dc.contributor.author | Githinji, N | |
dc.date.accessioned | 2013-05-23T06:40:31Z | |
dc.date.available | 2013-05-23T06:40:31Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | Masters of medicine in Paediatrics, | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24596 | |
dc.description.abstract | With the HIV pandemic and highly active antiretroviral therapy (HAART) expanding,there
is need to evaluate less expensive, more available and accessible bio- methods for
detecting level of immunosuppression. WHO guidelines recommend use of total lymphocyte
unt (TLC). CD4 and CD4% to depict level of immunosuppression. We therefore evaluated the
utilityof TLC as surrogate marker for CD4+ T cell count in HIV infected children in three
omprehensive Care Centres (CCCs) in Kenya; New Nyanza Provincial Hospital (NNPGH) in Kisumu Kenyatta
national Hospital (KNH) and Mbagathi District Hospital (MDH) in Nairobi
We carried out a hospital based retrospective study. Paired data on CD4+ T cell count
and TLC were collected from hospital records from HAART naive HIV infected children.
Data were categorized into < 12 months, 12 - 35 months. 36-59 months and >59 months age
strata.Spearman rho coefficient was used to establish correlation between TLC and CD4 and
TLC and CD4% pairs. The sensitivity, specificity. positive and negative predictive values of
various TLC cut offs was determined using the WHO CD4+ T cell cut-off values as the gold
standard.
Results
Four hundred and eighty seven HAART naive HIV infected children with a median
age of36 months (1-144 months) were enrolled into the study. 46% were females and 54%
were males. One hundred and twenty five children were enrolled from NNPGR 186 from
MDH and 176 from KNH.
Positive correlation was found between TLC and CD4+. Overall correlatiori for whole study
population was 0.66 (p<O.OO 1). This correlation varied by geographical region with highest
correlation in KNH (r=0.76, p<O.OOl), followed by MDH (r= 0.55. p<O.OOl), then NNPGH
(r= 0.54, p<O.OO1). It also varied by age with highest correlation coefficient in children above
59 months of age (r= 0.68, p<O.OO1), lowest in children less than 12 months of age (r=0.45.
p<O.OOI).The correlation also varied with severity of immuno suppression; higher in severely
immuno suppressed category (r= 0.72. p<O.OO1). lower in the non-severely immunosuppressed
(r-0.63, p<O.OOl). | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Utility of total lymphocyte count as a surrogate marker for cd4 cell count in HIV infected children | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Paediatrics, College of Health Sciences, University of Nairobi, Kenya. | en |