Human Immunodeficiency Virus in Children With Severe Acute Malnutrition (SAM) at Ola During Children’s Hospital Freetown, Sierra Leone

Prevalence of Tuberculosis among Children with Severe Acute Malnutrition at Ola during Children’s Hospital in Freetown Sierra Leone. Worldwide, pediatric tuberculosis account for about 1million cases, annually, accounting for 10-15% of all tuberculosis; with more than 100,000 estimated mortality annually, it is also one of the 10 most common causes of childhood mortality. Aim of this study was to determine the prevalence of tuberculosis among children with severe acute malnutrition at Ola During Children’s Hospital in Freetown Sierra Leone. It was a descriptive cross-sectional study, carried out at the therapeutic feeding center (TFC) of Ola During Children’s Hospital in 2018. An opportunistic sampling method in which every next patient whose mother gave consent was recruited until the number 74 was reached. Patients who met the World Health Organisation (WHO) criteria for diagnosis of severe acute malnutrition were admitted into the TFC and consecutively selected and interviewed using a structured questionnaire after obtaining written informed consent, from their mothers or caregivers. All the mothers approached during the study period consented for the study. Diagnosis of tuberculosis was both clinically and by laboratory investigations, 74 children whose mothers/caregivers consented for the study were recruited. Data was entered into an excel spread sheet and analyzed using Epi info version 7. There were 74 children with a median age of 11 months ± 9.9SD. Forty (54.1%) Males and 34(45.9%) Females, with a M:F ratio of 1.18:1. Prevalence of tuberculosis was 20%. Diagnosis of Tuberculosis was based on clinical findings of extreme weight loss or failure to gain weight, Chest x-ray findings of perihilar infiltrates. Gene Xpert MTB RIF results were all negative 0(0%). Most of the mothers 59 (79.7%) were aged between 20-29 years, 45(60.9%) of them were petty traders, while 15(20.3%) had no formal education. The chi square was used to determine the statistical difference, there was no statistically significant difference between gender and TB, P= 0.3415, there is a statistically significant difference between no formal education and occurrence of tuberculosis in their children P= 0.0467. Conclusions/Recommendations: Prevalence of Tuberculosis is still high among children with severe acute malnutrition. Gene Xpert MTB RIF was unable to make a bacteriological confirmation. There are difficulties with making bacteriological confirmation of tuberculosis in resource poor settings. Guidelines requiring mainly clinical parameters need to be developed for use in resource limited countries.

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An overview of the case fatality of inpatient severe acute malnutrition in Ethiopia and its association with human immunodeficiency virus/tuberculosis comorbidity—a systematic review and meta-analysis

International Health ◽

10.1093/inthealth/ihy043 ◽

2018 ◽

Author(s):

Fasil Wagnew ◽

Wubet Worku ◽

Getiye Dejenu ◽

Animut Alebel ◽

Setegn Eshetie

Keyword(s):

Systematic Review ◽

Human Immunodeficiency Virus ◽

Severe Acute Malnutrition ◽

Meta Analysis ◽

Case Fatality ◽

Acute Malnutrition ◽

Immunodeficiency Virus

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Screening for Hypothyroidism in children with severe acute malnutrition at Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan.

The Professional Medical Journal ◽

10.29309/tpmj/2022.29.01.5722 ◽

2021 ◽

Vol 29 (01) ◽

pp. 116-120

Author(s):

Saadia Khan ◽

Waqas Imran Khan ◽

Ayesha Fayyaz ◽

Ibad Ali ◽

Asad Abbas ◽

...

Keyword(s):

Child Health ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Total Serum ◽

Age Group ◽

Rehabilitation Center ◽

Mean Values ◽

Children's Hospital ◽

Children’S Hospital ◽

Nutrition Rehabilitation

Objective: To determine the percentage of Hypothyroidism in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan. Period: January 2019 to December 2019. Material & Methods: A total of 255 malnourished patients (as per inclusion criteria) were included in current study. A written Performa was designed to collect history, anthropometric measurements and systemic examination. Taking aseptic measures venous blood was sent for baseline tests as well as for T3, T4 and TSH, total serum protein albumin and total ferritin levels to hospital laboratory. Correlation between serum thyroid concentrations and total protein, albumin, hemoglobin and serum ferritin were estimated by using t-test and p-vlaue less than 0.05 was considered as significant. Total collected data was entered and analyzed in SPSS version 21.0. Results: A total of 255 malnourished children were included in this study. Majority of studied subjects were male (52.5%) with 83.92%, 3-5 years of age. Amongst the 255 children mean values of T3 in MAM and SAM patients were 105.4 ng/dl and 89.7 ng/dl respectively. There was a statistically significant (p <0.001) association between decreased T3 and type of malnutrition. Similarly, mean values of T4 in MAM and SAM patients were 6.3 ug/dl and 5.7 ug/dl respectively that was statistically significant (p <0.05). Lower values of T4 were higher among SAM children in 1 to 3 years age group compared to respective MAM children with p value .0.05 and high T4 value in 3-5 years age group of MAM children were both statistically insignificant. Higher mean Values of TSH was found in SAM compared to MAM children both age groups. Conclusion: Severe acute malnutrition (SAM) is associated with reduction in T3 and T4 levels and higher levels of TSH in SAM children as compared to MAM. The altered thyroid hormone status in children with PEM is perhaps a protective phenomenon to limit protein catabolism and lower energy requirements.

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Implementation of Opt-Out Testing and Change From Third- to Fourth-Generation Human Immunodeficiency Virus (HIV) Test Increases Acute HIV Diagnosis in an Urban Children's Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv133.261 ◽

2015 ◽

Vol 2 (suppl_1) ◽

Author(s):

Ann Petru ◽

Teresa Courville ◽

Abigail Aldridge

Keyword(s):

Human Immunodeficiency Virus ◽

Fourth Generation ◽

Hiv Diagnosis ◽

Children's Hospital ◽

Opt Out ◽

Hiv Test ◽

Immunodeficiency Virus ◽

Children’S Hospital ◽

Acute Hiv

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Fatal Outcome in a Hepatitis E Virus/Human Immunodeficiency Virus Co-Infected Malnourished Child in the Central African Republic

Infectious Disease Reports ◽

10.3390/idr12030017 ◽

2020 ◽

Vol 12 (3) ◽

pp. 82-86

Author(s):

Stéphanie Judith N’Yetobouko Tabounie ◽

Simplice Cyriaque Kango ◽

Julie Bouscaillou ◽

Vianney Tricou ◽

Arnaud Fontanet ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis E Virus ◽

Central African Republic ◽

Severe Acute Malnutrition ◽

Fatal Outcome ◽

Hepatitis E ◽

Malnourished Child ◽

Acute Malnutrition ◽

African Countries ◽

Immunodeficiency Virus

Hepatitis E virus (HEV) infection is responsible for major endemic outbreaks in developing countries. Human immunodeficiency virus (HIV) and HEV are widespread in the Central African Republic. We report the first documented case of an HEV infection in a 36-month-old child already suffering from HIV and severe acute malnutrition (SAM). The HIV patient was hospitalized for SAM with persistent diarrhea and prolonged fever. The presence of IgG anti-HEV antibodies was noted. Sequencing of the amplified HEV RNA revealed the presence of genotype 3c. The alanine aminotransferase level was slightly above average. The patient died despite being treated by antiretroviral therapy accompanied by probabilistic antibiotic therapy and nutritional rehabilitation. HEV/HIV co-infection in a malnourished patient can accelerate a fatal outcome. In the presence of biological abnormalities in a severe acutely malnourished HIV-infected patient, HEV RNA detection should be added to the standard medical assessment in sub-Saharan African countries.

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Burden of Malaria in Children Presenting with Anaemia at Ola During’s Children’s Hospital in Freetown Sierra Leone

American Journal of Pediatrics ◽

10.11648/j.ajp.20190502.16 ◽

2019 ◽

Vol 5 (2) ◽

pp. 70

Author(s):

Yaguo Ide Lucy Eberechukwu

Keyword(s):

Sierra Leone ◽

Children's Hospital ◽

Children’S Hospital

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Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial

Gut ◽

10.1136/gutjnl-2020-320769 ◽

2020 ◽

Vol 69 (12) ◽

pp. 2143-2149 ◽

Cited By ~ 1

Author(s):

David Taylor Hendrixson ◽

Claire Godbout ◽

Alyssa Los ◽

Meghan Callaghan-Gillespie ◽

Melody Mui ◽

...

Keyword(s):

Sierra Leone ◽

Vegetable Oil ◽

Severe Acute Malnutrition ◽

Milk Powder ◽

Acute Malnutrition ◽

Growth Time ◽

Controlled Clinical Trial ◽

Hydrogenated Vegetable Oil ◽

Therapeutic Food ◽

Time To Graduation

ObjectiveWe hypothesised that an alternative RUTF (ready-to-use therapeutic food) made with oats (oat-RUTF) would be non-inferior to standard RUTF (s-RUTF).DesignThis was a randomised, triple-blind, controlled, clinical non-inferiority trial comparing oat-RUTF to s-RUTF in rural Sierra Leone. Children aged 6–59 months with severe acute malnutrition (SAM) were randomised to oat-RUTF or s-RUTF. s-RUTF was composed of milk powder, sugar, peanut paste and vegetable oil, with a hydrogenated vegetable oil additive. Oat-RUTF contained oats and no hydrogenated vegetable oil additives. The primary outcome was graduation, an increase in anthropometric measurements such that the child was not acutely malnourished. Secondary outcomes were rates of growth, time to graduation and presence of adverse events. Intention to treat analyses was used.ResultsOf the 1406 children were enrolled, graduation was attained in 404/721 (56%) children receiving oat-RUTF and 311/685 (45%) receiving s-RUTF (difference 10.6%, 95% CI 5.4% to 15.8%). Death, hospitalisation or remaining with SAM was seen in 87/721 (12%) receiving oat-RUTF and in 125/685 (18%) receiving s-RUTF (difference 6.2%, 95% CI 2.3 to 10.0, p=0.001). Time to graduation was less for children receiving oat RUTF; 3.9±1.8 versus 4.5±1.8 visits, respectively (p<0.001). Rates of weight in the oat-RUTF group were greater than in the s-RUTF group; 3.4±2.7 versus 2.5±2.3 g/kg/d, p<0.001.ConclusionOat-RUTF is superior to s-RUTF in the treatment of SAM in Sierra Leone. We speculate that might be because of beneficial bioactive components or the absence of hydrogenated vegetable oil in oat-RUTF.Trial registration numberNCT03407326.

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Comparative Effectiveness of Four Specialized Nutritious Food Products for Treatment of Moderate Acute Malnutrition in Sierra Leone (P10-140-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-140-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Breanne Langlois ◽

Stacy Griswold ◽

Devika Suri ◽

Ye Shen ◽

Kenneth Chui ◽

...

Keyword(s):

International Development ◽

Graduation Rates ◽

Sierra Leone ◽

Severe Acute Malnutrition ◽

Cluster Randomized Trial ◽

Humanitarian Assistance ◽

Acute Malnutrition ◽

Mixed Effect ◽

Feeding Program ◽

Moderate Acute Malnutrition

Abstract Objectives This study compared the effectiveness of 4 specialized nutritious foods (SNFs) used for the treatment of moderate acute malnutrition (MAM) in children <5 years of age in Pujehun District, Sierra Leone. Methods This was a cluster-randomized trial operating through a supplementary feeding program (SFP) providing SNFs for treatment of MAM. Three study foods were fortified blended foods – Super Cereal Plus w/amylase (SC + A), Corn-soy Blend Plus w/oil (CSB + w/oil), and Corn-soy-whey Blend w/oil (CSWB w/oil) – and one was a lipid-based Ready to Use Supplementary Food (RUSF). From 4/2017 to 11/2018, children with MAM, defined as mid-upper arm circumference (MUAC) ≥11.5 cm and <12.5 cm without bipedal edema, were enrolled at participating health clinics and received rations bi-weekly until they reached an outcome or for up to 12 weeks. A stratified randomization technique was used to select 28 sites and randomize them into 7 per arm based on pre-determined criteria. During the study, an 8th site was added to the CSWB w/oil arm due to low enrollment. The primary outcome was graduation from SFP defined as MUAC ≥12.5 cm within the 12-week treatment period. Mixed-effect regression assessed whether there were differences in graduation rates among children treated with one of the 4 SNFs. Results A total of 2683 children were enrolled out of a planned sample size of ∼5000. Overall: 63% graduated from MAM, 19% developed severe acute malnutrition (SAM), 7% defaulted (missed 3 visits in a row), 1% died, and 10% reached no outcome within 12 weeks. Twenty-five % were transferred into the study from SAM treatment. By study arm, graduation rates were: 62% in CSWB w/oil, 65% in SC + A, 64% in CSB + w/oil, 62% in RUSF. In an unadjusted model, statistically significant differences in graduation rates between the arms were not detected. Data analysis is ongoing to determine if this finding is maintained in adjusted models. Conclusions The 4 foods performed comparably in treating MAM in unadjusted analysis. Decision-making by donors, governments, and programmers on which food to program should also be based on cost-effectiveness analysis. Funding Sources Supported by the Office of Food for Peace, Bureau for Democracy, Conflict, and Humanitarian Assistance, U.S. Agency for International Development.

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