Browsing by Author "Osinusi, K."

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Baseline chest radiograhic features among antiretroviral therapy naïve human immuno-deficiency virus positive children in a pediatric care program
(2012-01-12) Atalabi, O. M; Oladokun, R.; Adedokun, B,; Obajimi, M. O.; Osinusi, K.
Background: Pulmonary diseases are commonly seen in children with HIV infection, and their etiology is often unclear. The radiological appearances of these conditions are often non-specific. Conventional radiographs play an important role in the management of chest conditions especially in resource poor settings. Objective: This retrospective study was carried out to determine the chest radiographic pattern in children with HIV infection. Materials and Methods: The baseline chest X-ray of 150 HIV-positive but antiretroviral drug naïve children were analyzed between July 2008 and December 2009 at the University College Hospital in Ibadan, south-west Nigeria. All children were screened for tuberculosis (TB) by one or combination of mantoux, acid-fast Bacilli (AFB) sputum, and erythrocyte sedimentation rate. The CD4 count was also taken as part of baseline laboratory test. Chi-squared test was used to determine association between the pattern of chest X-ray findings, and sex, age, and CD4 counts. Results: The mean age of the study group was 51.6 months, with children older than 5 years dominating and there was no statistical difference in the sex distribution. A total of 115 children (76.7%) had abnormal chest X-ray, with lymphadenopathy accounting for 45.3% followed by parenchymal lesions with 37.3%, miliary shadows, and cavities accounted for 6.7% and 2.6%, respectively. Cavities were found to be common in patient who tested positive to AFB than AFB-negative patients. Other findings like reticulonodular or diffuse patterns, lymphadenopathy, pleural effusion, or soft tissue swelling were also commoner in the AFB-positive patients. The CD4 count was available for 42% of the patient and there was no significant association between the chest radiographic changes and the CD4 count. Conclusion: Definitive diagnosis of pulmonary disease might be difficult based on chest X-ray alone, however, chest X-ray is a basic radiological test and almost the easiest to perform in both resource poor or rich setting and it is still recommended that routine chest X-ray should remain part of investigation of HIV-positive children to serve as adjunct to other investigations in early detection of TB.
Bilateral orbital rhabdomyosarcoma mimicking burkitt's lymphoma
(1998) Falade, A. G.; Osinusi, K.; Baiyeroju-Agbeja, A. M.; Ogunbiyi, J. o.; Owoeye, J. F. A.; Thomas, J
Bilaterial orbital rhabdomyosarcoma mimicking Burkitt's lymphoma in an 11-year old girl is reported. The patient presented with bilateral proptosis and right cervical lymphadenopathy. Despite consultations at a number of hospitals, a definitive diagnosis was not made until presentation at the University College Hospital, Ibadan, where cytological examination of a fine needle aspiration biopsy specimen of the tumour and the lymph node revealed. changes that were consistent with those seen in rhabdomyosarcoma. This case emphasises the fact that rhabdomyosarcoma is an important differential diagnosis of orbital tumours in childhood, especially in Burkitt's lymphoma endemic areas.
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.
Mycobacterium tuberculosis and mycobacterium africanum in stools from children attending an immunization clinic in Ibadan, Nigeria
(Elsevier Ltd, 2009) Cadmus, S. I. B.; Jenkins, A. O.; Godfroid, J.; Osinusi, K.; Adewole, I. F.; Murphy, R. L.; Taiwo, B. O.
"BACKGROUND:Tuberculosis is a major cause of childhood morbidity and mortality in Nigeria. Diagnosis of childhood tuberculosis is a global challenge making early treatment a mirage. In this study we investigated the stools of children for the presence of mycobacteria. METHODS:Stool samples from children aged 3 days to 3 years who presented for postnatal immunization at a large university-based clinic in Nigeria, were subjected to Ziehl-Neelsen staining. Samples with acid-fast bacilli were further processed using mycobacterial culture, spoligotyping, and deletion typing. RESULTS:One hundred and ninety-two stool samples from different children were collected and processed. Thirty (15.6%) had acid-fast bacilli. Of these, eight had Mycobacterium tuberculosis and one had Mycobacterium africanum. CONCLUSIONS:Approximately 5% (9/192) of apparently well children had evidence of potentially serious tuberculosis infection. The usefulness of stool specimens for diagnosing pediatric tuberculosis warrants further investigation."
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.