Challenges Confronting the Prevention of Mother to Child Transmission of HIV/AIDS in Offa Local Government Area, Kwara-State

This study investigated the challenges confronting the prevention of mothers-to-child transmission of HIV/AIDS in Offa Local Government Area of Kwara State, Nigeria. The transmission of HIV/AIDS from mother-to-child has been a rampant phenomenon in Offa L.G.A. A descriptive research of survey type was used, the population for the study covered all the health workers in Offa Local Government Area, 145 respondents were sampled for the study. Three research questions were raised and three hypotheses were generated which were tested at 0.05 alpha level of significance. The research instrument used for the study was a questionnaire which was validated and tested for reliability. A reliability co-efficient of 0.76r was obtained; using pearson product moment correlation. The instrument was administered by the researchers and some trained research assistant. A descriptive statistic of frequency count and percentage was used for the personal data while the inferential statistic of chi-square was used at 0.05 alpha level of significance to test the hypotheses set for the study.The null hypotheses set were rejected, the findings of this study revealed that challenges such as non-disclosure of HIV/AIDS status, inadequate  staff training and  inavailability of antiretroviral drugs are parts of the major challenges militating against  the proper  implementation  of prevention  of mother to child  transmission of HIV/AIDS.It was recommended that there should be adequate staff training to improve their knowledge on the transmission of HIV/AIDS especially in the area of vertical transmission with appropriate treatment. Also, antiretroviral drugs should be available in Health centres and hospitals for the treatment of HIV/AIDS positive mothers and prevention of vertical transmission of the infection, lastly  HIV status  of pregnant women should be known in order to commence treatment immediatel

Prevalence and risk factors of hepatitis b infection in HIV infected children seen at national hospital Abuja

Background: Human immunodeficiency virus infection remains a global pandemic. Co infection with hepatitis B virus leads to rapid progression to AIDS if not diagnosed and promptly treated or better still prevented. The study aims at determining the prevalence and risk factors of hepatitis B infection in HIV infected children being followed up at the Paediatric HIV clinic. Patients and methods: A cross-sectional study of 261 HIV infected children aged eight months to fourteen years to determine the prevalence of Hepatitis B infection and pattern of hepatitis B vaccination was carried out between July and October 2012 at the Paediatric HIV clinic of National Hospital Abuja. Ethical approval was obtained from Ethical Committee of the hospital. Vaccination and transfusion history were obtained from the parents and guardians of the subjects using a proforma after signed informed consent. Blood samples were collected for Hepatitis B surface antigen screening and Hepatitis B screening in those with HBsAg positive blood samples. Results: Only 3 (1.15%) of the 261 HIV infected children had Hepatitis B infection. All the children less than 5 years old in this cohort received hepatitis B vaccination and none of them had Hepatitis B infection. The HIV/HBV co infected children were older than ten years (p = 0.047) and history of blood transfusion (p = 0.003) was also significant. However, scarification (p = 0.996), local circumcision (p = 0.928); uvulectomy (p = 0.898) were not significant risk factors in this cohort. Conclusion: There is need to intensify routine hepatitis B vaccination and routine screening of blood before necessary transfusion. This would further lead to a low prevalence of Hepatitis B in HIV infected children and the general populace at large

Strokes in children with sickle cell disease at the National Hospital Abuja Nigeria

Background: Strokes occur in sickle cell disease (SCD), and are associated with significant morbidity and mortality.Objectives: To determine the prevalence of strokes amongst childrenwith SCD, and document the major clinical features, complications, effect of treatment with chronic transfusion therapy (CTT) and outcome.Methods: A descriptive retrospective study of SCD children with strokes seen at the National Hospital Abuja, Nigeria over a 2.5 year period from January 2009 – June 2012. Data was collected by scrutinizing case files obtained from the hospital medical records unit. Information obtained included demographic data, clinical features, packed cell volume (PCV), brain imaging, long term neurologic deficits, effect of CTT, stroke recurrence and outcome.Results: There were 31 children with strokes among 596 children with SCD documented in the register, giving a prevalence of 5.2%. Twenty six (26) case notes were retrieved. There were 12 males and 14 females, M: F ratio of 0.9:1; mean age was 6.4 years (SD 3.4) range: 1 year 7 months – 14 years; mean PCV at the time of strokes was 21.1% (SD 3.9) range 14 –29%. All (100%) had Haemoglobin SS on electrophoresis. Presentationswere convulsions 18, inability to use limbs 11, weakness of limbs 10; long term neurological deficits were hemiplegia 11, cognition loss 11. Three (3) children had no deficits. Brain imaging (Computed Tomography Scan and Magnetic Resonance Imaging) done in 16 (61.5%) children showed cerebral atrophy in 10, acute cerebral infarcts in 9, chronic cerebral infarcts in 6, acute intra cranial haemorrhage in 1 and normal imagings in 4 children. Twelve (12) children (46.2%) children had recurrences of stroke ranging in number from 1 to 4, which occurred 6 months to 3 years afterthe initial stroke. There were no statistical significant differences between the children with recurrences of stroke compared to those without regarding the age, sex, weight or PCVs p > 0.05. Fifteen (15) children (57.7%) wereenrolled in CTT. Two (2) out of 7 children (28.6%) that had regular CTT had stroke recurrence; compared to 5 out of 11 children (45.4%) with no CTT (p > 0.05). Four (4) out of 6 (66.7%) children with irregular CTT and 1 of 2 children who stopped CTT had stroke recurrence.Outcome: 17 children were alive, 7 were lost to follow up, 1 died and 1 was referred to another center.Conclusion: Strokes were an important cause of morbidity in Nigerianchildren with SCD, with major long term neurologic deficits. CTT appearedbeneficial in preventing stroke recurrences. Primary prevention strategy by Trans Cranial Doppler ultrasound studies of the cerebral arteries, with the aim of promptly initiating appropriate preventive therapy for stroke is strongly advocated.Key words: Sickle cell disease, Stroke, Children, Chronic Transfusion Therap

Lecturers’ Assessment of Teaching Practice Exercise in Nigerian Universities

Teaching Practice is a crucial aspect of teacher education. Despite its importance, the programme is confronted with numerous challenges. Consequently, this paper examines the quality of teaching practice in Nigerian Universities from the perspective of education lecturers. Quality of Teaching Practice Questionnaire (QTPQ) was employed in obtaining data from 691 randomly selected education lecturers from the universities across the six geo-political zones in Nigeria. The data obtained were analysed using descriptive and inferential statistics. The study revealed that the respondents rated the quality of teaching practice exercise in Nigerian universities as fairly above average. It was also found that experience and job status had significant influence on the respondents’ assessment, while gender had no influence. Among others, it was recommended that more time should be allotted to teaching practice and re-training programmes should be organised for lecturers on the best practice in the internship aspect of teacher education. Key words: Assessment, Quality, Teaching Practice Exercise, Teacher Education

Imaging in Urinary Tract Infectioin

The imaging of a child with a proven urinary tract infection (UTI) remains a significant dilemma especially in Africa where some imaging modalities are either unavailable or unaffordable. The role of imaging in UTI is to assist in confirming the infection, identify those children with risk factors that will predispose them to recurrent UTI and also identify those who have suffered complications. This review article provides an overview and suggested approach to imaging in UTI. The different imaging tools and the type of information they provide and their possible side effects would be discussed.Keywords; UTI (urinary tract infection), Imaging, VUR (vesicoureteric reflux), Renal scarrin

The pattern of paediatric HIV/AIDS as seen at the National Hospital Abuja Nigeria

Background: Paediatric HIV/AIDS has become a significant cause of mortality and morbidity in our environment. Objectives: The objective of this paper is to determine the mode of transmission, clinical presentations and outcome of hospital admissions in children with Paediatric HIV/AIDS at the National Hospital Abuja Nigeria. Methods: A retrospective study of children with Paediatric HIV/AIDS admitted into the hospital from January – December 2000 was done. Screening for HIV infection was based on clinical criteria as recommended by WHO except in 3 children with previously diagnosed HIV seropositivity. One positive ELISA and one positive Western Blot assay diagnosed HIV seropositivity. Results: Forty-three HIV positive children aged six weeks to nine years (mean 16.5 months, SD 26.32) were admitted into the Paediatric unit (exclusive of the newborn unit) of the hospital, accounting for 5.7% of all admissions into the unit. There were 35 infants (81.4%). There were 18 males and 25 females (male: female ratio 1:0.72). The presumed modes of transmission were mother to child transmission 40(93.02%), blood transfusion 2 (4.6%) and an unidentified route 1 (2.3%). All parents were in the reproductive age group and there were 6 discordant couples identified (mother HIV positive, father HIV negative).Common presenting symptoms were fever 16(37.2.8%), diarrhoea 13(30.2%), difficult/fast breathing 12(27.9%) and vomiting 8(18.6%), while clinical signs were crepitations in the lungs 27(62.7%), pallor 22(51.2%), oral thrush 20(46.5%), hepatomegaly 18(41.9%), and dehydration 16 (37.2%). Admitting diagnoses were pneumonia 26(60.5%), septicaemia 4(9.3%), diarrhoea with dehydration, intestinal obstruction and malnutrition 2 (4.7%) each. There were 14 deaths (mortality rate 32.6%); accounting for 28.57% of total deaths in the paediatric unit during the period. Thirteen (13) (92.8%) deaths occurred in children aged 2 years old and below. The greatest contributors to mortality were pneumonia 10(71.4%) and septicaemia 2(14.3%). Poor nutritional status was associated (

PMTCT Programme reduced vertical transmission of HIV in Abuja, Nigeria

Objective: To determine the rate of mother to child transmission of HIV following the introduction of PMTCT program in Abuja.Method: A prospective study of 355 seropositive mothers and their newborns was conducted at the National Hospital Abuja and Asokoro District Hospital Abuja over a 12 months’ period following ethical approval. Using DNA PCR the HIV status of all the exposed babies delivered over the period was determined by taking their peripheral blood at 6 weeks of age. This was repeated 6 weeks post cessation of breast feeding for breastfed babies.. Furthermore, the babies were categorized based on the extent of participation of their mothers in the PMTCT programme and the transmission rates obtained were compared.Result: An overall HIV vertical transmission rate of 6.4% (23/359) was found. A lower rate of 1.6% (5/311) was obtained for those whose mothers fully accessed PMTCT programme as opposed to 15.0% (3/20) for those whose mothers had incomplete participation and 53.6%(15/28) for those whose mothers did not participate.Conclusion: Full participation in PMTCT programme significantly reduced mother to child transmission of HIV.Keywords: Paediatric HIV/ AIDS, MTCT, PMTCT, DNA-PCR, Abuja, Nigeri

The extent of basic school teachers involvement in the national basic education reform in Ilorin Emirate, Nigeria

While acknowledging the epochal nature of the educational reforms introduced by the Obasanjo administration, especially at the basic educational level, it is important to note that teachers who are the major stake-holder, had not been properly carried along in the formulation and implementation of the reform. This study therefore, examined the extent of basic school teachers' involvement in the reforms at the basic educational level in Nigeria. Findings in the study showed that the level of basic school teachers' involvement in the reform was still very low. It was presumed that the reforms may not be successful without adequate enlightenment and involvement of teachers who are the grass root implementers of the education policy. The paper has suggested strategies towards enhancing teachers' involvement in the successful implementation of the reforms of basic education in Ilorin, in particular, and other parts of the Nigeria in general