Objective: To determine the sero-prevalence and risk factors for Hepatitis B surface antigen (HBsAg) in sickle cell anaemia (SCA) patients in Nigeria Design: Descriptive study method. Sera were screened for HBsAg, using the enzyme linked immune­ absorbent assay (ELISA) kits. Personal information and risk factors associated with HBsAg were obtained, using a questionnaire. Setting: The Adult Haematology clinic, of the University of Benin Teaching Hospital, Benin City, Nigeria. Subjects: One hundred and fifteen HbSS patients aged 11-40 years .. Results: The sero-prevalence of HBsAg was 20% in HbSS patients.The associated risk factors included socio-economic status class land 8, odds ratio 3.18,95% confidence interval (1.57-5.09) p < O.OOOI and the age group 11-20years, odd s ratio 2.34 ,confidence interval (2.06-2.09) p < O.OOI. Conclusion: The high prevalence of HBsAg in SCA, increases the likelihood of an increase in morbidity and mortality.lnorder to curtail the morbidity and mortality, associated with HBsAg, routine screening for HBsAg and health education based on the epidemiology of HBsAg, is advocated.

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Introduction: The HIV!AIDS pandemic has posed a formidable health problem especially in sub­ Sahara Africa. In Nigeria, AIDS orphans is on the increase and as December 2003, Nigeria had about I million AIDS orphans. The death of parents living with HIVIAIDS and the changing socio-economic outlook may affect the number of AIDS orphans and their care. This study was undertaken to assess the socio-demographic characteristics of HIVIAIDS orphans seen in the University of Benin Teaching Hospital (UBTH). Patients and Methods: Consecutive children who have lost at least one parent to HIVIAIDS, and to the Child Health facilities of the UBT H, between I 996 - December 2003 were enrolled for the study. The bio data of the child and parents were obtained. Some socio-demographic parameters were determined. The HIV status of the child and parents, surviving or deceased was ascertained. Results: Of the 102 HIV patients seen in the period under review, 14(13.7%) were AIDS orphans. Their ages ranged from 2 to I 02 months with a mean of 49 ΁ 35.4 months. Majority of the orphans were five. Most had stopped schooling and childhood vaccination because of illness. The present caregivers of the orphans were relations in 50% of cases and in the other half, surviving parents. Most, (78.6%) of the children died either in hospital or on follow-up. T wo are alive and on anti-retroviral . Conclusion: The percentage of HIV patients that are orphans in this study is significant. The in the orphans had deprived them of early childhood education and immunization. Breastfeeding of all the orphans may have compounded the seemingly high mother to child HIV transmission. There is an urgent need for the government and NGOs to attend to rising AIDS orphan \!,roblems in Nigeria.

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Background: Infection with the human immunodeficiency virus is the most potent known risk factor for tuberculosis (TB). In sub-Saharan Africa, where an estimated one third of the population has latent Mycobacterium tuberculosis infection, the HIV pandemic is driving the incidence of TB to unprecedented heights and there is no reported data from this part of Nigeria. Objective: To determine the prevalence of HIV infection among tuberculosis patients. Methods: All patients aged 15 years and above with TB and confirmed HIV infection seen at the Medical outpatients' clinic and those admitted to the infectious diseases and medical Wards from 1st January 2002 to ^st December 2002 were included in the study. Results: In all, 55 patients were offered TB-related care in the hospital during the study period. Out of this, 37 (67.3%) were males while 18 (32.7%) were females. Their ages ranged between 15 and 73 years with a mean of 35.6 ΁ 12.4 years. The overall HIV prevalence was 23.6%. Patients in the range of 25-44 years were more vulnerable to both HIV and TB as this age range accounted for the highest number of HIV seropositive and TB cases.Most of the patients were housewives (32.7%) followed closely by farmers (30.9%) then traders (25.5%). All those positive for HIV antibodies admitted to have had unprotected sex with multiple sexual partners. None was a homosexual or IV drug abuser. Conclusion: The prevalence of HIV infection among patients with tuberculosis is high in this part of Nigeria and the most active and productive age groups as well as people in the lower socioeconomic stratum most affected.

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Aims and Objective: Bronchospasm is rarely seen in children less than two years of age unless they are genetically predisposed to allergy and atopy. Hyperreactive airway presenting with bronchospasm in such children is commonly misdiagnosed and managed as chest infections. This study therefore aims at examining the trigger factors of bronchospasm in these children. Setting/Method: The study was carried out in two private medical·centres in florin between June 2002 and May 2003. All children below the age of 2 years presenting with cough and breathlessness of sudden onset with audible wheeze were screened historically for the trigger factors of bronchospasm in their environment. Result: Nine hundred and twenty eight patients were recruited for the study over the one year period. The mean age of the children was 5.4 ΁ 1.3 months (range: 3 weeks to 24 months). There are two peaks of seasons during which the condition is common (July to September, and January to March). There is a male preponderance with a M : F ratio of 1.3:1. The presenting symptoms were cough (100%), breathlessness (100%), expiratory wheeze (97%), restlessness (65%), sleeplessness (63%), excessive sweating (57%), excessive crying (45%), family history of asthma / allergy / atopy (42%), inability to eat / suck (33%), running nose (31%), abdominal pain in the older infant (27%), vomiting (13%),and exhaustion (7%). The observed clinical signs are: tachypnoea (100%), recessions (100%), rhonchi (100%), dehydration (27%), cyanosis (5%), and hepatomegaly (3%) identified trigger factors include: insecticide spray in 36%, fumes from frying oil in 12%, smoke from kerosene stove in 10%, firewood smoke in 8%, dust in 9%, exposure to cold air and fan in 9%, perfume spray in 8%, mosquito coil smoke in 3%, and kerosene aspiration in 1%. All the children responded well to nebulised salbutamol, while only 7% required the addition of steroid and other supportive care where necessary. Conclusion: Identified household trigger factors of bronchospasm in children less than two years of age include: insecticide spray, fumes, smoke from stove and firewood, and exposure to cold air. The elimination of these factors from the environment of the affected child would go a long way in preventing the attacks.

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Aims and Objectives: Reference values are essential for the interpretation of data in clinical practice and research studies. The aim of this study was to establish reference ranges for CD4lymphocytes in healthy HIV-negative Nigerians. Methodology: 200 healthy Human Immunodeficiency Virus (HIV) antibody free individuals constituted the subjects for this study. 150 HIV-infected without AIDS-defining illness and 150 HIV-infected with AIDS-defining illness were included as controls. Results: Participants were aged 18-63years (mean age 34΁ 9.2years). the CD4 lymphocyte cou nt of healthy Nigerians mean΁ S D 685 ΁ 99, 95% CI 487- 883 was twice that of HIV-infected subjects without AIDS -defining illness (314 ΁ 45, 95% CI 224- 404). The CD4lymphocyte count of HIV-infected with AIDS-defining illness was one fourth or less (148 ΁ 30, 95% C/88 - 208). The mean AIDS-defining CD4lymphocyte count was (148 ΁ 30cells!ul). women had significantly higher mean absolute CD4 lymphocyte count (729 ΁ 87, 95% CI 555 to 903) compared to men ( 647 ΁ 93, 95% C/460 to 833) (p< 0.001). Age was found negatively correlated with CD4 lymphocyte count in healthy Nigerians (r = -.01, p< 0.05). the absolute CD4lymphocyte count and ranges of healthy H IV-negative Nigerians was significantly lower than those of Dutch and Ethiopian controls (p<0.05). Conclusion: Caucasian CD4 lymphocyte reference values are not applicable to Nigerians, as it does not reflect the Nigerian CD4 lymphocyte population. (Key words: CD4 lymphocyte count, Reference ranges, Port Harcourt, Nigerians).

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Background: Exclusive breastfeeding, an essential intervention for the reduction of infant mortality, is not widely practised. A major reason is the issue of thirst, especially in the hot regions of the world. Objective: To describe the pattern of specific gravity of breastfeeding infants aged 0-6 months as a measure of their hydration status, and thereby determine the need, or otherwise, of supplemental water in the first six months of life in Zaria, in the Guinea Savannah region of Nigeria. Design: Cross-sectional and hospital based. Patients and participants: Well babies, aged 0-6 months and being breastfed, attending the well baby clinic and immunization clinic of Ahmadu Bello U niversity Teaching Hospital between March and September, 1998. Method : A structured questionnaire and urine specific gravity measurements with a refractometer were used to compare data between exclusively and predominantly breastfed infants. Results: Urine specific gravity measurements were comparable in both exclusively breastfed and water-supplemented infants. Conclusion: Water supplementation in the first six months of life is not essential. Exclusive breastfeeding, therefore, should be actively encouraged.

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