Nigerian quarterly journal of hospital medicine最新文献

Background: Tetanus, though an eminently preventable disease still ranks as a leading cause of death in Nigeria as well as in other developing countries. Reported mortality for severe tetanus varies from 20-60% and depends on the availability and quality of intensive care. Farmers and artisans are mostly affected.

Objectives: This retrospective study was carried out to determine the pattern of clinical presentation of tetanus, the immunization status, case fatality rate and factors influencing mortality.

Methods: Case notes of patients (age > 10 and above) managed for tetanus from 2004-2008 at LAUTECH Teaching Hospital Osogbo were retrieved. Demographic, clinical data, laboratory investigation results and response to treatment were collated. The data obtained were analysed using the SPSS version 15 Statistical package.

Results: Over the 5-year period,80 cases of tetanus were managed in the medical wards of LAUTECH Hospital Teaching Osogbo. However, the medical records of 12 of them could not be retrieved, leaving 68(85%) for analysis. This comprised of 45 males and 23 females. Tetanus was highest in the third decade of life. The commonest portal of entry was the lower limb (n = 43). Only one subject was fully vaccinated and received booster dose of vaccine. Thirty-one (31)out of the 68 patients died giving a case fatality rate of 51.5%.

Conclusion: The mortality of tetanus is still very high from this retrospective study. The rate of immunization against tetanus was dismally low. Active immunization should be given to all Nigerians particularly those in the vulnerable group.

Background: HIV infection/AIDS being a multi-systemic disease affects the skin at various stages in course of the illness. A knowledge of the common skin diseases associated with HIV infection can lead to early detection, appropriate staging and commencement of appropriate care in the infected patients.

Objective: The study was to document the prevalence and pattern of skin diseases in children with HIV infection seen at the Paediatric department of a tertiary centre in Nigeria.

Methods: HIV positive children attending the PEPFAR HIV clinic of Lagos University Teaching Hospital, Nigeria were examined for the presence of skin lesions. Anthropometric measurements were also obtained. Blood samples Were taken for CD4+ cell count, viral load and full blood count.

Results: Two hundred and fourteen (214) patients were studied, consisting of 107 HIV infected children and 107 uninfected children as controls. Skin lesions were observed in 89 (83%) of the HIV infected patients, while only 72 uninfected controls had skin lesions. (p = 0.035). The predominant skin disease in the HIV infected children was Pruritic papular eruption (PPE) with a frequency of 25.9%, followed by fungal infections (24.6%). Herpes zoster was found only in HIV infected children (p = 0.041). There was a strong correlation between the degree of immunosuppression (as reflected by the value of age dependent CD4+ cell count/CD4+ percentage). and the prevalence of skin disease in the HIV infected patients. The presence of pruritic papular eruptions and Herpes zoster was associated with advanced immunosuppression.

Conclusion: Skin diseases are common in HIV infection in our environment. Early detection of HIV infection can be made in the presence of skin diseases like Pruritic papular eruption and Herpes zoster.

Background: The health and development.of populations irrespective of where they live is dependent on their behaviour. Adolescents constitute a huge chunk of the global population. A high proportion of the burden of diseases therefore occur in this age group as well. The maturation process occurs throughout this period and behaviours adopted often last for life and are determinants of healthy adult life. High prevalence of Sexually Transmitted Infections including Human Immunodeficiency Virus has been documented in adolescents.

Objective: This study was carried out to assess the use of HIV screening services and sexual behaviour of in-school adolescents in Surulere an urban community in Lagos State, Nigeria.

Methods: Cross sectional descriptive study design was used. Simple random sampling was used to select 9 public senior secondary schools in Surulere Local Government Area. All the enrolled and willing students in SSS3 who were available during the period of data collection were included in the study (1,029). Information was collected with a self-adrministered questionnaire. Data analysis was done with Epi info version 3.5.4. Frequency tables were generated and analysis was explored using chi square at. p<0.05.

Results: The mean age was 16 years. Majority of the students were in the 15-19 years age bracket, females, Christians and lived in monogamous homes. All the three arms namely commercial class, arts class and science class were included. Less than one tenth of the students 90 (8.9%) had been screened for HIV infection. Among this group., more than half had tested once and 37.8% tested because they had participated in risky behavior. Fifteen percent were sexually active, among this group 20% engaged in transactional sex. Only 36.8% used condom at first sex which increased to 57.2% at last sex, however consistent condom use was practiced by 22.4%. Students who are sexually experienced (p<0.001) were more likely to have been screened while those in science class (p=0.012) were more willing to screen for HIV. Male students were more likely to have had sex (p<0.001).Compared to Science and Commercial students, those in Arts class were more likely to have had sex (p=0.004), use condoms (p=0.017) and use it consistently (p<0.001).

Conclusion: Even though the adolescents in this study. engage in risky sexual behaviour, use of HCT services and other STI prevention strategies was poor. It is essential that young people have access to and utilize all HIV prevention tools at their disposal.

Background: During pregnancy, selenium deficiency and reduced antioxidant activities may result in adverse perinatal outcome such as low birthweight, which is associated with significant perinatal morbidity and mortality. Many studies have reported conflicting findings on the relationship between maternal selenium status and infant birth weight.

Objective: This study is to determine the relationship between maternal serum selenium concentration and infant birthweight in HIV-positive and HIV-negative pregnant women at term.

Methods: A cross-sectional study carried out among HIV-positive and HIV-negative pregnant women at term. Participants were recruited from the antenatal clinic at the Lagos University Teaching Hospital. After obtaining an informed consent, participants were interviewed using a structured questionnaire. Five milliliters of venous blood sample was collected from each participant for estimation of selenium levels using the Inductively Coupled Plasma Mass Spectrometry (ICP-MS) method. At delivery, the infant birth weights were measured using a standard infant weighing scale.

Results: Of the 240 participants, data were complete for analysis in 214 (89.2%) of the participants. HIV-positive women had significantly lower mean serum selenium concentration when compared with HIV-negative women (33.7 +/- 22.2 pg/L versus 83.6 +/- 18.7 pg/L; p<0.01). Compared with HIV-negative women, the mean birth weight of infants of HIV positive women was significantly lower (2952 +/- 572 g versus 3392 +/- 452 g; p<0.01). There was no significant association between maternal serum selenium levels at term and infant birth weight in both groups.

Conclusion: HIV-positive pregnant women had a lower mean serum selenium level and their infants had a lower mean birth weight, when compared to HIV-negative pregnant women. However, no significant association was found between maternal serum selenium concentration and birth weight in both groups.