Serum selenium status of HIV-infected children on care and treatment in Enugu, Nigeria.

Objective. To compare the selenium status of HIV-infected and HIV-uninfected children. Methods. This was a hospital-based comparative study using a structured questionnaire in the quantitative research domain at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria. Seventy-four HIV-infected children were compared with 74 non-HIV-infected children (35 males and 39 females in each group). The outcome measure was the selenium status of the study participants. Results. The mean (standard deviation (SD)) weight-for-height z-score among the subjects was –0.18 (1.53) compared with 0.05 (1.68) among the controls (p=0.457). The mean (SD) height-for-age z-score among the subjects was –1.16 (1.44) compared with 0.06 (1.06) among the controls (p<0.001). Eighteen subjects (24.3%) compared with eight controls (11.4%) were selenium deficient (odds ratio 2.49; 95% confidence interval 1.00 - 6.18; p=0.044). Median CD4 counts of selenium-deficient and non-deficient subjects were 765.5 (range 409 - 1 489) and 694.0 (range 85 - 2 196) cells/μL, respectively (p=0.321). The proportions of selenium deficiency were 26.4% and 22.2% in the highly active antiretroviral therapy (HAART) and pre-HAART groups, respectively (p=0.565). Conclusion. There was a significant difference in the proportion of HIV-infected children who were selenium deficient compared with their uninfected counterparts

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Background: Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent. Objective: To review the current and emerging challenges facing pediatric HIV care in sub-Saharan Africa; and proffer solutions that could help in tackling these challenges. Method: A Medline literature search of recent publications was performed to identify articles on “pediatric HIV”, “HIV and children”, “HIV and infants”, “HIV and adolescents” in sub-Saharan Africa. Result: There are a number of challenges and emerging complex issues facing children infected and affected by HIV in sub- Saharan Africa. These include late presentation, limited access to pediatric HIV services, delayed diagnosis, infant feeding choices, malnutrition, limited and complex drug regimen, disclosure, treatment failure and reproductive health concerns. A holistic cost effective preventive, diagnostic and treatment strategies are required in order to eliminate pediatric HIV in SSA. Conclusion: HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa

Important clinical and laboratory correlates of glomerular filtration rate in sickle cell anemia

Background: Renal impairment is routinely assessed using the estimated glomerular filtration rate (eGFR) and it may be helpful to obtain certain clinical or laboratory markers, which show relationship with glomerular filtration rate (GFR) in sickle cell disease (SCD).Aim: To assess the relationship between important clinical and laboratory parameters in SCD, and the eGFR.Patients and Methods: Steady state clinical and laboratory data were obtained from 228 homozygous SCD patients seen over a 7‑year period. The GFR was estimated using (isotope dilution mass spectrometry) traceable modification of diet in renal disease (MDRD) and Cockroft–Gault methods. The correlation coefficient and independent t‑test were done to assess the level of significance between the eGFR_MDRD and the known indicators of disease severity.Results: The serum alkaline phosphatase (ALP) and serum direct bilirubin levels both showed significant inverse relationship with eGFR_MDRD P = 0.012 and P = 0.24, respectively. The patients’ age, Hb, leukocyte count, platelet count, serum direct bilirubin and aspartate transaminase did not show a significant correlation. The eGFR_MDRD was more discriminatory revealing that 20.3% of the patients had suboptimal GFR. Proteinuria in steady state was observed in 20.3% of the patients.Conclusion: High serum direct bilirubin and ALP are associated with a deteriorating eGFR_MDRD. Other clinical and laboratory indicators of disease severity in SCD do not show the relationship with the GFR. MDRD_GFR estimation seemed to be a more appropriate method of estimating GFR in SCD.Key words: Cockroft–Gault, glomerular filtration rate, modification of diet in renal disease sickle cel

A review of paediatric acquired immunodeficiency syndrome

No AbstractKeywords: Paediatric HIV/AIDS, HIV Virus, AR

Evaluation of the capacity of Pediatricians in Nigeria to conduct research: A nationwide survey

Background: Research is key to quality healthcare. Clinicians should possess adequate research capacity to generate evidence. This study aimed to evaluate the research capacity of pediatricians in Nigeria.Methods: The study was a crosssectional using a questionnaire developed from the Research Capacity Assessment Framework. Information on previous research work, challenges encountered, and utilization of research outcome were obtained. The data was analyzed using SPSS version 20.Qualitative variables were grouped under thematic headings.Results: Paediatricians who had received grants for research were 21 (19.4%). Those whose research outcomes had informed policy and practice were 20 (18.2%). Less than 40% of the participants had received training on research capacity areas.Conclusion: The research capacity among pediatricians was low partly due to underfunding and lack of research training programs. Improvement on government fund allocation for research and introduction of short research trainings programs will improve research capacity in Nigeria. Key words: Clinical research; Pediatrician; Research Capacity; Policy-Practice Chang