of morbidity and mortality. There is paucity of data on the prevalence of CM in Nigeria. We aimed to determine the frequency of CM, the clinical presentation and immunological profile.Methods: A cross sectional study was carried out at the Jos University Teaching Hospital (JUTH), A total of 100 HIV-1 infected patients suspected of having meningitis or meningoencephalitis were subjected to cerebrospinal fluid (CSF) analysis (including Indian ink preparation and fungal culture by conventional methods) and CD4 count was determined using flow cytometry (count bit Y-R 1004 Partec Muster Germany).Results: The freguency of CM was 36% in our cohort. The commonest clinical presentation included headache (100.0%), neck stiffness (77.8%), fever (72.0%), vomiting (55.6%), personality changes (55.6%), photophobia (27.8%) and convulsions (27.8%). The mean duration of symptoms was 24 ±22 days with a median of 17 days. The mean CD4 count was 89±60 cells/mm3 with a median of 82 cells/mm3.Conclusion: The high prevalence of CM and the associated severe immunosuppression underscores the importance of early diagnosis of HIV infection which may reduce the incidence of CM. There is the urgent need for access to Amphotericin B and fluconazole in resource constrained settings in addition to a wide access to HAART.Key words: Cryptococcal meningitis, HIV, North central Nigeri

Pattern of cardiac diseases among children in a tertiary hospital in North Central, Nigeria: A three and half years retrospective cohort echocardiographic study

Background: Cardiac disease is an important noncommunicable disease encountered among paediatric populations with varying patterns in different regions. This study is aimed at finding the spectrum of cardiac diseases among the paediatric patients seen at Benue State University Teaching Hospital (BSUTH), Makurdi Nigeria.Method: A retrospective review of all cardiology patients seen at both in- and out-patient units of the paediatric department of BSUTH between June 2012 to December 2015. Data on age, gender, presenting complaints, final diagnosis, investigations, intervention and treatment outcome were obtained from the case folders. The analysis of the data was done with Excel spreadsheet and the results were presented as frequency and percentages.Results: Of the 8590 patients seen, 39 (0.45%) had cardiac diseases. The mean age of the patients was 60.2±59 months with Male: Female of 1.1:1. Twenty-eight (71.7%) of them had congenital heart disease (CHD) with the most prevalent type been acyanotic CHD among 21(53.8%). Ventricular septal defect (VSD) accounted for 15(71.4%) of the 21 (53.8%) patients. Hypertensive heart disease was found in one (2.6%) patient who was an obese adolescent.Conclusion: Congenital heart disease (CHD) and acquired heart disease (AHD) were all represented in this cohort with CHD being the most prevalent.Keywords: Cardiac disease, Children, Pattern, Tertiary Hospital, Echocardiograph

Retrospective assessment of neonatal morbidity and mortality in the special care baby unit of a private health facility in Benue State, North Central Nigeria

Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling  the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality. Key words: Neonate, Morbidity, Mortality, Nigeria&nbsp