HIV Infection among Under-Five Malnourished Children in Kano State
- 1 Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
- 2 Department of Microbiology, Faculty of Sciences, Ahmadu Bello University, Zaria, Nigeria
- 3 Department of Paediatrics, Teaching Hospital Gwagwalada, Abuja, Nigeria
- 4 Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
- 5 Department of Medical Laboratory Science, Faculty of Medicine, Bayero University, Kano, Nigeria
Abstract
Objective: Human Immunodeficiency Viral infection and Protein Energy Malnutrition (PEM) are highly prevalent in Nigeria and when they occur together, the outcome is usually severe as both conditions lead to immune suppression. HIV alone accounts for 14.0% of childhood mortality even though children constitute only 6% of global HIV infection burden. The objective of the study was to determ ine the prevalence of HIV infection among malnourished children below 5 years in Kano State, Nigeria. Methods: A total of 400 malnourished children were randomly selected and tested for the presence of HIV I & II using parallel ELISA rapid test kits, Stat park and Determine (both immunochromatographic techniques). Findings: Thirty-one samples were found to be positive to HIV 1 giving a prevalence of 7.8%. There was no statistically significant difference between sexes when male to female ratio was 1:1.3 and peak age of presentation was 2 - 3 years. Sixty - four percent (64.0%) were presented with severe form of HIV infection (stage 4) according to WHO paediatric HIV clinical stage and about half of them came with marasmus by the Wellcome classification of malnutrition. There was no significant association between the type of malnutrition and the severity of HIV infection at present, (p value > 0.05). The commonest signs and symptoms were oral candidiasis (67.7%), lymphadenopathy (44.0%), fever (64.5%) and cough (54.8%). Sixty - four percent of the children were from polygamous families. There was a significant statistical correlation between polygamy and incidence of HIV infection, (p < 0.01). Only 45.0% of the women were aware of their HIV status prior to this study. Seventy - four percent (74.0%) of those who were aware of their status had no knowledge of the prevention of mother to child transmission (PMTCT) services and even for those who were aware , none of them accessed the care. Conclusion: A population based HIV screening is therefore recommended while perinatal HIV screening and PMTCT services need to be expanded.
- D. C. Douek, M. Roederer and R. A. Koup, “Emerging Concepts in the Immunopathogenesis of AIDS,” Annual Review of Medicine, Vol. 60, 2009, pp. 471-484. http://dx.doi.org/10.1146/annurev.med.60.041807.123549
- R. A. Weiss, “How Does HIV Cause AIDS?” Science, Vol. 260, No. 5112, 1993, pp. 1273-1237. http://dx.doi.org/10.1126/science.8493571
- P. Andrew, T. Gareth, J. Prakash, B. Sandra and G. Philip, “International Perspectives, Progress and Future Challenges of Paediatric HIV Infection,” Lancet, Vol. 370, No. 9581, 2007, pp. 68-80. http://dx.doi.org/10.1016/S0140-6736(07)61051-4
- T. Denis, K. Janet, M. Phillippa, E. Brian, N. Ruth, C. Hoosen, B. Raziya, M. Dorathy and P. Mary, In: Handbook on Paediatric AIDS in Africa, Revised Edition, 2006, pp. 213-216.
- A. Oniyangi, B. Awani and K. C. Iregbu, “The Pattern of Paediatric HIV/AIDS as Seen at the National Hospital Abuja, Nigeria,” Journal of Clinical Practice, Vol. 9, No. 2, 2006, pp. 153-158.
- M. A. Bugaje and H. A. Aikhionbare, “Paediatric HIV/ AIDS Seen at Ahmadu Bello University Teaching Hospital Zaria, Nigeria,” Annals of African Medicine, Vol. 5, No. 2, 2006, pp. 73-77.
- I. J. Emodi and G. O. Okafor, “Clinical Manifestations of HIV Infection in Children at Enugu, Nigeria,” Journal of Tropical Paediatrics, Vol. 44, No. 2, 1998, pp. 73-76. http://dx.doi.org/10.1093/tropej/44.2.73
- G. N. Odaibo, D. O. Olaleye, L. Heyndrickx, K. Vereecken, K. Houwer and W. Jassens, “Mother-to-Child Transmission of Different HIV-1 Subtype among ARV Naïve Infected Pregnant Women in Nigeria,” Journal of Tropical Paediatrics, Vol. 51, No. 3, 2005, pp. 145-147.
- G. Foster and J. A. Williams, “Review of Current Literature on the Impact of HIV/AIDS on Children in Sub-Saharan Africa,” AIDS, Vol. 14, No. 3, 2000, pp. 275-285.
- S. I. Adeleke and Y. M Muktar, “Interactions of Childhood Malnutrition and Human Immunodeficiency virus Infection in Sub Saharan Africa: Emphasis on Epidemiological, Immunological, Clinical and Preventive Modalities,” Nigerian Journal of Clinical Sciences, Vol. 3, 2006, pp. 1-7.
- M. Cheesbrough, “District Laboratory Practice in Tropical Countries, Part 2,” Cambridge University Press, Cambridge, 2002, pp. 248-266.
- S. I. Adeleke and Y. M. Muktar, “A Comparative Study of HIV Seroprevalence among Malnourished Children and Controls in Kano,” Nigerian Journal of Pharmaceutical Medical Science, Vol. 1, 2004, pp. 23-26.