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.

Percutaneous kidney biopsy and the histopathologic patterns of kidney diseases in children: An observational descriptive study at a South-East Nigerian tertiary hospital.

Background: Kidney biopsy remains the best standard for kidney tissue analysis. Although percutaneous kidney biopsy is an invasive procedure, it is an indispensable part of interventional nephrology for accurate diagnosis, selection of appropriate therapy protocol, and prognostication of kidney diseases in children. With improvement in expertise among pediatric nephrologists, data on procedure outcomes are now being documented. Aim: We aimed to describe the outcomes in a 5-year practice of kidney biopsy at the pediatric nephrology unit in a southeast Nigerian tertiary hospital. Patients and Methods: An observational descriptive study conducted on the kidney biopsy performed in our facility from 2017 to 2022. The focus was on the patients' clinical profile, indications for biopsy, the adopted procedure, and the histopathologic findings. Results: A total of 69 patients had kidney biopsy, 40 (58.0%) were males, while 29 (42.0%) were females. Sixty-four (92.7%) patients had the procedure at the age of >10 years, while five (7.2%) at the age of <7 years. The patients' prebiopsy mean systolic and diastolic blood pressures were 111.20 ± 16.93 and 74.64 ± 12.69 mmHg, respectively. Their estimated glomerular filtration rate (eGFR) was 119.27 ± 52.78 ml/min/1.73 m2. The most frequent indication was steroid resistance (39/69, 56.5%). Focal segmental glomerulosclerosis was the commonest histopathologic finding (38/69, 55.0%). Conclusion: Outcomes of percutaneous kidney biopsy at a Nigerian tertiary hospital are adjudged successful. The histopathologic patterns highlight FSGS as the major cause of steroid resistance in childhood nephrotic syndrome in this clime.

Psychological Distress among Caregivers of Children Admitted into the Children Emergency Room of a Nigerian Tertiary Hospital.

BACKGROUND: Many caregivers experience significant psychological burden which may impact on the management of a sick child. OBJECTIVE: To determine the prevalence and associated factors of psychological distress among caregivers of children admitted at the Children Emergency Room. METHODS: This was a descriptive cross-sectional study among caregivers of children who were hospitalized for at least 24 hours. The 28-item General Health Questionnaire (GHQ 28) was used to assess the psychological distress among the caregivers. GHQ scores were stated as means ± standard deviation (SD). Chi-square or Fisher's exact test was used to test for association between sociodemographic variables and psychological distress. Mean GHQ scores in the various domains of psychological dysfunction were compared among groups using the independent sample t-test; at p<0.05. RESULTS: Of the 97 caregivers who participated in the study, 96 had their data analyzed. The caregivers were aged 19 to 63 (mean 34.25 (8.46)) years; 86 (89.7%) were females and 48 (50%) had tertiary education. The prevalence of psychological distress among the care givers was 69.8%. Caregivers had high levels of anxiety but low levels of depression. Those with lower educational attainment had higher scores on severe depression domain (p = 0.001). Unemployed caregivers had higher mean scores on the anxiety/insomnia (p = 0.039) and social dysfunction domains (p = 0.031). Those with large family sizes scored higher on the anxiety/insomnia domain (p = 0.03). CONCLUSION: Psychological distress was high among caregivers of children admitted at the children emergency room.

CONTEXTE: De nombreux aidants éprouvent une expérienceimportante charge psychologique pouvant avoir une incidence sur la prise en charge d'un malade enfant. OBJECTIF: Déterminer la prévalence et les facteurs associés de détresse psychologique chez les personnes qui s'occupent d'enfants admis à l'Salle d'urgence pour enfants. MÉTHODES: Il s'agissait d'une étude transversale descriptive parmi les soignants d'enfants qui ont été hospitalisés pendant au moins 24 heures. Le Questionnaire général sur la santé (QGH) en 28 éléments a été utilisé pour évaluer la détresse psychologique chez les soignants. Les scores GHQ étaient indiqué comme moyen ±'écart-type (ET). Chi-carré ou Fisher's le test exact a été utilisé pour tester l'association entre sociodémographiques variables et détresse psychologique. Scores GHQ moyens dans les domaines différentes de dysfonctionnement psychologique ont été comparés entre les groupes à l'aide du test t de l'échantillon indépendant; à p<0.05. RÉSULTATS: Sur les 97 aidants qui ont participé à l'étude, 96 leurs données ont été analysées. Les aidants étaient âgés de 19 à 63 ans (moyenne 34.25 (8.46)) ans; 86 (89.7 %) étaient des femmes et 48 (50 %) avaient l'enseignement supérieur. La prévalence de la détresse psychologique chez les les soignants étaient 69.8 %. Les aidants avaient des niveaux élevés d'anxiété, mais faibles niveaux de dépression. Ceux dont le niveau de scolarité est inférieur avaient des scores plus élevés dans le domaine de la dépression sévère (p = 0.001). Les aidants au chômage avaient des scores moyens plus élevés sur l'anxiété / insomnie (p = 0.039) et les domaines de dysfonctionnement social (p = 0.031). Ceux qui ont les grandes familles ont obtenu des scores plus élevés dans le domaine de l'anxiété / insomnie (p = 0.03). CONCLUSION: La détresse psychologique était élevée chez les aidants naturels des enfants admis à la salle d'urgence des enfants. Mots-clés: Soignant, enfants, urgence, détresse psychologique, Stitués dans la prise en charge des patients atteints de LA COVID-19.

Nutritional status of primary school children: Association with intelligence quotient and academic performance.

BACKGROUND: Nutrition plays a pivotal role in brain development throughout life. Sub-optimal intellectual ability and poor school performance are said to be among the long term effects of malnutrition. The aim of this study was to determine the association between nutritional status of the participants, their intelligence quotient (IQ) and academic performance. METHODS: Children aged 6-12 years who met the inclusion criteria were recruited from the public and private primary schools in the local government area using a proportionate multistage sampling technique. Weight and height were measured using standard protocols and interpreted as normal or abnormal using the World Health Organization AnthroPlus®. IQ was assessed using the Raven's Standard Progressive Matrices and was grouped into optimal and suboptimal. Academic performance was assessed using the past records of class assessment, and was classified into high, average and low academic performance. A semi-structured questionnaire was used to obtain data such as-age, gender, socioeconomic indices and family size of the study participants. RESULTS: The prevalence of underweight, thinness (wasting), stunting, overweight and obesity were 2.0%, 3.6%, 2.1%, 6.7%, and 4.2%, respectively. Indices of over-nutrition were significantly associated with optimal IQ and good academic performance. There was a trend in the association between wasting and suboptimal intelligence [AOR (95%CI) = 1.5 (1.0-3.0), p = 0.06]. CONCLUSION: Acute and chronic under-nutrition did not adversely affect the IQ and academic performance of the study population. The relationship between over-nutrition, IQ and academic performance disappeared when socio-economic status was controlled for.

Comparison of age-based weight estimation with actual measured weight in children aged one to twelve years in Enugu.

AIMS: This study was carried out to evaluate the degree of accuracy of age-based weight estimation methods in assessing the weight of the Nigerian child. METHOD: The weights of one thousand, four hundred and fifty-six (1,456) children were measured and compared with the updated Advanced Paediatric Life Support (APLS), Best guess, Nelson and Luscombe & Owen methods. RESULT: The updated APLS, Nelson and Luscombe & Owen methods underestimated the weights in younger children while overestimating in older ones. Best guess overestimated the weights across all ages. The Nelson formula had the best agreement within 10% and 20% of the measured weights among all methods. A linear regression analysis produced an equation for weight estimation: weight (W) = 2.058 Y + 9.925, where W is weight in kilogram and Y is the age in years. CONCLUSION: None of the weight estimation formulae assessed was entirely accurate in our study, though the Nelson method showed superior agreement.

Severe falciparum malaria in children in Enugu, South East Nigeria.

INTRODUCTION: Severe malaria remains one of the leading causes of morbidity and mortality in sub-Saharan Africa and parts of Asia despite several efforts in prevention and management. The prevalence and pattern of presentation may vary from one location to another and from one age group to another. OBJECTIVES: This study was undertaken to review the prevalence and pattern of severe malaria among children presenting in the two tertiary hospitals in Enugu, south-east Nigeria. METHODS: The case records of children presenting with malaria in the two tertiary hospitals in the state were retrieved and the necessary information were obtained using a structured questionnaire. RESULTS: The children aged from 1 month to 184 months (15 years), with a median age of 36 months and mean age of 49.2 ± 42.7 months. About two-thirds (68/102, 66.7%) of the children were under the age of 5 years, with only 6 of them (8.8%) being 6 months and below. There were significantly more males than females (χ2 = 6.48, P = 0.01); with a M:F ratio of 1.55:1. The peak of presentation was from August and November. Prostration, respiratory distress and severe anaemia were the commonest features of severe malaria, while shock, acute renal failure and abnormal bleeding were the least presenting features Of all the features, only severe anaemia was significantly related to age, (χ2 = 5.027, P = 0.02). Sixty-one (59.8%) of the children had one or more co-morbidities. There were 2 deaths, giving a case fatality rate of 1.96%. CONCLUSION: Early presentation will significantly reduce blood transfusions, prolonged admission and death in children with severe malaria.

HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

AIMS: To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. METHODS: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. RESULTS: Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. CONCLUSIONS: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.