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Type Thesis or Dissertation - Doctor of Philosophy
Title The effect of Selenium intake in progression of asymptomatic HIV type 1 infected children in Nyamasaria Sub County Kisumu County Kenya
Publication (Day/Month/Year) 2015
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.

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