CD4+ T-Lymphocyte counts among under-5 children with protein-energy malnutrition as seen in Usmanu Danfodiyo University Teaching Hospital , Sokoto, Nigeria

Background: Proteinenergy malnutrition is a prevalent public health  problem in the developing countries. It affects body systems including cell-mediated immunity.Objectives: To determine the effect of PEM on CD4+ Tlymphocyte counts among under -5 children.Methods: This was a prospective cross-sectional study conducted among HIV-negative children aged 6 - 59 months with PEM and the HIV-negative well-nourished children between November 1st, 2010 and July 31st, 2011. The socio-demographic characteristics, weight and some haematologicalindices of the both groups were documented. The CD4+ Tlymphocyte count was determined using Partec cytoflow machine.Result: One-hundred children were recruited for each group over a 9 month period. The two study groups were comparable in age (p= 0.53) and sex (p= 0.65). The mean CD4+ T-lymphocyte count in children with PEM was1705.5±605.6 cells/µL as compared to 2314.3±491.1 cells/µL among the controls (p= 0.0001). A statistically significant difference was observed in the mean CD4+ T-lymphocyte count of the different types of PEM with the highest value observed among children with kwashiorkor (2097.7±712.9 cells/µL) and lowest value observed among those with marasmus  (1449.3±368.2 cells/µL). There were significant differences in the mean CD4+ Tlymphocyte count of the control (2314.3±491 cells/µL) when  compared to those of marasmus (1449±368 cells/µL) (p= 0.001), marasmic-kwashiorkor (1888±762 cells/µL) (p= 0.002), underweight (1559±452 cells/µL) (p= 0.001) and underweight-kwashiorkor (1534±402 cells/µL) (p= 0.001), but it was comparable with that of kwashiorkor group (2098±713 cells/µL) (p= 0.21). A statistically significant difference was observed in the mean CD4+ Tlymphocyte count of the different types of PEM with the highest value observed among children with kwashiorkor (2097.7±712.9 cells/µL) and lowest value observed among those with  marasmus (1449.3±368.2 cells/µL).Conclusion: The PEM has deleterious effects on the CD4+ Tlymphocytecounts among under-5 children with PEM with the lowest count observed among those presenting with marasmus.Key words: CD4+ T-Lymphocyte, Count, PEM, Under-5

Prevalence of HIV-infection among under-5 children with protein energy malnutrition presenting at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Background: HIV infection is a major health problem worldwide. It is  associated with Protein-Energy Malnutrition (PEM) among under-5 childrenwith attendant high morbidity and mortality.Objective: To determine the prevalence of HIV-infection among children presenting withvarious subtypes of PEM.Methodology: Children suffering from PEM aged below 5 years admitted into the Paediatric units of UDUTH, Sokoto between October 1st, 2010 and April 30th, 2011 were tested for HIV infection using ELISA tests and HIVDNAPCR. Nutritional status was determined using the modified Wellcome Classification and socioeconomic classification was by the scheme developed by Oyedeji,s. Data were analyzed using SPSS 17.0 statistical package. P-value . 0.05 was considered significant.Results: One-hundred under-5 children (64 males, 36 females) with PEM were studied. The mean (±SD) age was 19.8&#177 9.2 months and the majority were aged 12.0-23.9 months. Twentyseven of the 100 children withPEM had HIV-infection giving a prevalence rate of 27%: 59.3% in males and 40.7% in females. Among the HIV-infected children, the 24.0 . 35.9 months age group was the most affected (53.8%). Infected and non-infected children were comparable in terms of age (χ2=7.35, p=0.12) , gender (χ2=0.36, p=0.55) and socioeconomic (χ2=3.01, p=0.25). Themode of transmission was maternal to child transmission in all cases. The highest prevalence of HIV infection was found among marasmus subgroup (65%). Twenty-two (81.5%) of the 27 cases were discharged home, whilefive patients died giving a case fatality rate of 18.5%.Conclusion: HIV infection is common among under-5 children with PEM with no age, gender or socioeconomic predilection. The clinical type of PEM most often affected is marasmus.Key words: Protein-energy malnutrition, HIV-infection, Under-

Malaria in Sokoto, North Western Nigeria

Malaria remains a major cause of mortality among children under the age of five years; it is endemic throughout Nigeria with seasonal variation in different geographic zones of the country. Malaria prevalence studies had been undertaken in many parts of Nigeria but there is probably no dataavailable from the far North Western region. This research study was undertaken to determine the prevalence, monthly distribution of malaria in Sokoto, North Western Nigeria in order to generate baseline information. A total of 1,297 blood samples were collected by simple random sampling, from patients attending the two health centres over the twelve calendar months. Thick and thin blood films were Giemsa stained and observed for the presence of malaria parasites. A total of 354 (27.29%) werepositive for malaria parasites with the highest prevalence rate being recorded in the month of August with 72 (59.5%) positive cases and the month of March having the least infection rate of 9 (9.18%). Theinfection rate according to gender showed that males had the higher infection rate of 192 (n = 635) or 30.24% than the females who had a total 162 infection (n = 662) or 24.47%. The age group 0 - 5 years hadthe highest infection rate of 123 (43.77%) while the age group 36 - 40 years had the least infection rate of 10 (9.8%). The study has revealed the presence of malaria transmission throughout the year in Sokoto, North Western Nigeria and the infection rate can be considered as moderately high

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

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

Posterior lumbar interbody fusion using non resorbable poly-ether-ether-ketone versus resorbable poly-l-lactide-co-d,l-lactide fusion devices. Clinical outcome at a minimum of 2-year follow-up

Previous papers on resorbable poly-l-lactide-co-d,l-lactide (PLDLLA) cages in spinal fusion have failed to report adequately on patient-centred clinical outcome measures. Also comparison of PLDLLA cage with a traditionally applicable counterpart has not been previously reported. This is the first randomized prospective study that assesses clinical outcome of PLDLLA cage compared with a poly-ether-ether-ketone (PEEK) implant. Twenty-six patients were randomly assigned to undergo instrumented posterior lumbar interbody fusion (PLIF) whereby either a PEEK cage or a PLDLLA cage was implanted. Clinical outcome based on visual analogue scale scores for leg pain and back pain, as well as Oswestry Disability Index (ODI) and SF-36 questionnaires were documented and analysed. When compared with preoperative values, all clinical parameters have significantly improved in the PEEK group at 2 years after surgery with the exception of SF-36 general health, SF-36 mental health and SF-36 role emotional scores. No clinical parameter showed significant improvement at 2 years after surgery compared with preoperative values in the PLDLLA patient group. Only six patients (50%) in the PLDLLA group showed improvement in the VAS scores for leg and back pain as well as the ODI, as opposed to 10 patients (71%) in the PEEK group. One-third of the patients in the PLDLLA group actually reported worsening of their pain scores and ODI. Three cases of mild to moderate osteolysis were seen in the PLDLLA group. Following up on our preliminary report, these 2-year results confirm the superiority of the PEEK implant to the resorbable PLDLLA implant in aiding spinal fusion and alleviating symptoms following PLIF in patients with degenerative spondylolisthesis associated with either canal stenosis or foramen stenosis or both and emanating from a single lumbar segment

Effectiveness and safety of COVID-19 vaccines on maternal and perinatal outcomes:a systematic review and meta-analysis

Objective: To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes. Design: Systematic review and meta-analysis. Data sources: Major databases between December 2019 and January 2023. Study selection: Nine pairs of reviewers contributed to study selection. We included test-negative designs, comparative cohorts and randomised trials on effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Non-comparative cohort studies reporting reactogenicity outcomes were also included. Quality assessment, data extraction and analysis: Two reviewers independently assessed study quality and extracted data. We undertook random-effects meta-analysis and reported findings as HRs, risk ratios (RRs), ORs or rates with 95% CIs. Results: Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women). Conclusion: COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women. PROSPERO registration number: CRD42020178076

Protein and energy utilization by cockerels fed four different commercial diet

An 8 weak feeding trial was conducted to evaluate the protein and energy utilization of four different commercial feeds fed to eight weeks old ANAK cockerels. The diets containing 14.14% CP, 2500 ME; (4.25% CP, 2650 ME; 15.41% CP, 2800 ME and 15.82% CP, 2800 ME were designated T 1,T 2, T 3, T 4 and were fed ad libitum to the cockerels. The results showed that cockerels fed diet 1 consumed significantly (