Morbidity pattern of underfives with moderate acute malnutrition in southern Nigeria

Background:Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described. Objective: To describe the morbidity pattern of underfives with MAM.Method: Across sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers'brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. Avalidated proforma was used to obtain the biodata and symptoms of common illnesses in the children. Ageneral physical examination, anthropometric measurements and systemic examination were performed. Results: Atotal of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss

Outcome of tube thoracostomy in paediatric non-traumatic pleural fluid collections

Objective: Management of pleural fluid collection not due to trauma increases workload of the paediatric thoracic surgeons; while delay or inappropriate treatment worsens the prognosis of the disease. This study aimed at assessing the outcome of therapeutic tube thoracostomy in non-traumatic paediatric pleural fluid collections and identifying factors responsible for treatment failure with tube thoracostomy. Design: Prospective analysis of socio-demographic characteristics; clinical features; clinical diagnosis; radiological diagnosis; and bacteriological diagnosis including bacteria cultured with sensitivity pattern; also treatment offered including tube thoracostomy with duration of tube thoracostomy and length of hospitalisation; indication for additional surgical procedure with type; and outcome of treatment of 30 paediatric patients with non-traumatic pleural fluid collection. Results: Thirty paediatric patients with various causes of non-traumatic pleural fluid collection in 34 pleural spaces were analysed. Their ages ranged between six months and 16 years (mean = 6.5 years) and M:F ratio of 2:1. Pleural effusion and empyema thoracis accounted for 46 and 40 with staphylococcus aureus and streptococcus pneumoniae cultured in 10 each and a high negative culture rate of 46; which was higher with age. The parents of 40 of the patients belonged to social class 3. Success rate of tube thoracostomy was 86 in unilateral cases; 50 in bilateral cases and 81 in all cases. Alternative treatment with thoracotomy and decortications gave a success rate of 100. Conclusion: Thoracotomy with decortication is superior to tube thoracostomy in paediatric non-traumatic pleural fluid collection and should be chosen as the primary treatment option when there is bilateral disease; chronicity; loculated effusion; thickened pleural membranes or trapped lung

Behavioural problems among schoolchildren in Nigeria

Background: Behavioural problems among schoolchildren can pose a burden on families and society. Objective: To determine the prevalence and pattern of behavioural problems among children living in Uyo, a town in South-South Nigeria. Methods: A cross-sectional study was carried out among 572 pupils from six primary schools selected randomly from private and government schools in Uyo. Pupils with a normal IQ were selected using a systematic sampling method. The Rutter behavioural scale for teachers (B2) was completed by their teachers, and that for parents (A2) was completed by the parents. Student's t-test was used to compare pairs of means, frequencies were compared using the chi-square test, and p<0.05 was taken as significant. Results: According to the teachers' scale 132 pupils (23.1%) had scores within the range indicating behavioural problems, compared with 103 pupils (18.0%) on the parents' scale. This was statistically significant (χ2=19.8, p=0.001). Pupils in government and private schools had mean scores of 7.4 (standard deviation (SD) 6.41) and 5.12 (SD 6.26) and 7.29 (SD 5.84) and 6.96 (SD 5.76), respectively. Behavioural problems were more common among children in government schools and among those in the lower socio-economic class. Boys had significantly higher mean scores than girls, and both scales showed more boys to be disturbed. Antisocial behaviour was commonest among boys and older children. Conclusion: There is a high prevalence of behavioural problems among primary school children in Uyo, with a predominance of antisocial behaviour. The government needs o provide appropriate services to deal with this state of affairs