Haematological features in children less than 12 years on cotrimoxazole prophylaxis seen in opportunistic onfection clinics at Harare and Parirenyatwa Teaching Hospitals

A journal article on HIV/AIDS infections in children in Zimbabwe.Paediatric Human Immunodeficiency Virus (HIV) infection has been growing parallel to the adult pandemic. Sub-Saharan Africa accounts for more than two thirds of the people living with HIV in the world. Approximately 90% of children with HIV infection in the world reside in this region. Estimates show that more than 145 000 children were living with HIV in Zimbabwe in 2010[Ministry of Health and Child Welfare, AIDS and TB Unit, Unpublished data]. Maternal to child transmission of HIV accounts for more than 95% of infections in children. Opportunistic infections (OI) are an important cause of morbidity and mortality in children infected with HIV. These infectious complications are critical indicators of disease progression

Rhabdomyosarcoma of the orbit in a four months old infant in Zimbabwe: a case report

Rhabdomyosacoma, as a medical condition, observed in a four month old infant at a Zimbabwe hospital.Infants younger than one year of age with Rhabdomyosacoma appear to have worse prognosis compared to older children due partly to high rates of local failure. We report a 4 months old infant with orbital rhabdomyosarcoma with poor outcome.. Reluctance to use aggressive local control measures and suboptimal chemotherapy dosing are significant contributory factors. Call is made for need for more studies to determine appropriate local therapy in infants with rhabdomyosarcoma

Patterns of retinoblastoma in Zimbabwe: 2000-2009

A research study on the high incidence of Retinoblastoma eye diseases among children from poor countries like Zimbabwe between the period 2 000 to 2009 .Retinoblastoma is the most common intraocular malignant tumour of childhood but it remains a rare disease. It occurs more commonly in less affluent regions of the world compared to richer regions. The incidence of retinoblastoma within age group 0-4 years varies from country to country. Africa generally has a higher incidence especially in the sub Saharan Africa region ranging from 10.6 to 42.5cases per million. This is in contrast to developed countries where in the USA, the incidence is 11.8 and in Europe it ranges from 6-12. Bulgaria has the lowest incidence of 3.4 cases per million."' In Zimbabwe the incidence of retinoblastoma is estimated at 23.3 per million ranking 3rd highest in the world after Uganda and Mali

The University of Zimbabwe College of Health Sciences (UZ-CHS) BIRTH COHORT study: rationale, design and methods

Background: Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy, a situation concurrently increasing numbers of HIV-exposed-uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants show higher rates of adverse birth outcomes, mortality, infectious/non-communicable diseases including impaired growth and neurocognitive development. There is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes. Methods: Six hundred (600) HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation will be enrolled from four primary health centres in high density residential areas of Harare. Participants will be followed up as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data will be assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis-B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord blood, amniotic fluid, placenta and milk including infant plasma, dried blood spot and stool will be collected at enrolment and follow-up visits. The composite primary endpoint is stillbirth and infant mortality within the first two years of life in HEU versus HUU infants. Maternal mortality in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies will address maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut, breast milk and amniotic fluid dysbiosis. Discussion: The University of Zimbabwe-College of Health-Sciences-Birth-Cohort study will provide a comprehensive assessment of risk factors and biomarkers for HEU infants’ adverse outcomes. This will ultimately help developing strategies to mitigate effects of maternal HIV, early-life ART exposures and comorbidities on infants’ mortality and morbidity. Trial registration: ClinicalTrial.gov Identifier: NCT04087239. Registered 12 September 2019

Anaemia and iron deficiency in peri-urban school children born in a National HIV Prevention Programme in Zimbabwe: A cross sectional study

Letten Foundation,Objective'. To determine the prevalence of anaemia, iron deficiency and iron deficiency anaemia in school children who were born in a national HIV prevention programme. Design'. This was a community based cross-sectional study. Setting: A resource poor peri-urban setting with high prevalence of HIV infection. Subjects: School aged children six to 10 years old who were bom in a national mother-to-child HIV prevention programme. Main Outcome Measures: Haemoglobin (Hb), serum Ferritin (F) and serum Transferrin receptor (sTfR) levels. Results: Three hundred and eighteen children were recruited including 21 HIV positive. The prevalence of anaemia (Hb 8.3pg/L) were 15%, 4% and 2% respectively. When a higher cut-off for ferritin of 30 micrograms per litre was applied to adjust for high infection disease burden, iron deficiency prevalence increased to 32% and iron deficiency anaemia increased to 5%. Anaemia was 4.9 (C.I 1.9-12.4) times more likely to occur in HIV infected children compared to the HIV uninfected children. Maternal HIV status at birth was not related to presence of anaemia in the school children. Conclusion: Anaemia was of mild public health significance in this cohort of children. Iron deficiency anaemia contributed less than a quarter of the cases of anaemia. HIV infection was an important determinant for presence of anaemia. Therefore continued efforts to eliminate paediatric HIV infection as a way of reducing anaemia in children are essential

Rhabdomyosarcoma of the orbit in a four month old infant in Zimbabwe: A case report

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Suspected idiopathic pulmonary hemosiderosis in two children at Parirenyatwa Hospital, Zimbabwe: Case reports

Idiopathic Pulmonary Haemosiderosis (IPH) is a rare condition that causes repeat diffuse alveolar hemorrhage, may result in pulmonary haemosiderosis and lung fibrosis. The classical triad of symptoms includes iron-deficiency anemia, hemoptysis and diffuse pulmonary infiltrates on chest imaging. We present the clinical features and management of suspected idiopathic pulmonary haemosiderosis in two paediatric patients at Parirenyatwa Hospital, a low-income setting. Barriers such as cost of investigations, fears of general anesthesiology and refusal of invasive lung procedures make diagnosis and management challenging

Haematological features in children less than 12 years on cotrimoxazole prophylaxis seen in opportunistic infection clinics at Harare and Parirenyatwa teaching hospitals

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Patterns od Retenoblastoma in Zimbabwe: 2000-2009

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Clinical characteristics and outcome of children admitted with bronchiolitis at Sally Mugabe Hospital, Harare, Zimbabwe

Main Objective: To document clinical characteristics and outcomes of patients admitted with bronchiolitis at the Children's Hospital, Harare March 2018 to February 2019. Study Design: A hospital based analytical cross sectional study. Study Setting: The study was conducted at the Children's Hospital, Sally Mugabe Hospital. Materials and Methods: Children aged 2months to 2 years hospitalised with bronchiolitis Results: A total of 206 children were recruited. Mean age was 5.4 (SD ±4.3) months with 148 (72%) less than six months.  The male to female ratio of 1.8:1. Only 15% of the children were born preterm (85%). The main symptoms were cough (91%), rhinorrhoea (69%) and hot body (66%). Thirteen percent had a comorbid condition. Physical examination findings were mainly tachypnoea (89%) and hypoxia (83%). A severe modified Tal (mTal) score was noted in 116(56%) children at admission and 51(25%) still had a severe mTal score when repeated within 12 hours of admission. The median length of hospital stay was 4 days (IQR 3; 6) and 90(44%) children had a prolonged stay (>4 days). Only 3 (1.5%) children died. A high repeat mTal score, wasting, hypoxia and expiratory/inspiratory wheezes, were associated with a prolonged hospital stay.  (p= 0.025, p= 0.004, p=0.001, p= 0.007 respectively). Conclusion: Majority of children admitted with bronchiolitis were less than 6 months of age. There was a male predominance. Bronchiolitis causes high morbidity but low mortality in children from this low-income setting