Department of Medicine

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    PREVALENCE OF UNDIAGNOSED POST TRAUMATIC STRESS DISORDER AMONG IN-PATIENTS IN A SUBSTANCE USE DISORDER TREATMENT CENTRE IN NIGERIA
    (JOURNAL OF BIOMEDICAL RESEARCH & CLINICAL PRACTICE, 2018-04-23) Makput, D.M.; Dami, N.; Piwuna, C.G.; Haa, T.N.; Maton, C.
    Post traumatic stress disorder is a clinical disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. It occurs commonly as a co-morbid diagnosis with substance related disorders, as well as other psychiatric disorders. We postulated that post traumatic stress disorder may be under- diagnosed in therapeutic wards where substance use disorders are treated. This study thus sought to determine the prevalence of undiagnosed post-traumatic stress disorder in a substance use disorder in-patient population. The posttraumatic stress disorder check list, Civilian version was administered to patients on admission at the Center for addiction treatment and research, Vom, Plateau state, Nigeria in June 2017. Sociodemographic data and information regarding substance use were also obtained from the patients. A total of 38 inpatients were analyzed and 8 (21%) met the Diagnostic and statistical manual of mental disorders (fourth edition) criteria for current post traumatic stress disorder. None of the patients had a diagnosis of post-traumatic stress disorder in their case notes prior to the post-traumatic stress disorder check list administration in this study. Post traumatic stress disorder which is frequently co-morbid with substance abuse remains undiagnosed in many patients admitted to our therapeutic center.
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    A Comparison of Iron and Folate with Folate Alone in Hematologic Recovery of Children Treated for Acute Malaria
    (The American Society of Tropical Medicine and Hygiene, 2010) Samuel N. Gara; Aboi J. K. Madaki; Tom D. Thacher
    Concern has been raised that iron supplementation for treatment of acute malaria may worsen the severity of malaria. We compared the effect of iron and folate with folate alone on hematologic recovery in children treated for acute malaria. We randomized 82 children 6-60 months of age from Nigeria with smear-positive malaria and anemia (hematocrit < 33%) to receive iron (2 mg/kg/day) plus folate (5 mg/day) or folate alone in addition to antimalarial drugs. The mean ± SD hematocrit at baseline was 28.5% ± 2.9%. At four weeks, the mean hematocrit increased by 2.5% ± 1.6% in the iron plus folate group and by 1.4% ± 1.0% in the folate alone group (P = 0.001). Baseline hematocrit, iron supplementation, weight for height, and weekly meat intake were significant predictors of final hematocrit. The effect of iron was not significantly modified by baseline hematocrit, weekly meat intake, nutritional status, mother's education, sex, or age of the child. Iron supplementation improved hematologic recovery in children with malarial anemia.
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    Mortality among pulmonary tuberculosis and HIV-1 co-infected Nigerian children being treated for pulmonary tuberculosis and on antiretroviral therapy: a retrospective cohort study
    (Original article, 2016-12) Augustine O. Ebonyi; Stephen Oguche; Oche O. Agbaji; Atiene S. Sagay; Prosper I; Okonkwo; John A. Idoko; Phyllis J. Kanki
    Mortality data, including the risk factors for mortality in HIV-infected children with pulmonary TB (PTB) being treated for PTB and who are on antiretroviral therapy (ART), are scarce in Nigeria. We determined the mortality rate and risk factors for mortality among such children, at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Jos, Nigeria. Methods We performed a retrospective cohort study on 260 PTB-HIV-1 co-infected children, aged 2 months to 13 years, being treated for PTB and on ART from July 2005 to March 2013. The mortality rate and associated risk factors were determined using multivariate Cox proportional hazards modelling. Results The mortality rate for the study cohort was 1.4 per 100 child-years of follow-up. Median follow-up time was 5.2 years (IQR, 3.5-6.0 years) with total study time being 1159 child-years. The median age of those who died was lower than that of survivors, 1.9 years (IQR, 0.6-3.6 years) versus 3.8 years (IQR, 1.8-6.0 years), p=0.005). The majority of the deaths occurred in males (13, 81.2%), those <5 years of age (14, 87.4%) and those who had severe immunosuppression (11, 68.8%). Risk factors for death were age (with the risk of dying decreasing by 25% for every 1 year increase in age, adjusted hazard ratio (AHR)=0.75 [0.58-0.98], p=0.032), male gender (AHR=3.80 [1.07-13.5], p=0.039) and severe immunosuppression (AHR=3.35 [1.16-9.66], p=0.025). Conclusion In our clinic setting, mortality among our PTB-HIV co-infected children being treated for PTB and on ART was low. However, those presenting with severe immunosuppression and who are males and very young, should be monitored more closely during follow-up in order to further reduce mortality.