RESUMO
BACKGROUND: Sickle cell disease is a common genetic disorder in Nigeria. OBJECTIVES: To determine the steady state haematocrit, liver size and spleen size in children with sickle cell disease and the factors that influence them. METHODS: This was a retrospective study of children with sickle cell disorders who attended the anaemia clinic of the Children's Outpatient Department, University College Hospital, Ibadan between the years 2000-2009. Relevant data extracted from their case notes included socio-demographic variables, haemoglobin phenotype, steady state haematocrit and liver and splenic sizes. Means were compared with t-test and correlation tested with Pearson correlation. Statistical significance was set at p < 0.05. RESULTS: A total of 415 (Male: female ratio 1.1:1) children were studied and 385 (92.8%) and 30 (7.2%) of the children were of haemoglobin (Hb) SS and Hb SC phenotypes respectively. Their ages ranged from 0.5-17 years with a mean (SD) of 7.3 (4.4) years. Mean (SD) steady state haematocrit for children with HbSC was 28.3 (4.5) % and significantly higher than 24.1 (3.7) % in HbSS. Mean steady state haematocrit was also higher in children from higher than lower socio-economic classes. There was a negative correlation of haematocrit with age, with hepatomegaly and splenomegaly. Steady state hepatomegaly occurred more frequently in HbSS than in HbSC. CONCLUSION: Haemoglobin phenotype, age and socio-economic status have some modifying influences on the steady-state features of sickle cell disease in Nigerian children. In addition, increasing liver and spleen sizes seem to be related to a decreasing haematocrit.
Assuntos
Anemia Falciforme , Hematócrito , Hemoglobinas Anormais/análise , Hepatomegalia , Esplenomegalia , Fatores Etários , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Anemia Falciforme/fisiopatologia , Criança , Pré-Escolar , Feminino , Hematócrito/métodos , Hematócrito/estatística & dados numéricos , Hepatomegalia/diagnóstico , Hepatomegalia/epidemiologia , Hepatomegalia/etiologia , Humanos , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Esplenomegalia/diagnóstico , Esplenomegalia/epidemiologia , Esplenomegalia/etiologia , Estatística como AssuntoRESUMO
In order to determine the age at diagnosis of sickle cell disease and some of the factors that influence the same at the University College Hospital Ibadan, a retrospective study of children with sickle cell disease who attended the children's outpatient department of the hospital between June 2000 and June 2009 was conducted by reviewing their case notes. A total of 457 children were studied (Male: Female ratio 1.1:1). Haemoglobin phenotype was SS in 421 children (92.1%) and SC in 36 children (7.9 %). Median age at diagnosis was 2.0 years (2.5 months - 14.0 years). Age at diagnosis was lower in children with Hb SS than HbSC (p = 0.01), in children from higher socioeconomic classes (p = 0.003) and in children with a history of dactylitis (N = 354, p = 0.000). Late diagnosis of haemogobinopathies in Ibadan calls for institution of neonatal screening to improve chances of survival.
Assuntos
Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Hemoglobinas/análise , Adolescente , Idade de Início , Criança , Pré-Escolar , Diagnóstico Precoce , Feminino , Genótipo , Hospitais Universitários , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos , Fatores Socioeconômicos , Fatores de TempoRESUMO
BACKGROUND: Febrile seizures are common among children and these are known to result from the diverse aetiological factors, known to cause fever in children. OBJECTIVES: To determine the prevalence of bacteraemia amongst children with febrile seizures at the children's emergency room of the University College Hospital, Ibadan, Nigeria. METHODOS: This was a prospective study involving 147 children who were presented with febrile seizures over a period of 13 months at the University College Hospital Ibadan. They all had their blood cultures sample taken under aseptic conditions. Other investigations performed on them included a packed cell volume, full blood count and blood film for malaria parasite. RESULTS: A total of 83 males and 64 females with febrile seizures were studied. Their ages ranged from 4 to 60 months with a mean age of 26.35 + 13.76 months. Bacteraemia was diagnosed in 32(21.8%) of the cases. The predominant organism isolated from the blood of these patients was Staphylococcus aureus. CONCLUSION: Bacteraemia is a frequent finding in children with febrile seizures hence, it may be beneficial to carry out blood culture in such children on the suspicion of a probable bacterial infection.
RESUMO
A review of the presentation, management and outcome in all children presenting with non-traumatic paraplegia managed by the paediatric neurology team at the University College Hospital Ibadan, Nigeria from June 1989 to May 2004 is presented. Of the 110 patients, there were 54 males and 56 females giving a M:F ratio of 1:1. The mean age of the group was 5.3 (SD = 3.1) years, with a range from 9 months to 11 years. Infections and infectious processes caused the paraplegia in 102 (92.7%) of the cases with poliomyelitis and tuberculosis (TB) of the spine accounting for 88 (80%) of cases. The study period was divided into three 5 year periods. While poliomyelitis was the commonest cause of paraplegia (60%) in the first 5 years: TB spine was responsible for most cases (40%) in the last 5-year period of the study. There was a significant reduction in the total number of cases seen when the initial 5-year period was compared with the last (45 and 26 respectively, P = 0.001). Overall mortality among the 110 admitted patients was 7.2% being highest (50%) in malignant disorders and none was recorded in TB spine. Prognosis for eventual ability to walk was best in cases of TB spine where 37 of the 39 patients (95%) were ambulant by discharge after 60 days of anti-TB treatment. The 2 non-ambulant patients eventually walked within 3 months of discharge while on maintenance treatment for TB. Only 2 of the 51 non-ambulant patients obtained wheelchairs at discharge. The implications of inadequate facilities for investigation and treatment as well as the lack of financial and social support for the families of affected children are discussed.
Assuntos
Neoplasias/mortalidade , Paraplegia/mortalidade , Poliomielite/mortalidade , Tuberculose da Coluna Vertebral/mortalidade , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Seguimentos , Hospitais Universitários , Humanos , Lactente , Masculino , Neoplasias/complicações , Neoplasias/terapia , Nigéria , Paraplegia/etiologia , Paraplegia/patologia , Poliomielite/complicações , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/terapiaRESUMO
We present the findings in 14 paediatrics patients with SCA who had CT examination at the University College Hospital Ibadan on account of stroke between 1993 and 2000. There were 8 female and 6 male with a mean age of 11.25 years and SD of 3.66. Cerebral infarction was the most common finding occurring in 57% of the patients while intracerebral bleed was seen in 21%. Two patients had a mixed lesion and atrophy was seen in one patient. Five patients (36%) had their lesion on the right hemisphere while eight (57%) had their lesions on the left side. The frontal and parietal lobes were mainly affected. Prompt CT screening of the brain in a child with sickle cell anaemia who presents with symptoms and signs suggestive of stroke can help identify the particular type of lesion and this may influence mode of therapy given as well as prognosis
Assuntos
Anemia Falciforme/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Hemorragia Cerebral/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Nigéria , Estudos Prospectivos , Acidente Vascular Cerebral/etiologia , Tomografia Computadorizada de EmissãoRESUMO
We reviewed our records over a 15-year period to determine whether or not the impression that stroke complicating sickle cell disease was less common than reported in North America. Records of children aged 16 years and below with a diagnosis of stroke seen at the University College Hospital, Ibadan, Nigeria between 1988 and 2002 were examined. Thirty-nine such patients were identified but only 31 had detailed records available for study. Twenty-seven of these had sickle cell disease, 26 with haemoglobin genotype SS and 1 with Hb S+C. Sickle cell disease was therefore responsible for 87% of stroke seen in children at our centre. With an average clinic population of about 500 patients with sickle cell disease, the hospital frequency of stroke among these patients is estimated at 5.4%. The mean age of occurrence of the first stroke was 6.8 years ranging from 17 months to 11 years. Of the 7 patients who had CT scans of the brain done, 5 had evidence of cerebral infarction while 2 had intracerebral haemorrhage. While only 2 deaths occurred among the cases reviewed, morbidity was significant with only 6 patients achieving complete recovery. Recurrent stroke occurred after an average of 25.6 months in 8 of 13 patients who were followed up (61.5%). The incidence of stroke among African children with sickle cell disease appears to be not as high as reported in patients from North America.
Assuntos
Anemia Falciforme/complicações , Acidente Vascular Cerebral/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologiaRESUMO
OBJECTIVES: A retrospective study of all children with a diagnosis of sciatic nerve injury managed at the University College Hospital, Ibadan, Nigeria over a 12 year period was carried out in order to determine predisposing factors to the nerve injury and highlighting practical preventive measures. DESIGN: The necessary data was collected from the case files of children seen at the hospital with a diagnosis of sciatic nerve injury, from 1988 to 1999. RESULTS: There were 27 children aged five months to 12 years with a diagnosis of sciatic nerve injury. Twenty (74%) of the children were aged five years or less. While seven patients (26%) presented within two weeks of development of foot drop consequent on intramuscular (i.m.) injection given on the buttock, 20 patients (74%) presented much later. Fever was the most common complaint for which the injection had been given. The identity of the drugs given was not known in 10 patients. In the remaining 17 patients drugs administered were specified and included Chloroquine, Novalgin, Paraldehyde, Procaine penicillin, and Sulfadoxine-Pyrimethamine. Most of the patients had received the injections in privately owned medical facilities where staff with minimal training are often allowed to administer i.m. injections. CONCLUSION: It is suggested that the i.m. route for injection be strongly discouraged when a drug can be given by other routes. Only trained staff should be allowed to administer i.m. injections. Giving i.m. injections at sites other than the buttock maybe advantageous in children particularly those aged five years and below.
Assuntos
Injeções Intramusculares/efeitos adversos , Nervo Isquiático/lesões , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Nigéria , Estudos RetrospectivosRESUMO
In a review of 94 paediatric patients treated for post-neonatal tetanus over a period of 11 years at the University College Hospital, Ibadan, Nigeria, reliable data regarding the care received for wounds that eventually resulted in tetanus was available in 58 patients. Seventeen of these patients had orthodox medical care for their wounds before developing tetanus. While some of the patients had received antibiotics and/or tetanus toxoid, no patient received antitetanus serum despite the fact that most of them had no previous immunization against tetanus. All the 3 victims of road traffic accidents were given tetanus toxoid but none of the 6 patients with chronic suppurative otitis media had any form of tetanus prophylaxis. The findings highlight the adverse consequences of failure to adhere to basic guidelines for management of the tetanus-prone wound.
Assuntos
Tratamento de Emergência/normas , Fidelidade a Diretrizes/normas , Imunização/normas , Guias de Prática Clínica como Assunto , Toxoide Tetânico , Tétano/prevenção & controle , Ferimentos e Lesões/terapia , Adulto , Criança , Países em Desenvolvimento , Serviço Hospitalar de Emergência/normas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Tratamento de Emergência/métodos , Tratamento de Emergência/estatística & dados numéricos , Seguimentos , Fidelidade a Diretrizes/estatística & dados numéricos , Hospitais Universitários , Humanos , Imunização/estatística & dados numéricos , Nigéria/epidemiologia , Qualidade da Assistência à Saúde , Análise de Sobrevida , Tétano/etiologia , Tétano/mortalidade , Ferimentos e Lesões/complicaçõesRESUMO
UNLABELLED: As part of a larger project on childhood urinary tract infection, antimicrobial sensitivity tests were carried out on the bacterial isolates from the urine of febrile children seen at the University College Hospital, Ibadan, Nigeria. METHODOLOGY: Midstream urine specimens were collected from 171 sickle cell anaemia children and from an equal number of haemoglobin-A controls and cultured by standard methods. Sensitivity to eleven antimicrobials was tested using the disc-diffusion technique of Stokes. RESULTS: Significant bacteriuria was obtained from 37 children with sickle cell anemia and 27 controls. The isolates were Escherichia coli, Klebsiella species, Non-haemolytic streptococcus, beta-haemolytic Streptococcus, Salmonella, Proteus and Pseudomonas species. Sensitivity was highest to Pefloxacin to which over 94% of the organisms were sensitive followed by Ceftriaxone (over 85%) and ceftazidime (over 85%). Sensitivities to nalidixic acid and cefuroxime were between 67.6% and 74.1%. Most of the isolates were resistant to gentamicin, amoxycillin, cotrimoxazole and ampicillin. In general the sensitivity pattern in the sickle cell anaemia group was similar to the pattern in the control group. CONCLUSION: Aetiological agents of childhood UTI in this environment are resistant to most of the drugs commonly recommended for its treatment. Nalixidic acid and cefuroxime are recommended as first line drugs while awaiting results of sensitivity testing. Ceftriazone and ceftazidime should be reserved for cases of non-response to first line drugs and in severe cases. Pefloxacin should be considered potential drug of treatment particularly in multi-drug resistant infections.
Assuntos
Anemia Falciforme/complicações , Infecções Bacterianas/microbiologia , Infecções Urinárias/microbiologia , Adolescente , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Nigéria/epidemiologia , Seleção de Pacientes , Saúde da População Urbana , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologiaRESUMO
BACKGROUND: Tuberculosis still remains a major problem in the developing countries. The involvement of the spine is also of increasing importance, because of the resurgence of TB in association with AIDS. This paper is designed to evaluate the applicability of CT in the diagnosis and definition of tuberculosis of the spine in Ibadan. METHOD: A restrospective study of the Computed Tomographic examination of 22 cases of spinal tuberculosis (Pott's disease) over a four-year period at the Radiology Department of the University College Hospital, Ibadan. RESULTS: There was a male prevalence in the study. The mean age of respondents was 41.2 years. Neurological symptoms and back pain were the most common presentations. The thoracic spine was mostly involved while the cervical spine was least involved. Most lesions 77.3 % were demonstrated in two contiguous vertebral bodies. The vertebral bodies were destroyed in all the patients while the posterior elements were involved in 59%. The other CT findings were paravertebral soft tissue shadow in 40.9%, narrowed irregular disc spaces in 27.3% and fusion of vertebral bodies in 13.6%. The frequent bony destruction was osteolytic in nature, and was present in 64% of patients. CONCLUSION: CT is an adequate modality for thorough imaging and diagnosis of Pott's disease especially in patients with non specific or ambiguous presentations. It offers a unique opportunity of demonstrating clearly the various component of the spine, it also defines the pattern and extent of the destructive process.
Assuntos
Tuberculose da Coluna Vertebral/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Tuberculose da Coluna Vertebral/epidemiologia , Tuberculose da Coluna Vertebral/patologiaRESUMO
BACKGROUND: Computed Tomography (CT) is an important tool for neuroimaging, it offers an opportunity to investigate structural lesions as a cause of seizures with little morbidity. This study is designed to evaluate it's applicability in children with epileptic seizures. METHOD: It is a descriptive study of the CT scans of the 103 consecutive children who were referred to the CT suite of the University College Hospital on account of seizure disorders over a 5 year period (1997--2001). RESULTS: Only 103 (4.6%) of the subjects who had cranial scans done in five years were children with seizures disorders. The CT scans were abnormal in 53 (51.5 %). Hydrocephalus was the most common finding in 14 (13.6%). Cerebral atrophy and infarct were reported in 10.6% and 8.7% respectively. The outlined cranial fractures found in 6.8% were all depressed. A high incidence (74.4%) of abnormal scans was reported in the children with partial seizures. Thirty-three (62.3%) of the abnormal scans were amenable to surgery. The presence of neurologic deficit increased the yield of abnormal CT features. CONCLUSION: CT scans are of extreme value in the screening and definitive evaluation of seizures in children. It is advocated for excluding treatable conditions and monitoring progression of the disorder.
Assuntos
Epilepsia/diagnóstico por imagem , Programas de Rastreamento/métodos , Tomografia Computadorizada por Raios X , Adolescente , Distribuição por Idade , Hemorragia Cerebral/complicações , Infarto Cerebral/complicações , Criança , Pré-Escolar , Epilepsia/classificação , Epilepsia/epidemiologia , Epilepsia/etiologia , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Hidrocefalia/complicações , Incidência , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento/normas , Nigéria/epidemiologia , Seleção de Pacientes , Vigilância da População , Encaminhamento e Consulta/estatística & dados numéricos , Distribuição por Sexo , Fraturas Cranianas/complicações , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/normas , Saúde da População Urbana/estatística & dados numéricosRESUMO
Hyperventilation exercise during electroencephalography precipitated a recurrence of right hemiplegia and aphasia in a patient with Hb SS disease. Although recovery of function started within hours of the event, full recovery has not occurred six months after. Hyperventilation provocative test during electroencephalography should be discouraged in patients with sickle cell anaemia.
Assuntos
Anemia Falciforme/complicações , Afasia/etiologia , Exercícios Respiratórios/efeitos adversos , Eletroencefalografia/efeitos adversos , Teste de Esforço/efeitos adversos , Hemiplegia/etiologia , Hiperventilação/complicações , Acidente Vascular Cerebral/etiologia , Adolescente , Anemia Falciforme/terapia , Afasia/diagnóstico , Eletroencefalografia/métodos , Transfusão Total , Teste de Esforço/métodos , Feminino , Hemiplegia/classificação , Hemiplegia/diagnóstico , Humanos , Recuperação de Função Fisiológica , Recidiva , Fatores de Risco , Convulsões/diagnóstico , Convulsões/etiologia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/diagnósticoRESUMO
BACKGROUND: Febrile seizures are commonly encountered in emergency paediatric practice. Initial pre-hospital intervention given by caregivers has been shown to impact outcome. OBJECTIVES: To describe the spectrum of pre-hospital interventions given for the treatment of childhood febrile seizures in Ibadan, Nigeria. METHODS: All consecutive cases of febrile seizures seen at the emergency room of University College Hospital, Ibadan over a period of 13 months were the subjects of the study. Details of history of illness including the interventions given before presentation were recorded. All the children had lumbar puncture and examination of their cerebrospinal fluid (CSF). All were followed up till discharge and the outcome was recorded. RESULTS: A total of 147 children, 83 males and 64 females with febrile seizures were studied. Harmful traditional practices were found to be common in the cohort studied. Fifty-nine (40.1%) of the children received at least one form of intervention believed to be capable of aborting the seizure during the attack at home. Herbal preparation was the most common form of pre-hospital treatment, given in 15 (10.2%) of the cases. Other forms of pre-hospital interventions given were application of substances to the eyes (6.1%), incisions on the body (2%) and burns inflicted on the feet and buttocks (1.4%). None of the children received rectal diazepam or buccal midazolam as home remedy for seizures. There was a statistically significant relationship between harmful cultural practices and the socio-economic class of the caregivers (P=0.008). CONCLUSIONS: Pre-hospital treatment of childhood seizures in Ibadan comprises mainly harmful traditional practices. There is a need for appropriate health education to reduce the morbidity and mortality associated with febrile seizures in the locality.
RESUMO
Splenic reticuloendothelial function, as determined by pitted red cell counts in 114 pediatric patients with sickle cell disease, was evaluated. Patients with homozygous sickle cell disease (HbSS) had a mean pit count of 11.8 +/- 7.0% and the count increased with age. Sickle cell hemoglobin C disease (HbSC) patients had a mean pit count of 4.9 +/- 9.1%, the count being unaffected by age. One patient with HbS-beta thalassemia had a count of 12%, while eight patients with HbS-beta + thalassemia had a mean count of 0.4 +/- 0.3%. There was one patient each with HbSS-alpha thalassemia, HbS-O Arab, and HbS-Lepore, and the pit counts were 4.9, 31.4, and 0.4%, respectively. In both HbSS and HbSC patients, the pit count was significantly lower in patients who had palpable spleens. The pit count may be used as a predictor of disease severity in the sickle cell disorders.
Assuntos
Anemia Falciforme/sangue , Adolescente , Fatores Etários , Anemia Falciforme/patologia , Criança , Pré-Escolar , Eritrócitos Anormais/patologia , Doença da Hemoglobina SC/sangue , Doença da Hemoglobina SC/patologia , Hemoglobinas Anormais/fisiologia , Humanos , Lactente , Baço/patologia , Talassemia/sangueRESUMO
In a retrospective review of 73 children with post-neonatal tetanus seen over an 11-year period at University College Hospital, Ibadan, Nigeria, atypical portals of entry of the causative agent were recorded in nine and five developed unusual complications during the course of treatment for tetanus. Localized tetanus was encountered in seven children; this involved the cephalic region in one and one lower limb in each of the remaining six. Among these six children, the portal of entry of the organism included intramuscular injections into the buttock in five and an infected insect bite on the buttock in one case. Another unusual portal of entry, observed in two children, was through an impacted foreign body in the ear in the absence of otitis media. Arthritis of large joints was encountered in three children and two had episodes of severe bronchospasm which responded to bronchodilator treatment. The findings in this study significantly widen the reported spectrum of presentations and complications of tetanus in third-world children.
Assuntos
Países em Desenvolvimento , Tétano/etiologia , Nádegas , Orelha , Corpos Estranhos/complicações , Humanos , Recém-Nascido , Injeções Intramusculares/efeitos adversos , Mordeduras e Picadas de Insetos/complicações , Nigéria , Estudos RetrospectivosRESUMO
The relationship of foetal haemoglobin (HbF) to several clinical and haematological parameters in 86 children aged 5 to 16 years who had sickle cell anaemia (SCA) has been examined. The mean HbF level was 6.8 +/- 3.6%. Higher HbF values were significantly associated with fewer blood transfusions, fewer hospital admissions and higher rate of hepatomegaly. A trend for children with higher HbF levels to have better physical development and a more normal haemogram was also noted though this was not statistically significant.
Assuntos
Hemoglobina Fetal/análise , Traço Falciforme/sangue , Adolescente , Criança , Pré-Escolar , Feminino , Hepatomegalia/etiologia , Humanos , Masculino , NigériaRESUMO
The concentration of haemoglobins F and A2 in 132 Hb SS children aged 6 months to 16 years and 50 age- and sex-matched controls has been determined. The mean HbF concentration in Hb SS patients and controls were 9.5 per cent (range 1.7-24.5 per cent) and 1.5 per cent (range 0.5-14.4 per cent) respectively while HbA2 concentrations were 2.7 per cent (range 1.6-3.7 per cent) and 2.4 per cent (range 1.3-3.9 per cent) respectively. For 18 Hb SS patients seen in the stable state and during vaso-occlusive crisis, there was no significant difference in HbF concentration between the two states.
Assuntos
Anemia Falciforme/sangue , Hemoglobina Fetal/fisiologia , Hemoglobina A2/fisiologia , Adolescente , Anemia Falciforme/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , NigériaRESUMO
Lymphocyte subpopulations in human cord blood have been examined using monoclonal antibodies, visualized with immunogold. The proportions of T11, T4, T8, and B1 cells in cord blood are very similar to values in adult peripheral blood. Some evidence of lymphocyte immaturity in cord blood is suggested by the presence of 12% CALLA-positive cells and the sum of T4 and T8 cells significantly exceeding the number of T11 cells; however, there were no TdT-positive cells. The presence of CALLA-positive lymphocytes in normal cord blood should be borne in mind when investigating blood smears from neonates for congenital leukemia.
Assuntos
Imuno-Histoquímica , Linfócitos/classificação , Antígenos de Superfície/análise , Sangue Fetal , Humanos , Recém-Nascido , Linfócitos/imunologia , Coloração e RotulagemRESUMO
Screening of 143 children 6 months to 12 years of age with sickle-cell anemia showed that 39.2% were HBsAg-positive as compared with 19.3% of the 161 control children of the same age group, who had Hb genotype AA (chi 2 = 14.7383; P less than 0.001). Fifty percent of the HbSS children under the age of 1 year were HBsAg-positive as opposed to 4.3% of the control group (chi 2 = 9.1955; P less than 0.001), while 28.6% of patients were HBsAg-positive at the age of 4 years compared with only 7.4% of the controls at the same age. The incidence of anti-HBc in both groups was similar. Markers of HBV infection (HBsAg + anti-HBc) were, however, on the whole higher in the patients with sickle-cell anemia [88/118 (74.6%)] than in the controls [54/88 (61.3%; P less than 0.005)].
Assuntos
Anemia Falciforme/epidemiologia , Portador Sadio/epidemiologia , Antígenos de Superfície da Hepatite B/análise , Hepatite B/epidemiologia , Fatores Etários , Anemia Falciforme/complicações , Anemia Falciforme/imunologia , Portador Sadio/imunologia , Criança , Pré-Escolar , Hepatite B/complicações , Humanos , Lactente , Fatores de RiscoRESUMO
A prospective study to determine the prevalence of bacteriuria and bacterial isolates in the urine of febrile children with sickle cell anaemia (SCA) was carried out at University College Hospital, Ibadan. Altogether, 171 febrile children (aged 1-15 years) with SCA and 171 age- and sex-matched controls were studied. After obtaining a history of the illness from the parents or guardians, each child was physically examined and a mid-stream urine specimen collected and subjected to microscopy and culture. The prevalence of bacteriuria in children with SCA was 21.6% compared with 15.8% in the controls. Escherichia coli and Klebsiella species were the predominant isolates from the urine, accounting for 64.9% and 18.9%, respectively, of the isolates from the SCA group and 63% and 22.2%, respectively, in the controls. In the SCA group, significant bacteriuria also occurred with other conditions such as pneumonia and osteomyelitis. Urinary tract infection (UTI) is common in children with SCA. Routine screening for it is therefore recommended during febrile illnesses. Children with fever from other overt causes, however, should not be exempted from the urine screening procedure in case there might be concomitant UTI.