Primary Hypertension with Target Organ Damage among Apparently Healthy Secondary School Students in Osogbo, South-Western Nigeria.

INTRODUCTION: In recent times, there has been an increase in the frequency of hypertension among young people which is contributing globally to the increase in cardiovascular morbidity and mortality in adults. OBJECTIVE: The aim of this study was therefore to determine the prevalence of primary hypertension and its risk factors among apparently healthy secondary school students in Osogbo, southwestern Nigeria. METHODS: A school-based cross-sectional study of a total of 404 secondary school students in Osogbo city. Following informed parental consents of all the students involved in the study, blood pressure (BP) measurements were taken at 2 different visits by auscultation after a negative urine dip stick test result (thus excluding haematuria or proteinuria) in every subject before each BP was measured. RESULTS: The overall prevalence of hypertension and prehypertension in this study was 3.5% (n = 14) and 6.2% (n = 25), respectively. Obesity, consumption of extra - uncooked salt, high parental education and attendance of privately-owned secondary schools were identified risk factors associated with elevated BP. Seven (29%) of 24 subjects with hypertension had features of left ventricular hypertrophy (an evidence of target organ damage) on echocardiography and electrocardiography. All subjects with elevated BP had normal renal scan. CONCLUSION: Hypertension with features of target organ damage exists among adolescents. No known primary aetiologies were found among the hypertensive adolescents in the study and thus they were all deemed to have essential hypertension.

INTRODUCTION: Ces derniers temps, on a constaté une augmentation de la fréquence de l'hypertension chez les jeunes, ce qui contribue globalement à l'augmentation de la morbidité et de la mortalité cardiovasculaires chez les adultes. OBJECTIF: Le but de cette étude était donc de déterminer la prévalence de l'hypertension primaire et de ses facteurs de risque parmi des élèves du secondaire apparemment en bonne santé à Osogbo, sud-ouest du Nigeria. MÉTHODES: Étude transversale en milieu scolaire portant sur un total de 404 élèves du secondaire dans la ville d'Osogbo. Après avoir obtenu le parents informés de tous les élèves participant à l'étude, des mesures de l'étude, la pression artérielle a été mesurée par auscultation lors de 2 visites après un résultat négatif à la bandelette urinaire (excluant ainsi l'hématurie ou la protéinurie) chez chaque sujet avant que la TA ne soit mesurée. RÉSULTATS: La prévalence globale de l'hypertension et de la préhypertension dans cette étude était de 3,5% (n = 14) et de 6,2% (n = 25), respectivement. L'obésité, la consommation de sel extra-cuit, le haut niveau d'éducation des parents et la fréquentation d'écoles secondaires privées ont été identifiés comme des facteurs de risque associés à une tension artérielle élevée. Sept (29%) des 24 sujets hypertendus présentaient des caractéristiques d'hypertrophie du ventriculaire gauche (preuve d'une atteinte des organes cibles) à l'échocardiographie et à l'électrocardiographie. Tous les sujets présentant une PA élevée avaient une scintigraphie rénale normale. CONCLUSION: L'hypertension avec des caractéristiques d'atteinte des organes cibles existe chez les adolescents. Aucune étiologie primaire connue n'a été trouvée chez les adolescents hypertendus de l'étude et donc tous considérés comme souffrant d'hypertension essentielle. Mots clés: Hypertension primaire, dommages aux organes cibles, adolescents sains.

Muco-Cutaneous Infections in HIV Infected Children at a Nigerian Tertiary Hospital.

BACKGROUND: Studies on mucous infections in HIV infected children are sparse. Cutaneous infections though common, vary in pattern and prevalence over time and location. OBJECTIVES: To provide updates on the prevalence and pattern of muco-cutaneous infections among HIV infected children attending a Nigerian tertiary hospital and identify neglected muco-cutaneous infections. METHODS: Consecutive HIV infected children seen over a 5-year period were studied. Relevant information on the subjects, HIV and presence or absence of skin infections was obtained. Data was analysed with SPSS version 16 software. RESULTS: One hundred and thirty-two children were studied with ages ranging between 3 months and 17 years of which 68(51.5%) were boys and 64(48.5%) girls. Of the 132 children 64(48.5%) had muco-cutaneous infections, comprising 50(78.1%) cutaneous and 14(21.9%) mucous infections. Superficial fungal, viral, bacterial and parasitic infections were recorded in 45(34.1%), 18(26.6%), 12(9.1%) children and 1 (0.8%) child respectively. Thirty-six (56.2%) of the 64 children with muco-cutaneous infection were unaware of their skin infection prior to consultation. The rates of skin infection were significantly higher amongst children with advanced HIV disease, children whose caregivers had skin disease and children whose parents had no formal education and educational attainments limited to the primary school.(p< 0.05). Presence of phlyctenular conjunctivitis in a child with hitherto undiagnosed tuberculosis was recorded. CONCLUSION: Muco-cutaneous infections are common disease conditions of HIV infected children. Awareness of muco cutaneous infections amongst those infected is poor. Interventions mitigating associated factors are expected to reduce the burden of this disease.

CONTEXTE: Études sur les infections muqueuses chez les personnes infectées par le VIH les enfants sont clairsemés. Les infections cutanées, bien que courantes, varient en le modèle et la prévalence au fil du temps et de l'emplacement. OBJECTIFS: Fournir des mises à jour sur la prévalence et la tendance des infections muco-cutanées chez les enfants infectés par le VIH fréquentant un hôpital tertiaire nigérian et identifier les muco-cutanés négligés Infections. MÉTHODES: Enfants infectés par le VIH consécutifs vus pendant 5 ans période ont été étudiés. Informations pertinentes sur les sujets, le VIH et la présence ou l'absence d'infections cutanées a été obtenue. Les données ont été analyses avec le logiciel SPSS version 16. RÉSULTATS: Cent trente-deux enfants ont été étudiés avec âges compris entre 3 mois et 17 ans, dont 68 (51.5 %) étaient des garçons et 64 (48.5 %) des filles. Sur les 132 enfants, 64 (48.5 %) avaient infections muco-cutanées, comprenant 50 (78.1 %) cutanés et 14 (21.9 %) infections muqueuses. Fongique superficiel, viral, bactérien et des infections parasitaires ont été enregistrées chez 45 (34.1 %), 18 (26.6 %), 12 (9.1 %)enfants et 1 (0.8%) enfant respectivement. Trentesix (56.2 %) des 64 enfants atteints d'une infection muco-cutanée n'étaient pas au courant de leur infection cutanée avant la consultation. Les taux d'infection cutanée étaient significativement plus élevé chez les enfants atteints d'une maladie à VIH avancée,les enfants dont les soignants avaient une maladie de la peau et les enfants dont les parentsn'avaient pas d'éducation formelle et de niveau de scolarité limité à l'école primaire. (p< 0.05). Présence de conjonctivite phlycténulaire chez un enfant atteint de tuberculose jusqu'alors non diagnostiquée a été enregistré. CONCLUSION: Les infections muco-cutanées sont des maladies courantes les conditions des enfants infectés par le VIH. Sensibilisation à la muqueuse-cutanéeles infections parmi les personnes infectées sont faibles. Interventions atténuantes on s'attend à ce que les facteurs associés réduisent le fardeau de cette maladie. Mots-clés: Pédiatrie, Infectieux, Dermatoses, Humain virus de l'Immuno déficience.

Pattern of paediatric dermatoses at dermatology clinics in Ile-Ife and Ilesha, Nigeria.

BACKGROUND: In developing countries, skin diseases are one of the most common causes of morbidity. AIM: A prospective descriptive study was conducted to determine the pattern of skin diseases in childhood and adolescents presenting to the outpatient dermatology clinics of Obafemi Awolowo University Teaching Hospitals Complex at Ile-Ife and Ilesha, Osun State. METHODS: Patients aged 2 weeks to 19 years attending the clinics between October 2009 and September 2012 were included. RESULTS: A total of 491 dermatoses were recorded in 441 patients. There were 244 (49.6%) males. Dermatophyte infections (17.1%), papular urticaria (6.7%), atopic dermatitis (6.3%), vitiligo (5.3%), acne (4.7%) and viral warts (3.7%) were the most frequent dermatoses. Skin infections and infestations, mostly dermatophyte infections and viral warts, accounted for 57.6% of the skin conditions. Of the non-infectious diseases, papular urticaria and atopic dermatitis were the most common. Dermatophyte infections were the most prevalent in children (25.8%), and acne vulgaris in adolescents (11.8%). CONCLUSION: Skin infections and infestations, mostly dermatophyte infections, were the most prevalent in children, and acne vulgaris in adolescents.

Pattern of dermatoses among inmates of Ilesha Prison, Nigeria.

AIMS AND OBJECTIVES: Dermatoses are common health problems in prisons and environmental conditions influence their prevalence and pattern. Hot and humid environment as obtains in the tropics, stress, and overcrowding are conditions that facilitate development of. The aim of this study was to determine the prevalence and pattern of dermatoses in a prison located in a tropical environment. MATERIALS AND METHODS: The study was done in May-July 2006 in a South-West Nigerian prison. Using a purpose designed questionnaire, information on sex, age, prison status, and number in rooms was obtained and inmates were clinically examined. RESULTS: Inmates studied were 305 (296 males and 9 females). Dermatoses were found in 221 inmates with overall prevalence of 72.5% (221/305). Infectious disorders were seen in 67.9% (150/221) and non-infectious in 32.1% (71/221). The diseases occurred in 72.9% (167/229) of awaiting trial persons and 72.9% (51/70) convicted persons. Overcrowding was more in cells (average sleeping area was 9.5 sq feet). Skin diseases affected 80.3% (61/76) of inmates in cells and 69.9% (160/229) in dormitory rooms.. About 71.2% (94/132) of inmates affected stay in five highly overcrowded dormitory rooms with infectious disorders in 48.5% (64/132). Dermatophyte infections were 34.3% of 332 dermatoses seen, pityriasis versicolor 14.5%, acne vulgaris 12.3%, dandruff 10.5%, 28.4%. A significant relationship was found with overcrowding and place where dermatoses were first noticed. CONCLUSION: Dermatoses are common health problem of prisoners, and prison conditions facilitate these problems.

Impact of intestinal helminthiases on the nutritional status of primary-school children in Osun state, south-western Nigeria.

In January-March 2000, the impact of intestinal helminthiases on the nutritional status of 749 pupils (353 boys and 396 girls) attending public primary schools in the Ife Central local government area of Osun state, in south-western Nigeria, was investigated. Demographic, socio-economic and other relevant information was collected on the pupils, on the same day that a single stool sample was collected from each subject and examined, using Stoll's dilution egg-count technique. The weights, heights and ages of the subjects were recorded and converted to percentages of the reference medians for weight-for-height, weight-for-age and height-for-age. The overall prevalences of helminth infection detected among the 465 malnourished pupils (i.e. those with any form of under-nutrition) and the 284 well-nourished pupils were 32.9% and 25.4%, respectively (P=0.029). The nutritional indices of the pupils who were found helminth-infected were generally lower than those of the pupils who appeared free of intestinal helminths. The mean values for weight-for-height, for example, were higher in the apparently uninfected pupils than in those found infected with any intestinal helminth (P=0.02) or only with Ascaris lumbricoides (P=0.05). Similarly, the mean height-for-age of the pupils who were apparently uninfected was higher than the corresponding value for the pupils found hookworm-positive (P=0.003). The pupils who were each found infected with two or more species of intestinal infection had significantly lower weights-for-heights, weights-for-ages and heights-for-ages than the pupils who appeared to be helminth-free. The results of a multivariate logistic-regression analysis indicated that hookworm infection was a significant risk factor for underweight (P=0.015), wasting (P=0.033) and stunting (P=0.015) whereas Trichuris was only a significant risk factor for stunting (P=0.025). It appears that intestinal helminthiasis may play a causal or contributory role in the occurrence of childhood malnutrition, at least in the present study area. Steps should be taken to control both of these important health problems, through functional school-health programmes that provide regular deworming, supervised school meals and health education.

Plasma lipid peroxidation and totalantioxidant status among dyslipidaemic and hypertensive Nigerians with high risk of coronary heart disease.

BACKGROUND: The oxidative modification hypothesis of atherosclerosis predicts that low density lipoprotein-cholesterol (LDL-C) oxidation is an early event in atherosclerosis and that oxidized LDL-C contributes to atherogenesis OBJECTIVE: To determine a link, if any, between the plasma lipid peroxidation and total antioxidant status (TAS) among dyslipidemic and hypertensive Nigerian patients with high risk of coronary heart disease. METHODS: The study groups comprised 58 hypertensive adult Nigerians whose fasting plasma total cholesterol (TC) levels were > 5.5 mmol/L and with high risk coronary heart disease (CHD) lipid fraction i.e. 'the ratio of high density lipoprotein cholesterol to total cholesterol' (HDL-C/TC) < 0.13 were selected for the study. The control groups comprised 58 non hypertensive adult Nigerians with (HDL-C/TC) > 0.30. RESULTS: The mean +/- SD TAS level (1.02 +/- 0.15 mmol/L trolox) for males and (0.99 +/- 0.17 mmol/L) for females were significantly reduced (p < 0.05) compared to the controls; however (MDA) level (5.15 +/- 0.82 mmol/ml) for males and (5.06 +/- 0.73 mmol/ml) for females were significantly increased (p < 0.01) compared to the controls. The mean +/- SD plasma TC and LDL-C malonyl level (5.87 +/- 0.23 mmol/L and 4.65 +/- 0.34 mmol/L) were significantly increased (p < 0.01) in males hypertensive compared to the control. An inverse correlation between the TAS/TC(r = -0.53, p < 0.001) and TAS/LDL-C (r = -0.50, p < 0.001), however a direct correlation between the MDA/TC(r = 0.51, p < 0.001) and MDA/LDL-C (r = 0.48, p < 0.01) for males hypertensive were found. In female subjects the mean +/- SD plasma TC (5.95 +/- 0.13 mmol/L) and LDL-C (4.45 +/- 1.04 mmol/L) were significantly increased (p < 0.05) and (p < 0.01) respectively compared to the controls. Also in hypertensive females inverse correlation between the TAS/TC (r = -0.59, p < 0.001) and TAS/LDL-C (r = -.41, p < 0.01), and a direct correlation between the MDA/TC ( r= .48, p < 0.01) and MDA/LDL-C (r = 0.31, p < 0.05) were found. CONCLUSION: Since dyslipidaemia, hypertension and lipid peroxidation were directly relate to the severity of atherosclerosis, elimination of free radicals in the plasma before the peripheral tissues can take them up might reduce atherosclerosis. In view of our present findings, a management strategy aimed at simultaneously reducing lipid peroxidation and increasing total antioxidant status in dyslipidemic patients may be of benefit.

Intestinal helminthiases among rural and urban schoolchildren in south-western Nigeria.

The prevalences and intensities of intestinal helminthic infection among primary schoolchildren were determined in rural and urban communities of the Ife Central local government area, in south-western Nigeria. After the schools in the study area had been stratified into urban and rural, a random sample from each stratum was selected for further study. In each study school, a single fresh stool specimen was obtained from each pupil in randomly selected classes and checked, using a quantitative method (Stoll's dilution egg-count technique), for helminth eggs and larvae. Overall, 366 rural and 383 urban schoolchildren were investigated and 30.0% of them (36.1% of the rural and 24.3% of the urban; P<0.001) were found to be harbouring at least one species of intestinal helminth. The mean intensities of infection, in terms of excreted eggs/g faeces of those infected, were 2371.4 for Ascaris, 1070.6 for hookworm, and 500 for Trichuris. Although the mean intensities of Ascaris infection were significantly lower among the infected rural children than among the infected urban (2025.7 v. 2791.4; P=0.014), the corresponding difference in the hookworm infections did not reach statistical significance (1458 v. 666.7; P=0.063). The means of the log-transformed egg outputs, in eggs/g faeces of those infected, also showed similar trends: a significant difference between the rural and urban Ascaris infections (3.1877 v. 3.3340; P=0.002) but not between the rural and urban hookworm infections (2.9667 v. 2.8027; P=0.453). Intestinal helminthiases still clearly represent a common childhood health problem in the study area, particularly in the rural communities.

Comparative study of nutritional status of urban and rural Nigerian school children.

Nutritional assessment in the community is essential for accurate planning and implementation of intervention programmes to reduce morbidity and mortality associated with under-nutrition. The study was, therefore, carried out to determine and compare the nutritional status of children attending urban and rural public primary schools in Ife Central Local Government Area (ICLGA) of Nigeria. The schools were stratified into urban and rural, and studied schools were selected by balloting. Information obtained on each pupil was entered into a pre-designed proforma. The weight and height were recorded for each pupil, and converted to nutritional indices (weight for age, weight for height, height for age). A total of 749 pupils (366 and 383 children from the rural and urban communities, respectively) were studied. The overall prevalent rates of underweight, wasting and stunting were 61.2, 16.8 and 27.6%, respectively. In the rural area these were 70.5, 17.8 and 35.8%, while in the urban they were 52.2, 15.9 and 19.8%, respectively. The mean nutritional indices (Weight for Age, Weight for Height and Height for Age) were found to be significantly lower among the rural pupils than urban pupils (P < 0.001 in each case). The present study shows that malnutrition (underweight, wasting and stunting) constituted major health problems among school children in Nigeria. This is particularly so in the rural areas. Therefore, prevention of malnutrition should be given a high priority in the implementation of the ongoing primary health care programmes with particular attention paid to the rural population.

Haematological profile and malarial parasitaemia in Nigerian children requiring emergency blood transfusion.

BACKGROUND: This study was carried out to determine the haematological profile and malarial parasitaemia of children requiring emergency blood transfusion. METHODS: This prospective study was carried out from 1st August to 30th of November, 1999 at the Children Emergency Ward (CHEW) of the Obafemi Awolowo University Teaching Hospital (OAUTH) Ile-Ife, Nigeria. All children requiring emergency blood transfusion seen at the CHEW were included in the study. Blood samples were taken on admission for haematocrit, white cell count and differentials, thin and thick blood films. Other data recorded include age, sex, clinical impression on admission. RESULTS: Four hundred children were admitted into the CHEW during the study period and 173(43%) required emergency blood transfusion. One hundred and forty-five (84%) of the children who required emergency transfusion were below the age of five years. There was no sex predilection. Although, clinical impression of malaria was made either singly or in combination with other diseases in almost all the patients, malaria parasitaemia was confirmed in 86 (50%) of the patients. The mean haematocrit was 0.14 L/L. In 60% of the children, there were mixed microcytic hypochromic and macrocytic red bloodcells. CONCLUSION: We conclude that severe anaemia requiring emergency blood transfusion is a major cause of morbidity and mortality in under five children. We also confirm that malaria and nutritional deficiencies are the major cause of severe anaemia in Nigerian children. We therefore recommend urgent need for prevention and prompt treatment of malaria in children under the age of five years. We also recommend the need for improvement in the nutritional intake of children under the age of five.