Masters Degrees (Paediatrics and Child Health)
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Browsing Masters Degrees (Paediatrics and Child Health) by browse.metadata.advisor "Gie, Robert Peter"
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- ItemChildhood necrotizing pneumonia in a region with high burden of tuberculosis and HIV(Stellenbosch : Stellenbosch University, 2017-03) Jacobs, Carmen; Goussard, Pierre; Gie, Robert Peter; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.ENGLISH ABSTRACT: The causes and outcome of children treated for necrotizing pneumonia (NP) in low- and middle-income countries have not been reported. The aim of this retrospective descriptive study was to investigate childhood NP in a region with a high prevalence of tuberculosis (TB) and HIV. Material and methods: Children with radiological features of childhood NP treated in a referral hospital in Western Cape, South Africa between 2004 -2007 were included. Results: Children (n=32), median age 16.5 (IQR 10-33 months) of whom 9 (32%) were HIV-infected were studied. Of the HIV-infected children, with a median blood CD4 count of 310 cells/ml, 67% were on antiretroviral treatment. On chest CT scan alveolar disease (100%), lung necrosis with cysts (88%) and pleural effusion (91%) were the commonest features; no features suggestive of pulmonary TB were observed. A causative organism was isolated in 66%. The commonest causes being: Streptococcus species (27%), Staphylococcus aureus (34%) and Mycobacterium tuberculosis (M.tb) (25%). In the TB group M.tb was cultured in 75% and the pleural fluid AFB positive in 25%. Where NP was caused by M.tb 75% were HIV-infected (p=0.007). In 47% (n=15) a surgical intervention was required: (25%) was an isolated pleural drainage. No patients died and at follow-up 6 months after admission (n=17) 82% had complete radiological resolution including the M.tb group. Conclusion: These findings indicate that in TB and HIV-prevalent countries in children with NP, TB must be actively excluded especially in HIV-infected children.
- ItemPeak expiratory flow rate in healthy urban Nigerian school children in Abuja, Nigeria(Stellenbosch : Stellenbosch University, 2018-11) Adeniyi, Folasade; Kling, Sharon; Gie, Robert Peter; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.ENGLISH ABSTRACT: Background Recent asthma management guidelines have reiterated the importance of lung function testing, such as Peak expiratory flow rate (PEFR), in the diagnosis and management of childhood asthma. Interpretation of PEFR requires comparison with patient’s personal best value or comparison with predicted norms. PEFR has been shown to vary with age, gender, anthropometric indices and importantly with race and ethnicity even within the same country. It is therefore important to establish reference ranges for different population groups. Objectives This study aimed to establish the pattern and determinants of PEFR amongst healthy Nigerian children aged 6-12 years attending public schools in Abuja, Nigeria and to derive a prediction equation for PEFR for this population. Methods The study was a cross-sectional descriptive study design involving a representative sample of 1067 healthy children aged 6-12 years attending 7 public primary schools in Abuja, Nigeria, obtained by a multistage stratified random sampling technique. Data collection took place in the selected schools following ethics approval and written informed consent in October 2009. Demographic and clinical history data were collected on questionnaires and structured case report forms. PEFR was measured with a mini-Wright’s peak flow meter with the best of three readings recorded in litres/minute. Height and weight were measured according to recognized standards. Data was analysed with SPSS™ statistical software version 25. Confidentiality of data was ensured. Results A total of 1067 school children aged 6-12 years were included in the study; of these, 512 (48%) were males, while 555 (52%) were females. The mean PEFR in litres/minute (+2SD) were: females 214.7 (±58.7) and males 217.7(±57.2), respectively. PEFR correlated with age and anthropometric measurements, with height showing the best correlation. Gender was not significantly correlated with PEFR. Using Multiple linear regression analysis, we derived a prediction equation for use in both genders: predicted PEFR (Litres/minute) = 2.6(height in cm) + 6.9(age in years) - 185. Conclusion The prediction equation for PEFR derived from this study provides reference values for PEFR which will be useful in the recognition and management of childhood asthma and other respiratory conditions amongst Nigerian children.