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

Regional skin histomorphology in adult greater cane rats (Thryonomys swinderianus): A pilot study.

The greater cane rat (Thryonomys swinderianus) demonstrated numerous dermal architectural peculiarities hitherto unreported. This investigation assessed and evaluated certain histologic features of skin samples from the fore and hind limbs, the neck, head, proximal to the ear and oro-nasal regions for follicular evaluations and micro anatomic assessments in the adult species. Twenty wild taken animals of equal gender distribution were used for histologic assessments of structural elements and histo-morphometric evaluations. Hair follicular density, size, distribution and orientations as well as sexual dimorphisms observed in the body regions studied with Motic Image Plus software analysis were also reported. Statistical analysis revealed sexual dimorphism in this feature as females demonstrated significantly higher (P < .05) follicular density and epidermal thickness at about twice the recorded values for males at similar sites evaluated, but half (P < .05) of follicular diameter of values of males. Mean follicular density for oro-nasal area, head, neck, fore and hind limbs were 50 ±â€¯3.55 and 70 ±â€¯3.34n/µm2, 16.24 ±â€¯3.02 and 12 ±â€¯4.00, 8.00 ±â€¯2.68 and 83.66 ±â€¯4.08, 8.02 ±â€¯4.00 and 3.23 ±â€¯3.85, 4.32 ±â€¯3.02 and 2.05 ±â€¯2.04 for females and males respectively. Follicular area decreased proportionally with density increase but it was inversely proportional with epidermal thickness in all evaluated regions. This investigation suggests that the peculiarities observed in dermal structures adapt this species to environmental forces, defense and self-preservation including thermoregulation, foraging and predator evasion, whereas histo-morphometric evaluation result suggests that thermoregulation and other skin sensory modalities may differ between genders in the greater cane rat.

PREDICTORS OF C-REACTIVE PROTEIN RESPONSE IN CHILDREN INFECTED WITH PLASMODIUM FALCIPARUM MALARIA.

OBJECTIVE: To assess the predictors of C-reactive protein response in plasmodium falciparum malaria as seen in children in a malaria endemic region of Nigeria. DESIGN: A prospective cross-sectional study. SETTING: The Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunisation Centre and Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. SUBJECTS: Three hundred and sixty children aged six to sixty months with microscopically confirmed P. falciparum malaria compared with 360 healthy children without malaria parasitaemia matched for age and gender. RESULTS: The predictors of the C-reactive protein response in malaria (CRP ≥ 10mg/l) were fever (t = 6.867; p = 0.001), malaria parasite count (t = 5.387; p = 0.001), severe anaemia (t = -11.23; p = 0.001) and age. Younger children had a greater CRP response. The logistic regression curve showed a 66.9% sensitivity, 92.1% specificity, positive predictive value, 83.2% and negative predictive value of 82.2% of predicting C-reactive protein response in malaria. CONCLUSION: P. falciparum malaria induces significant CRP responses. Younger children who present with fever, hyperparasitaemia and severe anaemia are more likely to have C-reactive protein response with malaria.

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.

Teachers' knowledge and attitudes towards seizure disorder: a comparative study of urban and rural school teachers in Akwa Ibom State, Nigeria.

BACKGROUND: Knowledge and attitude of school teachers with regard to seizure disorder has an important impact on continuation of schooling of children with seizure disorder. Though school teachers in both rural and urban settings are exposed to the same training, their perception of seizure disorder could be influenced by the environment in which they reside. OBJECTIVES: To determine the knowledge and attitudes of school teachers towards children with seizure disorder, and the influence of urban residence on perception of seizure disorder by the teachers. MATERIALS AND METHODS: A self-administered questionnaire on knowledge and attitudes to seizure disorder were filled by school teachers drawn from both urban and rural settings in Akwa-Ibom State, Nigeria. RESULTS: One-hundred and thirty-two urban school teachers and an equal number of their rural counterparts completed the questionnaire. There were significantly more female teachers in the urban schools whereas the rural schools were dominated by male teachers with male to female ratio of 1:5.6 and 1.2:1, respectively. Majority of the urban (60.6%) and rural (57.6%) school teachers were National Certificate of Education holders. Thirty-eight (28.8%) of urban respondents versus eight (6.1%) of rural respondents thought seizure disorder was caused by evil spirits whereas 60 (45.5%) urban respondents compared to 80 (60.6%) of rural respondents felt seizure disorder was infectious. Majority of the respondents from both urban and rural schools (68.2% and 63.6% respectively) believed that the foam from the mouth of a convulsing child with seizure disorder is the infecting agent. However, 62.1% of urban respondents as well as 45.5% of rural respondents would advise that children with seizure disorder be admitted into special schools. There was no significant difference in the mean overall knowledge and attitudes of school teachers to seizure disorder in the two settings ( P = 0.33 for knowledge and 0.28 for attitudes). Teachers' high level of education however, had a positive influence on their knowledge and attitudes towards children with seizure disorder. CONCLUSION: School teachers in both urban and rural schools exhibited poor knowledge and negative attitudes towards children with seizure disorder. Residing in the urban setting did not have a positive impact on teachers' perception of seizure disorder. Massive health education on seizure disorder is therefore advocated for teachers in both urban and rural schools.

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

Growth study and hydrocarbonoclastic potential of microorganisms isolated from aviation fuel spill site in Ibeno, Nigeria.

The growth study and hydrocarbonoclastic potential of microorganisms isolated from aviation fuel spill sites at Inua-eyet Ikot in Ibeno, Nigeria were examined using standard microbiological methods. The results of the analysis revealed that the viable plate count of microorganisms in the polluted soil ranged from 2.2 ± 0.04 × 10(3) to 3.4 ± 0.14 × 10(6) cfu/g for bacteria and 1.4 ± 0.5 × 10(2) to 2.3 ± 0.4 × 10(4) cfu/g for fungi while count of biodegraders ranged from 1.2 ± 0.4 × 10(3) to 2.1 ± 0.8 × 10(5) cfu/g. A total of 11 microbial isolates comprising of Micrococcus, Klebsiella, Flavobacterium, Bacillus, Pseudomonas, Candida, Aspergillus, Cladosporium, Penicillium, Saccharomyces and Fusarium were characterized. The ability of the selected isolates to utilize the pollutant (aviation fuel) as their sole source of carbon and energy was examined and noticed to vary in growth profiles between the isolates. The results of their degradability after 28 days of incubation shows that species of Cladosporium, Pseudomonas, Candida, Bacillus, Micrococcus and Penicillium were the most efficient Aviation fuel degraders with percentage weight loss of 86.2, 78.4, 78, 56, 53 and 50.6 respectively. Flavobacterium, Saccharomyces and Aspergillus exhibited moderate growth with percentage weight loss of 48, 45.8 and 43.4 respectively while Klebsiella and Fusarium species showed minimal growth with percentage weight loss of 20 and 18.5 respectively. The results imply that the most efficient biodegraders like Cladosporium, Pseudomonas, Candida, Bacillus and Microoccus could tolerate and remove aviation fuel from the environment.

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

Academic performance of school children with behavioural disorders in Uyo, Nigeria.

INTRODUCTION: Behavioural disorders can have a negative influence on the academic performance of school children. There are no similiar published is no known studies in Nigeria. OBJECTIVE: To compare the academic performance of primary school children with behavioural disorders with that of their controls. METHODS: A total of 132 primary school pupils aged 6-12 years with behavioural disorders using Rutter scale for teachers (Scale B(2)) and their matched-controls were selected. Their academic performance was assessed and compared using the overall scores achieved in the first and second term examinations in the 2005/2006 academic sessions, as well as the scores in individual subjects. Number of days absent from school was documented. RESULTS: While 26.5% and 12.9% pupils with behavioural disorders had high and poor academic performance respectively, 38.6% and 9.1% pupils without such disorders had high and poor performances respectively. The difference in the ooverall academic performance was statistically significant (p=0.04). The mean scores of the pupils with behavioural disorders on four core subjects compared well with those of the controls. Pupils with antisocial behaviour underachieved more than others. School absence rate had no significant influence on their performance. CONCLUSION: Behavioural disorders are associated with poor academic performance in school children in Uyo.

Radiation dose reduction in paediatric fluoroscopy using added filtration.

Studies on a water phantom indicate that the insertion of extra tube filtration combined with the removal of the antiscatter grid can reduce the total energy imparted from paediatric fluoroscopy by a factor of more than four when automatic exposure control is used. The omission of the grid is responsible for up to 40% of the reduction while the addition of 0.7 mm steel filtration is found to account for a further reduction in energy imparted of between 57% and 70%, for depths of water simulating small patients of 6-16 cm thickness. For all contrast paediatric examinations the reduction in image quality was considered to be small and the diagnostic information unimpaired with the filter in place.

Threat of number.

PIP: Population growth in Nigeria is particularly problematic because population is expected to increase dramatically from 115 million to 280 million in 25 years. At present there are 206 million in the entire West African sub-region. The population density issues within Nigeria and the region are also reasons for concern. About 50% of Nigeria's population is presently under 20 years old, and the likelihood of this proportion continuing for some time is very high. Population growth will mean increased demand for housing, food, health services, education, electricity, and water. The UN has issued warnings that population pressures strain scarce resources, the environment, and people's adjustment. A national population policy was established in order to improve the standard of living of Nigerians and to promote health and welfare among the population. The policy aims to lower population growth through voluntary family planning and through reductions in infant, child, and maternal mortality. In 1989 the Nigerian government in conjunction with the US Agency for International Development (USAID) committed about $100 million in a 5-year program to strengthen family planning: $33 million from Nigeria and $67 million from USAID. The federal Ministry of Health would maintain family health services with integrated primary health care and with promotion of the balance between resources and number of children. Other international efforts have contributed to family planning programs. For example, the Planned Parenthood Federation of Nigeria focused on adult males and youth. Oral contraceptives and injectables have received criticism in Nigeria for having undesirable health consequences despite their popularity worldwide, the absence of significant side effects, and international and national support. Vasectomy is becoming more popular in Oyo state. Family planning has not been popular because of many misconceptions. Both Muslim and Catholic leaders have encouraged responsible parenthood, although Catholic leaders reject contraception.^ieng