Effect of antiretroviral therapy on asymptomatic malaria parasitaemia in HIV-1 infected children.

OBJECTIVE: To investigate the effect of antiretroviral (ARV) therapy on the level of asymptomatic malaria parasitaemia in HIV-1 infected children. METHODS: Sixty-six HIV infected children had blood films prepared for malaria parasite identification and count. Mean parasite densities were compared across clinical stages and immunologic categories of disease and antiretroviral treatment status. RESULTS: Forty-five (68%) were less than 6 years old and 50 (75.7%) had advanced HIV disease. Twenty seven (41%) were on antiretroviral therapy. The prevalence of ASMP in the treated and untreated group was 44.4% and 15.4% respectively (p<0.01). The mean parasite density in the ARV treatment group was also significantly higher than in the untreated group (p=0.0071). CONCLUSIONS: ARV therapy seems to be associated with higher rates of ASMP and higher mean parasite counts.

Effect of antiretroviral therapy on asymptomatic malaria parasitaemia in HIV-1 infected children.

OBJECTIVE: To investigate the effect of antiretroviral ARV) therapy on the level of asymptomatic malaria parasitaemia in HIV-1 infected children. METHODS: Sixty-six HIV infected children had blood films prepared for malaria parasite identification and count. Mean parasite densities were compared across clinical stages and immunologic categories of disease and antiretroviral treatment status. RESULTS: Forty-five (68%) were less than 6 years old and 50 (75.7%) had advanced HIV disease. Twenty seven (41%) were on antiretroviral therapy. The prevalence of ASMP in the treated and untreated group was 44.4% and 15.4% respectively (p<0.01). The mean parasite density in the ARV treatment group was also significantly higher than in the untreated group (p=0.0071). CONCLUSIONS: ARV therapy seems to be associated with higher rates of ASMP and higher mean parasite counts.

Anthropometric measurements in the detection of low birth weight infants in Lagos.

The present study was undertaken to determine the anthropometric risk indicators in the detection of infants with low birth weight. A total of 788 consecutive, singleton, live born infants had anthropometric measurements determined within 24 hours of life using standard methods. There were 389 (49.37%) males and 399 (50.63%) females; 136 (17.56%) of the infants were of low birth weight (LBW). Birthweight was significantly correlated with occipitofrontal circumference (OFC; r = 0.66), length (r = 0.86), mid-arm circumference (MAC; r = 0.88) and maximum thigh circumference (MTC; r = 0.95) (p < 0.001). Furthermore, OFC of 33.6 cm and 32.3 cm, length of 47.7 cm and 45.5 cm, MAC of 9.6 cm and 9.1 cm, and MTC values of 15.5 cm and 14.9 cm were the corresponding cut-off values with the best combination of sensitivity, specificity and predictive values (p < 0.001) for identifying infants with birth weights of < 2500 g and < 2000 g respectively. The use of these risk indicators would help to identify newborns for close supervision and care, as well as prevent mortality and postnatal developmental retardation.

Evaluation of cassava-salt suspension in the management of acute diarrhoea in infants and children.

To identify a suitable substrate for an oral rehydration solution (ORS) at home, this study evaluated the efficacy and safety of cassava-salt suspension (CSS) prepared from a dietary staple, cassava, with added sodium chloride. The results were compared with those of standard World Health Organization (WHO) recommended ORS. One hundred thirty-two dehydrated children aged between 6 and 24 months with acute diarrhoea of less than 3 days duration were chosen for the study and randomly rehydrated with CSS or WHO-ORS. The intake of ORS (CSS or WHO-ORS), water, and food was comparable in both groups. The mean stool output on day 1, total stool output, and duration of diarrhoea were 45.3 +/- 37.3 g/kg, 60.8 +/- 58.9 g/kg, and 18.9 +/- 22.4 h for the group on CSS. These are significantly different from the corresponding values of 69.7 +/- 64.9 g/kg, 88.2 +/- 100.4 g/kg, and 28.2 +/- 27.0 h obtained for controls. Failure of therapy occurred in four children on CSS (6%) and three children on WHO-ORS (4.5%). It is concluded that CSS is both efficacious and safe for use as an ORS, particularly in the home management of acute diarrhoea in children.

Flame burns disasters from kerosene appliance explosions in Lagos, Nigeria.

A study of 55 cases of burns admitted to the Lagos University Teaching Hospital in the month of March 1984 revealed that 96 per cent were caused by flame burns due to explosions that occurred during the use of kerosene appliances for cooking and lighting. Thirty-four (62 per cent) were children, while 21 (38 per cent) were adults. In each of seven families, two or more people were affected. The overall mortality was 44 per cent, of which the larger contribution of 30 per cent was in children. By comparison, in the two preceding months there was a total of 17 and 20 burns admissions respectively. The mortality rate was 16 per cent while in March 1983 there was no death among the six paediatric admissions. Investigations showed that the explosions occurred due to petrol contamination of the kerosene before delivery to the domestic users. Appropriate precautions by kerosene suppliers and users, and health education can help prevent similar disasters in the future.

Adrenal rest tumour of the ovary associated with isosexual precocious pseudopuberty and cushingoid features.

A 2-year-old girl who presented with blindness, aphasia and inability to move the right arm and leg following a convulsive episode was found to have hypertension, precocious pseudopuberty, features of Cushing syndrome and an ovarian tumour. The hormonal profile suggested an adrenal cortical tumour, which turned out to be located in the ovary and the cause of the ovarian enlargement. Following removal of the mass, all the abnormal features regressed and the blood pressure returned to normal.

Evaluation of a maize-cowpea-palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea.

A randomized clinical trial was carried out to compare a locally available maize-cowpea-palm oil diet (group MCP) with a commercially produced lactose-free, soy protein isolate formula (group SF) for the dietary management of 69 Nigerian boys, 6-24 months of age, hospitalized for acute, watery diarrhea. Although the treatment groups were generally similar initially, the children in group SF had slightly lower mean weight-for-age z scores (p = 0.08), lower serum bicarbonate levels (p = 0.04) and greater stool outputs during the period of rehydration before the diets were initiated (p = 0.01). Rates of treatment failure in group MCP (5.7%) and group SF (8.8%) were similar (p = 0.67). There were no significant differences in the adjusted mean stool outputs by study group on days 1-5, but the children in group SF had slightly lower fecal weights on day 6 (p = 0.05). Children in group MCP had a substantially reduced duration of liquid stool excretion (estimated median duration 42 h versus 140 h; p < 0.001). On the other hand, children in group SF consumed considerably more of their diet, had greater net absorption of macronutrients and greater rates of weight gain than those in group MCP. We conclude that children can safely consume the MCP diet during acute, watery diarrhea without increasing their risk of treatment failure or augmenting stool output. However, the diet may not be adequate as a sole source of nutrients beyond the period of acute illness.