Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

BACKGROUND:The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV-related oral lesions in paediatric Nigerian patients on HAART with those not on HAART.MATERIALS AND METHODS: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross-sectional study over a 2-year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P-value of <0.05 was considered significant.RESULTS:A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm(3), 913 cells/mm(3) and 629 cells/mm(3) for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56-1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54-0.94; P=0.024) and HIV-gingivitis (OR=0.59; 95% CI=0.46-0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV-periodonttitis (OR=0.60; 95% CI=0.51-0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31-5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62-2.06).CONCLUSION: HIV-related Oral lesions are frequently seen in HIV-infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV-gingivitis

Impact of care and social support on wellbeing among people living with HIV/AIDS in Nigeria

Availability of antiretroviral therapies has transformed AIDS into a manageable chronic condition and improved well-being among people living with HIV/AIDS [PHA] in developed countries. In developing countries however, such transformations are yet to occur due to socio-economic, systemic and environmental constraint. This study examined the impact of social, economic, psychological and environmental factors on health and wellbeing among PHA living in southwest Nigeria. Using qualitative participatory methodology, 50 HIV positive people, 8 health personnel and 32 care providers were interviewed to explore how care and social support affect wellbeing among PHA in view of constraints to accessing antiretroviral drugs. Analysis of data used the grounded theory [GT] approach to identify themes, which are considered crucial to the wellbeing of PHA. The findings highlight several factors, apart from antiretroviral drugs, that impact the wellbeing of PHA in southwest Nigeria. These include concerns about deteriorating physical health, family and children's welfare, pervasive stigma, financial pressures and systemic failures relating to care among others. We describe how psychosocial and social support structures can considerably contribute to improving health outcomes among them because of how they affect the functioning of immune system, self-care activities and other illness behaviours. We recommend that interventions should address the psychosocial, socio-economic and other systemic issues that negatively influence the wellbeing of PHA and governments need to strengthen the policy environment that empowers PHA support groups

HIV risk perception and constraints to protective behaviour among young slum dwellers in Ibadan, Nigeria.

This study examined the relationship between HIV/AIDS risk perception and protective behaviour among sexually-active urban young slum dwellers in Ibadan, Nigeria. The multistage sampling techniques were used for selecting 1,600 respondents aged 15-24 years. Of these, 1,042 (65%) respondents who reported unprotected sex in the last three months were selected for analysis. Although the sexually-active respondents demonstrated basic knowledge of HIV/AIDS and high risk perception, risky behaviour was common and protective behaviour was poor. About 48% of 505 males and 12% of 537 females had multiple partners. Similarly, 29% of males and 38% of females were engaged in transactional sex. Only 14% of males and 5% of females used any form of protection, resulting in the high rates of sexually transmitted infections reported by 27% of males and 10% of females. Structural and environmental constraints were identified as barriers to adopting protective behaviour. Therefore, programme and policy interventions should be designed to address the peculiar circumstances of urban young slum dwellers to curtail the HIV epidemic.

Maxillofacial sarcomas in Nigeria

Background: Maxillofacial sarcomas are rare constituting between 4-8% of all malignancies in the region. A few case reports of individual tumours are available while reviews of significant series is lacking. This report presents 80 cases of sarcoma collected over 23 years at a tertiary oral care centre in Kaduna, Nigeria. Method: Retrospective study of all maxillofacial sarcomas in northern Nigeria. Results: There were 406 maxillofacial malignancies of which 80 (20%) were sarcomas. Fourteen histopathologic types were found of which osteosarcoma (28%), chondrosarcoma (17%), rhabdomyosarcoma (12%) and fibrosarcoma (12%) were predominant. The male to female ratio was roughly equal (1.3:1). Patients with sarcoma were between 24 days and 90 years old (mean age 31±15 years) with most patients (26%) in the third decade of life. Cases presented with symptoms such as swelling (100%), pain (54%) and tissue ulceration (26%). Surgery was performed for 46% of cases treated while radiotherapy was used for 26%. Some cases refused hospital treatment because of poverty and ignorance while poor medical infrastructure limited treatment options in several cases regarded as advanced lesions. Conclusion: In Northern Nigeria, sarcomas account for 20% of all maxillofacial malignancies with the osteosarcoma as the predominant type. Most affected were people in the third decade of life. Surgery was the main modality used for treatment while some patients had no treatment due to self-discharge and late presentation. The need for improved medical awareness and upgrading of infrastructure was stressed

Electrocardiographic and echocardiographic findings of Nigerian athletes. A Lagos Study

Summary In a prospective study spanning over 6 months involving one hundred and nineteen male and female subjects comprising 98 Nigerian athletes and 55 age and sex matched controls all had electrocardiography and echocardiographic assessment of left ventricular dimensions and systolic function. Athletes were found to have significant prevalence of bradycardia when compared to the non-athletes. (P=0.03). In addition a greater percentage of the athletes had T wave invertion in the anterior leads (V1-V3) and electrocardiographic features consistent with left ventricular hypertrophy; and first-degree heart block. Athletes were also found to have significantly larger left ventricular end diastolic dimension (p0.01); increased left ventricular posterior wall thickness (p0.01); greater left ventricular mass (p0.01) and left ventricular mass index (p0.01) than the control group. These parameters were found to be significantly higher in each gender category as well. Power trained athletes were found to have greater relative left ventricular wall thickening when compared to the endurance trained athletes. Left ventricular systolic functions of both categories of athletes were found to be within normal limits and better than the control group. None of the athlete had echocardiographic features suggestive of hypertrophic cardiomyopathy