Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria

Skin diseases are indicators of HIV/AIDS which correlates with WHO clinical stages. In resource limited environment where CD4 count is not readily available, they can be used in assessing HIV patients. The study aims to determine the mucocutaneous manifestations in HIV positive patients and their correlation with WHO clinical stages. A prospective cross-sectional study of mucocutaneous conditions was done among 215 newly diagnosed HIV patients from June 2008 to May 2012 at adult ART clinic, Wesley Guild Hospital Unit, OAU Teaching Hospitals Complex, Ilesha, Osun State, Nigeria. There were 156 dermatoses with oral/oesophageal/vaginal candidiasis (41.1%), PPE (24.4%), dermatophytic infections (8.9%), and herpes zoster (3.8%) as the most common dermatoses. The proportions of dermatoses were 4.5%, 21.8%, 53.2%, and 20.5% in stages 1–4, respectively. A significant relationship (using Pearson’s Chi square withPvalue<0.05) was obtained between dermatoses and WHO clinical stages. Pearson’s correlation coefficient showed a positive correlation between the number of dermatoses and the WHO clinical stages. Dermatoses can therefore serve as diagnostic and prognostic markers in resource limited settings to initiate HAART in clinical stages 3 and 4.

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Patients’ satisfaction with ophthalmic counselling services in a tertiary hospital in Calabar, South-South Nigeria

Ghana Medical Journal ◽

10.4314/gmj.v54i2.4 ◽

2020 ◽

Vol 54 (2) ◽

pp. 76-81

Author(s):

Bassey Etim ◽

Affiong Ibanga ◽

Martha-Mary Udoh ◽

Elizabeth Nkanga ◽

Utam Utam ◽

...

Keyword(s):

Social Workers ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Teaching Hospitals ◽

Cross Sectional ◽

Patients Satisfaction ◽

Counselling Services ◽

Resource Limited ◽

Ethical Approval ◽

The University

Objective: To assess the level of satisfaction of patients who access the Ophthalmic counselling services anchored by trained social workers of the University of Calabar Teaching Hospital, Calabar, NigeriaMethods: A cross-sectional study of serial consenting participants was done. Ethical approval was obtained from the University of Calabar Teaching hospitals’ ethics committee. Data was obtained using a semi-structured intervieweradministeredquestionnaire. Data were collated and analyzed using the SPSS for Windows (version 20, SPSS inc. Chicago, IL, USA). Modified Likert scale (very satisfied, satisfied and not satisfied) was used to rate the satisfaction level.Results: A total of 120 respondents met the inclusion criteria and were enrolled into the study. Majority of the respondents (60%) were male with an overall mean age of 45.32± 1.82. Over a quarter (28.3%) of the respondents were in the age bracket of 41-50. Glaucoma (48.3%) was the most common eye condition of the respondents. Seventy-five percent of the respondents were satisfied with the average time spent for the counselling services while 76.7% were satisfied with the overall ophthalmic counselling services they received with 46.7% believing that the service was provided by a social worker.Conclusion: Majority of the Patients were satisfied with the Ophthalmic counselling services mainly anchored by social workers. Training and retraining of allied support staff to render ophthalmic counselling services in order to ease the workload of the Ophthalmologist should be encouraged in resource-limited settings.Keywords: Patients satisfaction, ophthalmic counselling service, NigeriaFunding: None declared

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Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Prospective Study

10.21203/rs.2.11153/v2 ◽

2019 ◽

Author(s):

Sulaiman Lakoh ◽

Hannah Rickman ◽

Momodu Sesay ◽

Sartie Kenneh ◽

Rachael M. Burke ◽

...

Keyword(s):

Sierra Leone ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Cd4 Count ◽

Sub Saharan Africa ◽

World Health ◽

Categorical Variables ◽

Hiv Patients ◽

Cross Sectional ◽

Cryptococcal Disease

Abstract Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. MethodsA cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. ConclusionA substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal disease were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.

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Clinical Profile of Paediatric Head and Neck Cancers at a Tertiary Hospital in Tanzania

Rwanda Journal of Medicine and Health Sciences ◽

10.4314/rjmhs.v3i1.3 ◽

2020 ◽

Vol 3 (1) ◽

pp. 11-20

Author(s):

Zephania Saitabau Abraham ◽

Enica Richard Massawe ◽

Aveline Aloyce Kahinga ◽

Kassim Babu Mapondella ◽

Willybroad Augustine Massawe ◽

...

Keyword(s):

Head And Neck ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Head And Neck Cancers ◽

Clinical Profile ◽

Childhood Cancers ◽

Cross Sectional ◽

Paediatric Patients ◽

Clinical Stages ◽

Night Sweats

Background Paediatric head and neck cancers represent an important group of childhood cancers that require maximum attention at large. They are often diagnosed at advanced clinical stages at Muhimbili National Hospital (MNH). Objective To describe the clinical profile of paediatric head and neck cancers at a tertiary hospital in Tanzania Method A hospital based descriptive cross-sectional study was conducted involving 180 paediatric patients. Data were analyzed using SPSS program version 21. Results A total of 180 paediatric patients were recruited where 61.1% were males and 38.9% were females. Majority belonged to the age group 0-5 years (53.9%). A total of 10 primary anatomical sites were found with the neck (cervical lymph node) predominating (36.1%), followed by the orbit/eye (34.4%) and the least anatomical sites were oral cavity (1.1%) and parapharyngeal space (0.5%). Leukocoria (93.9%), red eye (93.9%) and orbital cellulitis (77.6%) predominated in retinoblastoma but in patients with lymphomas, predominant features were night sweats (100%), weight loss (100%) and fevers (95.8%). Conclusion The clinical profile depicted in this study appears to correlate with advanced clinical stages. Keywords: Paediatric; Head; Neck Cancers; Muhimbili; Tanzania

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Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Cross Sectional Study

10.21203/rs.2.11153/v1 ◽

2019 ◽

Author(s):

Sulaiman Lakoh ◽

Hannah Rickman ◽

Momodu Sesay ◽

Sartie Kenneh ◽

Rachael M. Burke ◽

...

Keyword(s):

Sierra Leone ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Cd4 Count ◽

World Health ◽

Categorical Variables ◽

Sectional Study ◽

Hiv Patients ◽

Cross Sectional ◽

Cryptococcal Disease

Abstract Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. Methods: A cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. Conclusion: A substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal diseases were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.

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CORRELATIONS BETWEEN CLUSTER DIFFERENTIATION 4 COUNTS, HUMAN IMMUNODEFICIENCY VIRUS CLINICAL STAGES, AND HEMOGLOBIN LEVEL AMONG HUMAN IMMUNODEFICIENCY VIRUS PATIENTS WITH ANEMIA IN MERPATI CLINIC, WANGAYA HOSPITAL, DENPASAR, BALI, INDONESIA: A CROSS-SECTI

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i3.30794 ◽

2019 ◽

pp. 426-429

Author(s):

KETUT SURYANA ◽

HAMONG SUHARSONO ◽

GEDE BUDIASA ◽

JARWA ANTARA ◽

PUJI ASTUTI ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Cross Sectional Study ◽

Deficiency Anemia ◽

Hiv Patients ◽

Cross Sectional ◽

Cd4 Counts ◽

Immunodeficiency Virus ◽

Clinical Stages ◽

The Mean ◽

Study Participants

Objective: The objective of this study was to determine the correlation between cluster of differentiation 4 (CD4) counts, human immunodeficiency virus (HIV) clinical stages, and hemoglobin (Hb) level among HIV-infected patients with anemia. Methods: A cross-sectional study was conducted in November 2017 at Merpati Clinic of Wangaya Hospital, Denpasar, Bali, Indonesia. We selected 79 HIV patients with anemia to participate in our study. We grouped CD4 counts into two categories: <200 cells/μL and ≥200 cells/μL, and we classified the HIV clinical stages into HIV and acquired immunodeficiency syndrome (AIDS). Results: About 55.7% (44) of men and 44.3% (35) of women were participated in this study. As many as, 91.1% (72) of participants were AIDS patients. The mean Hb was 8.77 g/dl with SD 1.79 g/dl. 81% (64) of study participants were suffered from anemia on chronic disease or inflammatory anemia, and 19% (15) of study participants were suffered from iron deficiency anemia. The median for CD4 counts was 94 cells/μL (3–309 cells/μL) with as many as 78.5% (62) of participants were found to have low CD4 counts (<200 cells/μL). Spearman analysis revealed a positive correlation between CD4 counts and Hb level (r=0.427, p<0.001). Independent sample t-test analysis found a correlation between the HIV clinical stages and Hb level. There was a difference between the mean of Hb level in each stage with the average difference of 0.8 g/dl (95% confidence interval 0.04–1.6; p<0.04). Conclusions: There is a correlation between CD4 counts, HIV clinical stages, and Hb level among HIV patients with anemia.

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A cross-sectional study of socio-demographic and clinical profile of HIV patients at ART plus centre, Sawai Man Singh Hospital, Jaipur, India

Journal of Ideas in Health ◽

10.47108/jidhealth.vol4.iss1.89 ◽

2021 ◽

Vol 4 (1) ◽

pp. 321-326

Author(s):

Charu Jain ◽

Lokendra Sharma ◽

Uma Advani ◽

Munesh Kumar ◽

Amit Tak ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Cross Sectional Study ◽

Clinical Profile ◽

Reproductive Age ◽

World Health ◽

Clinical Staging ◽

Sectional Study ◽

Skilled Workers ◽

Hiv Patients ◽

Cross Sectional

Background: This study aimed to understand the regional variation in the socio-demographic and clinical profile of human immunodeficiency virus (HIV) infected patients at antiretroviral therapy plus centre of Sawai Man Singh (SMS) hospital, Jaipur, India. Methods: A descriptive cross-sectional study was conducted on HIV patients from January to December 2019. The HIV-positive patients of all age groups and all categories were included in the study. The socio-economic status was assessed by BG Prasad classification-based consumer price index. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean ± standard deviation. Results: Among 525 HIV patients 59.16% were males, 40.26% females and 0.57% intersex. About half (51.0%) in the reproductive age group with mean age 36 ±13 years. The commonest mode of HIV transmission was heterosexual (89.77%). Maximum belonged to social class I (57.84%) and class II (26.05 %) of BG Prasad's socioeconomic status. Each of the non-agricultural laborers and semi-skilled workers constitutes 18.0%, and the housewives were 23.6%. At the time of presentation, baseline CD4+Tcell count was <350 /mm3 in 55.0% of HIV patients. Pulmonary tuberculosis and skin involvement were the most predominant secondary opportunistic infections accounting for 24.8% and 7.8%, respectively. More than half (52.09%) of patients were in WHO clinical stage I of HIV disease. Conclusion: Socio-demographic and clinical profile of study participants reflect an impact of early case detection and timely institution of highly active antiretroviral therapy.

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Antimicrobial susceptibility patterns of bacteria that commonly cause bacteremia at a tertiary hospital in Zambia

Future Microbiology ◽

10.2217/fmb-2020-0250 ◽

2020 ◽

Vol 15 (18) ◽

pp. 1735-1745

Author(s):

Maisa Kasanga ◽

Steward Mudenda ◽

Makomani Siyanga ◽

Misheck Chileshe ◽

Mark J Mwiikisa ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Bloodstream Infections ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

University Teaching ◽

Teaching Hospitals ◽

Cross Sectional ◽

Laboratory Information Systems ◽

University Teaching Hospitals ◽

Susceptibility Patterns

Background: Bloodstream infections and antimicrobial resistance cause global increases in morbidity and mortality. Aim: We evaluated the antimicrobial susceptibility patterns of bacteria that commonly cause bacteremia in humans. Materials & methods: We conducted a retrospective cross-sectional study at the University Teaching Hospitals in Lusaka, Zambia, using Laboratory Information Systems. Results: The commonest isolated bacteria associated with sepsis were Klebsiella pneumoniae. The distribution of bacteria associated with bacteremia in different wards and departments pneumonia. The distribution of bacteria associated with bacteremia in different wards and departments at University Teaching Hospitals was were statistically significant (χ2 = 1211.518; p < 0.001). Conclusion: K. pneumoniae, Escherichia coli, Pantoea agglomerans and Enterococcus species have developed high resistance levels against ampicillin, cefotaxime, ciprofloxacin, gentamicin and trimethoprim/sulfamethoxazole and a very low resistance levels against imipenem and Amikacin.

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Factors associated with stillbirths among women delivering at a resource limited tertiary hospital in Malawi

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2021.12.00594 ◽

2021 ◽

Vol 12 (5) ◽

pp. 289-295

Author(s):

Friday Saidi ◽

Grace Chiudzu ◽

Maganizo Chagomerana ◽

Beteniko Milala ◽

Jennifer H Tang

Keyword(s):

Uterine Rupture ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Full Blood Count ◽

Public Health Issue ◽

Stillbirth Rate ◽

Cross Sectional ◽

Factors Associated ◽

Resource Limited ◽

Major Factors

Background: Stillbirths remain a major public health issue worldwide with an estimated 3 million deaths per year globally. We investigated the factors associated with stillbirths in fetuses of at least 28 weeks’ gestation or 1000 grams at birth. Methods: We performed a hospital-based, cross-sectional study among women who delivered stillbirths at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi from May-November 2017. Eligible women were enrolled after obtaining informed consent, and their demographic and reproductive health information was collected. Blood samples were collected for full blood count, malaria, blood glucose, syphilis, and HIV testing, and the probable risk factors associated with stillbirths were assessed. Results: A total of 1,687 deliveries with 126 stillbirths occurred during the 6-month period, representing a stillbirth rate of 79 per 1,000 births. Seventy percent of these stillbirths were diagnosed on admission at KCH, and about 49% were fresh stillbirths. Half of the stillbirths had a birthweight of at least 2,500g, and the majority of these stillbirths were fresh (60%). The following factors were associated with stillbirth: uterine rupture (15.1%), placental abruption (14.3%), Hypertension (10.3%), obstructed/prolonged labor (5.8%), syphilis (7.1%), malaria (2.4%), congenital anomalies (2.4%), and diabetes (1.5%). Conclusions: The stillbirth rate at KCH is high, and most fetal deaths occurred prior to arrival at KCH. Although most of the stillbirths were unexplained, uterine rupture and abruption placenta emerged as major factors associated with stillbirths and these are largely preventable even in resource limited settings.

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