Attending Lagos University Teaching Hospital Research Articles

Clinico-cytological analysis of conjunctiva and ocular surface symptoms of patients on topical anti-glaucoma medications attending Lagos University Teaching Hospital, Lagos, Nigeria: A case-control study.

The long-term use of topical anti-glaucoma medications is often associated with ocular surface toxicity that can affect the patient's drug compliance and quality of life. This study assessed the effect of these medications, using cytological changes of the conjunctiva and ocular surface symptoms. This was a clinic-based, case-control study that was conducted at the Lagos University Teaching Hospital that compared glaucoma patients on topical medications with age-sex-matched controls. The controls were non-glaucoma patients, who were not on any topical ocular medications at least 6 months prior to the study. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess ocular surface symptoms. Schirmer's I test, tear film break-up time (TBUT) test and corneal fluorescein staining of the ocular surface were used for ocular surface disease (OSD) assessment and conjunctival impression cytology (CIC) for histological assessment and grading. Six hundred and ninety-six eyes of 348 respondents, 174 cases and 174 controls, were assessed for OSD. The mean ages of the case and control groups were 56.3 ± 12.9 years and 55.5 ± 13.2 years, respectively, with no statistical difference (P = 0.589). All ocular parameters assessed were significantly abnormal in the case group compared to the control group. The use of topical anti-glaucoma medications was significantly associated with abnormal TBUT (P < 0.001), Schirmer's test (P < 0.001), ocular surface staining (P < 0.001), CIC (P < 0.001) and OSDI scores (P = 0.001). A significant association was seen between abnormal TBUT and the number of medications (P = 0.044, odds ratio [OR] =0.79, 95% confidence interval [CI]: 0.44-1.14), between abnormal ocular surface staining and duration of anti-glaucoma medications usage (P = 0.0104, OR = 1.2, 95% CI: 1.04-1.43) and between abnormal CIC and the duration of anti-glaucoma medications (P = 0.0007, OR = 0.7, 95% CI: 0.59-0.86). The study demonstrates that prolonged use of topical anti-glaucoma medications may be associated with damage to the ocular surface structures.

The Quality of Life of Medically Versus Surgically Treated Primary Open-angle Glaucoma Patients at a Nigerian Hospital.

The purpose of this study is to compare the quality of life (QoL) of medically treated versus surgically treated primary open-angle glaucoma (POAG) patients attending Lagos University Teaching Hospital, Lagos, Nigeria. The study was a hospital-based, comparative cross-sectional study. Consecutive consenting POAG participants who met the inclusion criteria were recruited until the sample size was achieved. QoL of all participants was assessed using the glaucoma QoL-15 and National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) questionnaires. Analysis was done using the IBM statistical package for the social sciences version 25.0. The study involved 81 participants who were only on medical treatment for POAG and 81 age- and sex-matched POAG participants who had trabeculectomy surgery. Surgically treated participants had a lower mean intraocular pressure 11.68 mmHg when compared to the medically treated participants 14.82 mmHg. Medically treated participants however had a better overall mean glaucoma QoL using the glaucoma QoL-15 (medical 34.36 ± 10.4, surgical 39.11 ± 13.9 P = 0.015) and NEI-VFQ-25 questionnaires (medical 68.32 ± 15.0, surgical 62.44 ± 18.8 P = 0.029). Controlling for the severity of glaucoma using the glaucoma QoL-15 questionnaire, medically treated participants had a better QoL only among participants with severe POAG (medical 49.13 ± 5.9, surgical 54.06 ± 4.6 P = 0.003). While using the NEI-VFQ-25 questionnaire, medically treated participants had a significantly better QoL only among participants with moderate (medical 74.70 ± 6.6, surgical 67.07 ± 15.6 P = 0.012) and severe POAG (medical 54.52 ± 6.3, surgical 45.51 ± 10.0 P = 0.004). The study demonstrated that although participants that had trabeculectomy had a lower mean intraocular pressure, their overall mean QoL was reduced compared to the medically treated participants.

Medication nonadherence in Nigerian heart failure patients: A cross sectional study

Background: Anti-failure therapy is vital to the reduction of morbidity and mortality associated with heart failure (HF). Medication nonadherence (MNA) has been identified as a major limiting factor for the attainment of therapeutic goals. This study aimed to determine the prevalence and characteristics of MNA in HF patients attending Lagos University Teaching Hospital (LUTH), Lagos. Methods: This was a descriptive cross-sectional study involving 202 previously diagnosed HF patients attending an outpatient clinic in LUTH. Data were obtained from patient's medical records and the use of an interviewer-administered questionnaire. Medication Adherence Report Scale 5-items was used to determine MNA. Results: Of the 202 HF subjects, 68% (n = 128) were aged 31–60 years, 65% (n = 132) were females, 58%, (n = 116) were taking ≤4 pills/day, 54.5% were taking pills twice daily, and 72.3% (n = 146) had comorbid conditions. The overall prevalence of MNA was 69.3% with ACE inhibitors having the highest MNA of 73.2% and angiotensin receptor blocker/neprilysin inhibitor having the least MNA of 0%. MNA was independent of age, gender, educational status, pill burden, duration of HF, history of HF admission, functional status, and specific comorbidities (P

Comparison of autorefractor with focometer in patients with refractive errors attending Lagos University Teaching Hospital, Lagos, Nigeria - A cross sectional survey

Background: Uncorrected refractive error is the most common cause of visual impairment globally. Yet, there is paucity of refractionists in rural areas of most developing countries. Thus, there is a need for a cost effective but accurate method of refraction that could be used by rural health workers with minimal training. To compare refractive error measurements of autorefractor with that of focometer with a view to determining the accuracy and reliability of focometer. Methods: This was a comparative cross-sectional study conducted among patients with refractive errors attending the Guinness Eye Centre Clinic, Lagos University Teaching Hospital, Lagos, Nigeria. Consecutively consenting patients who met the eligibility criteria were recruited until the sample size was attained. All participants had a standardized protocol examination including visual acuity assessment and ocular examination. Refractive error was measured using the autorefractor, focometer and subjective refraction in both eyes of each participant. Comparison was done based on the means of variables of autorefractor, subjective refraction and focometer measurements using the paired-sample t-tests, Pearson's correlation and linear regression. Agreement between the measurements was investigated using the Bland-Altman analysis and reliability of the repeated measurements tested with Cronbach's alpha. The analysis was considered statistically significant when the P < 0.05. Results: Four hundred eyes of 200 patients were analyzed in this study. The mean age of respondents was 45.1 ± 16.3yrs and the male:female ratio was 1: 2.1. There was a statistically significant difference between the mean spherical (P < 0.001) and cylindrical (P < 0.001) readings of the focometer and autorefractor. However, the mean difference between the spherical equivalent of focometer and that of the autorefractor was not statistically significant (P = 0.66). Pearson correlation coefficient was high for the compared methods of refraction as both the bivariate linear regression between the autorefractor and focometer, and that between the subjective refraction and focometer showed good linearity. Bland-Altman plot showed good agreement between the mean focometer measurements with both the autorefractor (mean difference = +0.02 ± 0.85 DS; mean difference ± 1.96 standard deviation [SD] = 1.69 to − 1.65 DS) and subjective refractive (mean difference = +0.06 ± 0.72 DS; mean difference ± 1.96 SD = 1.49 to − 1.36 DS) measurements. Cronbach's alpha showed good reliability of focometer and autorefractor repeated measurements. Conclusion: This study showed a good correlation and agreement between focometer and autorefractor. Hence, focometer could be used for refraction in low resource settings where locals could be trained in its use.

Adolescents and Young Adults Knowledge, Adherence and Experiences While on Antiretroviral Therapy in a Tertiary Hospital in Lagos, Nigeria: A Mixed-Method Study

In Nigeria, there is a paucity of data on knowledge and experiences of adolescents and young adults (AYAs) with HIV and ART, as well as their challenges maintaining optimal adherence. A mixed-method study was carried out between August and September 2018 among AYAs attending Lagos University Teaching Hospital, Nigeria. Data collection was via AYAs' hospital records, standardized questionnaires, and in-depth interviews (IDIs). The 4-day ACTG tool was used to measure adherence. Collected data were analyzed descriptively. Assessment of 34 AYAs comprising 18 (52.9%) males with 28 (82.4%) students revealed an overall knowledge score about ART and its effect of 73.6%. Twenty-five (73.5%) had poor knowledge of the development of resistant strains of HIV due to non-adherence recorded. Optimal adherence (≥95%) was recorded in 20 (58.8%) AYAs. IDI produced 4 themes: (i) reasons for non-adherence, (ii) ensuring optimal adherence, (iii) Social support systems and disclosure, and (iv) stigmatization. Our study provided formative data and revealed areas for intervention to improve knowledge and adherence to ART.

Relationship between corneal sensitivity and diabetic retinopathy among diabetics attending a Nigerian Teaching Hospital.

To determine the relationship between corneal sensitivity and diabetic retinopathy among diabetics attending Lagos University Teaching Hospital, compared to their age-sex-matched non-diabetics, with a view to proposing its use as a screening tool for diabetic retinopathy. The study was a hospital-based comparative cross-sectional study among diabetics aged 25-65 years and their age-sex-matched non-diabetics at Lagos University Teaching Hospital, Lagos, Nigeria. Interviewer-based questionnaire was administered. Corneal sensitivity was assessed with Cochet-Bonnet aesthesiometer. Dilated fundoscopy examination was carried out using slit-lamp bio-microscope with 78D lens and binocular indirect ophthalmoscope. A total of 120 diabetics and 120 age- and sex-matched non-diabetics were enrolled into the study. Among the diabetics, the mean corneal sensitivity was 52.6 ± 6.9 mm, which was statistically lower than among non-diabetics - 58.2 ± 3.0 mm (p-value < 0.05). Twenty-one percent of the diabetic respondents had diabetic retinopathy. The mean cornea sensitivity was statistically lower among diabetics who had developed diabetic retinopathy compared to those with no diabetic retinopathy (48.9 ± 7.3 vs. 55.3 ± 5.4, p < 0.05). The sensitivity and specificity of the aesthesiometer for proliferative diabetic retinopathy at 55 mm cut-off were 100% and 58%, respectively. Cornea sensitivity was significantly lower among diabetics with retinopathy compared to those without retinopathy. Also, the degree of cornea sensation loss among diabetics reduced significantly with severity of diabetic retinopathy. Larger validity studies need to be conducted to further assess the use of corneal aesthesiometer as a screening tool for diabetic retinopathy among non-ophthalmologists and other cadres of health workers.

Correlation between clinical and cytological parameters of dry eye among diabetics in a Nigerian tertiary hospital.

To correlate the clinico-cytological features of dry eye among diabetic patients attending Lagos University Teaching Hospital, Lagos. This was a cross-sectional, comparative study among 104 diabetic and 104 age-/sex-matched non-diabetic participants. Demographics were obtained using interviewer-administered questionnaire. Ocular Surface Disease Index (OSDI) questionnaire was used for subjective assessment of dry eye. All participants underwent ocular examination and dry eye assessment including Schirmer I test, tear film break-up time (TBUT) and ocular surface staining. In addition, conjunctival impression cytology (CIC) samples were taken for histological assessment. Data were analysed using IBM Statistical Package for the Social Sciences version 20.0 (IBM Corp., Armonk, NY USA). The mean age was 58.5 ± 10.05years and 58.32 ± 10.48years among the diabetics and non-diabetics, respectively (p = 0.856). The male/female ratio was 1:1.4. Three hundred and ninety-seven (199 diabetic and 198 non-diabetic) eyes were assessed. Diabetics had a significantly higher median OSDI score and ocular surface staining grade compared to non-diabetics (p = 0.002 and 0.005, respectively). The TBUT was slightly lower, while the Schirmer test was slightly higher among the diabetics, but not significant (p = 0.058 and 0.033, respectively). The diabetics had a significantly higher CIC grade (p < 0.001). There was a moderate positive correlation between conjunctival cytology and ocular surface staining (r = 0.50, p < 0.01). This study demonstrates worse ocular surface damage among diabetics characterised by ocular surface staining and abnormal CIC. Furthermore, it shows a positive correlation between ocular surface staining and CIC. Dry eye assessment should be incorporated in routine diabetic eye screening.

Selenium deficiency and pregnancy outcome in pregnant women with HIV in Lagos, Nigeria.

To investigate the prevalence of maternal selenium deficiency and its effects on pregnancy outcomes in pregnant women with HIV in Lagos, Nigeria. The present descriptive cross-sectional study enrolled women aged 15-49years with HIV who were at 14-26weeks of a singleton pregnancy and were attending Lagos University Teaching Hospital, Lagos, Nigeria, between August 1, 2016, and April 30, 2017. Participants were selected by consecutive sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure selenium concentrations, and associations between low maternal selenium concentrations (defined as <0.89μmol/L) and pregnancy outcomes were examined using bivariate and multivariate analysis. The final analysis included 113 patients; selenium deficiency was recorded in 23 (20.4%) patients. Women with selenium deficiency had an approximately eight-fold higher risk of preterm delivery (adjusted odds ratio 7.61, 95% confidence interval 4.37-18.89; P=0.031) and of delivering a term neonate with a low delivery weight (adjusted odds ratio 8.11, 95% confidence interval 3.27-17.22; P=0.012), compared with women with a normal selenium concentration. The prevalence of selenium deficiency among pregnant women with HIV in Lagos was relatively high. The significant associations observed between maternal selenium deficiency and adverse pregnancy outcomes could have implications for the future management of HIV in pregnancy.

EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FEACAL CARRIAGE RATES OF RESISTANT ISOLATES OF ESCHERICHIA COLI IN HIV-INFECTED ADULT PATIENTS IN LAGOS.

The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with human immunodeficiency virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public health concern, globally. This study investigated the effect of daily TMP-SMX prophylaxis on feacal carriage rates of resistant isolates of Escherichia coli in HIV-infected adult patients in Lagos. A total of 550 HIV-infected patients with CD4-cell counts of less than 350 cells/mm3 who were eligible for TMP-SMX prophylaxis and attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited for this study. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity. There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significance in association with TMP-SMX resistance (p<0.0001). The Escherichia coli isolates showed a progressive increase in resistance to the tested antibiotics over the 12-month period. The resistance was in the following order: Ampicillin (74% to 82.6% in the first 3 months; 98.3% by the 6th month and 99.4% by the 9th month; all isolates were resistant by the 12th month), Augmentin (32.5% to 47.7% in first 3 months; 76.1% by the 6th month; 86.3% by the 9th month; all isolates were resistant by 12 months), Ceftriaxone (2.0% to 10.8% in first 3 months; 20.6% by the 6th month; 24.2% by the 9th month; 54.3% by the 12 months). The carriage rate of feacal E. coli resistant to TMP-SMX is common before TMP-SMX prophylaxis. Initiation of TMP-SMX leads to further increase in resistance to TMP-SMX and cross-resistance to other antimicrobials.

EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FEACAL CARRIAGE RATES OF RESISTANT ISOLATES OF Escherichia Coli IN HIV-INFECTED ADULT PATIENTS IN LAGOS

Background:The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with human immunodeficiency virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public health concern, globally. This study investigated the effect of daily TMP-SMX prophylaxis on feacal carriage rates of resistant isolates of Escherichia coli in HIV-infected adult patients in Lagos.Methods:A total of 550 HIV-infected patients with CD4-cell counts of less than 350 cells/mm3 who were eligible for TMP-SMX prophylaxis and attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited for this study. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity.Results:There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significance in association with TMP-SMX resistance (p<0.0001). The Escherichia coli isolates showed a progressive increase in resistance to the tested antibiotics over the 12-month period. The resistance was in the following order: Ampicillin (74% to 82.6% in the first 3 months; 98.3% by the 6th month and 99.4% by the 9th month; all isolates were resistant by the 12th month), Augmentin (32.5% to 47.7% in first 3 months; 76.1% by the 6th month; 86.3% by the 9th month; all isolates were resistant by 12 months), Ceftriaxone (2.0% to 10.8% in first 3 months; 20.6% by the 6th month; 24.2% by the 9th month; 54.3% by the 12 months).Conclusions:The carriage rate of feacal E. coli resistant to TMP-SMX is common before TMP-SMX prophylaxis. Initiation of TMP-SMX leads to further increase in resistance to TMP-SMX and cross-resistance to other antimicrobials.

EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FAECAL CARRIAGE RATES OF RESISTANT ISOLATES OF ESCHERICHIA COLI IN HIV-INFECTED ADULT PATIENTS IN LAGOS.

Background:The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with Human Immunodeficiency Virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public concern globally. This study investigated the effect of daily TMP-SMX prophylaxis on faecal carriage rates of resistant isolates of Escherichia coli in HIV-infected adult patients in Lagos.Methods:A total of 550 HIV-infected patients with CD4-cell count of less than 350 cell/mm3 and were eligible for TMP-SMX prophylaxis attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity.Results:There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significant association with TMP-SMX resistance (p<0.0001). The Escherichia coli isolates showed a progressive increase in resistance to the tested antibiotics over the 12-month period. The resistance was in the following order: Ampicillin (74% to 82.6% in the first 3 months; 98.3% by the 6th month and 99.4% by the 9th month; all isolates were resistant by the 12th month). Augmentin (32.5% to 47.7% in first 3 months; 76.1% by the 6th month; 86.3% by the 9th month; all isolates were resistant by 12 months). Ceftriaxone (2.0% to 10.8% in first 3 months; 20.6% by the 6th month; 24.2% by the 9th month; 54.3% by the 12 months).Conclusion:The carriage rate of faecal E. coli resistant to TMP-SMX is common before TMP-SMX prophylaxis. Initiation of TMP-SMX leads to further increase in resistance to TMP-SMX and cross-resistance to other antimicrobials.

Prevalence of Hepatitis B Viral Markers among Suspected Liver Disease Patients Attending Lagos University Teaching Hospital, Nigeria

Prevalence of Hepatitis B Viral Markers among Suspected Liver Disease Patients Attending Lagos University Teaching Hospital, Nigeria

Efficacy of medical therapy in patients with trigeminal neuralgia attending Lagos University Teaching Hospital, Lagos, Nigeria

Background: Trigeminal neuralgia is characterized by brief episodes of sharp, shock-like, unilateral pain in the area of distribution of the Trigeminal nerve. Objective: This study seeks to assess the efficacy of medical treatment of patients suffering from Trigeminal neuralgia. Methods: A preliminary descriptive study of patients with Trigeminal neuralgia attending the Oral Medicine clinic of a tertiary institution in western Africa, using information from their case notes. Results: A total of 16 patients with Trigeminal neuralgia were assessed. 9 (56.3%) were females, 7 (43.8%) were males with age range of 29-80 years. All the patients presented with sharp, shock-like pain with sudden onset. With the institution of medical therapy, there was reduction of pain in 85% of patients within 6 months of therapy, while 4 (30.8%) were completely pain free after institution of therapy. Recurrence of the condition occurred in 8 cases, with 2 of the patients presenting with periods of complete remission of pain for a period of 3-4 months before recurrence. None of the patients have had the option of surgical intervention as an alternative to medical treatment since the response to medical treatment was good in majority of cases. Conclusion: There is no definite cure for this condition, therefore the ability to control pain to improve the quality of life of patients is of importance. Medical therapy (either monotherapy or multi-drug therapy) has been shown to be an effective treatment modality in managing this debilitating condition. Keywords: Trigeminal neuralgia, pain, medical therapy

Relationship of Oral Lesions and CD4 Count in Female HIV Patients in South Western Nigeria

ABSTRACT Background: Oral lesions have been reported to be early clinical features of HIV infection. Objective: The purpose of this study was to establish the prevalence of oral lesions in HIV Seropositive female patients and correlate the CD4 count with the appearance of oral lesions in the female patients attending Lagos University Teaching Hospital (LUTH) and University of Benin Teaching Hospital, Benin (UBTH). Methods: A prospective study was undertaken in 172 newly diagnosed adult HIV infected female patients (not on antiretroviral therapy), who attended the PEPFAR clinic at LUTH and the HIV Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria. They were assessed for oral lesions which were evaluated using EEC/WHO (2003) – Classification on the diagnostic criteria for oral lesions in HIV. Data were collected using an interviewer administered questionnaire. Following Oral examination undertaken, oral lesions were detected, recorded and Original Research Article

Compliance To and Knowledge of Anti-Hypertensive Therapy amongst Hypertensive Patients Attending Lagos University Teaching Hospital (Luth), Idi-Araba, Lagos, Nigeria

Abstarct: Good knowledge and compliant to antihypertensive therapy can have a positive effect on high blood pressure control. The objective of this study is to assess compliance to and knowledge of antihypertensive therapy amongst outpatient’s attending the hypertensive clinic of the Lagos University Teaching Hospital, IdiAraba, Lagos. This descriptive cross-sectional study on out-patients attending the hypertension clinic of LUTH, was conducted from the16 th June to 20 th July, 2012. Multistage sampling technique was utilized to select the calculated minimum sample size of 282 (133 males and 149 females). A validated questionnaire by Morisky Green was modified to suite the study, pretested and self administered by two (2) trained medical personnel (nurses). Collected data was entered, cleaned and analyzed using Epi-Info version 2007 statistical software. Up to 252(96.18%) of the hypertensive patients showed good knowledge of anti-hypertensive therapy while only 10(3.82%) had poor knowledge. Majority 196 (74.81%) of the respondents were not compliant to antihypertensive treatment while only 66(25.19%) complied. Poor compliance was found to be mainly due to forgetfulness 188(71.76%) and non-availability of drugs in respondent’s place of domicile 136(51.91%). There was relationship between sex, religion, education and knowledge of respondents to hypertensive therapy. Significant association was found between knowledge of hypertensive therapy and forgetfulness. There was a significant association between forgetfulness and poor compliance 14.8(3.9-54.8). Good knowledge of antihypertensive therapy has not significantly improved compliance to antihypertensive therapy thereby leading to low healthcare outcome. Keyword: Antihypertensive therapy, Compliant, Hypertension, Knowledge.

Predictors of pneumococcal immunization uptake among caregivers of children with sickle cell disease in Lagos, Nigeria

Pulmonary infections are still the most prevalent cause of death of children with sickle cell disease (SCD) in low and middle income countries. Pneumococcal conjugate vaccine (PCV) has been reported to reduce the incidence of pneumococcal disease by up to 90% in children under five. This study set out to report the proportion of children under five attending Lagos University Teaching Hospital (LUTH) and Massey Street Children’s Hospital (MSCH) in Lagos that received PCV and the factors influencing uptake. A cross sectional study assessed the sociodemographic characteristics, knowledge and practices of 380 caregivers of children with SCD and the immunization status of the children. Proportion of children who had received routine immunization was 99.7%. However, 87 children (22.9%) had been immunized with PCV and predictors for immunization were attending LUTH, mothers’ age, knowledge level of PCV and higher monthly income. The study recommends PCV being made part of the national immunization programme. Key words: Lagos, Nigeria, sickle cell disease, pneumococcal conjugate vaccine, immunization uptake.

Extent of breastfeeding among nursing mothers attending Lagos University Teaching Hospital

ObjectiveThe study investigated the extent of breast feeding among nursing mothers whose infants or children were receiving specialist attention in various child care units of Lagos University Teaching Hospital in...

Aetiology of bacteraemia among adult AIDS patients attending Lagos University Teaching Hospital (LUTH), Lagos, Nigeria

Bacteraemia is a relatively common event in HIV-infected patients, especially in late infection. Studies in Africa have shown that more than 23% of AIDS patients have bacteraemia but there is paucity of data from Nigeria. Blood samples from 67 consecutive patients with AIDS attending the Lagos University Teaching Hospital between April and August 2000 were cultured. Temperature, ESR, Full blood count, and where possible CD4 counts were obtained. Socio-demographic details were also recorded. Thirty apparently healthy people were randomly selected from a low-risk population to act as non-AIDS controls. The Oxoid Signal Blood Culture System was used to investigate bacteraemia. Antibiotic sensitivity tests were carried out on all isolates. Twenty-two (33%) of the 67 AIDS patients were culture positive. Non-typhoidal Salmonella spp (45.5%), coagulase-negative staphylococci (22.7%) and Staphylococcus aureus (18.2%) were most commonly isolated. One isolate each of Klebsiella pneumoniae, Pseudomonas aeruginosa and Bacillus spp were identified. All bacteraemic patients had temperatures above 38 degrees C and white blood cell counts ranged between 2,700-13,500/mm(3). There was a high rate of antibiotic resistance particularly to chloramphenicol, tetracyclines, cotrimoxazole and beta-lactam antibiotics. However, most isolates were still susceptible to gentamicin and the fluoroquinolones. There was no significant difference in the socio-demographics of the bacteraemic AIDS and non-bacteraemic AIDS patients. Salmonella spp. were the most common aetiological agent of bacteraemia among AIDS patients seen at the Lagos University Teaching Hospital (LUTH), Nigeria. A high temperature was a pointer to the presence of bactaeraemia while total white blood cell counts were not useful. It is recommended that blood culture should be done for AIDS patients with elevated temperature irrespective of the total white blood cell count.