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      Prevalence of Human Immunodeficiency Virus Transmission among Transfused Children with Sickle Cell Anemia in Enugu Nigeria

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          Abstract

          Background:

          There are a number of routes for human immuno-deficiency virus (HIV) transmission in children. Blood transfusion-related HIV is still common in developing countries like Nigeria especially among high risk children such as those who require repeated blood transfusions.

          Aim:

          The aim of this study was to find the prevalence of HIV among transfused children with sickle cell anemia in Enugu.

          Subjects and Methods:

          This is a descriptive cross-sectional study conducted at the Sickle Cell Clinic of the University of Nigeria Teaching Hospital, Enugu Sixty-nine transfused children with SCA were enrolled after obtaining consent from their caregivers and assent from older children. Non transfused children matched for age, sex, and social status with the subjects served as control. Voluntary counseling and testing were then provided. Relevant data were obtained using pretested questionnaire. Statistical Package for Social Science (SPSS) version 11 (Chicago, IL) was used for data analysis. The chi-square was used to test for significant association of categorical variables and a P-value of less than 0.05 accepted as significant.

          Results:

          HIV antibodies were found in 2.9% (2/69) of the subjects and in 1.6% (1/64) of the control ( P = 0.604). All the infected individuals among the subjects were males, had only been transfused once and were from the lower socioeconomic class. The only infected child from the control group was a 7-year-old male and he probably acquired it through vertical transmission since the mother also tested positive to HIV antibody.

          Conclusions:

          Blood transfusion is still a risk factor for HIV transmission among children with sickle cell anemia in Nigeria. Strategies that will ensure improved blood transfusion safety at health facilities need to be strengthened.

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          Most cited references29

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          Socioeconomic and cultural background of hospitalized children in Ilesa

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            Survival in children with perinatally acquired human immunodeficiency virus type 1 infection.

            We describe our experience at Jackson Memorial Hospital in Miami, Florida, with 172 children who were given diagnoses of perinatally acquired infection with human immunodeficiency virus type 1 (HIV-1). The 146 mothers of the children acquired HIV-1 through heterosexual contact (69 percent), intravenous drug use (30 percent), or blood transfusion (1 percent). The children presented with symptomatic disease at a median age of eight months; only 21 percent presented after the age of two years. The most common first manifestations of disease were lymphoid interstitial pneumonia (in 17 percent), encephalopathy (in 12 percent), recurrent bacterial infections (in 10 percent), and candida esophagitis (in 8 percent), for which the median survival times from diagnosis were 72, 11, 50, and 12 months, respectively. Nine percent of the children had Pneumocystis carinii pneumonia at a median age of five months and had a median survival of only one month. The median survival for all 172 children was 38 months from the time of diagnosis. Mortality was highest in the first year of life (17 percent), and by proportional-hazard analysis the probability of long-term survival is low. In multivariate analyses, early age at diagnosis and the first identifiable pattern of clinical disease were found to be independently related to survival. We conclude that children with perinatally acquired HIV-1 infection have a very poor prognosis and that most become symptomatic before one year of age. Early diagnosis is important, since there is only a short interval in which to initiate prophylactic or antiviral treatment before progressive disease begins.
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              Natural history of human immunodeficiency virus type 1 infection in children: a five-year prospective study in Rwanda. Mother-to-Child HIV-1 Transmission Study Group.

              To compare morbidity and mortality of human immunodeficiency virus type 1 (HIV-1)-infected and HIV-1-uninfected children and to identify predictors of acquired immunodeficiency syndrome (AIDS) and death among HIV-1-infected children in the context of a developing country. Prospective cohort study. Maternal and child health clinic of the Centre Hospitalier de Kigali, Rwanda. Two hundred eighteen children born to HIV-1-seropositive mothers and 218 born to seronegative mothers of the same age and parity were enrolled at birth. Deaths, clinical AIDS, nonspecific HIV-related manifestations, and use of health care services. Fifty-four infected and 347 uninfected children were followed up for a median of 27 and 51 months, respectively. With the exception of chronic cough, the risk of occurrence of nonspecific HIV-related conditions was 3 to 13 times higher in infected than in uninfected children. The recurrence rate and severity of these findings were increased systematically in infected infants. Estimated cumulative risk of developing AIDS was 28% and 35% at 2 and 5 years of age, respectively. Estimated risk of death among infected children at 2 and 5 years of age was 45% and 62%, respectively, a rate 21 times higher than in uninfected children. Median survival time after estimated infection was 12.4 months. Early infection, early onset of HIV-related conditions, failure to thrive, and generalized lymphadenopathy were associated with subsequent risk of death and/or AIDS, whereas lymphoid interstitial pneumonitis was predictive of a milder disease. In Africa, HIV-1-infected children develop disease manifestations early in life. Specific clinical findings are predictive of HIV-1 disease, AIDS stage, and death. Bimodal expression of HIV-1 pediatric disease is encountered in Africa, as in industrialized countries, but prognosis is poorer. human immunodeficiency virus infection, children, vertical transmission, natural history, Africa.
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                Author and article information

                Journal
                Ann Med Health Sci Res
                Ann Med Health Sci Res
                AMHSR
                Annals of Medical and Health Sciences Research
                Medknow Publications & Media Pvt Ltd (India )
                2141-9248
                2277-9205
                Jul-Dec 2012
                : 2
                : 2
                : 109-113
                Affiliations
                [1] Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
                Author notes
                Address for correspondence: Dr. Agozie Ubesie, Department of Paediatrics, University of Nigeria, Enugu Campus, Nigeria. E-mail: zionagoz@ 123456yahoo.co.uk
                Article
                AMHSR-2-109
                10.4103/2141-9248.105655
                3573502
                23439999
                c8b16867-30b7-4f8b-91c6-84f8adb037db
                Copyright: © Annals of Medical and Health Sciences Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Medicine
                hiv infection,blood transfusion,sickle cell anemia
                Medicine
                hiv infection, blood transfusion, sickle cell anemia

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