Prevalence and Pattern of Feeding Problems and Relationship to Motor Function Severity in Children with Cerebral Palsy in Umuahia.

BACKGROUND: Reports show that feeding problems in children with cerebral palsy (CP) significantly reduce nutritional intake and affect their nutritional status. OBJECTIVE: To determine the prevalence and types of feeding problems and its association with functional severity and nutritional status in children with cerebral palsy. METHODS: This cross-sectional study involved 169 children with CP aged 1 - 17 years seen at the Neurology clinic of Federal Medical Centre, Umuahia. Gross motor skills were described using Gross Motor Function Classification System (GMFCS).Nutritional status was determined and classified based on WHO Child Growth Standards. Data was analyzed using SPSS version 20.0. RESULTS: Feeding problem was seen in 39.1% of the subjects, with spitting out food (57.6%), prolonged feeding time (45.5%) and choking (16.7%) being the most common types. Malnutrition occurred in 37.3% of patients. Feeding problems were significantly associated with functional severity (χ2 = 52.06 and p < 0.001) and proportion of feeding problems increased with increasing functional severity. All the subjects with functional severity level V (100%) had feeding problems. There was no statistically significant association between nutritional status and feeding problems (χ2 = 0.77 and p = 0.38), although the proportion of feeding problems was highest (44.3%) in the underweight subjects. CONCLUSION: The prevalence of feeding problem in children with CP is 39.1%. There was no association between feeding problems and nutritional status. Feeding problem was however significantly associated with functional severity. Therefore there is need for routine evaluation for feeding problems in children with CP to prevent complications.

CONTEXTE: Les rapports montrent que les problèmes d'alimentation chez les enfants atteints de paralysie cérébrale (PC) réduisent de manière significative l'apport nutritionnel et affectent leur statut nutritionnel. OBJECTIF: Déterminer la prévalence et les types de problèmes d'alimentation et leur association avec la sévérité fonctionnelle et le statut nutritionnel des enfants atteints de paralysie cérébrale. MÉTHODES: Cette étude transversale a porté sur 169 enfants atteints de paralysie cérébrale âgés de 1 à 17 ans et vus à la clinique de neurologie du Centre médical fédéral, Umuahia. Les capacités motrices brutes ont été décrites à l'aide du système de classification de la fonction motrice brute (GMFCS), l'état nutritionnel a été déterminé et classé selon les normes de croissance de l'enfant de l'OMS. Les données ont été analysées à l'aide de SPSS version 20.0. RÉSULTATS: Des problèmes d'alimentation ont été observés chez 39,1 % des sujets, les plus fréquents étant les régurgitations (57,6 %), le temps d'alimentation prolongé (45,5 %) et l'étouffement (16,7 %). La malnutrition est apparue chez 37,3 % des patients. Les problèmes d'alimentation étaient significativement associés à la sévérité fonctionnelle (÷2 = 52,06 et p < 0,001) et la proportion de problèmes d'alimentation augmentait avec la sévérité fonctionnelle. Tous les sujets présentant un niveau de sévérité fonctionnelle V (100%) avaient des problèmes d'alimentation. Il n'y avait pas d'association statistiquement significative entre l'état nutritionnel et les problèmes d'alimentation (÷2 = 0,77 et p = 0,38), bien que la proportion de problèmes d'alimentation était la plus élevée (44,3 %) chez les sujets présentant une insuffisance pondérale. CONCLUSION: La prévalence des problèmes d'alimentation chez les enfants atteints de PC est de 39,1%. Il n'y avait pas d'association entre les problèmes d'alimentation et l'état nutritionnel. Les problèmes d'alimentation étaient cependant significativement associés à la sévérité fonctionnelle. Il est donc nécessaire de procéder à une évaluation systématique des problèmes d'alimentation chez les enfants atteints de PC afin de prévenir les complications. Mots clés: Infirmité motrice cérébrale, Sévérité fonctionnelle, Problèmes d'Alimentation, Nutrition, Umuahia.

Intestinal Helminthiasis: Risk factors and relationship with Nutritional status and Anaemia among Institutionalised Children in three States of South-East Nigeria.

BACKGROUND: Intestinal helminthiasis occurs in sub-optimal living conditions with poor hygiene practices and is more prevalent in rural, suburban and institutionalized centres. Heavy helminthic burden negatively affects the nutritional status and the severity of anaemia among children living in orphanages. AIM: To determine the risk factors and relationship of intestinal helminthiasis with nutritional status and anaemia among institutionalized children in three states of South-East Nigeria. METHODS: A cross-sectional study was conducted over seven months involving 198 children recruited from orphanages in Anambra, Ebonyi and Enugu states. Their stool samples were analyzed using the Kato-Katz and Ether concentration techniques, and packed cell volume and anthropometric indices were documented. Data were analyzed. RESULTS: Of the 198 children, 109 (55.1%) were females with a median age of 2.5 years and interquartile range (3 months - 17 years). The prevalence of intestinal helminthiasis was 2.5%. Among the children that had intestinal helminthiasis, 4 (80%) had mono-parasitism with Ascaris lumbricoides, while 1 (20%) had mixed infestation of Ascaris lumbricoides and Trichuris trichiura. There was a significant association (p=0.01) between being infested with intestinal helminthiasis and caregiver handwashing practices. The anthropometric indices demonstrated that 5.6%, 6.6% and 13.1% of the children were underweight, wasted and stunted respectively. No helminth-infested child had malnutrition and only 1 (20%) infested child had moderate anaemia. CONCLUSION: Caregivers' good handwashing practice was associated with reduced prevalence of intestinal infestations and should be encouraged. There was no relationship found between the presence of helminthic infestations and nutritional status or anaemia among the institutionalised children.

CONTEXTE: Les helmintiases intestinales surviennent dans des conditions de vie sous-optimales avec des pratiques d'hygiène médiocres et sont plus fréquentes dans les centres ruraux, périurbains et institutionnalisés. Une charge helminthique importante affecte négativement l'état nutritionnel et la gravité de l'anémie chez les enfants vivant dans des orphelinats. OBJECTIF: Déterminer les facteurs de risque et la relation entre les helmintiases intestinales, l'état nutritionnel et l'anémie chez les enfants institutionnalisés dans trois États du sud-est du Nigéria. MÉTHODES: Une étude transversale a été menée sur sept mois, impliquant 198 enfants recrutés dans des orphelinats des États d'Anambra, d'Ebonyi et d'Enugu. Leurs échantillons de selles ont été analysés à l'aide des techniques de Kato-Katz et de concentration à l'éther, et le volume globulaire et les indices anthropométriques ont été documentés. Les données ont été analysées. RÉSULTATS: Sur les 198 enfants, 109 (55,1 %) étaient des filles avec un âge médian de 2,5 ans et une plage interquartile (3 mois - 17 ans). La prévalence des helmintiases intestinales était de 2,5 %. Parmi les enfants atteints d'helmintiases intestinales, 4 (80 %) présentaient une mono-parasitose à Ascaris lumbricoides, tandis que 1 (20 %) présentait une infestation mixte à Ascaris lumbricoides et Trichuris trichiura. Il y avait une association significative (p=0,01) entre l'infestation par les helmintiases intestinales et les pratiques de lavage des mains par les aidants. Les indices anthropométriques ont montré que 5,6 %, 6,6 % et 13,1 % des enfants étaient respectivement sous-pondérés, émaciés et retardés en taille. Aucun enfant infesté par les helminthes n'était malnutri et seul 1 (20 %) enfant infesté avait une anémie modérée. CONCLUSION: La bonne pratique du lavage des mains par les aidants était associée à une prévalence réduite des infestations intestinales et devrait être encouragée. Aucune relation n'a été trouvée entre la présence d'infestations helminthiques et l'état nutritionnel ou l'anémie chez les enfants institutionnalisés. Mots-clés: Anémie, Enfants, Helminthes, Institutionnalisés, État nutritionnel.

Left Ventricular Function and Geometry of Children with Chronic Kidney Disease (CKD) in a Resource-Poor Setting of Africa.

BACKGROUND: Chronic Kidney Disease (CKD) is a multisystemic clinical condition characterized by an irreversible deterioration of renal function that invariably progresses to end-stage renal disease (ESRD). Cardiovascular affectation portends morbidity and mortality in chronic kidney disease. OBJECTIVE: The aim of the study was to compare the prevalence of changes in function, and geometry of the left ventricle in children with CKD and their controls. METHODOLOGY: This was a descriptive cross-sectional study. Children aged 6 to 17 years with features suggestive of CKD along with age and sex-matched apparently healthy controls seen at the University of Nigeria Teaching Hospital, Enugu were enrolled consecutively. Blood samples werecollected for baseline investigations and e-GFR, followed by trans-thoracic two-dimensional echocardiography to assess the left ventricular function and geometry. Data was analysed using the statistical package for social sciences (SPSS) version 17.0. Simple frequencies and proportions, Student's t-test and chi-square were applied appropriately. P value at <0.05 was significant. RESULTS: Out of 9,419 children aged 6-17 years seen within the study period in the hospital, 24 met the criteria for CKD. The incidence rate was 5 cases per million child population per year. Mean age was 12.33 ± 4.24 years, with a male to female ratio of 2:1. Left ventricular hypertrophy (LVH), eccentric LVH and Left ventricular dilatation (LVD) were seen in 50.0%, 33.3% and 41.7% of subjects respectively. Left ventricular diastolic dysfunction and left ventricular systolic dysfunction occurred in 37.5% and 8.3% subjects, respectively. CONCLUSION: Prevalence of left ventricular geometry and function abnormalities was high in subjects. Intervention measures are advocated.

CONTEXTE: La maladie rénale chronique (MRC) est un état clinique multisystémique caractérisé par une détérioration irréversible de la fonction rénale qui évolue invariablement vers l'insuffisance rénale terminale (IRT). L'atteinte cardiovasculaire est un facteur de morbidité et de mortalité dans la maladie rénale chronique. OBJECTIF: Le but de l'étude était de comparer la prévalence des changements de la fonction et de la géométrie du ventricule gauche chez les enfants atteints d'IRC et chez les témoins. MÉTHODOLOGIE: Il s'agissait d'une étude descriptive transversale. Des enfants âgés de 6 à 17 ans présentant des caractéristiques suggérant une IRC, ainsi que des témoins apparemment sains, appariés par l'âge et le sexe, vus au University of Nigeria Teaching Hospital, Enugu, ont été inscrits consécutivement. Des échantillons de sang ont été prélevés pour les examens de base et l'e-GFR, suivis d'une échocardiographie trans-thoracique bidimensionnelle pour évaluer la fonction et la géométrie du ventricule gauche. Les données ont été analysées à l'aide du progiciel statistique pour les sciences sociales (SPSS) version 17.0. Les fréquences et proportions simples, le test t de Student et le chi-carré ont été appliqués de manière appropriée. La valeur P à <0,05 était significative. RÉSULTAT: Sur les 9 419 enfants âgés de 6 à 17 ans vus à l'hôpital pendant la période d'étude, 24 répondaient aux critères de l'IRC. Le taux d'incidence était de 5 cas par million d'enfants par an. L'âge moyen était de 12,33 ± 4,24 ans, avec un rapport hommes/femmes de 2:1. Une hypertrophie ventriculaire gauche (HVG), une HVG excentrique et une dilatation ventriculaire gauche (DVG) ont été observées chez 50,0 %, 33,3 % et 41,7 % des sujets respectivement. Une dysfonction diastolique du ventricule gauche et une dysfonction systolique du ventricule gauche ont été observées chez 37,5 % et 8,3 % des sujets, respectivement. CONCLUSION: La prévalence des anomalies de géométrie et de fonction du ventricule gauche était élevée chez les sujets. Des mesures d'intervention sont préconisées. Mots clés: Fonction ventriculaire gauche, Géométrie ventriculaire gauche, Maladie rénale chronique, Enfants.

The prevalence and intensity of intestinal helminths among institutionalized children in three states of South-East Nigeria.

Background: Intestinal helminthiasis is one of the most common and neglected diseases affecting all age groups, especially among school children. It is a disease condition of suboptimal environment and poor personal hygiene, and is more prevalent in children in institutionalized centers. Aims: This study was aimed to determine the prevalence, pattern, and intensity of intestinal helminthiasis among children in motherless babies' homes/orphanages and the relationship between the prevalence and demographic characteristics of the children. The outcome may be useful in strengthening these homes through advocacy to the appropriate authorities on general health promotion and awareness for the management of the homes. Subjects and Methods: It was a descriptive cross-sectional study carried out over 7 months (March-September 2017) in three states of the South-East Nigeria. Prior to the studies ethical clearance and permissions from relevant bodies were obtained. A total of 198 children aged 3 months to 17 years were recruited using multi-stage sampling methods from the homes and orphanages in Anambra, Ebonyi, and Enugu states. Their stool samples were collected and analyzed for ova of intestinal helminths using ether concentration and Kato-Katz techniques.Frequency tables were designed for relevant variables while quantitative variables were summarized using median and interquartile range (IQR). The relationship between demographic factors and presence of intestinal helminths amongst study participants was tested using Chi-square test and Fisher's exact test (FET) where appropriate. All analyses were done at the 5% level of significance, and a P value <.05 was considered statistically significant. Results: : Children aged 1-5 years constituting the highest proportion 110 (55.6%). The median age (IQR) of the participants was 2.5 years (3 months to 17 years). They comprised of 89 (44.9%) males and 109 (55.1%) females with a male: female ratio of 1:1.2. The overall prevalence of intestinal helminths among institutionalized children was 5/198 (2.5%). Ascaris lumbricoides only was seen in four out of five (80%) infested subjects while mixed infestation of A. lumbricoides and Trichuris trichiura was seen in one out of five (20%) subjects. All the infected subjects had light intensity of 100-300 EPG. It was noted that three out of five infested subjects were preschool children. However, the difference between the age groups and intestinal infestation was not statistically significant (P > 0.05). All the subjects with helminthic infection were females. Gender and location of motherless babies' homes/orphanages were not significantly associated with the presence of infestation (P > 0.05). Conclusion: This study showed that the prevalence and intensity of intestinal helminthiasis amongst the surveyed children in the South-Eastern Nigeria are 2.5% and more common among preschool aged children.

Health-related quality of life in children and adolescents with epilepsy in Enugu: Need for targeted intervention.

BACKGROUND: Epilepsy, a chronic brain disorder, predisposes children to low Health-Related Quality of Life (HRQOL). OBJECTIVE: This study aimed at assessing the HRQOL in Nigerian children with epilepsy and compare it with that in healthy children. METHODS: A cross-sectional study of 166 children with epilepsy (CWE), aged 5-18 years on anti-epileptic drugs (AEDs) for at least 6 months and 166 age and sex-matched apparently healthy children was conducted. A generic version of the Pediatric Quality of Life (Peds QoL version 4) scale was used to assess HRQOL. RESULTS: There were significant differences in Quality-of-Life mean scores in the domains of social functioning, psychosocial combination, and psychosocial plus physical activities between cases and controls. The school function scores of <50, indicating low QOL, were significantly more (Chi square = 35.37) (P = 0.0001) among the cases (32.5%) compared to the controls (6.3%). Similarly, low quality of life in the psychosocial combination were observed significantly (P_ = 0.042) more among the cases (12.7%) compared to the controls (6.3%). Low quality of life in emotional feeling domain were noted significantly (Chi square = 12.9) (P = 0.0002) more in subjects aged between 8 and 12 (20%). QOL scores of below 50 in the social function domain were observed significantly (Chi square = 6.49) (P = 0.039) more in subjects aged between 5 and 7 years (44.8%). There was significant gender difference in Quality-of-life index in school functioning domain in subjects. (Chi Square = 6.49) (P value = 0.039). Children in the upper social class scored higher in the social functioning domain, and social class was significantly associated with scores in the social domain of functioning. (F = 3.75 and P = 0.03). QOL scores below 50 in the emotional domain were significantly more among subjects aged 8-12 years/13-18 year, s and QOL scores of <50 in the school function domain were significantly more in subjects aged 5-7 years. (P = 0.0002) (P = 0.039), respectively. CONCLUSION: HRQOL is reduced in CWE in all domains of Peds QoL. Significant predictors of reduced HRQOL include age, gender, and socioeconomic class. Beyond seizure control, epilepsy management should be oriented towards ensuring the optimal health-related quality of life.

Micronutrient Levels in Children with Cerebral Palsy in Abia State, Nigeria.

BACKGROUND: Micronutrients are essential for growth and development and their deficiencies are reported in children with cerebral palsy who have attributes that predispose them to such nutrient deficiencies. There are few studies on micronutrients status of CP children in our sub-region. OBJECTIVE: To investigate micronutrient status of children with cerebral palsy and compare values with those of controls. METHODS: One hundred and sixty- nine children with CP and 169 controls were enrolled consecutively. Clinical features were documented using Gross Motor Functional Classification System to assess severity. Venous blood was collected for micronutrient levels measurement. Student's t test, Chi-square test and bivariate analysis were used as appropriate. Multiple linear regression was used to identify clinical antecedents of any deranged micronutrient. RESULTS: The serum zinc, calcium and vitamin D levels were lower in the subjects compared with the controls (p <0.001).There was significant association between the serum levels of the micronutrients and age in the subjects (<0.05). Serum zinc level was associated with socioeconomic class in both subjects and controls (p < 0.001, 0.001 respectively). Serum zinc and calcium were significantly low in 69.7% and 15.2% of subjects with feeding problems respectively. Age, gender, socioeconomic class and feeding problems had significant independent effect on serum zinc levels of the subjects. CONCLUSION: Serum levels of zinc, calcium and vitamin D are significantly low in children with CP. Age, socioeconomic class and feeding problems independently influenced the serum zinc level in the subjects. Periodic assessment of children with CP to identify those who might need specific intervention is advocated.

Prevalence and Pattern of Psychosocial Disorders among Caregivers of HIV-infected Children in Enugu, South-Eastern Nigeria.

BACKGROUND: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may result in significant life stressors, on both the infected children and their caregivers. METHODS: This included a hospital-based cross-sectional and comparative study. Subjects and controls who met the inclusion criteria were enrolled consecutively. Their socio-demographic variables were obtained and GHQ-28 was used to assess their psychosocial status. RESULTS: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled into this study. In total, 42 (27.3%) and 112 (72.7%) of the subjects were males and females, respectively, compared with 37 (24.0%) and 117 (76.0%) of the controls, respectively. The prevalence of psychosocial disorders among the subjects and controls was 39 and 2.6%, respectively (p < 0.001; odds ratio: 23.936). The patterns of psychosocial disorders among the caregivers of HIV-infected children were somatic symptoms (85%), anxiety/insomnia (80%), social dysfunction (63.3%) and severe depression (48.3%). CONCLUSION: There is a high prevalence of psychosocial disorders among caregivers of HIV-infected children.

Psychosocial dysfunction among adolescents who abuse substances in secondary schools in Abakaliki, Nigeria.

BACKGROUND: Substance abuse has been associated with psychosocial dysfunction from previous reports; however, the prevalence and pattern of such morbidity is unknown in our environment. AIMS: The aim of the study was to determine the prevalence and pattern of psychosocial dysfunction among adolescents who abuse substance. METHODS: A case-control study was carried out among adolescents selected from five secondary schools in Abakaliki. A multistage sampling procedure was used to select the students and the World Health Organization student drug use questionnaire was used to screen respondents for substance abuse. Substance abusers and matched controls (non substance abusers) were assessed for psychosocial dysfunction using the 35-item Pediatric Symptom Checklist (PSC). Socioeconomic classification was done using the parental educational attainment and occupation. RESULTS: Two hundred and four students were abusers of one or more substances. The mean PSC score for substance abusers was 21.96 ± 10.77 whereas that for controls was 16.07 ± 8.69 (t = -6.74, P = 0.000). Eighty-nine individuals (43.7%) and 28 controls (13.9%) had PSC scores in the morbidity range of ≥ 28 for psychosocial dysfunction. This was statistically significant (χ2 = 13.57, P = 0.001). Prevalence of dysfunction was significantly associated with age group, gender, and socioeconomic class in both participants and controls. The prevalence of dysfunction was significantly higher in multiple abusers than the single abusers. CONCLUSION: The prevalence of psychosocial dysfunction is higher in adolescents abusing substance than in controls. Psychosocial dysfunction was however not related to age, gender, or social classes in the study population but was related to the abuse of multiple substances.

Physical growth and nutritional status assessment of school children in Enugu, Nigeria.

BACKGROUND: Physical growth of a child is a reflection of its state of nutrition. In some developing countries such as Nigeria with changing economy and rapidly growing population, the nutritional status of the children is a reflection of the general well-being of the society. MATERIALS AND METHODS: This was a descriptive cross-sectional study in which participants were selected using a multistage sampling method. Heights and weights of randomly selected school children aged 6-12 years were measured using standard protocols. Weight-for-age, height-for-age, and body mass index (BMI)-for-age expressed as Z-scores were used to characterize the nutritional status. Descriptive statistics was used to determine the frequency and standard deviations (SDs) of the anthropometric measurements. Age and gender differences in the mean body weight, height, and BMI were evaluated using an independent samples t-test. Significant levels were set at P< 0.05. RESULTS: A total of 1305 males and 1311 females were enrolled in the study. The mean age was 8.9 ± 1.9 years. Their mean height, weight, and BMI were 136.6 ± 10.2 cm, 29.7 ± 7.7 kg, 15.7 ± 2.4 kg/m2, respectively. Their mean ± SD scores of the WAZ, HAZ, and BAZ were 0.33 ± 1.20, 0.78 ± 1.17, and - 0.51 ± 1.27, respectively. A majority (78.9%, 2090/2616) were in the normal growth category. Wasting, overweight, obesity, underweight, and stunting were noted in 9.3% (243/2616), 6.3% (166/2616), 4.4% (117/2616), 0.9% (26/2616), and 0.4% (13/2616) of the children, respectively. Wasting was more in males (P = 0.069), and overweight was more in females (P = 0.138). CONCLUSION: A majority of the children have normal growth with the remainder in both extremes of malnutrition. Institution of school-feeding programs in all Nigerian schools as well as nutrition education/campaign directed at parents and their children will help forestall the double burden of under- and over-nutrition among our children.

Some behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu, south eastern Nigeria.

UNLABELLED: The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. DESIGN: A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. SETTING: This study was carried out in the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Centre, Enugu. METHOD: Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis. RESULTS: The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (chi2 = 75.77; df= 2; p = 0.001) and with different habits of washing fruits before eating (chi2 = 52.79; df=2; p = 0.001) among the pupils. Also, the rate ofhelminthic infection varied significantly with the source of drinking water (chi2 = 55.12; df = 3; p = 0.01), water boiling habits (chi2 = 40.89; df = 2; p = 0.001), use of footwear after school hours (chi2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (chi2 = 80.25; df=3; p = 0.001) also significantly influenced the rate ofhelminthic infection. CONCLUSION: Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic habits which are obvious risk factors for intestinal helminthiasis.

Academic performance of school children with epilepsy.

BACKGROUND: Studies in developed countries show conflicting reports on effect of epilepsy on academic performance. There is also a dearth of information on the academic performance of Nigerian children with epilepsy. OBJECTIVE: This study is aimed at determining the academic performance of children with epilepsy with the hope that the findings will help in formulating policies that will be used in their educational programme. METHODS: The academic performance of 50 epileptic children attending normal primary school was compared with those of non-epileptic classmates matched for age, sex and socioeconomic status. The academic performance was assessed using the overall scores achieved in the terminal examination in the 2001/2002 academic years, as well as the scores in individual subjects. RESULTS: There were 36 males and 14 females. The most common seizure type among the epileptic children was generalized tonic-clonic seizure. Thirteen (26%) of the epileptic children had a low overall score, and therefore poor academic performance, compared to 16% of the controls. (p = 0.35). However, the mean score of the epileptic children was significantly lower than that of the controls in English (p = 0.02), Science (p = 0.02) and Social studies (p = 0.02). CONCLUSION: The overall academic performance of epileptic children without other chronic disorders attending normal schools is not different from that of normal children in the same setting, though they are under-achieving in some subjects.

Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital, Enugu.

BACKGROUND: Ear related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children. OBJECTIVE: To determine the prevalence of ear-related problems among children presenting at the Paediatric and Otorhinolaryngology clinics of the University of Nigeria Teaching Hospital, Enugu. MATERIALS AND METHODS: This was a cross-sectional study conducted at the Paediatric and Otorhinolaryngology Clinics of the University of Nigeria Teaching Hospital Enugu. All children aged 0 and 17 years presenting between 1(st) June and 31(st) August 2006 with ear-related problems were enrolled consecutively into the study. Data analysis was by SPSS version 11. RESULTS: Three thousand and twenty-one children were seen during the study period. Out of these, 248 children (8.2%) presented with ear-related problems. Chronic otitis media (30.5%), acute otitis media (29.9%), cerumen auris (11.3%), otitis externa (10.1%), hearing impairment (7.3%) and foreign body in the ear (5.7%) were the most commonly diagnosed ear-related problems. CONCLUSION: Ear-related problems among children presenting at the UNTH Enugu were not uncommon. However, otitis media was the most commonly diagnosed ailment affecting the ears in children.

Serum calcium, phosphate and alkaline phosphate levels in epileptic children treated with phenobarbitone.

A longitudinal study to estimate the serum calcium, phosphate and alkaline phosphatase levels of 89 ambulatory epileptic children, aged between 3 years and 12 years, and having generalised tonic-clonic seizures, was carried out. None was on any form of medication for the treatment of seizures prior to presentation. Each patient received only phenobarbitone during the period of study. Serum levels of the biochemical parameters were determined at presentation, 6 months and 12 months, while serum phenobarbitone levels were estimated at 6 months and 12 months. Mean serum calcium, phosphate and alkaline phosphatase of the patients remained within the normal range. Using the paired 't' test, the differences in the levels of the parameters at the three measurements were not statistically significant (P > 0.05). Serum phenobarbitone levels remained within the therapeutic range during the period of study. Our results show that over a 12-month period, serum levels of calcium, phosphate, and alkaline phosphatase, remain normal in ambulant epileptic children treated with phenobarbitone.

Ethosuximide induced lymphadenopathy--a case report.

A wide range of adverse effects has been reported following prolonged use of anticonvulsant drugs. More commonly reported adverse effects for ethosuximide include gastric disturbances, psychiatric disorders and Systemic Lupus Erythematosus (SLE). Rare instances of leukopenia and pancytopenia have been noted. A case is presented of a 12 year old girl who developed generalized lymphadenopathy with progressive weight loss and leukopenia following prolonged use of ethosuximide for simple absence seizures. The enlarged lymph nodes regressed with withdrawal of the drug but re-appeared when the drug was recommenced. Sodium valproate was then introduced and ethosuximide discontinued. The seizures were successfully controlled with sodium valproate. Histopathology report of the lymphnode biopsy showed marked reactive lymphnode hyperplasia.

A comparison of axillary with rectal thermometry in under 5 children.

BACKGROUND: Body temperature measurement is a crucial clinical assessment in the care of an acutely ill child, especially the under fives. Most temperature measurements in our hospital are done from the axilla. OBJECTIVE: To study the relationship between temperatures taken in the axilla with those taken in the rectum in febrile and afebrile children less than 5 years. MATERIALS AND METHODS: Rectal and axillary temperatures were taken concurrently in 400 febrile and 400 afebrile children aged less than 5 years using mercury-in-glass thermometers. RESULT: The rectal temperature measurements ranged from 38.0 to 41.4°C and 36.4 to 37.9°C in the febrile and afebrile groups of children respectively while the axillary temperatures ranged from 36.7 to 41.0°C and 35.9 to 37.5°C in the febrile and afebrile groups of children, respectively. There were significant differences between the temperatures measured at the two sites in all the age groups studied. There was good positive correlation between the rectal and axillary temperatures. A linear relationship between axillary and rectal temperatures was derived using the simple regression analysis. The equation is: rectal temperature = 0.94×axillary temperature+2.92. CONCLUSION: Although there's good correlation between axillary and rectal temperatures, significant difference exits between them that cannot be explained by the addition of any single value or any particular equation.

Academic performance of school children with behavioural disorders in Uyo, Nigeria.

INTRODUCTION: Behavioural disorders can have a negative influence on the academic performance of school children. There are no similiar published is no known studies in Nigeria. OBJECTIVE: To compare the academic performance of primary school children with behavioural disorders with that of their controls. METHODS: A total of 132 primary school pupils aged 6-12 years with behavioural disorders using Rutter scale for teachers (Scale B(2)) and their matched-controls were selected. Their academic performance was assessed and compared using the overall scores achieved in the first and second term examinations in the 2005/2006 academic sessions, as well as the scores in individual subjects. Number of days absent from school was documented. RESULTS: While 26.5% and 12.9% pupils with behavioural disorders had high and poor academic performance respectively, 38.6% and 9.1% pupils without such disorders had high and poor performances respectively. The difference in the ooverall academic performance was statistically significant (p=0.04). The mean scores of the pupils with behavioural disorders on four core subjects compared well with those of the controls. Pupils with antisocial behaviour underachieved more than others. School absence rate had no significant influence on their performance. CONCLUSION: Behavioural disorders are associated with poor academic performance in school children in Uyo.

Factors influencing the academic performance of school children with epilepsy.

The academic performance and intelligence quotient (IQ) of 50 children with epilepsy aged between 5 and 14 years, attending normal primary schools in Enugu, were compared with those of their non-epileptic classmates. The academic performance was assessed using the overall scores achieved in terminal examinations in the 2001-2002 academic year. IQ was assessed using the Draw-A-person Test. The influences of school absence rate, Rutter behavioural scores, socio-economic status and seizure-related variables on academic performance were then determined. Twenty-six percent of the children with epilepsy had a low overall score, and therefore poor academic performance, compared with 16% of the controls (p = 0.35). The mean IQ of the children with epilepsy was significantly lower than that of the controls (p = 0.02). The mean school absence rate for the children with epilepsy was significantly higher than that of the controls (p = 0.001). The mean Rutter score of the children with epilepsy was significantly higher than that for the controls (p < 0.001). On multiple linear regression analysis, only IQ (p = 0.01) and seizure type (p = 0.03) had significant predictive effects as risk factors for low overall scores and poor academic performance. It is concluded that the academic performance of epileptic children is influenced by their IQ and type of seizures rather than by other seizure variables or socio-demographic characteristics.