Exercise Induced Bronchospasm and associated factors in primary school children: a cross-sectional study.

BACKGROUND: Exercise Induced Bronchospasm(EIB) is not equivalent to asthma. As many as 20%of school aged children are estimated to have EIB. In Nigeria, there is still a dearth of information on EIB as a clinical entity. This study determined the presence of EIB(using pre and post-exercise percentage difference in peak expiratory flow rate(PEFR) and associated factors such as age, gender, social class and nutritional status in primary school children in Nnewi, Anambra state, South-East Nigeria. The study also grouped those with EIB into those with asthma(EIBA) and those without asthma(EIBWA). METHODS: This was a community based cross-sectional study involving 6-12 year olds. The PEFR was taken at rest and after a 6 min free running test on the school play-ground using a Peak Flow Meter. A diagnosis of EIB was made if there was a decline of ≥ 10%. Those who had EIB were grouped further based on the degree of decline in post-exercise PEFR (a decline ≥ 10% < 25% → Mild EIB, ≥ 25% < 50% → Moderate EIB and ≥ 50% → Severe EIB) and then categorized as those with EIBWA/EIBA. RESULTS: EIB in the various minutes post-exercise was as follows: 19.2%(1stmin), 20.9%(5thmin), 18.7%(10thmin), 10%(20thmin), 0.7%(30thmin). Mild EIB accounted for the greater proportion in all minutes post-exercise and none of the pupils had severe EIB. Using values obtained in the 5thmin post-exercise for further analysis, EIBWA/EIBA = 84.1%/15.9% respectively. Mean difference in the post-exercise PEFR of EIB/no EIB and EIBWA/EIBA was -48.45(t = -7.69, p = < 0.001) and 44.46(t = 3.77, p = 0.01) respectively. Age and gender had a significant association to the presence of EIB and 58% of the pupils with EIB were of high social class. The BMI for age and gender z-scores of all study subjects as well as those with EIB was -0.34 ± 1.21, -0.09 ± 1.09 respectively. Other features of allergy(history of allergic rhinitis: OR-5.832, p = 0.001; physical findings suggestive of allergic dermatitis: OR-2.740, p = 0.003)were present in pupils diagnosed with EIB. CONCLUSION: EIB has a high prevalence in primary school children in Nnewi and the greater proportion of those with EIB had EIBWA. EIB therefore needs to be recognized as a clinical entity and stratified properly based on the presence or absence of asthma. This will help the proper management and prognostication.

Hepatitis e prevalence, knowledge, and practice of preventive measures among secondary school adolescents in rural Nigeria: a cross-sectional study.

BACKGROUND: Currently, there is a paucity of data on the knowledge and practice of preventive measures for Hepatitis E infection in Nigerian populations. This study provided data on the prevalence, knowledge and practices of prevention in an adolescent population from Nigeria. METHODS: This cross-sectional study was conducted over 3 months among rural Nigerian secondary school adolescents. An interviewer-based questionnaire was used to collect data on sociodemographic profile, knowledge, and practice of preventive measures for Hepatitis E infection. Blood samples collected from participants were analysed for Hepatitis E IgG using Elisa Kits (Sigma Diagnostics, USA). Data were analysed using SPSS software version 20.0. Tests of association were done with a level of significance set at 5%. RESULTS: A total of 9 out of the 414 participants tested positive for Hepatitis E IgG antibodies giving a prevalence of 2.2%. Significant factors for Hepatitis E infection were male gender {P = 0.004} and school {P < 0.001, however logistic regression gave infinite value. Most participants (98.6%) had poor knowledge of Hepatitis E infection, 239(57.7%) had good preventive practices, while 175(42.3%) had average preventive practices. CONCLUSION: A low prevalence of HEV infection was recorded among study participants. There was poor knowledge of Hepatitis E, and association could not be established between HEV infection and individual preventive practices.

Vitamin D and Acute Respiratory Infections in Children.

Background: This study sought to evaluate the association between serum vitamin D levels and acute respiratory infection (ARI) in under-five children in Nnamdi Azikiwe University Teaching Hospital (NAUTH) in Nigeria. Methodology: This study was conducted in NAUTH, Nigeria, in 2017, in 250 children with ARI, classified into those with acute upper respiratory infection (AURI) and those with acute lower respiratory infection (ALRI). and 250 children without ARI, matched for age and gender. Sociodemographic data and serum vitamin D were obtained. The data were compared between the study and the control groups. The data were compared between those with AURI and those with ALRI. Results: The mean serum 25(OH)D of (52.2±25.6 ng/ml) in the study subjects was lower than the (57.0±23.9 ng/ml in the control group (t=2.20, p=0.03).The mean serum 25(OH)D levels in children with ALRI [39.8±23.8 ng/ml] was lower than in those with AURI [56.0±24.9ng/ml] (t= 14.83, p <0.001). In addition, the association between low levels of serum 25(OH)D and severity of ALRI was significant (x2 = 9.45, p = 0.002). Conclusion: In under-five children, serum vitamin D levels were low, and these low levels were associated more with ALRIs than AURIs in this study.

Glycemic outcomes related to depression in adults with type 1 diabetes.

Glycemic outcomes of adults with type 1 diabetes may be affected by depression. Our aim was to compare outcomes of "depressed" (Patient Health Questionnaire-9 ⩾ 10, N = 83) to "not-depressed" matched control (Patient Health Questionnaire-2 < 3, N = 166) adults with type 1 diabetes with objective measures. The depressed group had poorer blood glucose control and, for those with glucose meter downloads, fewer glucose tests/day. The groups did not differ on glucose variability or episodes of hypoglycemia. Depression in adults with type 1 diabetes is associated with poorer glycemic control and less blood glucose monitoring. Future research should examine whether treatment of depression results in better self-care and glycemic outcomes.

Glycemic outcomes related to depression in adults with type 1 diabetes.

Glycemic outcomes of adults with type 1 diabetes may be affected by depression. Our aim was to compare outcomes of "depressed" (Patient Health Questionnaire-9 ⩾ 10, N = 83) to "not-depressed" matched control (Patient Health Questionnaire-2 < 3, N = 166) adults with type 1 diabetes with objective measures. The depressed group had poorer blood glucose control and, for those with glucose meter downloads, fewer glucose tests/day. The groups did not differ on glucose variability or episodes of hypoglycemia. Depression in adults with type 1 diabetes is associated with poorer glycemic control and less blood glucose monitoring. Future research should examine whether treatment of depression results in better self-care and glycemic outcomes.

Hypertension and prehypertension among adolescents attending secondary schools in urban area of South-East, Nigeria.

INTRODUCTION: in the past, the need for regular blood pressure screening in children was doubtful, and the main reason against it is that hypertension is an adult illness and there is no evidence that screening healthy children for hypertension was worthwhile. We did this study to determine the prevalence of hypertension and prehypertension as well as some risk factors for hypertension among secondary school adolescents in an urban area of the South-East, Nigeria. METHODS: this was a cross-sectional study of 984 adolescents aged 10-19 years in secondary schools in Awka South Local Government Area of Anambra state, South-East, Nigeria. The multi-stage sampling method was used to select the subjects. Data were collected from all eligible subjects with the aid of a questionnaire administered to them. Weight, height, and blood pressure were measured and recorded. RESULTS: nine hundred and eighty-four adolescents were recruited for this study, and they comprised 470 (47.8%) males and 514 (52.2%) giving a male: female ratio of 1:1.1. Their ages ranged from 10-19 years. The mean systolic blood pressure and mean diastolic BP were 110.5±10.2mmHg 71.5±8.5mmHg respectively. Prevalence of hypertension and pre-hypertension were 6.3% and 5.0% respectively. There were a higher proportion of females (7.3%) than males (5.4%) with hypertension, and more females (5.8%) than males (4.2%) with prehypertension but these were not statistically significant. Overweight and obesity were significantly associated with hypertension. CONCLUSION: hypertension exists among secondary school adolescents in Awka South Local government area of Anambra state, with a prevalence of 6.3%. Early detection and treatment will forestall the early development of complications.

Level of awareness of the baby friendly initiative among home economics teachers in Nigeria.

A cross-sectional questionnaire was used to assess the level of awareness of the Baby Friendly Initiative among Home Economics teachers in Nigeria. Only 34.5 per cent of the teachers were able to define BFI as the Baby Friendly Initiative while 60 per cent defined exclusive breastfeeding correctly. Although 70.2 per cent acknowledged that breastfeeding prevents malnutrition in babies, only 12.5 per cent knew about the protective effects of colostrum. Of the study population 29.8 per cent knew that breastfeeding should be on demand and not regulated. Over 80 per cent of the teachers advocated that the BFI should be taught at all levels of education. We conclude that their knowledge of the BFI is poor and that they will require further education before they can be used effectively as resource personnel in training girls (potential mothers) in BFI.