C. Uzoigwe, F. Edegbe, F. Iyare, C. Okani, U. Nnadozie, A. Umeokonkwo, C. Ndukwe, A. Efunshile
Introduction: Childhood malignancies (CM) have been one of the major causes of death in the world. It appears to be increasing in significance due to the ongoing reduction in both infectious and nutritional diseases.Aims: The study was conducted to document the histopathological pattern, age and sex distribution of childhood malignancies in a University Teaching Hospital in Southeast Nigeria.Method: The materials consisted of histology slides, formalin-fixed paraffin-embedded tissue blocks (FPTB), and requisition forms of all cases diagnosed with CM at a University Teaching Hospital between the periods January 2005 and December 2015Results: A total of 2,528 surgical biopsies were received at the Department. Only 60 (2.4%) specimens represented childhood malignancies. Thirty-one cases (51.7%) of the entire CM were lymphomas; 12 (20.0%) were non-Hodgkin lymphoma, 17 (28.3%) others were Burkitt’s type whereas 2(3.3%) were Hodgkin lymphoma. Childhood malignancies were more in males 36 (60.0 %) than females 24 (40.0%), giving a male to female ratio of 3:2. However, Burkitt’s lymphoma was higher in females 12 (70.6%) than males 5 (29.4%) with a male to female ratio of 1.2:3. Twenty-six (43.3%) cases of the CM occurred in children aged 0-5 years but 20 (36.7%) presented in children aged 11 to 15 years. Twelve (20.0%) cases were seen in children 6 to 10 years. Six (23.1%) of the children had Burkitt's lymphoma all of whom were under 5 years.Conclusion: Lymphomas were the commonest CM, Burkitt’s lymphoma being the dominant subtype in this study. There was a female preponderance of Burkitt’s lymphoma.
{"title":"Histopathological patterns of childhood malignancies seen at Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria: A 10 year retrospective study","authors":"C. Uzoigwe, F. Edegbe, F. Iyare, C. Okani, U. Nnadozie, A. Umeokonkwo, C. Ndukwe, A. Efunshile","doi":"10.4314/njp.v49i1.5","DOIUrl":"https://doi.org/10.4314/njp.v49i1.5","url":null,"abstract":"Introduction: Childhood malignancies (CM) have been one of the major causes of death in the world. It appears to be increasing in significance due to the ongoing reduction in both infectious and nutritional diseases.Aims: The study was conducted to document the histopathological pattern, age and sex distribution of childhood malignancies in a University Teaching Hospital in Southeast Nigeria.Method: The materials consisted of histology slides, formalin-fixed paraffin-embedded tissue blocks (FPTB), and requisition forms of all cases diagnosed with CM at a University Teaching Hospital between the periods January 2005 and December 2015Results: A total of 2,528 surgical biopsies were received at the Department. Only 60 (2.4%) specimens represented childhood malignancies. Thirty-one cases (51.7%) of the entire CM were lymphomas; 12 (20.0%) were non-Hodgkin lymphoma, 17 (28.3%) others were Burkitt’s type whereas 2(3.3%) were Hodgkin lymphoma. Childhood malignancies were more in males 36 (60.0 %) than females 24 (40.0%), giving a male to female ratio of 3:2. However, Burkitt’s lymphoma was higher in females 12 (70.6%) than males 5 (29.4%) with a male to female ratio of 1.2:3. Twenty-six (43.3%) cases of the CM occurred in children aged 0-5 years but 20 (36.7%) presented in children aged 11 to 15 years. Twelve (20.0%) cases were seen in children 6 to 10 years. Six (23.1%) of the children had Burkitt's lymphoma all of whom were under 5 years.Conclusion: Lymphomas were the commonest CM, Burkitt’s lymphoma being the dominant subtype in this study. There was a female preponderance of Burkitt’s lymphoma.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89160162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Alabi, Ayedele Ojuawo, M. Onigbinde, V. Joel-Medewase, Grace Olukemi Alabi
Background: Many cl inicaland haematological changes occur as a result of severe malaria, of which cerebral malaria (CM) is a common entity. These changes affect virtually all organs and systems of the body. We identify various clinical and haematological determinants of outcome in CM so as to institute proactive management of such children. Methods: All children who met World Health Organization (WHO) diagnostic criteria for CM over 8 month-period were prospectively studied. The presenting symptoms and its duration, detailed physical examination and laboratory parameters were obtained. Logistic regression was employed to determine the prognostic significance of various clinical and laboratory parameters. Outcome indicators were full recovery, alive with neurological sequelae or death of the children.Results: Of the 892 children admitted into the Children Emergency Unit (CEU) over the study period, 50 (5.6%) had CM with M: F ratio of 1:1 and age range of 6 months to 12 years. Sixty percent were aged less than 5 years. The defining symptoms were fever (100%), coma (100%) and convulsion (98%). Forty-one (82%) patients survived, while nine (18%) died. Of the 41 survivors, 30 (73.2%) recovered fully, while 11 (26.8%) had neurological deficits at discharge.Identified clinical and laboratory predictors of mortality and neurological sequelae in CM included Blantyre coma score of 0-2(p = 0.018) prolonged coma recovery time > 26 hours (p =0.026), abnormal breathing pattern (p = 0.0124), absent corneal reflex (p = 0.012), absent pupillary reflex (p = 0.012), depressed tendon reflex (p = 0.028), hyperreflexia (p =0.014), retinal haemorrhage (p =0.001), duration of admission (p=0.000), hyper parasitaemia (p=0.001), hypoglycemia (p= 0.014) and leucocytosis (p = 0.008). Independent determinants of immediate post-recovery neurological deficits and death were hyper-parasitaemia (OR = 8.657, p = 0.017.) and leucocytosis (OR = 1.090; p = 0.035Conclusion: CM is a potentially reversible encephalopathy associated with high mortality and sequelae. Affected children with the above listed clinical / haematological parameters especially hyperparasitemia and leucocytosis should be given proactive management to improve the outcome.
{"title":"Clinical and haematological determinants of outcome among children with cerebral malaria in a tertiary centre in Nigeria","authors":"A. Alabi, Ayedele Ojuawo, M. Onigbinde, V. Joel-Medewase, Grace Olukemi Alabi","doi":"10.4314/njp.v49i1.1","DOIUrl":"https://doi.org/10.4314/njp.v49i1.1","url":null,"abstract":"Background: Many cl inicaland haematological changes occur as a result of severe malaria, of which cerebral malaria (CM) is a common entity. These changes affect virtually all organs and systems of the body. We identify various clinical and haematological determinants of outcome in CM so as to institute proactive management of such children. Methods: All children who met World Health Organization (WHO) diagnostic criteria for CM over 8 month-period were prospectively studied. The presenting symptoms and its duration, detailed physical examination and laboratory parameters were obtained. Logistic regression was employed to determine the prognostic significance of various clinical and laboratory parameters. Outcome indicators were full recovery, alive with neurological sequelae or death of the children.Results: Of the 892 children admitted into the Children Emergency Unit (CEU) over the study period, 50 (5.6%) had CM with M: F ratio of 1:1 and age range of 6 months to 12 years. Sixty percent were aged less than 5 years. The defining symptoms were fever (100%), coma (100%) and convulsion (98%). Forty-one (82%) patients survived, while nine (18%) died. Of the 41 survivors, 30 (73.2%) recovered fully, while 11 (26.8%) had neurological deficits at discharge.Identified clinical and laboratory predictors of mortality and neurological sequelae in CM included Blantyre coma score of 0-2(p = 0.018) prolonged coma recovery time > 26 hours (p =0.026), abnormal breathing pattern (p = 0.0124), absent corneal reflex (p = 0.012), absent pupillary reflex (p = 0.012), depressed tendon reflex (p = 0.028), hyperreflexia (p =0.014), retinal haemorrhage (p =0.001), duration of admission (p=0.000), hyper parasitaemia (p=0.001), hypoglycemia (p= 0.014) and leucocytosis (p = 0.008). Independent determinants of immediate post-recovery neurological deficits and death were hyper-parasitaemia (OR = 8.657, p = 0.017.) and leucocytosis (OR = 1.090; p = 0.035Conclusion: CM is a potentially reversible encephalopathy associated with high mortality and sequelae. Affected children with the above listed clinical / haematological parameters especially hyperparasitemia and leucocytosis should be given proactive management to improve the outcome.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86167567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Alao, Y. Olasinde, D. Gbadero, O. Tongo, O. T. Adeleke, T. Slusher
Background: The knowledge of the aetiology for neonatal jaundice is important in the early detection and effective management of infants with or at risk of severe jaundice before hospital discharge. This study assessed the aetiological factors of neonatal jaundice among apparently well late preterm and termnewborns to ensure timely intervention where these risk factors exist.Method: This was a cross sectional study involving 174 apparently well neonates at a tertiary mission hospital. Detailed history, physical examination, relevant haematological and biochemical tests were undertaken. Significant jaundice was defined as serum bilirubin greater than 2 standard deviations above the postnatal age and weight dependent treatment concentration.Results: Of the 844 neonates admitted into the neonatal care unit, 174 (20.6%) had significant jaundice. Median age at presentation was 3 days (95% CI of median 3-4days). The mean ±SD gestation age and birth weight of the neonates at recruitment were 38.1±1.6 weeks and 3.1± 0.5kg respectively. Males were 108 (62.4%; M: F.1.6.1). The mean ±SD total serum bilirubin was 13.9±4.7mg/dl. Significant jaundice was more common with maternal-baby concordant paired blood group of AA, O-O compared with discordant materno-baby group pairs. Of the known causes of significant neonatal jaundice, G6PD deficiency (57-38.5%) ranked topmost. Half (87-50.0%) of the causes of significant jaundice were unidentified.Conclusion : G6PD deficiency remains the leading aetiology for significant neonatal jaundice. G6PD screening should be mandated before hospital discharge, compatible mother-baby blood group pairs do not rule the risk for significant jaundice; further research is required to elucidate other inherent unidentified aetiologies.
{"title":"Aetiology of neonatal jaundice in apparently well late-preterm and term neonates at a mission hospital, Southwestern Nigeria","authors":"M. Alao, Y. Olasinde, D. Gbadero, O. Tongo, O. T. Adeleke, T. Slusher","doi":"10.4314/njp.v49i1.6","DOIUrl":"https://doi.org/10.4314/njp.v49i1.6","url":null,"abstract":"Background: The knowledge of the aetiology for neonatal jaundice is important in the early detection and effective management of infants with or at risk of severe jaundice before hospital discharge. This study assessed the aetiological factors of neonatal jaundice among apparently well late preterm and termnewborns to ensure timely intervention where these risk factors exist.Method: This was a cross sectional study involving 174 apparently well neonates at a tertiary mission hospital. Detailed history, physical examination, relevant haematological and biochemical tests were undertaken. Significant jaundice was defined as serum bilirubin greater than 2 standard deviations above the postnatal age and weight dependent treatment concentration.Results: Of the 844 neonates admitted into the neonatal care unit, 174 (20.6%) had significant jaundice. Median age at presentation was 3 days (95% CI of median 3-4days). The mean ±SD gestation age and birth weight of the neonates at recruitment were 38.1±1.6 weeks and 3.1± 0.5kg respectively. Males were 108 (62.4%; M: F.1.6.1). The mean ±SD total serum bilirubin was 13.9±4.7mg/dl. Significant jaundice was more common with maternal-baby concordant paired blood group of AA, O-O compared with discordant materno-baby group pairs. Of the known causes of significant neonatal jaundice, G6PD deficiency (57-38.5%) ranked topmost. Half (87-50.0%) of the causes of significant jaundice were unidentified.Conclusion : G6PD deficiency remains the leading aetiology for significant neonatal jaundice. G6PD screening should be mandated before hospital discharge, compatible mother-baby blood group pairs do not rule the risk for significant jaundice; further research is required to elucidate other inherent unidentified aetiologies.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85254470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Adedayo, Akinsete Adeseye, B. Adegboyega, O. Awofeso, M. Jimoh, M. Habeebu
Background: Parents of children diagnosed with cancer are handed a frightening diagnosis, with attendant emotional, social, and financial challenges. They often have many questions that remain unanswered by busy doctors and nurses, who are themselves overwhelmed by the challenges of caring for cancer patients in resource-constrained circumstances. The objective of this study is to evaluate the impact of a childhood cancer handbook on the experience of caregivers of children diagnosed with paediatric cancer in Nigeria.Methodology: A series of focus group discussions involving caregivers of children with histologically diagnosed cancer were held. A childhood cancer handbook was given to each participant to read. Data was collected four weeks later and analysed using qualitative content analysis.Results: In general, 91.7% of focus group participants reported that they found the handbook useful and having it at diagnosis would have significantly increased their level of information and made dealing with the diagnosis more tolerable. However, many of the participants reported that while the book completely catered to their informational and emotional needs, it did not adequately address certain practical needs such as paying for cancer treatment.Conclusion: Many Nigerian families go through the entire paediatric cancer journey, feeling like they are stumbling in the dark. No dedicated information resource on paediatric cancer exists in Nigeria. The provision of a detailed handbook at diagnosis may reduce the psychological and emotional toll of a cancer diagnosis on parents and family of a child diagnosed with cancer.
{"title":"Childhood cancer in Nigeria: The effect of a handbook in the experiences of caregivers","authors":"J. Adedayo, Akinsete Adeseye, B. Adegboyega, O. Awofeso, M. Jimoh, M. Habeebu","doi":"10.4314/njp.v49i1.2","DOIUrl":"https://doi.org/10.4314/njp.v49i1.2","url":null,"abstract":"Background: Parents of children diagnosed with cancer are handed a frightening diagnosis, with attendant emotional, social, and financial challenges. They often have many questions that remain unanswered by busy doctors and nurses, who are themselves overwhelmed by the challenges of caring for cancer patients in resource-constrained circumstances. The objective of this study is to evaluate the impact of a childhood cancer handbook on the experience of caregivers of children diagnosed with paediatric cancer in Nigeria.Methodology: A series of focus group discussions involving caregivers of children with histologically diagnosed cancer were held. A childhood cancer handbook was given to each participant to read. Data was collected four weeks later and analysed using qualitative content analysis.Results: In general, 91.7% of focus group participants reported that they found the handbook useful and having it at diagnosis would have significantly increased their level of information and made dealing with the diagnosis more tolerable. However, many of the participants reported that while the book completely catered to their informational and emotional needs, it did not adequately address certain practical needs such as paying for cancer treatment.Conclusion: Many Nigerian families go through the entire paediatric cancer journey, feeling like they are stumbling in the dark. No dedicated information resource on paediatric cancer exists in Nigeria. The provision of a detailed handbook at diagnosis may reduce the psychological and emotional toll of a cancer diagnosis on parents and family of a child diagnosed with cancer.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86550017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Malaria is a major public health problem in sub-Saharan Africa. Several efforts are being made to reduce its prevalence and morbidity in Nigerian children with emphasison vector control measures.Methods: This was acrosssectional descriptive study conducted on 382 febrile children seen at a tertiary hospital in Nigeria over an eight-month period. A structured questionnaire was used to collect information on sociodemographic, vector control measures and care given to the subjects. Investigations conducted included malaria microscopy and total leukocyte count.Results: Eighty percent (308/382) employed at least one vector controlmeasures to prevent malaria infection, and majority 232 (75.2%) use only one control measure. The commonest control measures used included always keeping doors and windows shut 298 (96.7%) and/or netted 280 (90.9%), use of conventional insecticide sprays 183 (59.4%), use of insecticide treated bed nets (ITNs) 178 (57.8%) and ensuring child sleeps at night with body adequately covered 77(25%). Approximately half (178/315) of households who owned ITN used it, and only 40.4% (72/178) used it daily. It was noted that children that slept under an insecticide treated bed net (RR 0.56, 95% CI 0.33-0.94; P=0.029) and those who slept well covered at night (RR 0.26, 95% CI 0.12-0.61; P=0.002) had less risk of malaria infection. The use insecticide treated bed net however lost significance following adjustment for other control measures used and socio-demographic factors of interest (RR 0.63, 95% CI 0.36-1.10;P=0.101).Conclusion: There is need to intensify education on appropriate malaria control measures especially proper use of insecticide-treated nets and suitable clothing during sleep at night.
背景:疟疾是撒哈拉以南非洲的一个主要公共卫生问题。正在作出若干努力，以减少尼日利亚儿童的流行率和发病率，并着重采取病媒控制措施。方法:这是横断面描述性研究进行了382发烧儿童看到在三级医院在尼日利亚8个月期间。采用结构化问卷收集有关社会人口学、病媒控制措施和对受试者的护理的信息。调查包括疟疾显微镜和总白细胞计数。结果:80%(308/382)的医院采取了至少一种病媒控制措施预防疟疾感染，多数(75.2%)的医院仅采取了一种控制措施。使用的最常见控制措施包括始终关闭门窗298例(96.7%)和/或蚊帐280例(90.9%)，使用常规杀虫剂喷雾183例(59.4%)，使用经杀虫剂处理的蚊帐178例(57.8%)，以及确保儿童夜间睡眠时身体得到充分覆盖77例(25%)。大约一半(178/315)拥有ITN的家庭使用它，只有40.4%(72/178)每天使用它。注意到，睡在杀虫剂处理过的蚊帐下的儿童(相对危险度0.56,95%可信区间0.33-0.94;P=0.029)和夜间睡得好的人(RR 0.26, 95% CI 0.12-0.61;P=0.002)感染疟疾的风险较低。然而，在调整了其他控制措施和社会人口因素后，使用杀虫剂处理过的蚊帐失去了显著性(RR 0.63, 95% CI 0.36-1.10;P=0.101)。结论:应加强疟疾防治措施教育，特别是夜间睡眠时应正确使用驱虫蚊帐和穿着。
{"title":"Caregivers’ vector control methods and its effect on malaria infection in febrile children presenting in a Tertiary Hospital in Nigeria","authors":"E. Nwaneli","doi":"10.4314/njp.v49i1.8","DOIUrl":"https://doi.org/10.4314/njp.v49i1.8","url":null,"abstract":"Background: Malaria is a major public health problem in sub-Saharan Africa. Several efforts are being made to reduce its prevalence and morbidity in Nigerian children with emphasison vector control measures.Methods: This was acrosssectional descriptive study conducted on 382 febrile children seen at a tertiary hospital in Nigeria over an eight-month period. A structured questionnaire was used to collect information on sociodemographic, vector control measures and care given to the subjects. Investigations conducted included malaria microscopy and total leukocyte count.Results: Eighty percent (308/382) employed at least one vector controlmeasures to prevent malaria infection, and majority 232 (75.2%) use only one control measure. The commonest control measures used included always keeping doors and windows shut 298 (96.7%) and/or netted 280 (90.9%), use of conventional insecticide sprays 183 (59.4%), use of insecticide treated bed nets (ITNs) 178 (57.8%) and ensuring child sleeps at night with body adequately covered 77(25%). Approximately half (178/315) of households who owned ITN used it, and only 40.4% (72/178) used it daily. It was noted that children that slept under an insecticide treated bed net (RR 0.56, 95% CI 0.33-0.94; P=0.029) and those who slept well covered at night (RR 0.26, 95% CI 0.12-0.61; P=0.002) had less risk of malaria infection. The use insecticide treated bed net however lost significance following adjustment for other control measures used and socio-demographic factors of interest (RR 0.63, 95% CI 0.36-1.10;P=0.101).Conclusion: There is need to intensify education on appropriate malaria control measures especially proper use of insecticide-treated nets and suitable clothing during sleep at night.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79526667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Udoh, B. Nwazuluoke, Victor E. Bassey, O. Motilewa, R. Ejemot-Nwadiaro, M. Meremikwu
Introduction : Moderate acute malnutrition (MAM) is a leading cause of under-five morbidity and mortality globally. Supplementary feeding is a strategy recommended by WHO for managing the condition.Objective: To evaluate the effectiveness and tolerability of standardized milk-based formulation (SMBF), standardized non-milk based formulation (SNMBF) and hospital-based formulation (HBF) in under-fives with MAM.Method: This was an open label randomized clinical trial in which eligible children aged 6 – 59 months with MAM were assigned to receive the SMBF, SNMBF or HBF at 50% of their daily caloric requirement with their regular family diet for four months. Their baseline characteristics and anthropometric indices were noted. They were followed up on two weekly basis during which further assessments were performed. The analysis for effectiveness and tolerability of the formulations were based on “per protocol”.Results: A total of 687 children were screened and 188 enrolled. Seventy children received SMBF, 63 received SNMBF while 55 received HBF. There were 54/70 (77.1%), 57/64 (89.1%) and 46/55 (83.6%) evaluable participants in the SMBF, SNMBF and HBF group respectively. Recovery from MAM was 43/54 (79.6%), 40/57 (70.2%) and 32/46 (69.6%) in the SMBF, SNMBF and HBF group respectively. Normal nutritional status was attained by 13 (24.0%), 10 (17.6%) and 5 (10.9%) children in the SMBF, SNMBF and HBF group respectively. Diarrhea and skin rashes were the main features of poor tolerability.Conclusions: The formulations were effective in managing MAM in childhood but the SMBF was the most effective. Diarrhea and skin rashes were the main features of poor tolerability.
{"title":"Effectiveness and tolerability of standardized milk based, standardized non-milk based and hospital-based formulations in the management of moderate acute malnutrition in under-five children: A randomized clinical trial","authors":"E. Udoh, B. Nwazuluoke, Victor E. Bassey, O. Motilewa, R. Ejemot-Nwadiaro, M. Meremikwu","doi":"10.4314/njp.v49i1.7","DOIUrl":"https://doi.org/10.4314/njp.v49i1.7","url":null,"abstract":"Introduction : Moderate acute malnutrition (MAM) is a leading cause of under-five morbidity and mortality globally. Supplementary feeding is a strategy recommended by WHO for managing the condition.Objective: To evaluate the effectiveness and tolerability of standardized milk-based formulation (SMBF), standardized non-milk based formulation (SNMBF) and hospital-based formulation (HBF) in under-fives with MAM.Method: This was an open label randomized clinical trial in which eligible children aged 6 – 59 months with MAM were assigned to receive the SMBF, SNMBF or HBF at 50% of their daily caloric requirement with their regular family diet for four months. Their baseline characteristics and anthropometric indices were noted. They were followed up on two weekly basis during which further assessments were performed. The analysis for effectiveness and tolerability of the formulations were based on “per protocol”.Results: A total of 687 children were screened and 188 enrolled. Seventy children received SMBF, 63 received SNMBF while 55 received HBF. There were 54/70 (77.1%), 57/64 (89.1%) and 46/55 (83.6%) evaluable participants in the SMBF, SNMBF and HBF group respectively. Recovery from MAM was 43/54 (79.6%), 40/57 (70.2%) and 32/46 (69.6%) in the SMBF, SNMBF and HBF group respectively. Normal nutritional status was attained by 13 (24.0%), 10 (17.6%) and 5 (10.9%) children in the SMBF, SNMBF and HBF group respectively. Diarrhea and skin rashes were the main features of poor tolerability.Conclusions: The formulations were effective in managing MAM in childhood but the SMBF was the most effective. Diarrhea and skin rashes were the main features of poor tolerability.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89282077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enoobong Edet Ekpenyong, Usen-obong Morgan Akpan, I. Oloyede, A. Ekanem, N. Umoette, Etete Peters
Background: Corona virus disease 2019 (COVID-19) is a global pandemic that affects all age groups. Infected asymptomatic children can transmit the disease to vulnerable adults with co-morbidities resulting in severe disease in the latter. There are few reports of COVID-19 in children in Sub-Saharan Africa in general and in Nigeria in particular.Aim: To determine the prevalence, symptoms and risk factors for COVID-19 in Southern Nigerian children.Methods: This was a one-year retrospective cross-sectional study between April 2020 and March 2021. Data of all children tested for COVID-19 was extracted from the Epidemiology unit of Akwa Ibom state ministry of health. All patient identifiers were omitted and data was analyzed using STATA version 13.Results: Two hundred and fifty five children (2.25%) out of a total of 11,289 people were tested for COVID-19. Fifty -four children (0.47%) of the total number of persons tested for COVID-19 were positive. Twenty one percent of the 255 children tested were positive for COVID-19. Two hundred and fifty- four (99.6%) of children that were tested had a positive history of contact with a confirmed COVID-19 case. Five (9.3%) of COVID-19 positive children were symptomatic. The commonest symptoms seen were Fever (90.9%), Anosmia (63.6%) and Aguesia (36.4%). Increasing age (15 years and above) was significantly associated with COVID-19 positivity (p=0.000). In addition, the presence of symptoms was significantly associated with COVID-19 positivity (p=0.04).Conclusion/Recommendation: The prevalence of COVID-19 in Southern Nigerian children is low. Majority of the children have asymptomatic disease. Increasing age is significantly associated with COVID-19 positivity. We recommend increased COVID-19 testing in the general children population.
{"title":"Spectrum of COVID-19 infection in children in Southern Nigeria","authors":"Enoobong Edet Ekpenyong, Usen-obong Morgan Akpan, I. Oloyede, A. Ekanem, N. Umoette, Etete Peters","doi":"10.4314/njp.v49i1.4","DOIUrl":"https://doi.org/10.4314/njp.v49i1.4","url":null,"abstract":"Background: Corona virus disease 2019 (COVID-19) is a global pandemic that affects all age groups. Infected asymptomatic children can transmit the disease to vulnerable adults with co-morbidities resulting in severe disease in the latter. There are few reports of COVID-19 in children in Sub-Saharan Africa in general and in Nigeria in particular.Aim: To determine the prevalence, symptoms and risk factors for COVID-19 in Southern Nigerian children.Methods: This was a one-year retrospective cross-sectional study between April 2020 and March 2021. Data of all children tested for COVID-19 was extracted from the Epidemiology unit of Akwa Ibom state ministry of health. All patient identifiers were omitted and data was analyzed using STATA version 13.Results: Two hundred and fifty five children (2.25%) out of a total of 11,289 people were tested for COVID-19. Fifty -four children (0.47%) of the total number of persons tested for COVID-19 were positive. Twenty one percent of the 255 children tested were positive for COVID-19. Two hundred and fifty- four (99.6%) of children that were tested had a positive history of contact with a confirmed COVID-19 case. Five (9.3%) of COVID-19 positive children were symptomatic. The commonest symptoms seen were Fever (90.9%), Anosmia (63.6%) and Aguesia (36.4%). Increasing age (15 years and above) was significantly associated with COVID-19 positivity (p=0.000). In addition, the presence of symptoms was significantly associated with COVID-19 positivity (p=0.04).Conclusion/Recommendation: The prevalence of COVID-19 in Southern Nigerian children is low. Majority of the children have asymptomatic disease. Increasing age is significantly associated with COVID-19 positivity. We recommend increased COVID-19 testing in the general children population.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79495233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zinc is essential in the metabolic activities in the body including protein, DNA and RNA synthesis. It plays a role in neurogenesis, maturation, and migration of neurons and in synapse formation. Zinc is high in the hippocampal neurons which is involved in learning and memory. Deficiency of zinc during pregnancy has been related to many congenital abnormalities of the foetal nervous system. Furthermore insufficient levels of zinc in children is associated with lowered learning ability, apathy, lethargy and mental retardation. Maternal deficiency of zinc during lactation has been associated with impairment of infant brain development. Zinc status in mother and child can be assessed by measurement of zinc in plasma; zinc deficiency can be corrected with appropriate diet and zinc supplements. Red meat, poultry items, oysters, cashew nuts and almonds are rich sources of zinc.
{"title":"Zinc function in childhood brain","authors":"A. Asindi, C. Torty","doi":"10.4314/njp.v49i1.3","DOIUrl":"https://doi.org/10.4314/njp.v49i1.3","url":null,"abstract":"Zinc is essential in the metabolic activities in the body including protein, DNA and RNA synthesis. It plays a role in neurogenesis, maturation, and migration of neurons and in synapse formation. Zinc is high in the hippocampal neurons which is involved in learning and memory. Deficiency of zinc during pregnancy has been related to many congenital abnormalities of the foetal nervous system. Furthermore insufficient levels of zinc in children is associated with lowered learning ability, apathy, lethargy and mental retardation. Maternal deficiency of zinc during lactation has been associated with impairment of infant brain development. Zinc status in mother and child can be assessed by measurement of zinc in plasma; zinc deficiency can be corrected with appropriate diet and zinc supplements. Red meat, poultry items, oysters, cashew nuts and almonds are rich sources of zinc.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72792271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Human immunodeficiency virus infection remains a global pandemic. Co infection with hepatitis B virus leads to rapid progression to AIDS if not diagnosed and promptly treated or better still prevented. The study aims at determining the prevalence and risk factors of hepatitis B infection in HIV infected children being followed up at the Paediatric HIV clinic. Patients and methods: A cross-sectional study of 261 HIV infected children aged eight months to fourteen years to determine the prevalence of Hepatitis B infection and pattern of hepatitis B vaccination was carried out between July and October 2012 at the Paediatric HIV clinic of National Hospital Abuja. Ethical approval was obtained from Ethical Committee of the hospital. Vaccination and transfusion history were obtained from the parents and guardians of the subjects using a proforma after signed informed consent. Blood samples were collected for Hepatitis B surface antigen screening and Hepatitis B screening in those with HBsAg positive blood samples. Results: Only 3 (1.15%) of the 261 HIV infected children had Hepatitis B infection. All the children less than 5 years old in this cohort received hepatitis B vaccination and none of them had Hepatitis B infection. The HIV/HBV co infected children were older than ten years (p = 0.047) and history of blood transfusion (p = 0.003) was also significant. However, scarification (p = 0.996), local circumcision (p = 0.928); uvulectomy (p = 0.898) were not significant risk factors in this cohort. Conclusion: There is need to intensify routine hepatitis B vaccination and routine screening of blood before necessary transfusion. This would further lead to a low prevalence of Hepatitis B in HIV infected children and the general populace at large.
{"title":"Prevalence and risk factors of hepatitis b infection in HIV infected children seen at national hospital Abuja","authors":"O. Adeoye, O. Oniyangi, I. Ojuawo","doi":"10.4314/njp.v48i2.1","DOIUrl":"https://doi.org/10.4314/njp.v48i2.1","url":null,"abstract":"\u0000 \u0000 \u0000Background: Human immunodeficiency virus infection remains a global pandemic. Co infection with hepatitis B virus leads to rapid progression to AIDS if not diagnosed and promptly treated or better still prevented. The study aims at determining the prevalence and risk factors of hepatitis B infection in HIV infected children being followed up at the Paediatric HIV clinic. \u0000Patients and methods: A cross-sectional study of 261 HIV infected children aged eight months to fourteen years to determine the prevalence of Hepatitis B infection and pattern of hepatitis B vaccination was carried out between July and October 2012 at the Paediatric HIV clinic of National Hospital Abuja. Ethical approval was obtained from Ethical Committee of the hospital. Vaccination and transfusion history were obtained from the parents and guardians of the subjects using a proforma after signed informed consent. Blood samples were collected for Hepatitis B surface antigen screening and Hepatitis B screening in those with HBsAg positive blood samples. \u0000Results: Only 3 (1.15%) of the 261 HIV infected children had Hepatitis B infection. All the children less than 5 years old in this cohort received hepatitis B vaccination and none of them had Hepatitis B infection. The HIV/HBV co infected children were older than ten years (p = 0.047) and history of blood transfusion (p = 0.003) was also significant. However, scarification (p = 0.996), local circumcision (p = 0.928); uvulectomy (p = 0.898) were not significant risk factors in this cohort. \u0000 \u0000 \u0000Conclusion: There is need to intensify routine hepatitis B vaccination and routine screening of blood before necessary transfusion. This would further lead to a low prevalence of Hepatitis B in HIV infected children and the general populace at large. \u0000 \u0000 \u0000","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77684291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Imoudu A. Iragbogie, Yusuf O. Maimuna, Ahmad Hayatu, Afegbua S. Dalhat, Ismail K. Musa
Background: Sickle cell disorders (SCD) are the commonest inherited haemoglobin (Hb) disorders. Globally, about 300,000 babies are born annually with these conditions. The clinical profiles of SCD have been described in many parts of the world. These however have not been adequately investigated in some parts of Nigeria. This study evaluated the clinical features, Hb phenotype and complications of children with SCD being managed at a Paediatric haematology clinic in Northern Nigeria. Methods: A prospective observational study of steady state SCD patients aged 2 – 16 years, was conducted from January, 2019 -October, 2020. Historical and examination findings were documented. Analysis of data was done with the Statistical Package for Social Sciences (SPSS) version 20.0. Results: One hundred children were studied. Mean age was 6.97 ± 3.63 years. Male: female ratio was 1.6:1.Mean weight and mean height were lower than reference standards (t= -1.20, p= 0.14), (t= - 0.66, p= 0.27) respectively. Mean age at diagnosis was 13.24 ±14.83 months, and at first presentation was 13.86 ±17.51 months, 58.5% of subjects were adequately vaccinated for age, while 92% had a Hb phenotype of SS. Acute chest syndrome occurred more frequently in children aged 9-12 years (χ2= 11.59, P ˂ 0.001), and in those with severe bacterial infections (χ2= 7.41, p= 0.006). Conclusion: The complications of Paediatric SCD in this part of North-Eastern Nigeria mirrors those in other parts of the country. Socio-economic class, Hb phenotype and vaccination status had no influence on the development of complications.
{"title":"Clinical profile of paediatric sickle cell disease at a reference hospital in North–eastern Nigeria","authors":"Imoudu A. Iragbogie, Yusuf O. Maimuna, Ahmad Hayatu, Afegbua S. Dalhat, Ismail K. Musa","doi":"10.4314/njp.v48i2.3","DOIUrl":"https://doi.org/10.4314/njp.v48i2.3","url":null,"abstract":"\u0000 \u0000 \u0000Background: Sickle cell disorders (SCD) are the commonest inherited haemoglobin (Hb) disorders. Globally, about 300,000 babies are born annually with these conditions. The clinical profiles of SCD have been described in many parts of the world. These however have not been adequately investigated in some parts of Nigeria. This study evaluated the clinical features, Hb phenotype and complications of children with SCD being managed at a Paediatric haematology clinic in Northern Nigeria. \u0000Methods: A prospective observational study of steady state SCD patients aged 2 – 16 years, was conducted from January, 2019 -October, 2020. Historical and examination findings were documented. Analysis of data was done with the Statistical Package for Social Sciences (SPSS) version 20.0. \u0000Results: One hundred children were studied. Mean age was 6.97 ± 3.63 years. Male: female ratio was 1.6:1.Mean weight and mean height were lower than reference standards (t= -1.20, p= 0.14), (t= - 0.66, p= 0.27) respectively. Mean age at diagnosis was 13.24 ±14.83 months, and at first presentation was 13.86 ±17.51 months, 58.5% of subjects were adequately vaccinated for age, while 92% had a Hb phenotype of SS. Acute chest syndrome occurred more frequently in children aged 9-12 years (χ2= 11.59, P ˂ 0.001), and in those with severe bacterial infections (χ2= 7.41, p= 0.006). \u0000Conclusion: The complications of Paediatric SCD in this part of North-Eastern Nigeria mirrors those in other parts of the country. Socio-economic class, Hb phenotype and vaccination status had no influence on the development of complications. \u0000 \u0000 \u0000","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"218 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72676166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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