Acquired ventricular septal defect: a rare sequel of blunt chest trauma in a 7-year-old boy.

Ventricular septal defect (VSD) is the most common congenital cardiac lesion encountered worldwide. Only very rarely is it acquired, and causation through blunt injury in a child is extremely rare. A previously healthy 7-year-old boy suffered blunt chest trauma while at play. He presented 11 days later with features of acute congestive cardiac failure. Two-dimensional echocardiographic examination revealed a mid-muscular VSD. The connection between the defect and the trauma was not initially appreciated. Facilities for required urgent open-heart surgery were not available. Cardiac failure was refractory to anti-failure therapy. His clinical condition steadily worsened, and he succumbed after 20 days on admission. We conclude that a diagnosis of traumatic VSD, though rare, should be considered in any previously well child presenting in acute congestive cardiac failure following blunt trauma to the chest. Any such patient should undergo careful echocardiographic evaluation. There is an urgent need for facilities for open-heart surgery to be more readily available and accessible in Nigeria.

Transcatheter closure of patent ductus arteriosus and atrial septal defect without on-site surgical backup: a two-year experience in an African community.

Congenital heart disease contributes significantly to the health burden of children in Nigeria. Interventions for congenital heart disease have been available in the developed world since the first report on device closure of patent ductus arteriosus (PDA) in 1967 by Porstmann. However, this did not start in Nigeria until October 2010. This study aimed to document the profiles of the patients who had undergone interventions for congenital heart diseases since the availability of the procedure, the challenges encountered, and the prospects associated with the interventions at the study site. All the patients referred to undergo interventions for congenital heart disease at the study center between October 2010 and 2012 were studied. The profile of the patient, including diagnosis at referral, indication for interventions, and interventions performed, were documented. The patients ranged in age from 3 to 62 years (mean age, 13.54 ± 17.7 years), and the male-to-female ratio was 1:3. The diagnosis at referral included PDA in 10 (83 %) of the 12 patients and secundum atrial septal defect in 2 patients (17 %). They all had transcatheter closure of the defects. Interventional procedures for congenital heart diseases currently are available locally, but the high degree of manpower training required, the cost, and the local availability of consumables are major factors limiting their use. Regional and international collaboration could be mutually beneficial.

Socio-economic determinants of child labour and attitudes to child labour among school children in Ibadan.

This cross sectional study was designed to compare the characteristics of working and non-working school children. Two hundred and thirty one working and 236 non-working children were interviewed. The socio economic factors associated with child labour were trading as mother's occupation, father's educational status, religion, family type (monogamous vs polygamous) and type of residence. Family type (OR = 0.562, 95% C.I. 0.353-0.897, p = 0.016), religion (OR = 0.559, 95% C.I. 0.361-0.867, p = 0.009) and trading as mother's occupation (O.R = 2.49, 95% CI 1.68-3.68, p = 0.000) were sustained on logistic regression analysis. With regard to attitude to child work, 186 (40%) of all respondents thought that children should be allowed to work. The majority of those who held this opinion 150, were child workers. Ten percent of working children had themselves chosen to work without any parental influence to do so. Seventy five respondents had ever repeated a class. Forty nine of these were working children a prevalence of 21% of repeaters compared to 26 non working children, (11%.) p = 0.004. Sixty eight percent of children aspiring to careers in artisan trades were child workers. Road traffic accidents and poor school performance were the commonest adverse effects of child labour indicated by school children. Parents should be educated about the adverse effects of child labour on child development. As poverty is one of the major root causes of child labour, free and compulsory primary education may help to reduce the notion of child work as an option for survival in poor families.