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Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

1*Okechukwu, A. A., and 2Thairu, Y.
1Deparment of Paediatrics, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
2Department of Microbiology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
Correspondence to: nebokest@yahoo.com; +2348036719906

Abstract:
Background: Cytomegalovirus (CMV) co-infection with human immunodeficiency virus (HIV) is known to accelerate HIV disease progression. It has the potential of being a killer disease or a silent lifetime companion in HIV patients. There is dearth of information on CMV prevalence among HIV infected children and adolescents in our environment. We therefore conducted this study to determine its sero-prevalence, and risk factors for co-infection among HIV infected children and adolescents on highly active antiretroviral therapy (HAART) in our center.
Method: A descriptive cross sectional study of HIV-infected children and adolescents aged 2 months to 18 years on HAART was conducted over a 6 month period between October 2017 and March 2018 in our health facility. Blood samples of subjects were screened for CMV IgM using commercial test kits. Biodata of subjects, CD4 cell count, and viral load were collected into a designed proforma, and statistical analysis was done with SPSS version 22.0.
Result: A total of 161 HIV-infected children and adolescents were recruited, 103 (64.0%) were males, 83 (51.6%) were between the ages of 5 and <10 years, 113 (70.2%) were from lower socio-economic class, and 138 (85.7%) were on 1st line HAART. Of the 17 (10.6%) subjects positive for CMV IgM, 3 (17.6%) were less than 5 years old, 11 (64.7%) were between the ages of 5-10 years, and none was older than 15 years. Univariate analysis showed significant differences in the mean age, weight, length/height, and systolic blood pressure between CMV IgM positive and negative patients (p<0.05), but no significant difference in gender, socioeconomic class, types of antiretroviral drugs, CD4 cell count, and viral load (p>0.05). Multivariate analysis however did not show any significant difference in age, weight, length/height, and systolic blood pressure. Conclusion: The prevalence of active CMV infections among HIV infected children and adolescents on HAART in our centre is high. Low CD4 cell count and high viral load were not associated with active CMV disease, and no risk factor for co-infection was also identified. Identifying those with primary/active infection will be necessary for possible treatment with anti-herpes drugs before development of reactivated CMV disease.

Keywords: CMV, HIV, co-infection, anti-retroviral,  children, adolescents

Received June 27, 2019; Revised October 10, 2019; Accepted October 12, 2019

Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License (http://creativecommmons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Co-infection par le cytomégalovirus et le VIH chez des enfants et des adolescents sous traitement antirétroviral à Abuja, au Nigéria

1*Okechukwu, A. A., et 2Thairu, Y.
1Département de pédiatrie, Hôpital universitaire de Abuja, Gwagwalada, Abuja, Nigéria 2Département de microbiologie, hôpital universitaire de Abuja, Gwagwalada, Abuja, Nigéria Correspondance à: nebokest@yahoo.com; +2348036719906

Abstrait:

Contexte: On sait que la co-infection par le cytomégalovirus (CMV) et le virus de l’immunodéficience humaine (VIH) accélère la progression de la maladie. Il a le potentiel d’être une maladie mortelle ou un compagnon
silencieux à vie chez les patients VIH. Il existe peu d’informations sur la prévalence du CMV chez les enfants et les adolescents infectés par le VIH dans notre environnement. Nous avons donc mené cette étude pour déterminer sa séroprévalence et les facteurs de risque de co-infection chez les enfants et les adolescents infectés par le VIH sous traitement antirétroviral hautement actif (HAART) dans notre centre. Méthode: Une étude transversale descriptive des enfants et adolescents infectés par le VIH et âgés de 2 mois à 18 ans sous multithérapie a été menée sur une période de 6 mois entre octobre 2017 et mars 2018 dans notre établissement de santé. Des échantillons de sang de sujets ont été testés pour l’IgM de CMV en utilisant des kits de test commerciaux. Les données biologiques des sujets, le nombre de cellules CD4 et la charge virale ont été recueillis dans un formulaire conçu à cet effet et une analyse statistique a été réalisée avec SPSS version 22.0. Résultat: 161 enfants et adolescents infectés par le VIH ont été recrutés, dont 103 (64,0%) étaient des hommes, 83 (51,6%) étaient âgés de 5 à moins de 10 ans, 113 (70,2%) étaient issus de milieux socio-économiques inférieurs. et 138 (85,7%) suivaient la multithérapie de première ligne. Sur les 17 (10,6%) sujets positifs pour l’IgM du CMV, 3 (17,6%) avaient moins de 5 ans, 11 (64,7%) étaient âgés de 5 à 10 ans et aucun n’avait plus de 15 ans. Une analyse univariée a montré des différences significatives dans l’âge moyen, le poids, la taille / taille et la pression artérielle systolique entre les patients positifs et négatifs pour IgM anti-CMV (p<0,05), mais aucune différence significative entre le sexe, la classe socio-économique, les types de médicaments antirétroviraux et les cellules CD4 nombre et charge virale (p>0,05). L’analyse multivariée n’a cependant montré aucune différence significative d’âge, de poids, de taille / taille et de pression artérielle systolique. Conclusion: La prévalence des infections à CMV actives chez les enfants et les adolescents infectés par le VIH sous HAART dans notre centre est élevée. Un faible nombre de cellules CD4 et une charge virale élevée n’étaient pas associés à la maladie à CMV active et aucun facteur de risque de co-infection n’a également été identifié. Identifier les personnes présentant une infection primaire / active sera nécessaire pour un traitement éventuel avec des médicaments anti-herpès avant le développement d’une maladie à CMV réactivée.

Mots-clés: CMV, HIV, co-infection, anti-rétroviral, Enfants, les adolescents

CMV and HIV co-infection in children Afr. J. Clin. Exper. Microbiol. 2020; 21 (1): 36 – 44

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Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

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Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

  1. 1Okechukwu, A. A., and 2Thairu, Y. Departments of 1Paediatrics and 2Microbiology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
    Correspondence to: nebokest@yahoo.com; +2348036719906

Abstract:

Background: Urinary tract infection (UTI) remains the second commonest opportunistic infections among HIV infected children. This study was conducted to determine the prevalence and causative bacteria of UTI in HIV infected children and adolescents on antiretroviral medications in our health institution. Method: The study was a cross sectional design conducted between October 2017 and March 2018 among HIV infected children and adolescents aged 2 months to 18 years on follow up attendance at the Paediatric Outpatient Special Treatment Clinic (POSTC) of University of Abuja Teaching Hospital (UATH). Early morning midstream urine was collected from each participant for urinalysis, microscopy and aerobic bacterial culture. Bacteria were identified from culture by standard microbiological methods and antibiogram of the isolates was determined by the disk diffusion method. Result: Of 166 HIV infected children and adolescents studied, 106 (63.9%) were males, 82 (49.4%) were in age group 5-10 years, and 110 (66.3%) were from lower socio-economic class. Significant bacteria (UTI) were isolated in 54 (32.5%) subjects, with 38 (70.4%) from females, and 51 (94.4%) from those on first line antiretroviral therapy. Isolates recovered were Escherichia coli 20 (37.0%), Klebsiella pneumoniae 16 (29.6%), Staphylococcus aureus 8 (14.8%), Pseudomonas aeruginosa 6 (11.1%), and Proteus mirabilis 4 (7.4%). Leucocyturia in 19 (35.2%), nitrituria in 10 (18.5%), and haematuria in 15 (27.8%) subjects with significant bacteriuria were also recorded. Isolates were sensitive to ofloxacin (81.5%), nalidixic acid (74.1%) and cefuroxime (61.1%), while they were resistant to cotrimoxazole (100%), ampicillin (98.1%) and piperacillin (94.4%). Significant difference was observed in the mean CD4 cell count and viral load of subjects with significant bacteriuria compared to those without; 838.6 ± 177.8 versus 1009.9 ± 234.7 cells/μL (p=0.02), and 10, 360.5 ± 471.0 versus 5, 840.8 ± 563.8 copies/ml (p=0.003) for CD4 cell count and viral load respectively. Conclusion: This study reported a high prevalence of UTI among HIV infected children and adolescents, especially in those with high viral load. Routine screening for UTI should be offered to HIV infected children and adolescents with high viral load.

Keywords: HIV, urinary tract infection, children, adolescents

Received March 4, 2019; Revised June 22, 2019; Accepted July 13, 2019
Copyright 2019 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License (http://creativecommmons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Infection des voies urinaires par des bactéries chez des enfants et des adolescents infectés par le VIH à Abuja, au Nigeria: étude transversale

1Okechukwu, A. A., et 2Thairu, Y.
Départements de 1pédiatrie et 2microbiologie, Hôpital universitaire de Abuja, Gwagwalada, Abuja, Nigeria Correspondance à: nebokest@yahoo.com; +2348036719906
Bacteria UTI in HIV infected children and adolescents Afr. J. Clin. Exper. Microbiol. 2019; 20 (4): 306-314
307
Abstrait:

Contexte: L’infection des voies urinaires (UTI) reste la deuxième infection opportuniste la plus répandue chez les enfants infectés par le VIH. Cette étude a été menée pour déterminer la prévalence et la bactérie causale des infections urinaires chez les enfants et les adolescents infectés par le VIH prenant des antirétroviraux dans notre établissement de santé. Méthode: L’étude était une conception transversale menée entre octobre 2017 et mars 2018 chez des enfants et des adolescents infectés par le VIH âgés de 2 mois à 18 ans et suivis à la Clinique de traitement spécial pour enfants ambulatoires (POSTC) de l’Hôpital universitaire de Abuja (UATH) ). Des échantillons d’urine, de microscopie et de cultures bactériennes aérobies ont été recueillis chez chaque participant. Les bactéries ont été identifiées à partir de cultures par des méthodes microbiologiques standard et l’antibiogramme des isolats a été déterminé par la méthode de diffusion sur disque. Résultat: Sur 166 enfants et adolescents infectés par le VIH étudiés, 106 (63,9%) étaient des hommes, 82 (49,4%) étaient âgés de 5 à 10 ans et 110 (66,3%) appartenaient à la classe socio-économique inférieure. Des bactéries significatives (UTI) ont été isolées chez 54 sujets (32,5%), dont 38 (70,4%) de femmes et 51 (94,4%) de celles sous traitement antirétroviral de première intention. Les isolats récupérés étaient Escherichia coli 20 (37,0%), Klebsiella pneumoniae 16 (29,6%), Staphylococcus aureus 8 (14,8%), Pseudomonas aeruginosa 6 (11,1%) et Proteus mirabilis 4 (7,4%). Une leucocyturie chez 19 sujets (35,2%), une nitriturie chez 10 (18,5%) et une hématurie chez 15 sujets (27,8%) présentant une bactériurie importante ont également été enregistrés. Les isolats étaient sensibles à l’ofloxacine (81,5%), à l’acide nalidixique (74,1%) et au céfuroxime (61,1%), tandis qu’ils étaient résistants au cotrimoxazole (100%), à l’ampicilline (98,1%) et à la pipéracilline (94,4%). Une différence significative a été observée entre le nombre moyen de cellules CD4 et la charge virale des sujets présentant une bactériurie significative par rapport à ceux ne présentant pas; 838,6 ± 177,8 par rapport à 1009,9 ± 234,7 cellules/μL (p = 0,02) et 10, 360,5 ± 471,0 par rapport à 5 840,8 ± 563,8 copies/ml (p = 0,003) pour le nombre de cellules CD4 et la charge virale, respectivement. Conclusion: Cette étude a révélé une prévalence élevée d’UTI chez les enfants et les adolescents infectés par le VIH, en particulier chez ceux ayant une charge virale élevée. Un dépistage systématique des infections urinaires doit être proposé aux enfants et aux adolescents à charge virale élevée infectés par le VIH

Mots-clés: VIH, infection des voies urinaires, enfants, adolescents

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Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria a cross-sectional study

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Laboratory diagnosis of malaria in children under five years in a rural community: microscopy versus malaria PF test

CP Enwuru, SI Umeh, UM Abasi, RC Egbuobi

 

Abstract

The morbidity and mortality associated with malaria in children below 5 years is really worrisome especially in the rural communities with little or no laboratory diagnostic facilities. This study was carried out to compare microscopy with Malaria Pf test for the diagnosis of malaria in a rural community in Ideato North Local Government Area of Imo State. Two hundred and fifty blood smears of children below 5 years were stained with Giemsa and examined microscopically for malaria parasites. Also the Malaria Pf rapid diagnostic test was used to test the same blood samples for malaria antigens. Thirty two per cent of the blood samples were positive for malaria parasite. Compared with microscopy, the sensitivity of the Malaria Pf test was 90.0%, the specificity was 98.2%. The positive predictive value was 96.0% and negative predictive value was 95.4%. The Malaria Pf test is reliable in the parasite based diagnosis of malaria in children under 5 years. We recommend the application of this test for parasitological confirmation of malaria in all places where it is not possible to provide facilities for good quality microscopy especially in the rural communities.

KEY WORDS: MALARIA, DIAGNOSIS, CHILDREN, MICROSCOPY, MALARIA PF

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Laboratory diagnosis of malaria in children under five years in a rural community microscopy versus malaria PF test

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Prevalence and management of Falciparium malaria among infants and children in Ota, Ogun state, Southwestern Nigeria

G.I Olasehinde, A.A Ajay, S.O Taiwo, B.T Adekeye, O.A Adeyeba

 

Abstract

Studies were carried out to determine the prevalence of malaria parasite infection among infants and children (0-12yrs) in Ota, Southwestern Nigeria between April and December 2008. The two hospitals used were Ota General Hospital and Covenant University Health Centre, Canaanland, Ota. Thick and thin films were made and stained using standard parasitological procedures. Structured Questionnaires were distributed to ascertain the age, sex, drugs or insecticides used and state of health of the subjects before recruiting them into the study. Overall, 215 (80.5%) of the 267 children investigated were found to have malaria infection. Age group (0-5 years) had the highest frequency rate of 84.7% with mean parasite density of 900 and the difference between the age groups was statistically significant (p<0.05). Children of illiterates from suburb villages had the highest mean parasite density of 850 with 78.1% prevalence rate. 20% of the children were given local herbs and 22% used orthodox medicine as prophylaxis. Only 18% used insecticide treated mosquito nets while 24% of the parents spray insecticides to prevent mosquito bites. There is therefore need for more awareness on effective use of drugs and Insecticide Treated bed nets in malaria hyperendemic regions.

Key words: % Prevalence, malaria parasite, Plasmodium falciparum, infants, Children

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Prevalence and management of Falciparium malaria among infants and children in Ota Ogun state Southwestern Nigeria

 

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Onchocerciasis Amongst Children Of An Endemic Community In Edo State, Nigeria

MS Aisien, EE Adeyemi, VA Wagbatsoma

 

Abstract

Onchocerciasis among 278 children (0-15yrs) of Ekpan village, a hyperendemic community in Uhunmwode Local Government Area of Edo State, Nigeria was investigated using the prevalence of nodules as index. The overall prevalence of palpable nodules was 26.3%. Nodule prevalence increased with age and the association was found to be statistically significant (P<0.001). More males than females presented with onchocercal nodules; and the difference was also found to be statistically significant (P<0.05). Majority of the nodules found were located on the head, followed by the abdomen. Of the 186 children eligible to take ivermectin, only 124 (66.7%) actually took the drug. The efficacy of ivermectin against onchocerciasis is demonstrated in the observation that those who took the drug presented with fewer nodules. Therefore, a timely introduction of eligible children (>5yrs) to the treatment programme is advocated.

Keywords: Onchocerciasis, children, Nigeria, nodules, prevalence, ivermectin

African Journal of Clinical and Experimental Microbiology Vol. 9 (2) 2008 pp. 97-102

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Soil transmitted helmeinthiasis among apparently healthy children in Kano municipality

G U Ihesiulor, M A Emokpae, S I Adeeke, A B Samaila

 

Abstract

The prevalence of soil transmitted helminth infections in apparently healthy children of mean age 12.2 years drawn randomly from one school in each of the four local government areas of Kano, northern Nigeria were evaluated. Stool sample from 570 children were analyzed using formol ether concentration technique. 130(22.8%) of the subject were infected by soil transmitted helminthes (STH). The overall prevalence by species were Ascaris Lumbricoides (7.9%), Hookworm (5.3%) and trichuris trichiura (3.5%) respectively. 35(6.1%) of the subjects were infected with two or more soil
transmitted helminthes. The prevalence in males (24.2%) was generally higher than that of females (22%), Hookworm infection was high(45.5%) in the 15-20 years old age group, while Ascaris Lumbricoides infection was high (100%) in the 6-10 years old age group. The mean number of eggs per gramme (epg) of faeces was moderate. The study shows that subjects had high intensity of infections for Ascaris Lumbricoidesas hook worm, trichuris
trichiura as epg of faeces counted were high in them compared to what was obtained for mixed infections. It also reveals a moderately high prevalence across board for all soil transmitted helminth (STH) in Ungogo local government

Keywords: Soil transmitted helminthes, Children, prevalence

African Journal of Clinical and Experimental Microbiology Vol. 8 (1) 2007: pp.77-83

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Epidemiological Study Of Asymptomatic Bacteriuria Among Nursery School Children In Ahvaz, Iran

M Jalali, T Asteraki, E Emami-Moghadam, E Kalantar

 

Abstract

This study was undertaken to determine the prevalence of asymptomatic bateriuria in preschool children of different age and sex groups and to isolate the organisms responsible for asymptomatic bacteriuria and determine their antimicrobial susceptibility pattern. A total of 475 children from 17 nurseries in Ahvaz city, Iran were screened by collecting mid-stream urine samples for the presence of causative organisms. Asymptomatic bacteriuria was observed in 16 cases (3.36%). The isolated pathogens included Escherichia coli (50 %), Proteus mirabilis (25 %) and coagulase negative staphylococcus (25 %). The antibiograms indicated that Gentamicin (100 %), Nalidixic acid (100 %), Amikacin (75%), Kanamycin (75 %), Nitrofurantoin ( 62.5 %), Tobramycin ( 62.5 %), Tetracycline ( 50 %) and Chloramphenicol (37.5%), were in that order the most effective of the antibiotics tested against E. coli isolates. Proteus mirabilis showed 100% sensitivity to Amikacin, Gentamicin, Kanamycin, Nalidixic acid and Tobramycin followed by Nitrofurantoin (75%), Cephalotin (50%) and Chloramphenicol (50%). Similarly, antibiogram of coagulase negative staphylococcus showed 75% sensitivity to both Nalidixic acid and Kanamycin. This result indicated a significant rise in the frequency of Escherichia coli in asymptomatic bacteriuria.
Key words: Asymptomatic bacteriuria, children, urinary tract infections

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 159-161

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CARE SEEKING PRACTICES ON DIARRHOEA IN A RURAL COMMUNITY IN NIGERIA

JF Olawuyi, BE Egbewale, LA Anifalaje, EA Okochi

 

Abstract

Although diarrhoea is a preventable disease, it still remains a major cause of morbidity and mortality among Nigeria children. A Nigerian child under age of five has an average of 4.3 diarrhoea episodes each year. The transfer to 70 million episodes of diarrhoea in children under five, based on the 1991 census. With case fatality rate of 0.4% (1), Nigeria records 300,000 diarrhoea related deaths each year in children under five years of age. This community survey was conducted in the south west of Irepodun Local Government Area of Kwara state, Nigeria, to enable us determine care-seeking and diarrhoea management practices in a typical rural setting. Four thousand and sixty one (4,061) children under five year of age from nine villages were studied using the standard WHO questionnaire on diarrhoea case management and morbidity. The survey focused mainly on children who had diarrhoea in the 24-hour period prior to the study. Of the 4061 children who were 5 years or below, 876(21.6%) had diarrhoea two weeks prior to the study. There were 207 children (5.1%) who had diarrhoea within 24 hours prior to the study. The rate of use of salt sugar solution (SSS) was 16%, while that of oral rehydration salt (ORS) was 6%. Seventy three percent of mothers interviewed did nothing for the treatment of diarrhoea, nor understood what to do. 16% used various drugs. 69% of the health facilities in these rural districts used antibiotics as their first line anti-diarrhoea treatment. Health education on oral rehydration therapy (ORT) needs to be intensified at the grassroots level.

Keywords: Diarrhoea, Children, Care, Rural

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 119-125