Browsing by Author "Brown, B. J."

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Clinical and immunological profile of pediatric HIV infection in Ibadan, Nigeria
(SAGE, 2011) Brown, B. J.; Oladokun, R. E.; Odaibo, G. N.; Olaleye, D. O.; Osinusi, K.; Kanki, P.
In spite of the increasing number of children living with HIV in Nigeria, published data on their clinical profile are few. We describe the clinical profile at presentation of HIV-infected children at the University College Hospital, Ibadan, in a prospective study. Among 272 children studied (149 [54.8%] males; mean age 4.2 years [range 2 months to 15 years]), infection was acquired through vertical transmission in 252 (92.6%), blood transfusion in 5 (1.80%), and undetermined routes in 15 (5.5%) cases. Clinical features included weight loss (62.5%), prolonged fever (55.4%), generalized lymphadenopathy (48.6%), chronic cough (45.4%), and persistent diarrhea (28.3%). Tuberculosis was present in 45.3%, World Health Organization (WHO) clinical stages 3 and 4 disease in 70.6% and severe immunosuppression in 44.5% of cases. Pediatric HIV in Ibadan is acquired mainly vertically and most cases present with severe disease. Improved access to prevention services and early diagnosis are recommended.
Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) in Ibadan, Southwest Nigeria
(Scientific Research, 2014) Ogunbosi, B. O.; Oladokun, R. E.; Awolude, O.; Brown, B. J.; Adeshina, O. A.; Kuti, M.; Taiwo, B.; Berzins, B.; Kyriacou, D. N.; Chadwick, E. G.; Osinusi, K.; Adewole, I. F.; Murphy, R. L.
Background: Nigeria has the largest paediatric HIV-infected population in the world. Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric HIV infections. Methods: Six hundred children, aged < 15 years, presenting to the pediatric units of the University College Hospital (UCH), Ibadan Southwest Nigeria between June to December 2007 were studied. The demographics, HIV status and socioeconomic status of mothers and their children were studied. A 4-step hierarchy was used to assess the missed opportunities for PMTCT. Step 1: utilization of a health facility for antenatal care and delivery; Step 2: maternal HIV status determination during pregnancy; Step 3: provision of antiretroviral medication to HIV-infected mother and baby; and Step 4: avoidance of mixed feeding in HIV-exposed children. The rates of missed opportunities for PMTCT services at different steps in the PMTCT cascade, perinatal transmission rates, and associated factors were reported. Results: There were 599 mothers and 600 children (one set of twins), 60 (10%) were HIV infected and 56 (93.3%) of these were adjudged perinatally infected. Of 78 HIV-infected women, 7 (9.0%) accessed all interventions in the PMTCT cascade and 71 (91.0%) had missed opportunities for PMTCT. Missed opportunities for PMTCT occurred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mother-baby pairs who accessed complete PMTCT interventions received care at a teaching hospital. Among infants with perinatal HIV infection, 53 (94.6%) were born to mothers who had missed opportunities for PMTCT. Most women with missed opportunities attended antenatal care outside the teaching hospital setting and belonged to low socioeconomic status. Conclusion: It is imperative to expand PMTCT access to women who receive antenatal care outside the teaching hospitals and to those of low socioeconomic status.
Service uptake and performance of the prevention of mother-to-child transmission (PMTCT) programme in Ibadan, Nigeria
(2010) Oladokun, R. E.; Awolude, O. A.; Brown, B. J.; Adesina, O. A.; Oladokun, A.; Roberts, A.; Odaibo, G. N.; Osinusi, K.; Olaleye, D. O.; Adewole, I. F.; Kanki, P.
Service uptake and performance of the prevention of mother-to-child transmission (PMTCT) programme in Ibadan, Nigeria
(2010) Oladokun, R. E.; Awolude, O.; Brown, B. J.; Adesina, O.; Oladokun, A.; Roberts, A.; Odaibo, G.; Osinusi, K.; Olaleye, D.; Adewole, I. F.; Kanki, P.
The Prevention of Mother to Child Transmission (PMTCT) programme in the University College Hospital (UCH), Ibadan has been in existence for more than five years and has scaled up to other sites. The study evaluated the service uptake and performance of the programme using national key indicators. Antenatal and delivery records of women enrolled between July 2002 and June 2007 were reviewed. A total of 51952 women attended first antenatal visits and received HIV pre-test counselling. Of these, 51614 (99.5%) accepted HIV test and 49134 (95.2%) returned for their results. Out of the tested patients, 2152 (4.2%) were identified to be HIV positive. Partners of positive patients accepting HIV testing were 361 (16.7%) with 87 (18.6%) testing positive. There were a total of 942 deliveries out of which 39.2% of the mothers and 95.2% of the babies respectively received ARV prophylaxis. In all, 85.8% (788/918) of the mothers opted for formula as the method of infant feeding. Out of the 303 babies eligible for ELISA testing, 68.3% reported for the test and 17 (8.7%) tested positive. There has been progress in the programme, reflected in the increase in the number of new clients accessing the PMTCT service. However, partner testing and follow up of mother-infant pairs remain formidable challenges that deserve special attention.