Olukemi Omowumi Ige

The objective of this article was to compare the left ventricular (LV) systolic function of human immunodeficiency virus (HIV)-infected children with that of healthy controls, determine the prevalence of LV systolic dysfunction in HIV-infected children, and its association with age, stage of disease, and use of zidovudine. This was a comparative cross-sectional descriptive study. A University Teaching Hospital in North-Central Nigeria in 2008. One hundred fifty HIV-infected children aged 6 weeks-14 years, and an equal number of age- and sex-matched apparently healthy controls. Left ventricular internal dimensions in diastole and systole, LV fractional shortening (FS) and ejection fraction (EF). Left ventricular systolic dysfunction was considered present when FS was <28% or EF was <50%. Mean LV internal dimensions in diastole was similar in subjects and controls (P= .26). Left ventricular internal dimensions in systole was significantly larger in subjects (2.7 cm, 95% confidence interval [CI] 2.6-2.8 cm) than controls (2.4 cm, 95% CI 2.3-2.5 cm) (P < .001). Mean FS of 27.8% (26.8-28.8%) in subjects was significantly reduced compared with 33.7% (33.1-34.3%) in controls (P < .001), as was EF 61.5% (60.7-62.3%) in subjects and 70.5% (69.7-71.3%) in controls (P < .001). Left ventricular systolic dysfunction was detected in 75 (50.0%, 95% CI 41.7-58.3%) subjects and 5 (3.3%, 95% CI 2.2-6.7) controls (P < .001). Subjects with left ventricular systolic dysfunction were significantly older than those without (P < .001) but did not differ significantly from them with respect to zidovudine therapy or stage of disease. Left ventricular systolic dysfunction is significantly more frequent in HIV-infected children compared with controls. Left ventricular systolic function in HIV-infected children deteriorates with increasing age and should be serially evaluated in them.

Worldwide 15.5% of neonates are born with low birth weight, 95.6% of them in the developing countries. Prematurity accounts for 10% of neonatal mortality globally. The purpose of this study was to evaluate the effects of birth weight and gender on neonatal outcome. The data of 278 neonates managed in the Special Care Baby Unit (SCBU) of Jos University Teaching Hospital (JUTH) over a 2 year period from July 2006 to June 2008 were analyzed.One hundred and fifty nine (57.2%) were males and 119(42.8%) females. There were 87(31.3%) preterm and 191 (68.7%) term babies. Twelve of the babies died. Seven (2.52%) and 5 (1.80%) being males and females respectively. The neonatal mortality rate by gender was not significant (p > 0.05). The neonatal mortality was 25.2 deaths per 1000 live births for boys and 18.0 for girls. The mean birth weights of the preterm and term babies were 1.88 ± 0.47 kg and 3.02 ± 0.50 kg respectively, with a mean gestational age of 30.62 ± 3.65 weeks and 38.29 ± 0.99 weeks respectively.Eighty seven (31.3%) of the babies were of low birth weight, 188(67.6%) were of normal birth weight and 3(1.1%) high birth weight. Of the low birth weight babies, 6(2.2%) were term small for gestational age. Six (2.2%) of the preterm infants had normal birth weight.Eleven of the babies that died were preterm low birth weight. The overall mortality rate was 4.32%. The birth weight specific mortality rate was 126 per 1000 for the preterm low birth weight and 5 per 1000 for the term babies. Birth weight unlike gender is a significant predictor of mortality, mortality being higher in neonates of <2.5 kg (OR = 0.04; 95% Cl 0.005-0.310, p = 0.002) (p = 0.453). Seven (58.3%) and 4(33.3%) of the pre-terms that died were appropriate and large for gestational age respectively. Gestational age is not a significant predictor of neonatal mortality (p = 0.595). Babies delivered at less than 37 weeks of gestation recorded a higher rate of mortality than those of 37 weeks and above (p = 0.000).The subjects showed one or more major clinical indications for admission. The major clinical indications for the preterm and term babies were respectively as follows: neonatal sepsis 63(22.7%) and 124(44.6%); neonatal jaundice 32(11.1%) and 71(24.7%); malaria 9(3.1%) and 13(4.5%); birth asphyxia 3(1.0%) and 7(2.4%). Neonatal sepsis was a common denominator among the babies that died. Birth weight unlike gender is a significant predictor of neonatal outcome.