Introduction: Breastfeeding is essential for optimum childhood development. Although there is an increased awareness of the importance of breast milk, the Nigerian Demographic and Health Survey of 2018 showed that less than one-third (29%) of mothers in Nigeria practice exclusive breastfeeding. This may be attributed to several factors, hence the need for this study to assess the indicators and predictors of breastfeeding practices among mothers in a tertiary facility in Calabar, Cross River State. Methods: This cross-sectional study was conducted in the University of Calabar Teaching Hospital, Calabar, Nigeria. Consenting mothers of children aged six weeks to two years were sequentially recruited into the study using an interviewer-administered questionnaire. A test of association of categorical variables was done using Chi square test and pvalue was set at 0.05. Results: One hundred and twenty one children and their mothers were surveyed. Mean age of children was 6.2±3.8months and mothers was 28±25years. Exclusive breastfeeding rate for six months was 67.8%.Timely breastfeeding within one hour of life was 44.6%,ever breastfed rate was 86%. Practice of giving water alongside breast milk and use of breast milk substitute was 18.2% and 14.0% respectively. Mothers age was significantly associated with practice of exclusive breastfeeding (p=0.014) and giving water alongside breast milk (p=0.005) while birth order was associated with timely commencement of breastfeeding within one hour of life (p=0.022). Conclusion: The ever breastfed and exclusive breastfeeding rates were fairly high. However, the timely first suckling rate, increased use of breast milk substitute and giving of water alongside breast milk in the first six months of life were low. There is the need for continuous health education of mothers.
{"title":"Predictors of breastfeeding practices among mothers in a developing African country – A tertiary facility based study in Calabar, Nigeria","authors":"JM Ikobah, K. Uhegbu, I. Agbor, E. Udoh","doi":"10.4314/NJP.V48I1.4","DOIUrl":"https://doi.org/10.4314/NJP.V48I1.4","url":null,"abstract":"Introduction: Breastfeeding is essential for optimum childhood development. Although there is an increased awareness of the importance of breast milk, the Nigerian Demographic and Health Survey of 2018 showed that less than one-third (29%) of mothers in Nigeria practice exclusive breastfeeding. This may be attributed to several factors, hence the need for this study to assess the indicators and predictors of breastfeeding practices among mothers in a tertiary facility in Calabar, Cross River State. Methods: This cross-sectional study was conducted in the University of Calabar Teaching Hospital, Calabar, Nigeria. Consenting mothers of children aged six weeks to two years were sequentially recruited into the study using an interviewer-administered questionnaire. A test of association of categorical variables was done using Chi square test and pvalue was set at 0.05. Results: One hundred and twenty one children and their mothers were surveyed. Mean age of children was 6.2±3.8months and mothers was 28±25years. Exclusive breastfeeding rate for six months was 67.8%.Timely breastfeeding within one hour of life was 44.6%,ever breastfed rate was 86%. Practice of giving water alongside breast milk and use of breast milk substitute was 18.2% and 14.0% respectively. Mothers age was significantly associated with practice of exclusive breastfeeding (p=0.014) and giving water alongside breast milk (p=0.005) while birth order was associated with timely commencement of breastfeeding within one hour of life (p=0.022). Conclusion: The ever breastfed and exclusive breastfeeding rates were fairly high. However, the timely first suckling rate, increased use of breast milk substitute and giving of water alongside breast milk in the first six months of life were low. There is the need for continuous health education of mothers.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"7 2 1","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2021-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91242782","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: Researchers in medicine and related fields in Nigeria have usually made recourse to the instrument developed by Olusanya et al and Oyedeji in the past three-and-a half decades for determination of socioeconomic status (SES). Beside the question of their age, however, these instruments were purposive and might no longer be suitable because of the changes in the parameters on which they were based.Objective: To develop a robust but generic scheme that takes into consideration the changes in the nation’s socioeconomic space in the succeeding three and a half decades.Methods: A detailed and comprehensive review of the extant schemes was undertaken with a view to identifying their inherent weaknesses. The latter were then factored into the design of a new scheme taking into consideration the emergent restructuring of career positions in the civil/public service as well as the place of private and informal sectors of the economy. The new scheme was validated at the University of Beninand Irrua Specialist Teaching Hospitals.Results: The new scheme had a remarkably high Inter-rater reliability (r = 0.947, p<0.001), raterre- rater reliability (r = 0.984, p <0.001) and % agreement (with modified Oyedeji’s tool as standard) of 67% (K coefficient = 0.47, r = 0.71, p<0.001)Conclusion/Recommendation: The new scheme could be a viable tool for the assessment of SES of families and individuals, which not only takes into consideration current realities of the nation’s economy, but also is readily adaptable to meet foreseeable changes.
{"title":"A revised scoring scheme for the classification of socio-economic status in Nigeria","authors":"M. Ibadin, G. Akpede","doi":"10.4314/NJP.V48I1.5","DOIUrl":"https://doi.org/10.4314/NJP.V48I1.5","url":null,"abstract":"Background: Researchers in medicine and related fields in Nigeria have usually made recourse to the instrument developed by Olusanya et al and Oyedeji in the past three-and-a half decades for determination of socioeconomic status (SES). Beside the question of their age, however, these instruments were purposive and might no longer be suitable because of the changes in the parameters on which they were based.Objective: To develop a robust but generic scheme that takes into consideration the changes in the nation’s socioeconomic space in the succeeding three and a half decades.Methods: A detailed and comprehensive review of the extant schemes was undertaken with a view to identifying their inherent weaknesses. The latter were then factored into the design of a new scheme taking into consideration the emergent restructuring of career positions in the civil/public service as well as the place of private and informal sectors of the economy. The new scheme was validated at the University of Beninand Irrua Specialist Teaching Hospitals.Results: The new scheme had a remarkably high Inter-rater reliability (r = 0.947, p<0.001), raterre- rater reliability (r = 0.984, p <0.001) and % agreement (with modified Oyedeji’s tool as standard) of 67% (K coefficient = 0.47, r = 0.71, p<0.001)Conclusion/Recommendation: The new scheme could be a viable tool for the assessment of SES of families and individuals, which not only takes into consideration current realities of the nation’s economy, but also is readily adaptable to meet foreseeable changes.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89797113","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}
S. Abdullahi, H. Idris, Halima A. Sadiku, E. Abubakar
Gangliosidoses belong to the group of genetic lipid metabolism disorders, caused by defects of lysosome enzymes, inherited as an autosomal recessive trait. Gangliosidosis GM1 is caused by the deficiency of the acid beta-galactosidase (GLB11) resulting in the storage of the substrate- GM1 ganglioside in brain and visceral organs. GM1 gangliosidosis comprises three phenotypes, depending on the age of onset: an infantile, juvenile and adult type. In the infantile type dysmorphic features, severe psychomotor retardation, hepatosplenomegaly, bone changes and a cherry red spot in the macular region are seen. The juvenile GM1 gangliosidosis has no such external distinguishing features. In the adult type behavioural problems, dementia, extrapyramidal problems are specifically prominent. The authors present symptoms, clinical course and laboratory findings of a one-year-old boy with a diagnosed GM1 gangliosidosis. He presented with skin rashes since birth, delay in achievement of developmental milestones, progressive weight loss and recurrent diarrhoea of six-months duration.
{"title":"GM1-gangliosidosis in a Nigerian infant: A case report","authors":"S. Abdullahi, H. Idris, Halima A. Sadiku, E. Abubakar","doi":"10.4314/NJP.V48I1.10","DOIUrl":"https://doi.org/10.4314/NJP.V48I1.10","url":null,"abstract":"Gangliosidoses belong to the group of genetic lipid metabolism disorders, caused by defects of lysosome enzymes, inherited as an autosomal recessive trait. Gangliosidosis GM1 is caused by the deficiency of the acid beta-galactosidase (GLB11) resulting in the storage of the substrate- GM1 ganglioside in brain and visceral organs. GM1 gangliosidosis comprises three phenotypes, depending on the age of onset: an infantile, juvenile and adult type. In the infantile type dysmorphic features, severe psychomotor retardation, hepatosplenomegaly, bone changes and a cherry red spot in the macular region are seen. The juvenile GM1 gangliosidosis has no such external distinguishing features. In the adult type behavioural problems, dementia, extrapyramidal problems are specifically prominent. The authors present symptoms, clinical course and laboratory findings of a one-year-old boy with a diagnosed GM1 gangliosidosis. He presented with skin rashes since birth, delay in achievement of developmental milestones, progressive weight loss and recurrent diarrhoea of six-months duration.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"40 1","pages":"50-53"},"PeriodicalIF":0.0,"publicationDate":"2021-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90636604","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. Ayodeji, Fatungase Oluwabunmi Motunrayo, Nwokoro C. Chigbundu, Shoyemi R. Oluwatoyin
Background: Anaesthesia for herniotomy may be challenging because the margin of error in managing such a young patient can be extremely small since the body reserves are limited and the organ systems may not be fully developed. Also, the psychological, physiological and pharmacological responses to anaesthesia are quite different from adult. Safe and effective care of children under anaesthesia is therefore crucial. This study aims to audit the pattern of anaesthetisia techniques used and their associated complications during herniotomy procedure in our health facility. Material and methods: This is a retrospective review of patients’ files, theatre records and anaesthetic-record charts of herniotomy cases performed in a tertiary health Institution from January 2011 to December 2015. Relevant clinical information were entered into proforma designed for the study. Data was analysed with descriptive statistics using the Statistical Package for Social Sciences (SPSS) version 20 Chicago IL (U.S.A). Inferential statistics of Chi-Square, Mann-Whitney and Kruskal-Wallis Test were alsoperformed. Results: One hundred and fortyfour in-patient children who belonged to American Society of Anesthesiologists Physical Health Status (ASA) grade I and II had herniotomies during the study period. The mean age is 4.21±3.72years (range, 6months – 16years) with male to female ratio of 47:1 (i.e 141 to 3). General anaesthesia (135, 94%) of various techniques was the most common technique while regional anaesthesia was only employed in nine (6%) children. The regional anaesthesia techniques were caudal block 1 (0.7%) and subarachnoid block 8 (5.5%) and were sedated to allow for cooperation in some of the cases. One hundred and twenty-four (86%) children presented as simple, elective cases while twenty (14%) children as complicated or emergency cases. Conclusion: This study showed that herniotomy can be safely performed under various options of anaesthesia techniques depending on the expertise of the anaesthetists involved. The simple, electives inguinal hernia and hydroceles could have been performed as day cases.
背景:疝切开术的麻醉可能是具有挑战性的，因为管理这样一个年轻的病人的误差范围可能非常小，因为身体储备有限，器官系统可能没有完全发育。此外，对麻醉的心理、生理和药理反应与成人有很大的不同。因此，对处于麻醉状态的儿童进行安全有效的护理至关重要。本研究的目的是审核在我们的医疗机构疝气切开术中使用的麻醉技术及其相关并发症的模式。材料和方法:回顾性分析2011年1月至2015年12月在某三级医疗机构行疝切开术的患者档案、手术室记录和麻醉记录。将相关临床信息输入为研究设计的表格中。使用社会科学统计软件包(SPSS)版本20 Chicago IL(美国)对数据进行描述性统计分析。进行卡方检验、Mann-Whitney检验和Kruskal-Wallis检验的推论统计。结果:144名住院儿童在研究期间接受了疝切开术，他们属于美国麻醉医师协会身体健康状况(ASA) I级和II级。平均年龄为4.21±3.72岁(范围6个月- 16岁)，男女比例为47:1(即141:3)。全麻是各种麻醉方法中最常见的麻醉方法(135,94%)，而区域麻醉仅在9例(6%)患儿中使用。区域麻醉技术为尾侧阻滞1(0.7%)和蛛网膜下腔阻滞8(5.5%)，并在某些情况下镇静以允许合作。124名(86%)儿童表现为简单的选择性病例，而20名(14%)儿童表现为复杂或紧急病例。结论:本研究表明，根据麻醉师的专业知识，疝切开术可以在各种麻醉技术下安全进行。单纯的、选择性的腹股沟疝和鞘膜积液可以作为日间病例进行。
{"title":"Pattern of anaesthesia techniques for herniotomy at a southwestern tertiary health institution: a 5-year review","authors":"E. Ayodeji, Fatungase Oluwabunmi Motunrayo, Nwokoro C. Chigbundu, Shoyemi R. Oluwatoyin","doi":"10.4314/NJP.V48I1.1","DOIUrl":"https://doi.org/10.4314/NJP.V48I1.1","url":null,"abstract":"Background: Anaesthesia for herniotomy may be challenging because the margin of error in managing such a young patient can be extremely small since the body reserves are limited and the organ systems may not be fully developed. Also, the psychological, physiological and pharmacological responses to anaesthesia are quite different from adult. Safe and effective care of children under anaesthesia is therefore crucial. This study aims to audit the pattern of anaesthetisia techniques used and their associated complications during herniotomy procedure in our health facility. Material and methods: This is a retrospective review of patients’ files, theatre records and anaesthetic-record charts of herniotomy cases performed in a tertiary health Institution from January 2011 to December 2015. Relevant clinical information were entered into proforma designed for the study. Data was analysed with descriptive statistics using the Statistical Package for Social Sciences (SPSS) version 20 Chicago IL (U.S.A). Inferential statistics of Chi-Square, Mann-Whitney and Kruskal-Wallis Test were alsoperformed. Results: One hundred and fortyfour in-patient children who belonged to American Society of Anesthesiologists Physical Health Status (ASA) grade I and II had herniotomies during the study period. The mean age is 4.21±3.72years (range, 6months – 16years) with male to female ratio of 47:1 (i.e 141 to 3). General anaesthesia (135, 94%) of various techniques was the most common technique while regional anaesthesia was only employed in nine (6%) children. The regional anaesthesia techniques were caudal block 1 (0.7%) and subarachnoid block 8 (5.5%) and were sedated to allow for cooperation in some of the cases. One hundred and twenty-four (86%) children presented as simple, elective cases while twenty (14%) children as complicated or emergency cases. Conclusion: This study showed that herniotomy can be safely performed under various options of anaesthesia techniques depending on the expertise of the anaesthetists involved. The simple, electives inguinal hernia and hydroceles could have been performed as day cases.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"1 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2021-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89370594","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}
S. Abdullahi, H. Idris, S. Mado, A. Sadiku, A. Alfa, E. Abubakar, Y. Adzu, A. Suleiman
Congenital chylous ascites (CCA) is a rare disease that results from the maldevelopment of the intra-abdominal lymphatic system. Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A 3-month-old girl diagnosed with congenital chylous ascites. She was managed initially with nil per oral, parenteral nutrition, medium chain triglyceride (MCT) containing oil and abdominal paracentesis, followed by octreotide. Medium chain triglyceride formula, the main stay of management was discontinued with gradual reintroduction of breast feeds. This case was selected due to the rarity of CCA and the lack of standards in the diagnosis and therapy.
{"title":"Congenital chylous as cites in a 3-month-old infant in Zaria: A case report","authors":"S. Abdullahi, H. Idris, S. Mado, A. Sadiku, A. Alfa, E. Abubakar, Y. Adzu, A. Suleiman","doi":"10.4314/njp.v48i2.7","DOIUrl":"https://doi.org/10.4314/njp.v48i2.7","url":null,"abstract":"Congenital chylous ascites (CCA) is a rare disease that results from the maldevelopment of the intra-abdominal lymphatic system. Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A 3-month-old girl diagnosed with congenital chylous ascites. She was managed initially with nil per oral, parenteral nutrition, medium chain triglyceride (MCT) containing oil and abdominal paracentesis, followed by octreotide. Medium chain triglyceride formula, the main stay of management was discontinued with gradual reintroduction of breast feeds. This case was selected due to the rarity of CCA and the lack of standards in the diagnosis and therapy.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80721065","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}
Histiocytoses are a rare group of proliferative disorders with very similar clinical and histological pictures. We present a case report of two variants seen in an eight-month-old female and five-month-old male in a tertiary hospital in southern Nigeria. They both presented with painless neck swellings and fever, leucocytosis, neutrophilia and lymphopenia. Initial histologic examinations of the cervical lymph nodes biopsy posed a diagnostic conundrum. However, Immuno-histochemical analysis done on both sample showed CD1a, positive S100 in keeping with Langerhans cell histiocytosis in the former. While, that of the latter showed strongly positive CD68, positive S-100 in 30% cells in keeping with Sinus histiocytosis with massive lymphadenopathy (SLMH) in the latter. Clinicians should have a high index of suspicion for histiocytosis in children presenting with generalised lymphadenopathy. Also, apart from the routine histology, immunohistochemistry analysis is recommended for all cases
{"title":"Histiocytosis in Nigerian children: A report of two variants","authors":"E. Udo, I. Precious Oloyede, E. Bassey, O. Udoh","doi":"10.4314/njp.v48i2.8","DOIUrl":"https://doi.org/10.4314/njp.v48i2.8","url":null,"abstract":"Histiocytoses are a rare group of proliferative disorders with very similar clinical and histological pictures. We present a case report of two variants seen in an eight-month-old female and five-month-old male in a tertiary hospital in southern Nigeria. They both presented with painless neck swellings and fever, leucocytosis, neutrophilia and lymphopenia. Initial histologic examinations of the cervical lymph nodes biopsy posed a diagnostic conundrum. However, Immuno-histochemical analysis done on both sample showed CD1a, positive S100 in keeping with Langerhans cell histiocytosis in the former. While, that of the latter showed strongly positive CD68, positive S-100 in 30% cells in keeping with Sinus histiocytosis with massive lymphadenopathy (SLMH) in the latter. Clinicians should have a high index of suspicion for histiocytosis in children presenting with generalised lymphadenopathy. Also, apart from the routine histology, immunohistochemistry analysis is recommended for all cases","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77387105","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}
Folic acid supplementation does not only prevent neural tube defects in the foetus but is an essential ingredient in the growth and development of the cerebral cortex. This micronutrient promotes the thickness of the cerebral cortex; the extent of the thickness being directly proportional to the intelligent quotient, neurocognitive and psychological output of the child. Children with thin cortices are prone to poor cognitive performance, autism and psychiatric disorders such as depression. Folic acid supplementation in the first three months of pregnancy largely protects against neural tube defects; studies have shown that children whose mothers take folic acid supplement throughout pregnancy exhibit relatively higher levels of emotional intelligence. Nevertheless, in spite of long-standing recommendations that women of child-bearing age take folic acid to protect against neural impairment, a large proportion do not comply; less than half of the world’s population lives in countries that require folic acid fortification of grain products. A large portion of pregnant women in poor world countries do not attend antenatal care hence have no access to prescription of essential haematinic/folic acid. It is recommended that all women who are either planning or capable of pregnancy take a daily supplements containing 0.4 - 0.8 mg (400-800 μg) of folic acid. Fortified foods like some breads, juices, and cereals contain adequate folic acid; others are leafy green vegetables, like spinach, broccoli, and lettuce beans, peas, and lentils. Fruits like lemons, bananas, and melons are also rich sources of folate. There is need for more advocacy regarding antenatal care of pregnant mothers with emphasis on folate supplementation before and throughout pregnancy, to boost the intellectual and psychological capacity of children into adulthood.
{"title":"Folic acid and brain function in childhood","authors":"A. Asindi, Komomo Eyong","doi":"10.4314/njp.v48i2.5","DOIUrl":"https://doi.org/10.4314/njp.v48i2.5","url":null,"abstract":"Folic acid supplementation does not only prevent neural tube defects in the foetus but is an essential ingredient in the growth and development of the cerebral cortex. This micronutrient promotes the thickness of the cerebral cortex; the extent of the thickness being directly proportional to the intelligent quotient, neurocognitive and psychological output of the child. Children with thin cortices are prone to poor cognitive performance, autism and psychiatric disorders such as depression. Folic acid supplementation in the first three months of pregnancy largely protects against neural tube defects; studies have shown that children whose mothers take folic acid supplement throughout pregnancy exhibit relatively higher levels of emotional intelligence. Nevertheless, in spite of long-standing recommendations that women of child-bearing age take folic acid to protect against neural impairment, a large proportion do not comply; less than half of the world’s population lives in countries that require folic acid fortification of grain products. A large portion of pregnant women in poor world countries do not attend antenatal care hence have no access to prescription of essential haematinic/folic acid. It is recommended that all women who are either planning or capable of pregnancy take a daily supplements containing 0.4 - 0.8 mg (400-800 μg) of folic acid. Fortified foods like some breads, juices, and cereals contain adequate folic acid; others are leafy green vegetables, like spinach, broccoli, and lettuce beans, peas, and lentils. Fruits like lemons, bananas, and melons are also rich sources of folate. There is need for more advocacy regarding antenatal care of pregnant mothers with emphasis on folate supplementation before and throughout pregnancy, to boost the intellectual and psychological capacity of children into adulthood.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81272279","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. Joseph, A. Akinsete, B. Adegboyega, O. Awofeso, A. Ajose
Background: Caregiver delay in presentation has been cited as a major contributor to poor prognosis of paediatric cancers in low-middle income countries like Nigeria. This study explored the time duration between onset of symptoms and presentation to healthcare facilities, diagnosis, and referral for specialist care. Methods: Data were compiled from caregivers of newly registered children at a teaching hospital in Nigeria. Sociodemographic and clinical history of the child were taken. Type of cancer, date of diagnosis, centre where the diagnosis was made, treatment start date, and duration of symptoms until treatment were elicited from consenting caregivers and documented. Results: Acute lymphoblastic leukaemia was the most prevalent cancer type among the patients. The mean time from first symptom to presentation was 15 weeks and from presentation at any health care facility to specialist referral and diagnosis was 38 and 39 weeks, respectively. Time from diagnosis to treatment was a mean of 8 weeks (range: 1 to 27 weeks) Conclusion: Delayed presentation has become a commonly cited factor for poor cancer outcomes in Nigeria and may often inaccurately assign blame to the patient/caregivers. The results of this study point to delayed detection, delayed diagnosis and delayed referral for specialist care, as more accurate contributors to late-stage presentation and consequently worse outcomes of paediatric cancers in Nigeria. Strengthening of community and primary level healthcare professionals’ understanding of paediatric cancers, establishment of simple detection algorithms and national implementation of efficient referral protocols will potentially reduce delays in specialist attention and improve outcomes.
{"title":"Delayed referral and treatment of paediatric cancer in Nigeria: Time to stop blaming the victim","authors":"A. Joseph, A. Akinsete, B. Adegboyega, O. Awofeso, A. Ajose","doi":"10.4314/njp.v48i2.4","DOIUrl":"https://doi.org/10.4314/njp.v48i2.4","url":null,"abstract":"Background: Caregiver delay in presentation has been cited as a major contributor to poor prognosis of paediatric cancers in low-middle income countries like Nigeria. This study explored the time duration between onset of symptoms and presentation to healthcare facilities, diagnosis, and referral for specialist care. Methods: Data were compiled from caregivers of newly registered children at a teaching hospital in Nigeria. Sociodemographic and clinical history of the child were taken. Type of cancer, date of diagnosis, centre where the diagnosis was made, treatment start date, and duration of symptoms until treatment were elicited from consenting caregivers and documented. Results: Acute lymphoblastic leukaemia was the most prevalent cancer type among the patients. The mean time from first symptom to presentation was 15 weeks and from presentation at any health care facility to specialist referral and diagnosis was 38 and 39 weeks, respectively. Time from diagnosis to treatment was a mean of 8 weeks (range: 1 to 27 weeks) Conclusion: Delayed presentation has become a commonly cited factor for poor cancer outcomes in Nigeria and may often inaccurately assign blame to the patient/caregivers. The results of this study point to delayed detection, delayed diagnosis and delayed referral for specialist care, as more accurate contributors to late-stage presentation and consequently worse outcomes of paediatric cancers in Nigeria. Strengthening of community and primary level healthcare professionals’ understanding of paediatric cancers, establishment of simple detection algorithms and national implementation of efficient referral protocols will potentially reduce delays in specialist attention and improve outcomes.","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78405468","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. Ochoga, R. Abah, A. Michael, L. Ide, R. Onalo, A. Idoko, S. Okolo, A. Onyemocho
Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality. Key words: Neonate, Morbidity, Mortality, Nigeria
{"title":"Retrospective assessment of neonatal morbidity and mortality in the special care baby unit of a private health facility in Benue State, North Central Nigeria","authors":"M. Ochoga, R. Abah, A. Michael, L. Ide, R. Onalo, A. Idoko, S. Okolo, A. Onyemocho","doi":"10.4314/njp.v47i4.9","DOIUrl":"https://doi.org/10.4314/njp.v47i4.9","url":null,"abstract":"Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality. \u0000Key words: Neonate, Morbidity, Mortality, Nigeria","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"50 1","pages":"353-357"},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88506926","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: Rapid diagnostic test (mRDT) is a useful tool in demonstrating parasitologically proven malaria. Its efficacy is however hampered when parasite density is low. Prophylactic use of cotrimoxazoleas in cases of HIV infected children can cause reduction in parasite count. It is doubtful if mRDT will retain its diagnostic usefulness among such individuals.Objectives: The study sought to evaluate the diagnostic value of mRDT in HIV infected children on cotrimoxazole prophylaxis in Benin City.Methods: In the prospective, cross sectional and descriptive study, we assessed malaria parasitaemia using standard methods in microscopy and parasite density and malaria antigenaemia using Care Start Pf (monoclonal antibodies specific to histidine rich protein – 2 antigen) in 221 each of HIV infected subjects on cotrimoxazole managed in a specialist clinic and HIV negative controls all seen at the University of Benin Teaching Hospital between April and June 2016.Results: Malaria antigenaemia rate MAr (20.8%) was lower than malaria parasitaemia rate MPr (24.4%) in subjects. MAr (20.8) and MPr (24.4%) in subjects were higher than MAr (18.10%) and MPr (17.7%) in controls. Mean (SEM) parasite count in subjects of was low (50.88 + 2.24 per μl). Using microscopy as gold standard the sensitivity, specificity, PPV and NPV of mRDT in subjects were 77.8%, 97.6%, 91.3% and 93.1%. Corresponding values in controls were 100.0%, 99.5%, 97.5% and 100.0%.Youden indices for subjects and controls were 0.75 and 0.99.Conclusions/Recommendations: Sensitivity of mRDT in HIV infected children on cotrimoxazole prophylaxis for opportunistic infections (OI) is reduced. However the indices of specificity, PPV and NPV are high enough to retain its value in the evaluation of HIV infected children for asymptomatic malaria and perhaps the clinical disease. Keywords: mRDT, Utility, HIVinfected Children, Cotrimoxazoleprophylaxis, Benin City
{"title":"Usefulness of rapid diagnostic test in the diagnosis of asymptomatic malaria in HIV infected children on cotrimoxazole prophylaxis in Benin City, Nigeria","authors":"M. Ibadin, N. Eghafona","doi":"10.4314/njp.v47i4.3","DOIUrl":"https://doi.org/10.4314/njp.v47i4.3","url":null,"abstract":"Background: Rapid diagnostic test (mRDT) is a useful tool in demonstrating parasitologically proven malaria. Its efficacy is however hampered when parasite density is low. Prophylactic use of cotrimoxazoleas in cases of HIV infected children can cause reduction in parasite count. It is doubtful if mRDT will retain its diagnostic usefulness among such individuals.Objectives: The study sought to evaluate the diagnostic value of mRDT in HIV infected children on cotrimoxazole prophylaxis in Benin City.Methods: In the prospective, cross sectional and descriptive study, we assessed malaria parasitaemia using standard methods in microscopy and parasite density and malaria antigenaemia using Care Start Pf (monoclonal antibodies specific to histidine rich protein – 2 antigen) in 221 each of HIV infected subjects on cotrimoxazole managed in a specialist clinic and HIV negative controls all seen at the University of Benin Teaching Hospital between April and June 2016.Results: Malaria antigenaemia rate MAr (20.8%) was lower than malaria parasitaemia rate MPr (24.4%) in subjects. MAr (20.8) and MPr (24.4%) in subjects were higher than MAr (18.10%) and MPr (17.7%) in controls. Mean (SEM) parasite count in subjects of was low (50.88 + 2.24 per μl). Using microscopy as gold standard the sensitivity, specificity, PPV and NPV of mRDT in subjects were 77.8%, 97.6%, 91.3% and 93.1%. Corresponding values in controls were 100.0%, 99.5%, 97.5% and 100.0%.Youden indices for subjects and controls were 0.75 and 0.99.Conclusions/Recommendations: Sensitivity of mRDT in HIV infected children on cotrimoxazole prophylaxis for opportunistic infections (OI) is reduced. However the indices of specificity, PPV and NPV are high enough to retain its value in the evaluation of HIV infected children for asymptomatic malaria and perhaps the clinical disease. \u0000Keywords: mRDT, Utility, HIVinfected Children, Cotrimoxazoleprophylaxis, Benin City","PeriodicalId":19199,"journal":{"name":"Nigerian journal of paediatrics","volume":"74 1","pages":"312-317"},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78651627","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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