Spectrum of congenital heart diseases in children with Down Syndrome at Usmanu Danfodiyo University Teaching Hospital, Sokoto

Objective: Congenital heart diseases (CHD) frequently occur in children with Down syndrome. A few studies in Nigeria have highlighted the pattern of CHD in such patients, but results are variable with no data from the study area for comparison. This study aims to determine the pattern of CHD among children with Down syndrome as seen at UDUTH, SokotoMethods: A prospective study conducted between 1st October 2011 and 31st April 2015. Subjects included all children with phenotypic features of Down syndrome (DS) who were seen at the Pediatric cardiology clinic and had echocardiography diagnosis of congenital heart diseases.Results: Of the 41 cases of DS seen during the study period, 32 (78.0%) children aged 2 weeks to 22 months (Mean +SD = 5.6 ± 4.0 months) were diagnosed with CHD. Male to female ratio was 2.2:1. Atrioventricular septal defect (AVSD) was the commonest CHD seen in 18 (56.3%) patients. Nine (28.1%) patients had isolated ventricular septal defect (VSD), three (9.4%) had VSD coexisting with atrial septal defect (ASD) while one (3.1%) patient each had isolated ASD and Fallot's tetralogy respectively. Only three (9.4%) patients had surgical closure abroad, with good postoperative outcome in two of the patients.Conclusion: AVSD is the commonest CHD in our series, which is similar to previous reports. Increased access to definitive intervention is advocated since surgical outcome in such patients may be favorable.Keywords: Down syndrome, congenital heart diseases, pattern, Sokot

Prevalence and clinical forms of malaria among febrile HIV-infected children seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Background: Malaria and HIV infections are major health problems facing the world today. Sub-Saharan Africa with 10 percent of world’s population harbors more than half the burden of the scourge. The present study determined the prevalence and clinical forms of malaria among febrile HIV-infected children aged 3months to 15years, seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria.Materials and Methods: Cross-sectional study among febrile HIV-infected children and their control cohort were carried out between May and October 2016. The participants had the following investigations: malarial parasite, packed cell volume, random blood sugar, retroviral test.Results: A total of 140 febrile HIV-infected children aged 3 months to 15 years and 140 febrile HIV-negative age- and gender-matched children were recruited; 100 of the HIV-infected children were on ART and cotrimoxazole. The prevalence of malaria among the febrile HIV-infected children was 71.4% (100/140) which was significantly lower than the prevalence of 94.3% (132/140) among the control group (χ2 27.72, p=0.001). Among the febrile HIV-infected children that had malaria, 54(54.0%) had uncomplicated malaria while 46(46.0%) had severe malaria. Of the 132 controls that had malaria, 48(36.4%) had uncomplicated malaria and 84(63.6%) had severe malaria (χ2 =7.184, p=0.007).Conclusion: Malaria is a problem in HIV-infected children. Since nearly half of the febrile HIV-infected children had severe form of malaria, it is recommended that health promotion, intermittent malaria prophylaxis, early diagnosis and prompt effective treatment should be instituted for HIV-infected children. This may prevent severe form of malaria and its attendant mortality. Key words: Malaria; Prevalence and clinical forms of malaria; Febrile, HIV-infected, Sokoto state