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Abstract Background Haemoglobinuria is one of the manifestations of severe malaria and results from severe intravascular haemolysis. Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been implicated in its aetiology. Haemoglobinuria may be associated with severe anaemia and, less frequently, acute renal failure. Methods A prospective case-control study was carried out to determine the incidence of haemoglobinuria as confirmed by dipstick urinalysis, microscopy and spectrophotometric measurement, among children with severe malaria. A total of 251 children presenting at the Children’s Emergency Ward with severe malaria were recruited over a period of 21 months. The G6PD status and the outcomes of severe malaria in children with and without haemoglobinuria was studied with respect to renal failure, the recurrence of haemoglobinuria and blood pressure changes over a three-month follow-up period. Results It was found that the incidence of haemoglobinuria among children with severe malaria is 19.1%. Children Conclusions Haemoglobinuria was a prominent feature of severe malaria and it was significantly associated with jaundice at presentation. Haemoglobinuria was commoner in older children than younger children but not related to sex. G6PD deficiency was not an independent predictor of the occurrence or outcome of haemoglobinuria. Blood pressure was not affected by haemoglobinuria on admission nor during follow-up.

Abstract Background The prevalence of Paediatric HIV infection is largely unknown in many countries in sub-Saharan Africa. This study was aimed at determining the prevalence, clinical pattern of HIV infection and outcome among new patients aged Methods A prospective cross sectional study was carried out using the provider initiated HIV testing and counselling (PITC) model. HIV rapid test in parallel was used for screening and confirmation was with HIV DNA PCR in children Results A total of 600 children were enrolled with ages ranging between one day and 179 months. Male: female ratio was 1.2:1. HIV seroprevalence was 12.3% and after confirmatory tests, the prevalence was 10%. Fourteen (37.8%) of the children aged less 18 months were exposed but not infected. Mother-to-child transmission accounted for 93.3% of cases. Features predictive of HIV infection were diarrhoea, cough, weight loss, ear discharge generalized lymphadenopathy, presence of skin lesions, parotid swelling and oral thrush. About 75% presented in advanced or severe clinical stages of the disease, 56.8% had severe immunodeficiency while 50% had viral loads more than 100,000 copies/ml. Mortality rate was 14.3% among HIV positive compared with 11.3% in HIV negative children but was not significant. Among the HIV positive children, 26.7% were orphans. Conclusions The prevalence rate of HIV infection among new patients screened using the PITC model was high, majority resulting from mother-to-child transmission. Most children presented in advanced stages of the disease and mortality rate among them was high. Though, the study site being a referral centre might have contributed to the high prevalence observed in this study, there is a need to expand access to PMTCT services, ensure implementation of PITC in paediatric settings and expand support services for HIV infected children.

Introduction: This study describes the epidemiologic features and clinical course of children with blood transfusion-associated HIV infection (TAHI) in Ibadan, Nigeria.Methodology: All children diagnosed to have TAHI at the University College Hospital, Ibadan, were studied and compared with children who acquired HIV vertically using the pediatric HIV database in the hospital.Results: Transfusion-associated HIV infection accounted for 14 (2.3%) of the 597 children diagnosed to have HIV infection between January 2004 and December 2011. The mean age at diagnosis of TAHI was 10.2 years and that of vertically acquired HIV infection was 3.9 years ( P < .001). In 9 cases, blood transfusion took place in private hospitals and in 5 cases in public hospitals. Median interval between infection and diagnosis of AIDS was 84 months in cases with TAHI and 48 months in vertically acquired cases ( P = .542).Conclusion: Optimal blood safety practices are advocated for prevention of TAHI in Nigeria. [ABSTRACT FROM AUTHOR]

Most cases of human immunodeficiency virus (HIV) infection in children result from mother to child transmission. Other risk factors for transmission include transfusion of infected blood and use of contaminated instruments. We report the case of a five-month-old female infant who presented with a history of cough and weight loss of a month's duration. Her mother was diagnosed HIV positive in the first trimester of pregnancy but defaulted from prevention of mother to child transmission services. After delivery, the child was circumcised on the eighth day and severe bleeding complicated the procedure. She was then taken to a private hospital were she was transfused with her father's blood without screening. Both parents were subsequently confirmed HIV positive. The child was also confirmed HIV positive by DNA polymerase chain reaction and had features of HIV encephalopathy and severe immunosuppression (CD4 9.3%). Exposure of this infant to HIV through the mother only carries a transmission risk of 30%. Female genital mutilation and transfusion with her father's blood that was probably already infected constituted increased or additional risks. There is need for health education against transfusion of unscreened blood even when the parents are the donors. Female genital mutilation should also be discouraged by health education and appropriate legislation. [ABSTRACT FROM AUTHOR]

Background: ral lesions may indicate the presence of HIV infection and may differ in children and adults in different regions., Aim: To determine the prevalence, types of oral lesions in HIV positive children and their association with the clinical stage, CD4 count and viral load., Methods: A cross-sectional study involving consecutive HIV positive children whose sero-positive status was confirmed with ELISA screening and Western immunoblot. Oral lesions were diagnosed clinically by a trained dental surgeon using previously established classification. Data obtained was analyzed with SPSS 15.0., Results: There were 127 children with age range of 3 to 204 months (median: 60 months) and male preponderance of 58.3% (n=74). 55.9% (n=71) of the subjects had oral lesions and pseudomembranous candidiasis (55.9%) was the commonest followed by caries (12.7%), xerostomia (7.8%) and gingivitis (6.9%). Correlation between prevalence of oral lesions and clinical stage of the disease did not reveal any statistically significant association (p=0.354). Also there is no statistically significant difference in prevalence of oral lesions between children on Antiretroviral Therapy (ART) and those who are not on ART (p=0.875). Incidence of oral lesions was however associated with lower mean baseline CD4 count (p= 0.004) but not with mean log10 viral load (p=0.256)., Conclusion: This study has shown that HIV associated oral lesions are prevalent in our environment and antiretroviral therapy does not have significant correlation with occurrence of these lesions in HIV infected children. CD4 count is a better indicator of disease progression than viral load.