CD4+ T-Lymphocyte counts among under-5 children with protein-energy malnutrition as seen in Usmanu Danfodiyo University Teaching Hospital , Sokoto, Nigeria

Abstract

Background: Proteinenergy malnutrition is a prevalent public health  problem in the developing countries. It affects body systems including cell-mediated immunity.
Objectives: To determine the effect of PEM on CD4⁺ Tlymphocyte counts among under -5 children.
Methods: This was a prospective cross-sectional study conducted among HIV-negative children aged 6 - 59 months with PEM and the HIV-negative well-nourished children between November 1st, 2010 and July 31st, 2011. The socio-demographic characteristics, weight and some haematological
indices of the both groups were documented. The CD4⁺ Tlymphocyte count was determined using Partec cytoflow machine.
Result: One-hundred children were recruited for each group over a 9 month period. The two study groups were comparable in age (p= 0.53) and sex (p= 0.65). The mean CD4⁺ T-lymphocyte count in children with PEM was
1705.5±605.6 cells/µL as compared to 2314.3±491.1 cells/µL among the controls (p= 0.0001). A statistically significant difference was observed in the mean CD4⁺ T-lymphocyte count of the different types of PEM with the highest value observed among children with kwashiorkor (2097.7±712.9 cells/µL) and lowest value observed among those with marasmus  (1449.3±368.2 cells/µL). There were significant differences in the mean CD4⁺ Tlymphocyte count of the control (2314.3±491 cells/µL) when  compared to those of marasmus (1449±368 cells/µL) (p= 0.001), marasmic-kwashiorkor (1888±762 cells/µL) (p= 0.002), underweight (1559±452 cells/µL) (p= 0.001) and underweight-kwashiorkor (1534±402 cells/µL) (p= 0.001), but it was comparable with that of kwashiorkor group (2098±713 cells/µL) (p= 0.21). A statistically significant difference was observed in the mean CD4⁺ Tlymphocyte count of the different types of PEM with the highest value observed among children with kwashiorkor (2097.7±712.9 cells/µL) and lowest value observed among those with  marasmus (1449.3±368.2 cells/µL).
Conclusion: The PEM has deleterious effects on the CD4⁺ Tlymphocyte
counts among under-5 children with PEM with the lowest count observed among those presenting with marasmus.

Key words: CD4⁺ T-Lymphocyte, Count, PEM, Under-5.