SUMMARYTo assess possible differences in immune status, proportions and absolute numbers of subsets of CD4 þ and CD8 þ T cells were compared between HIV ¹ healthy Ethiopians (n ¼ 52) and HIV ¹ Dutch (n ¼ 60). Both proportions and absolute numbers of naive CD4 þ and CD8 þ T cells were found to be significantly reduced in HIV ¹ Ethiopians compared with HIV ¹ Dutch subjects. Also, both proportions and absolute numbers of the effector CD8 þ T cell population as well as the CD4 þ CD45RA ¹ CD27 ¹ and CD8 þ CD45RA ¹ CD27 ¹ T cell populations were increased in Ethiopians. Finally, both proportions and absolute numbers of CD4 þ and CD8 þ T cells expressing CD28 were significantly reduced in Ethiopians versus Dutch. In addition, the possible association between the described subsets and HIV status was studied by comparing the above 52 HIV ¹ individuals with 32 HIV þ Ethiopians with CD4 counts > 200/ml and/or no AIDS-defining conditions and 39 HIV þ Ethiopians with CD4 counts < 200/ml or with AIDS-defining conditions. There was a gradual increase of activated CD4 þ and CD8 þ T cells, a decrease of CD8 þ T cells expressing CD28 and a decrease of effector CD8 þ T cells when moving from HIV ¹ to AIDS. Furthermore, a decrease of naive CD8 þ T cells and an increase of memory CD8 þ T cells in AIDS patients were observed. These results suggest a generally and persistently activated immune system in HIV ¹ Ethiopians. The potential consequences of this are discussed, in relation to HIV infection.

The efficacies of 3-day regimens of artemether-lumefantrine (AL), artesunate-amodiaquine (AA), and dihydroartemisinin-piperaquine (DHP) were evaluated in 910 children < 5 years old with uncomplicated malaria from six geographical areas of Nigeria. Parasite positivity 1 day and Kaplan-Meier estimated risk of persistent parasitemia 3 days after therapy initiation were both significantly higher, and geometric mean parasite reduction ratio 1 day after treatment initiation (PRRD1) was significantly lower in AL-treated children than in AA- and DHP-treated children. No history of fever, temperature > 38°C, enrollment parasitemia > 75,000 μL, and PRRD1 < 5,000 independently predicted persistent parasitemia 1 day after treatment initiation. Parasite clearance was significantly faster and risk of reappearance of asexual parasitemia after initial clearance was significantly lower in DHP-treated children. Overall, day 42 polymerase chain reaction-corrected efficacy was 98.3% (95% confidence interval [CI]: 96.1-100) and was similar for all treatments. In a non-compartment model, declines of parasitemias were monoexponential with mean terminal elimination half-life of 1.3 hours and unimodal frequency distribution of half-lives. All treatments were well tolerated. In summary, all three treatments evaluated remain efficacious treatments of uncomplicated malaria in young Nigerian children, but DHP appears more efficacious than AL or AA.

Background: Infections are a common cause of childhood morbidity and mortality in developing countries. Proper management of these conditions in appropriate health facilities provides the best opportunity for survival and reducing disability. Aims: To evaluate the care-seeking behavior by parents of under-five children with fever in Nigeria and determine household characteristics associated with appropriate care-seeking. Material and methods: The study is a secondary analysis of 2013 Demographic and Health Survey data for Nigeria, which was a cross-sectional survey conducted nationwide to obtain demographic and health characteristics of the population among 40,680 households selected using a multistage cluster sampling method. Under-five children with fever in the preceding two weeks were selected alongside their mothers. Selected sociodemographic parameters were related to parents seeking care from appropriate health facilities or otherwise. Logistic regression analysis was employed to evaluate the association of these parameters with appropriate care-seeking. Results: There were 3632 (12.6%) under-five children with fever in the preceding two weeks. Of these, 1142 (31.4%) had been taken to an appropriate health facility for care. Factors associated with appropriate care-seeking were paternal secondary (OR, 95% CI; 1.49, 1.16-1.90), paternal tertiary education (OR, 95% CI; 2.03, 1.49-2.76) and belonging to the Muslim faith (OR, 95% CI; 2.31, 1.86-2.87). Others were age of child <36 months, being married and working mother. Conclusion: There is poor care-seeking for fever in under-five children by parents in Nigeria. Improved literacy, women empowerment and health education are strategies that may improve care-seeking behavior. Highlighted regional differences are additional considerations for such interventions.

Background: Timely receipt of immunization is an essential prerequisite to ensure early protection of the child. However, a low proportion of children in Nigeria benefit from the timely administration of the birth dose vaccines. Objectives: These were identification of factors associated with timely presentation and reasons for presentation beyond 24 hours at an immunization centre in Ilorin, Nigeria. Method: A descriptive cross-sectional study involving 480 mother-infant pairs was conducted at an immunization centre. Socio-demographic, antenatal care (ANC) and delivery details, infant's birthday and day of presentation for vaccination were recorded. Logistic regression was used to identify factors associated with time to presentation within day one. Findings: 239 (49.8%), 421 (87.7%) and 454 (94.6%) babies were vaccinated within days one, seven and 14 respectively. Post-secondary education level of mothers (

The majority of febrile under-fives came to the hospital to seek competent medical care within the first 24 hours of illness. However, there is a need for more parental education on early hospital presentation for parents of low socioeconomic status and educational background.