PHD-Department of Public Health

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Browsing PHD-Department of Public Health by Author "Otieno, Samwel Boaz"

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    The effect of selenium intake in progression of asymptomatic hiv type 1 infected children in Nyamasaria Sub county Kisumu County Kenya
    (2015) Otieno, Samwel Boaz
    The prevalence of the Human-Immuno-deficiency Virus has been observed to be inversely related to selenium levels in foods. More recent Demographic Health Surveys have shown that despite the prevalence of HIV reducing by half in Kenya the prevalence in Kisumu County still remains twice the National prevalence, which suggests that there could be other factors involved in HIV epidemiology in the County. The hypothesis of this study was that selenium intake does not cause rapid progression of to AIDS from HIV infected children in Kisumu County. The main objective was to determine the effect the intake of yeast selenium on CD4 T cells and Weight for Age Z Score in HIV positive children (3-16 years). In this study a total of 68 HIV positive children were registered in the study to asses the efficacy of selenium. Yeast selenium (50μgm) was given to 34 children while the remaining 34 were put on a placebo.Blood samples and weight of the both groups were taken at 3 months intervals from 0, 3months and 6 months. The blood samples were analyzed by Enzyme Linked Immunosorbent Assay for CD4T cells while Weight for Age Z score was analyzed by Epi.Info version 3.4 and SPSS version16 for significance.In the study it was shown that children on selenium had progressive improvement of WAZ and which was significantly different at six months between children on selenium and the controls {F (5,12) = 5.758, P=0.006}.By using -2 standard deviations Z scores as a measure of cut-off, 15% boys and no girl on selenium was wasted at six months. Among the controls 64% of boys and 38% of girls were wasted at six months. The children on selenium had weight gain of up to 2.5 kilograms in six months. There was a significant mean increase CD4 T cell count at six months among the children on selenium,{ t( 1, N=30) = -2.943, p=0.006} compared to the matched controls {t =(1,N=30) =1.258 p= 0.0.0218}. CD4 T cell count increased among all age groups on test,3-5years (+ 267.1),5-8 years (+200.3) 9-15 years (+71.2) cells/mm3 . In matched controls a decrease was observed in all age categories, 3-5 years (-71),5-8 years (-125) and 9-13years (-10.1) cells/mm3 . There was no significant difference in CD4 T cell count between boys {F (2, 32) = 1.531 p= 0.232} and between girls {F (2, 49) = 1.040, p= 0.361} and between boys and girls {F (5, 81) = 1.379, p= 0.241} among the children on test. Similarly no significant difference was observed between boys and girls {F (5, 86) = 1.168, p= 0.332} in matched controls. In the test group there was a significant positive correlation between weight for age (WAZ), and CD4 T Cell Count p=0.007, R2= 0.252, F<0.05, β =252.23.There was a significant correlation observed between Weight for Z score and CD4 T cell count{ t( 2, N=27) = 2.94 p=0.007} with β = +252.23 and adjusted R² of 0.2016..In matched controls no significant correlation between weight for age Z-Score and CD4 T cell count change was observed at six months{ t (2, N=26) =0.08 p = 0.934} with β coefficient of +3.366 and adjusted R² =0.0337 .No positive correlation was observed among the children on selenium between CD4 T Cell count, and gender {t (2,27) = -0.69 p=0.0.495} with β coefficient of -138.23. Similarly in a matched control there was no significant correlation between CD4 T cell count and gender {t (2, N=26) = -0.90 p= -0.380} with β coefficient of -135.50.Majority (96.78%) of children on test either remained or progressed to WHO immunological stage I. It can be concluded that selenium intake slowed the rate of progression to AIDS from HIV positive patients as shown by increase in CD4 T cell count and further that there was no significant response between girls and boys. It is recommended that selenium be given as supplement to the HIV positive children on WHO clinical stage I to III as away of delaying progression to WHO stage IV.