RESUMEN

BACKGROUND: Even though tuberculosis is a common disease among children in developing countries, tuberculous dactylitis is an uncommon form of Skeletal tuberculosis specially with involvement of both the hands and feet. CASE PRESENTATION: A one-and-a-half-year-old previously healthy female Ethiopian toddler presented to our pediatric outpatient clinic with a history of two-month duration of painful multiple swellings over both her hands and feet. The swelling involved the proximal phalanx of the left index finger, dorsum of the right hand, and dorsum of both feet over the first metatarsal bone. Physical examination, radiologic findings, and histopathology suggested tuberculous dactylitis. The patient was treated with anti-tuberculosis drugs for one year and she showed clinical and radiologic improvement and recovery. CONCLUSION: Tubercular dactylitis should be considered in the differential diagnosis of children from endemic areas presenting with bone and joint pain or swelling. Our experience of a twelve-month course of antitubercular treatment, which is in line with WHO recommendations, for skeletal tuberculosis, showed excellent outcomes.

Asunto(s)

Antituberculosos , Mano , Tuberculosis Osteoarticular , Humanos , Femenino , Tuberculosis Osteoarticular/tratamiento farmacológico , Tuberculosis Osteoarticular/diagnóstico , Tuberculosis Osteoarticular/diagnóstico por imagen , Antituberculosos/uso terapéutico , Mano/patología , Mano/microbiología , Lactante , Etiopía , Radiografía , Pie/patología , Pie/microbiología , Resultado del Tratamiento

RESUMEN

BACKGROUND: Pneumonia, which is an infection and inflammation of an air-space in the lungs due to an impurity. Child mortality due to pheumonia is estimated at 921,000 children under 5 years (U5) in 2015. OBJECTIVE: To determine the TTR and factors of severe pneumonia among U5 children admitted at UOGCSH, Northwest Ethiopia.with. METHODS: A facility-based retrospective follow-up study was conducted on children U5 severe pneumonia from 2015 to 2020. The data were collected using pre-test and structured questionnaires. Statistical analysis was performed using Stata version 14.1. RESULT: The average TTR was 3 days IQR (3-6). TTR from severe pneumonia was 13.5 (95% CI: 13.54-17.15) per 100-persons. The cumulative time for children at risk was 1112 days, with a TTR of 29.7 per 100 children per day. Severity, signs and symptoms of pneumonia (AHR, 3.88 (95% CI =3.12-5.57)); mode of infancy feeding (cows milk feeding) (AHR, 2.4, (95% CI: 2.22-6.6)), and formula feeding (AHR, 0.68, (95% CI 0.58-1.25)) as compared to breastfeeding; nutritional status (underweight) (AHR, 2.2, (95% CI: (2.1-3.76)) as compared to normal, age (2-3-years) (AHR, 1.4, (95% CI: 1.31-2.22)), and ≥4-years (AHR, 1.32, (95% CI: 1.3-2.32)) as compared to age of ≤1 year were important factors of TTR. CONCLUSION: The overall TTR was 3 days IQR (2-6). This study identifies severity, signs, and symptoms of pneumonia, Mode of infancy feeding (cows milk feeding, formula feeding), nutritional status, and age were main determinants of TTR.

RESUMEN

INTRODUCTION: There are few studies on the hematologic parameters of HIV-infected individuals in Ethiopia; of these, almost all studies researched adults. Our current study is unique in that it mainly focused on the pediatric population and compared both pre- and post-antiretroviral therapy (ART) children. Inference from this study can be used for other developing countries where the burden of HIV disease is high. OBJECTIVE: The aim of this study was to identify hematologic abnormalities in HIV-infected children before and after initiation of ART. METHODOLOGY: A cross-sectional study was conducted on HIV-infected children from June 1 to August 30, 2015. Data were collected using a pretested and structured questionnaire. Statistical analysis was performed using SPSS 20 version. RESULTS: The median age of study subjects was 10 years with an interquartile range (IQR) of (6, 12). Two-thirds (74.3%) of study subjects received ART for >1 year. The median of CD4 count before ART was 490 cells/mm3 with an IQR of (286, 765); this increased to 663 cells mm3 with an IQR of (499, 908) after ART. Likewise, the median of hemoglobin before ART was 11.5 mg/dL with an IQR of (9.9, 13), which increased after ART to 13 mg/dL with an IQR of (11.8, 14). The prevalence of anemia was 42.8% before and 18.9% after ART initiation. The median of absolute neutrophil count before ART was 3×103 with an IQR of (2.1, 4.6) and after ART, it became 3×103 with IQR of (1.9, 4.2). Age <5 years (adjusted odds ratio [AOR]: 2.76; 95% CI: 1.5, 5.0), an advanced stage of AIDS (AOR: 2.8; 95% CI: 1.4, 5.6) and CD4% <25% (AOR: 2.4; 95% CI: 1.2, 4.9) were significantly associated with anemia before ART initiation, while opportunistic infections were associated with anemia after initiation of ART (AOR: 2.3; 95% CI: 1.08, 4.8). CONCLUSION: ART positively or negatively affects the hematologic profile of HIV-infected children. The current study demonstrated a significant reduction of anemia after initiation of ART.