An assessment of sexual maturation among school girls in Abakaliki Metropolis, Ebonyi State, South-East Nigeria.

BACKGROUND: Sexual maturation is an important milestone which starts between 8 and 14 years in girls. However, varying ages of onset of sexual maturation have been reported in different environments, with more recent studies showing earlier ages of onset in girls. There is therefore need to describe the sexual maturation of girls in each environment. SUBJECTS AND METHODS: A cross-sectional study of 6-18-year-old school girls in Abakaliki. One thousand one hundred and fifty-five girls were selected through multi-staged sampling. They were interviewed, and sexual maturation was assessed using breast and pubic hair development. RESULTS: Pubic hair development occurred earliest at a mean age of 9.87 ± 2.19 years. Breast development followed at a mean age of 10.53 ± 2.38 years. The mean age for menarche was 12.82 ± 1.29 years, which chronologically occurred between sexual maturity rating stages 3 and 4. Overweight/obesity was found to be correlated with an earlier age of onset of sexual maturation (P < 0.05). Participants belonging to the upper socioeconomic class also had earlier age of onset of sexual maturation (P < 0.05). Compared with earlier studies, positive secular trend for earlier maturation was found using pubic hair development, breast development and menarche as markers of onset of maturation. CONCLUSIONS/RECOMMENDATIONS: Against the background of the present findings of a continuing secular trend of earlier sexual maturation in Igbo girls, there is a need to provide relevant information to parents/guardians and to reduce puberty-related anxiety. This will go a long way in improving quality of parental support for adolescents during this crucial period.

Epidemiology of congenital anomalies of the central nervous system in children in Enugu, Nigeria: A retrospective study.

BACKGROUND: Congenital anomalies, including those of the central nervous system (CNS), are among the leading causes of morbidity, mortality, and fetal loss. OBJECTIVE: To determine the prevalence and associated factors of CNS congenital anomalies in children. METHODS: A cross-sectional retrospective study of children managed with CNS anomalies was undertaken. Relevant clinical data of identified cases based on standard case definitions were retrieved from their case record files. Data were analyzed using SPSS 20.0 while the level of statistical significance was set at P < 0.05. RESULTS: Seventy-two cases of CNS anomalies were identified over the period under review; out of 7329 total pediatric admissions giving a prevalence of 0.98%. Spina bifida cystica, 49 (68.0%) was the most common of the five anomalies seen followed by congenital hydrocephalus 11 (15.3%). Fifty-seven (79.2%) of the mothers did not take periconceptional folic acid supplementation (P < 0.05) whereas 25 (34.7%), 6 (8.3%), and 1 (1.4%) reported history of febrile illness in the first trimester of pregnancy, alcohol use, and diabetes mellitus in pregnancy, respectively. Majority of the cases of spina bifida cystica (30 [61.2%]) seen had corrective surgeries while the overall case fatality rate was 1 (1.4%). CONCLUSIONS: Spina bifida cystica was the most common anomaly of the CNS seen in this study and majority of the mothers of affected children did not take periconceptional folic acid supplementation (P < 0.05). Efforts should be made to create awareness and apply adequate preventive health education models including the use of periconceptional folic acid supplementation as well as the provision of access to standard prenatal care to at risk mothers.

Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria.

Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason.

End--users' perception of quality of care of children attending children's outpatients clinics of University of Nigeria Teaching Hospital Ituku--Ozalla Enugu.

BACKGROUND: Knowledge of the specific details of end-users actual experiences with health system helps to identify areas for improvement in ways that standardized satisfaction measures are less able to provide in order to save lives, uphold public confidence and trust in healthcare delivery. The aim of the study was to assess the end-users' perception of the quality of clinical services rendered to children attending paediatric out-patient clinics of University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu. METHODS: A cross sectional descriptive study was undertaken using exit point interviewer administered pre-tested/semi-structured questionnaire.Assessment of perception of quality of care was undertaken in three service areas; waiting time, attitude of staff and comfort of the waiting hall. Data was analyzed using SPSS 16.0 and presented as percentages. Chi-square was used to compare means (p < 0.05). RESULTS: A total of 367 respondents were interviewed. Over 50% of them were generally satisfied with overall quality of care. 329 (89.6%) were very satisfied with quality of doctors' services, while the least satisfaction was with the quality of medical records services 139 (37.9%). Majority of the respondents 197 (53.7%) spent between 3-6 hours for each clinic visit and most of the waiting time spent was in the medical records and consultation. CONCLUSION: The care--givers perception of the general quality of care was adjudged high. However, overall waiting time was perceived to be unsatisfactory.Efforts should be made to reduce the time spent by clients while accessing care in the facility.

Factors influencincing discharge against medical advice among paediatric patients in Abakaliki, Southeastern Nigeria.

Discharge against medical advice (DAMA) has become a major problem in health care delivery in Nigeria. Children are the victims because most of the times they are not the one taking the decision, and may not understand or contribute to it. This retrospective study was undertaken to identify the factors that influence DAMA among paediatric patients in Ebonyi State University Teaching Hospital, Abakaliki in southeastern Nigeria, with a view at curbing it. There were 97 cases of DAMA out of a total admission of 6505 giving a prevalence rate of 1.5%. Infants constituted 52.2% of them, of which 37.8% were neonates. Majority (96.7%) were from lower social classes residing in rural villages (61.1%).Neonatal conditions (36.7%) were the most common condition for which DAMA was sought, followed by severe malaria (22.2%) and road traffic accident with fractures (12.2%). The common reasons given for DAMA were financial constraint (33.3%), resort to native treatment (25%) and hopelessness of the disease condition (15%). DAMA at the study site is closely asssociated with parental poverty and ignorance. Neonates and older children with surgical conditions are the most vulnerable group. Policies should be targeted at protecting these groups.

Infant sleeping environment in South-eastern Nigeria (sleeping place and sleeping position): a preliminary survey.

Objective. To determine infant sleeping position/place and the factors associated with them in South-eastern Nigeria. Methods. this is a cross-sectional study on infant sleeping environment. Subjects were the mother/ infant pairs that attended the well baby clinics at the Institute of Child Health of the University of Nigeria Teaching Hospital, Enugu (ICH-UNTH), Mother of Christ Specialist Hospital (MCSH), Enugu and the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. Results. Lying on the side was the most common (51.1%) and the least stable sleeping position. Only 36.6% of infants who slept in that position were likely to be found in the same position the following morning; lying supine was the most stable (74.1%). The difference in stability of sleeping positions was statistically significant (P < .01). Twenty six point seven percent of the mothers routinely lay their infants in prone position. On logistic regression, maternal parity was the only factor that was predictive of nonprone sleeping position (P = .01). Bed sharing, though common (66.9%), was more among the experienced (P = .03) and less educated mothers (P < .01). Conclusion. There is a high level of prone sleeping position and bed sharing among infants in this study site. The potential consequences of these are unclear. There is therefore a need to conduct local studies to clarify its implication.