The pattern of steroid sensitivity and steroid resistance in childhood idiopathic nephrotic syndrome: A 5-year retrospective observational descriptive study in a South-East Nigerian tertiary hospital.

Background/Aim: Nephrotic syndrome is the most common glomerular disease of childhood. Majority of the idiopathic cases frequently respond to steroid therapy and are regarded as steroid-sensitive nephrotic syndrome. Several studies have reported a change in this usual pattern to steroid-resistant nephrotic syndrome in Nigerian children. This study aimed to determine the pattern of steroid sensitivity and steroid resistance in childhood idiopathic nephrotic syndrome seen at a tertiary hospital in Enugu, south-east Nigeria. Materials and Methods: A retrospective study conducted in children with idiopathic nephrotic syndrome seen at the University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, over 5 years (from 2016 to 2020). The demographic variables, clinical data, and histopathological pattern were documented. Renal biopsies were studied by light microscope only. Results: Of a total of 150 patients, 105 (70%) were males, while 45 (30%) were females. Ninety six (64%) were aged 1-10 years. Fifty four (36%) were aged 11-18 years. Forty eight (32%) were aged 1-5 years. Mean age was 8.67 ± 4.69 years. One hundred and six (71%) initially had steroid-sensitive nephrotic syndrome; 12 (11.3%) and seven (6.6%) later became frequent-relapsers and steroid-dependent, respectively. Forty four (29.3%) had steroid-resistant nephrotic syndrome. Sixty eight had renal biopsy; the most common indication being steroid-resistance. The most common histological pattern was focal segmental glomerulosclerosis seen in 63.2% of these patients. Only four (9%) had renal transplant. Conclusion: Although the prevalence of steroid-sensitive nephrotic syndrome is higher in this clime, there is a rising incidence of steroid-resistant pattern attributed to incident cases of focal segmental glomerulosclerosis.

Parental practice of child car safety in Enugu, Southeast Nigeria.

Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs) among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=-0.121, P=0.310). Only respondent's use of seat belt during driving (P=0.001) and having being cautioned for non-use of CCRs (P=0.005) maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%); restraints not being important, 53 (26%), and restraints being too expensive, 32 (15%). Similarly, for irregular users, exceptions for non-use included the child being asleep (29%), inadequate number of CCRs (22%), and the child being sick (18%). There is a need for a strategy change to enforce the use of CCRs in Nigeria.