Department of Paediatrics, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Department of Haematology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
PLoS One. 2018 Oct 4;13(10):e0200435. doi: 10.1371/journal.pone.0200435. eCollection 2018.
Human immunodeficiency virus and protein energy malnutrition are still prevalent in Nigeria and the occurrence of the two conditions together confers a poor prognosis. The aim of this study was to determine the current categories of malnutrition amongst under-5 children in Lagos, document their HIV status and determine any peculiarities in the clinical features, haematological and some biochemical profile in these children.
The study was a cross-sectional study conducted at the Paediatric departments of the Lagos University Teaching Hospital and the Massey Street Children's Hospital, both in Lagos, over a 6-month period. All the subjects had anthropometry, HIV testing, full blood count and serum proteins done. The factors associated with HIV status were determined with the logistic regression analysis.
Two hundred and fourteen (214) malnourished children ≤5 years, including 25 (11.7%) with HIV were recruited in the study. Among the study participants, 150 (70.1%) and 54 (29.9%) had moderate and severe malnutrition, respectively. Fever, cough and diarrhea were the most common symptoms in the study participants. The haematological indices were comparable in the two groups, the serum globulin levels though higher in the HIV infected group was not statistically significantly different from the non-infected group.(p = 0.66). None of the factors explored on multivariate analysis was able to predict the occurrence of the infection in this cohort.
Malnourished children remain a high risk group for HIV infection and the prevalence of the infection obtained in this group of children is still unacceptably high. Discriminatory features between malnutrition and HIV remains difficult. The presence of hyperglobulinaemia on laboratory analysis in a malnourished child may heighten the suspicion of possible underlying associated HIV infection. Screening of malnourished children for HIV infection and further longitudinal studies on malnourished children with HIV is advocated.
在尼日利亚,人类免疫缺陷病毒和蛋白质能量营养不良仍然很普遍,这两种情况同时发生预后不良。本研究旨在确定拉各斯 5 岁以下儿童目前的营养不良类别,记录他们的艾滋病毒状况,并确定这些儿童在临床特征、血液学和一些生化特征方面的特点。
本研究是在拉各斯的拉各斯大学教学医院和梅西街儿童医院儿科部门进行的一项横断面研究,为期 6 个月。所有受试者均进行了人体测量学、艾滋病毒检测、全血细胞计数和血清蛋白检测。使用逻辑回归分析确定与艾滋病毒状态相关的因素。
本研究共纳入 214 名≤5 岁营养不良儿童,包括 25 名(11.7%)艾滋病毒感染者。在研究参与者中,150 名(70.1%)和 54 名(29.9%)分别患有中度和重度营养不良。发热、咳嗽和腹泻是研究参与者中最常见的症状。两组的血液学指标相似,感染组的血清球蛋白水平虽然较高,但与未感染组无统计学差异(p=0.66)。在多变量分析中,没有任何因素能够预测该队列中感染的发生。
营养不良儿童仍然是艾滋病毒感染的高危人群,本研究中获得的感染率仍然高得令人无法接受。在营养不良和艾滋病毒之间的鉴别特征仍然很困难。在营养不良儿童的实验室分析中存在高球蛋白血症可能会增加潜在相关艾滋病毒感染的怀疑。建议对营养不良儿童进行艾滋病毒感染筛查,并对感染艾滋病毒的营养不良儿童进行进一步的纵向研究。