Prevalence and Pattern of Feeding Problems and Relationship to Motor Function Severity in Children with Cerebral Palsy in Umuahia.

BACKGROUND: Reports show that feeding problems in children with cerebral palsy (CP) significantly reduce nutritional intake and affect their nutritional status. OBJECTIVE: To determine the prevalence and types of feeding problems and its association with functional severity and nutritional status in children with cerebral palsy. METHODS: This cross-sectional study involved 169 children with CP aged 1 - 17 years seen at the Neurology clinic of Federal Medical Centre, Umuahia. Gross motor skills were described using Gross Motor Function Classification System (GMFCS).Nutritional status was determined and classified based on WHO Child Growth Standards. Data was analyzed using SPSS version 20.0. RESULTS: Feeding problem was seen in 39.1% of the subjects, with spitting out food (57.6%), prolonged feeding time (45.5%) and choking (16.7%) being the most common types. Malnutrition occurred in 37.3% of patients. Feeding problems were significantly associated with functional severity (χ2 = 52.06 and p < 0.001) and proportion of feeding problems increased with increasing functional severity. All the subjects with functional severity level V (100%) had feeding problems. There was no statistically significant association between nutritional status and feeding problems (χ2 = 0.77 and p = 0.38), although the proportion of feeding problems was highest (44.3%) in the underweight subjects. CONCLUSION: The prevalence of feeding problem in children with CP is 39.1%. There was no association between feeding problems and nutritional status. Feeding problem was however significantly associated with functional severity. Therefore there is need for routine evaluation for feeding problems in children with CP to prevent complications.

CONTEXTE: Les rapports montrent que les problèmes d'alimentation chez les enfants atteints de paralysie cérébrale (PC) réduisent de manière significative l'apport nutritionnel et affectent leur statut nutritionnel. OBJECTIF: Déterminer la prévalence et les types de problèmes d'alimentation et leur association avec la sévérité fonctionnelle et le statut nutritionnel des enfants atteints de paralysie cérébrale. MÉTHODES: Cette étude transversale a porté sur 169 enfants atteints de paralysie cérébrale âgés de 1 à 17 ans et vus à la clinique de neurologie du Centre médical fédéral, Umuahia. Les capacités motrices brutes ont été décrites à l'aide du système de classification de la fonction motrice brute (GMFCS), l'état nutritionnel a été déterminé et classé selon les normes de croissance de l'enfant de l'OMS. Les données ont été analysées à l'aide de SPSS version 20.0. RÉSULTATS: Des problèmes d'alimentation ont été observés chez 39,1 % des sujets, les plus fréquents étant les régurgitations (57,6 %), le temps d'alimentation prolongé (45,5 %) et l'étouffement (16,7 %). La malnutrition est apparue chez 37,3 % des patients. Les problèmes d'alimentation étaient significativement associés à la sévérité fonctionnelle (÷2 = 52,06 et p < 0,001) et la proportion de problèmes d'alimentation augmentait avec la sévérité fonctionnelle. Tous les sujets présentant un niveau de sévérité fonctionnelle V (100%) avaient des problèmes d'alimentation. Il n'y avait pas d'association statistiquement significative entre l'état nutritionnel et les problèmes d'alimentation (÷2 = 0,77 et p = 0,38), bien que la proportion de problèmes d'alimentation était la plus élevée (44,3 %) chez les sujets présentant une insuffisance pondérale. CONCLUSION: La prévalence des problèmes d'alimentation chez les enfants atteints de PC est de 39,1%. Il n'y avait pas d'association entre les problèmes d'alimentation et l'état nutritionnel. Les problèmes d'alimentation étaient cependant significativement associés à la sévérité fonctionnelle. Il est donc nécessaire de procéder à une évaluation systématique des problèmes d'alimentation chez les enfants atteints de PC afin de prévenir les complications. Mots clés: Infirmité motrice cérébrale, Sévérité fonctionnelle, Problèmes d'Alimentation, Nutrition, Umuahia.

Association between Height and Blood Pressure in Middle Age and Older Adults in Southeast Nigeria.

BACKGROUND: This study was carried out in Abia State, Southeast Nigeria, to determine the association between height and blood pressure in middle age and elderly adults. MATERIALS AND METHODS: This was a cross-sectional study carried out in Abia State, Southeast Nigeria, between August 2011 and March 2012. The participants were residents in the state and were recruited from the three senatorial zones of the state. The total number of participants that took part in the study was 2,487 adults. The World Health Organisation STEPwise approach to surveillance of chronic disease risk factors was used. Information collected included blood pressure and anthropometric measurements. The association between height and blood pressure was determined. RESULTS: A total of 1,363 participants that took part in the study were >40 years old. Six hundred and fifty-five participants (48.1%) were males and 708 participants (51.9%) were females. There was no significant inverse relationship between height and blood pressure components ( Systolic Blood Pressure Diastolic Blood Pressure, and Pulse Pressure ) among the males. Among the females there was a high inverse relationship between height and blood pressure components. However, this relationship was not statistically significant. In addition, among the males there was no relationship between height and hypertension. Among the females, there was some degree of inverse relationship between height and hypertension, although multivariate regression analysis showed that this was not significant. CONCLUSION: There was an inverse but non-significant relationship between height and blood pressure components/ hypertension among males and females in Southeast Nigeria in this study.

CONTEXTE: Cette étude a été menée dans l'État d'Abia, au sud-est du Nigeria, pour déterminer, pour déterminer l'association entre la taille et la pression artérielle chez les adultes d'âge moyen et les personnes âgées. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale réalisée dans l'État d'Abia, au sud-est du Nigeria, entre août 2011 et mars 2012. Les participants étaient des résidents de l'État et ont été recrutés dans les trois zones sénatoriales de l'État. Le nombre total de participants ayant pris part à l'étude était de 2 487 adultes. L'approche STEPwise de l'Organisation mondiale de la santé pour la surveillance des facteurs de risque des maladies chroniques a été utilisée. Les informations recueillies comprenaient la pression artérielle et les mesures anthropométriques. L'association entre la taille et la pression artérielle a été déterminée. RÉSULTATS: Au total, 1 363 participants à l'étude étaient âgés de plus de 40 ans. Six cent cinquante-cinq participants (48,1%) étaient des hommes et 708 participants (51,9 %) étaient des femmes. Il n'y avait pas de relation inverse significative entre la taille et les composantes de la pression artérielle (pression artérielle systolique, pression artérielle diastolique et pression du pouls) chez les hommes. Chez les femmes, on a constaté une forte relation inverse entre la taille et les composantes de la pression artérielle. Cependant, cette relation n'était pas statistiquement significative. En outre, Chez les hommes, il n'y a pas de relation entre la taille et l'hypertension. Chez les femmes, on a constaté un certain degré de relation inverse entre la taille et l'hypertension, bien que l'analyse de régression multivariée a montré qu'elle n'était pas significative. CONCLUSION: Il existe une relation inverse, mais non significative, entre la taille et les composantes de la pression artérielle/ hypertension chez les hommes et les femmes du sud-est du Nigeria. Mots clés: Taille, Hypertension, Pression artérielle, Pression artérielle systolique.

Pattern of Disabilities among Leprosy Patients in Abia State, Nigeria - a Retrospective Review.

Early case detection and prompt treatment have been identified as key strategies for effective control and elimination of leprosy disease. Hence, control efforts should include among others treatment of the disease and disability prevention. This study is aimed at determining prevalence and pattern of disability among leprosy patients treated in a Leprosy Center in Abia State, Nigeria. Records of 287 leprosy patients treated in Uzoakoli Leprosy Center, Abia State between 2002 and 2006 were reviewed and analysed. Findings showed 23 (9.9%) with childhood leprosy, 206 (83.7%) multi-bacillary type and 64 (28.4%) with grade 2 disability among the leprosy cases.Four children (15.4%) presented with grade 2 disability at diagnosis. Prior to treatment 80 (27.9%) had grade 2 disability, while 11 (6.6%) at the end of the treatment.,Based on EHF score 85 patients (50.9%) out 167 patients who completed treatment had impairment before treatment; on completion of treatment 133 (89.9%) of them improved, while 5 (3.4%) deteriorated. The lower limb (92.6%) was the most affected site in the leprosy patients,, while the eye (3.4%) was the leastaffected. The current leprosy control efforts should be intensified to ensure early case detection and prompt treatment in order to reduce the leprosy burden, including disabilities in individuals and community at large.

Parents' perceptions of timing of initiation of sexuality discussion with adolescents in Anambra State, South Eastern Nigeria.

STUDY OBJECTIVE: This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria. DESIGN: A cross-sectional, descriptive, community-based study. SETTING: The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria. PARTICIPANTS: The study participants were parents with adolescent children resident in the study areas for at least 2 years. RESULTS: Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status. CONCLUSION: Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Pattern and Magnitude of Treatment Delay among TB Patients in Five States in Southern Nigeria

Prompt diagnosis and early treatment of Tuberculosis (TB) cases is an important strategy in TB prevention and control. Thus; passive case finding of TB suspects; sputum examination for diagnosis; and prompt treatment using Directly Observed Treatment Short Course (DOTS) are key elements in the national guideline for TB control programme. The aim of this study is to determine the time interval between diagnosis of smear-positive TB cases and the commencement of treatment in DOTS facilities in southern Nigeria. The study was carried out in 20 healthcare facilities supported by TB Control Assistance Program (TB-CAP) involved in TB management in southern Nigeria; which comprised tertiary; secondary; and primary healthcare facilities including public and private facilities. Data were collected through review of clients' and facility records covering July-September 2009. Data collected were sociodemographic characteristics; sputum-smear result; date of diagnosis; and date of commencement of treatment. Data were analyzed using SPSS version 15.0 software. Of the total 2;507 TB suspects examined for Acid-Fast Bacillus (AFB); 323 were diagnosed to be Sputum-Smear-Positive (SS+ve); However; 269 new smear positive cases were commenced on treatment within the period; thus 54 (17.0) of the new SS+ve cases defaulted initially. One hundred and two (38) of them commenced TB treatment within 3 days of smear examination for diagnosis; while 59 (22) commenced 4-6 days after diagnosis. The study revealed significant delay in commencement of TB treatment for most new smear positive TB cases in southern Nigeria and underlines the need to further explore factors responsible for delay in commencement of TB treatment following diagnosis

Determinants of breastfeeding pattern among nursing mothers in Anambra State, Nigeria.

OBJECTIVES: The practice of optimal breastfeeding including exclusive breastfeeding for the first six months of life is still rare among nursing mothers despite numerous benefits of breastfeeding. This study was aimed at identifying the factors influencing breastfeeding pattern among nursing mothers in Anambra State, Nigeria. METHODS: A cross sectional study was carried out in three comprehensive health centres of Nnamdi Azikiwe University Teaching Hospital (NAUTH) located at Neni, Ukpo and Nnewi communities of Anambra State. A semi structured questionnaire was interviewer administered on 228 nursing mothers consecutively selected by a systematic random sampling method as they visited the maternal and child welfare clinics. In addition, four sessions of focus group discussions (one in each centre) involving 8-10 nursing mothers were held. RESULTS: Most mothers 190 (83.3%) were aged between 20 and 34 years. About 152 (66.6%) had attended or completed secondary education and were mainly traders 86 (37.7%) and full time house wives 66 (29.0%). Majority 208 (91.2%) had at least good knowledge of breastfeeding. Their main source of breastfeeding education was government health facilities (80.85%). Only 85 (37.3%) breastfed exclusively. Exclusively breastfeeding was significantly associated with maternal older age, parity, delivery at government facility, positive family attitude towards exclusive breastfeeding and breastfeeding education from government health facility (p < 0.05). Focus group discussion showed that mothers believed that adequate nutrition, physical, financial and emotional support to them would increase exclusive breastfeeding practice. CONCLUSION: Exclusive breastfeeding rate was low among the mothers and the factors identified to influence its practice have important implications to breastfeeding intervention programmes. Activities to promote exclusive breastfeeding should be focused on the group of women and location in which it was poorly practiced. In addition, support to the mothers would be necessary.