Decreased prevalence and severity of asthma symptoms among adolescents in Ibadan, Nigeria, 1995-2018.

BACKGROUND: Phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC) documented increased asthma symptoms among Nigerian 13-14-year old adolescents. We investigated the trend further using the Global Asthma Network (GAN) surveillance.METHODS: Using ISAAC methodology, GAN Phase I data on symptoms and risk factors for asthma and asthma management were obtained from February to July 2018.RESULTS: There were 2,897 adolescents from 23 secondary schools. For current wheeze, there was an absolute prevalence fall per decade of -1.4 with -1 standard error (SE) in 16 years from 2002 (ISAAC Phase III) to 2018 (GAN Phase I). This pattern was evident for prevalence of reported asthma ever, severe asthma symptoms and night cough with ≥1 SE. During the 23-year interval between ISAAC Phase I and GAN Phase I, there was a fall (≥1 SE) in the absolute prevalence of reported asthma ever, severe asthma symptoms and night cough, except for severe asthma symptoms (-0.2 SE). Respectively 36% and 43% of symptomatic adolescents purchased and used salbutamol and prednisolone.CONCLUSION: The prevalence and severity of asthma symptoms remain high among adolescents in Ibadan. This could be mitigated by improved access to affordable and effective asthma treatments.

Infant Care Practices at Home in the First Weeks of Life in Ibadan, South-West Nigeria.

BACKGROUND: The World Health Organization recommends essential newborn care, which includes components that should be provided at home and in the community, to improve newborn outcomes. This study was carried out to assess infant care practices at home in the first week of life and how they conform to the provisions of essential newborn care. METHODS: A total of 678 mothers who delivered their babies at Adeoyo Maternity Hospital, Ibadan were visited at home between the 8th and 10th days of delivery. Information on infant care practices with respect to hygiene, feeding, provision of warmth, eye care, cord care, immunization and health seeking behaviour was obtained. RESULTS: Only 9.3% of the mothers washed their hands always before handling their babies, 83.3% did sometimes and 94.0% did so after diaper change. Breastfeeding was the first feed given by 93.8% of mothers, but only 21.6% of them started within one-hour of life. At the end of the first week, 71.2% were still breastfeeding exclusively. Only 16.6% of mothers bathed their newborns on the first day of life. To keep newborns warm, 82.0% shut their windows all day, and 9% lit kerosine-wick lanterns indoors. Mothers used alcohol (97.2%) and breastmilk drops (18.2%) for umbilical cord and eye care, respectively. Only 58.6% and 14.5% of babies had received any vaccination or had postnatal visit, respectively. CONCLUSION: Infant care practices at home for newborns in Ibadan did not substantially conform to the provisions of essential newborn care and many practices were harmful. The need for supportive supervision in addition to health education for essential newborn care is indicated.

CONTEXTE: L'Organisation mondiale de la santé recommande des soins essentiels pour les nouveau-nés, qui comprennent des éléments qui devraient être fournis à domicile et dans la communauté, afin d'améliorer les résultats des nouveau-nés. Cette étude a été menée pour évaluer les pratiques de soins aux nourrissons à domicile au cours de la première semaine de vie et leur conformité aux dispositions des soins essentiels aux nouveau-nés. MÉTHODES: 678 mères ayant accouché à la maternité d'Adeoyo, Ibadan, ont été visitées à leur domicile entre le 8e et le 10e jour de l'accouchement. Des informations sur les pratiques de soins du nourrisson en matière d'hygiène, d'alimentation, d'apport de chaleur, de soins oculaires, de soins du cordon, de vaccination et de comportement de recherche de santé ont été obtenues. RÉSULTATS: Seulement 9,3% des mères se lavaient toujours les mains avant de manipuler leur bébé, 83,3% le faisaient parfois et 94,0% le faisaient après le changement de couche. L'allaitement maternel était le premier aliment donné par 93,8% des mères, mais seulement 21,6% d'entre elles ont commencé dans l'heure qui suit la naissance. A la fin de la première semaine, 71,2% étaient encore en train d'allaiter exclusivement. Seuls 16,6 % des mères ont donné un bain à leur nouveau-né le premier jour de sa vie. Pour garder les nouveau-nés au chaud, 82,0% fermaient leurs fenêtres toute la journée et 9% allumaient des lanternes à mèche de kérosène à l'intérieur. Les mères utilisaient de l'alcool (97,2%) et des gouttes de lait maternel (18,2%) pour les soins du cordon ombilical et des yeux, respectivement. Seuls 58,6% et 14,5% des bébés avaient reçu une vaccination ou une visite postnatale, respectivement. CONCLUSION: Les pratiques de soins à domicile pour les nouveaunés à Ibadan n'étaient pas essentiellement conformes aux dispositions des soins essentiels pour les nouveau-nés et de nombreuses pratiques étaient néfastes. La nécessité d'une supervision de soutien en plus de l'éducation sanitaire pour les soins essentiels aux nouveau-nés est indiquée. Mots clés: Soins aux nourrissons ; Domicile; Nouveau-nés; Première semaine; Communauté.

Delayed presentation of transposition of the great arteries with intact ventricular septum in an 8-week-old male infant at University College Hospital in Ibadan, Nigeria.

Transposition of the great arteries is a rare type of critical congenital heart disease (CCHD) which commonly presents in the neonatal period and requires early diagnosis and intervention if the infant is to witness his/her first birthday. Here, we report a case of an 8-week-old term male infant who presented with a 2-day history of cough, breathlessness and cyanosis. Echocardiography confirmed dextro-transposition of the great arteries (d-TGA) with patent ductus arteriosus (PDA) and patent foramen ovale (PFO). The infant succumbed to cardiogenic shock due to late presentation and no access to definitive surgical intervention.

BILATERAL GANGLIONIC HAEMORRHAGIC STROKE COMPLICATING SUSPECTED MENINGOCOCCAEMIA: A CASE REPORT.

Haemorrhagic stroke in pyogenic meningitis is a rare complication accounting for about 2% of all complications1,2. It often results from disseminated intravascular coagulation, which is a complication of bacterial meningitis and portends a poor prognosis. A superimposed intracranial haemorrhage, although extremely rare, is associated with high mortality rate. We report a child who had haemorrhagic stroke during the acute phase of bacterial meningitis. The diagnosis was made during post mortem examination. It was discovered that she had suffered haemorrhagic necrosis of both basal ganglion nuclei. Early imaging is advised in meningitis patient presenting with altered levels of consciousness to detect cerebrovascular complications.