BackgroundHuman Immunodeficiency Virus infection is a multisystem disease that contributes to significant morbidity. Renal involvement is reported to be common among patients with HIV. This study was carried out to determine renal involvement using simple bedside tests combined with ultrasonography examination.MethodsWe recruited 240 children from the HIV clinic at Muhimbili National Hospital. Data were collected using structured questionnaires and included demographic, clinical information, radiological tests; renal ultrasound and laboratory tests; serum creatinine, white blood cells, CD4+ counts and percent, urine for microalbuminuria and proteinuria.ResultsMicroalbuminuria and proteinuria were present in 20.4 % and 7.1 % respectively. Significantly higher prevalence of microalbuminuria (p < 0.01) and proteinuria p < 0.01) were noted with low CD4 percent (<25 %). Lower mean CD4+ count were noted among children with microalbuminuria [937.4 ± 595.3 cells/μL vs 1164.7 ± 664.3 cell/μL, (p < 0.05)] and proteinuria [675.5 ± 352.3 cells/μL vs 1152 ± 662 cells/μL (p < 0.001)]. Fourteen (5.8 %) HIV infected children had estimated glomerular filtration rate (eGFR of 30–59) consistent with severe renal impairment. Increased cortical echogenicity was noted in 69/153 (39.2 %) of participants who had ultrasound examination.ConclusionMicroalbuminuria, proteinuria and renal dysfunction were noted to be prevalent among HIV infected children indicating the need to consider routine screening of renal complications in these children.
There are few published reports of hypertrophic cardiomyopathy (HCM) in Africans, partly due to lack of Echocardiography machines at most hospitals. Among 6680 patients referred for echocardiography at Muhimbili National Hospital between June 1998 and October 2002, 134 (0.19%) patients had HCM. Their mean age was 54.8+/-14.2 years. In total 67.9% were men and 32.1% were women. Due to the diverse clinical features only eight (5.9%) patients had a correct diagnosis of HCM prior to their ECHO. The important role of echocardiography in the diagnosis of HCM is stressed with a plea for the increasing availability of this non-invasive technique for early and accurate diagnosis.
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