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Human immunodeficiency virus-associated nephropathy (HIVAN) has rarely been reported in African children. In this single-center
study, we analyzed ten children diagnosed with HIVAN from January 2000 to October 2006. There were eight boys and two girls,
with a male:female ratio of 4:1. Their ages were from 5 months to 15 years (mean 6.8 ± 6.2 years), with a peak age of 5–9 years.
The presenting complaints included generalized edema (60%) and hypertension (50%). All patients had proteinuria on urine dipstick,
with four (40%) at nephrotic range (proteinuria ≥500 mg/dl). Nine (90%) patients were in renal failure, with elevated serum
creatinine (6.3–24 mg/dl) and serum urea (70–120 mg/dl). Renal disease was the first manifestation of HIV infection in six
patients, whereas the diagnosis was made on autopsy in three. The duration from HIV infection to development of HIVAN ranged
from 5 months to 10 years. CD4+ cell count, done in only three patients due to financial constraints, was below 200/mm3. The kidneys were hyperechoic on abdominal ultrasound in all patients, and three (30%) showed grossly enlarged kidneys. Histology
of renal tissues available by autopsy in three patients showed mainly collapsing focal segmental glomerulosclerosis. Treatments
given were angiotensin-converting enzyme (ACE) inhibitors and highly active antiretroviral therapy (HAART) in four and two
patients, respectively, and one patient underwent peritoneal dialysis. On outcome analysis, seven (70%) patients died, two
were lost to follow-up, and one was alive on HAART therapy at the writing of this article. In conclusion, HIVAN occurs in
Nigeria children, and the mortality is very high from uremia. 相似文献
93.
Congenital dermal sinus tracts most commonly involve the midline and may communicate with the central nervous system. We present a 3-year-old girl with a pit in the upper lateral buttock noted since birth. Surgical exploration revealed a firm tract that dissipated in the gluteal fascia, and ultrasound confirmed the absence of any deeper extension. Microscopic examination revealed a sinus tract lined by dermal appendages and surrounded by an exuberant inflammatory reaction to hair. This location is distinctly unusual, and our report expands the clinical spectrum of congenital dermal sinus tracts and raises awareness that lesions prone to having a connection with the central nervous system may present quite laterally. Furthermore, this case provides insight into the pathogenesis of a disease that is often explained as a “defect of midline closure” and also illustrates an unusual setting for so-called “pilonidal disease.” 相似文献
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Lett Elle Asabor Emmanuella Ngozi Tran Nguyen Dowshen Nadia Aysola Jaya Gordon Allegra R. Agénor Madina 《AIDS and behavior》2022,26(11):3713-3725
AIDS and Behavior - HIV prevalence and engagement in sexual behaviors associated with HIV transmission are high among transgender people of color. Per intersectionality, this disproportionate... 相似文献
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Ifeyinwa Chizoba Akamike Ijeoma Nkem Okedo-Alex Chigozie Jesse Uneke Henry Chukwuemeka Uro-Chukwu Onyedikachi Echefu Chukwu Ngozi Immaculata Ugwu Urudinachi Nnenne Agbo Abel Ebeh Ezeoha 《African health sciences》2020,20(3):1080
BackgroundThe aim of this study was to appraise the implementation of the National HIV guidelines and determine the effect of an educational intervention on health worker knowledge and practice of the guidelines.MethodsA before and after study design without control was carried out using a self-administered questionnaire and key informant interviews. Data was also collected from client record cards. An educational intervention was carried out using pamphlets containing summarized information on the guideline. Data analysis was carried out using IBM-SPSS version 20.ResultResults showed that 54.5% of the respondents were males and 76% were medical doctors. Baseline knowledge level of respondents was high with 97% of respondents having good knowledge with a mean score of 3.9. This increased to 4.1 out of 5 post-intervention. All respondents had good practice of the guidelines before and after intervention with a mean score of 4.5 out of 5. Client records also showed good practice. Barriers to guideline implementation include: poor knowledge, inadequate training, guideline unavailability, poor functioning of the laboratory equipment, poor funding.ConclusionHIV guidelines are being implemented in the clinic to a large extent; however, trainings, funding and provision of the guideline in the clinics are recommended. 相似文献
100.
We report 2 cases of rat-bite fever (RBF), a multisystem zoonosis, in children and review the literature. RBF is caused by I of 2 Gram-negative organisms: Streptobacillus moniliformis or, less commonly, Spirillum minus. Both of our cases developed in school-aged girls with a history of rat exposure who presented with a multisystem illness consisting of fever, petechial and purpuric rash, arthralgia and polyarthritis. Both responded promptly to antibiotic treatment. An additional 10 cases from a MEDLINE review (1960-2000) are reviewed. RBF must be included in the differential diagnosis of febrile patients with rashes and a history of exposure to rats. 相似文献