Impact of climatic variables on childhood severe malaria in a tertiary health facility in northern Nigeria.

Introduction: Despite the recent progress in the malaria burden, climatic factors are important if the world will achieve the set target of its eradication. Hence, this study determined the impact of climatic conditions on childhood severe malaria in a tertiary health facility in northern Nigeria. Methodology: This was a retrospective descriptive study that involved children with severe malaria managed between July 2016 and August 2017. The diagnosis of severe malaria was according to the World Health Organization 2015 guidelines. We extracted relevant data from case records and obtained the weather information from the Nigerian Meteorological Agency and www.worldweatheronline.com. Data were entered in Microsoft Excel 2013 and analyzed with Statistical Package for the Social Sciences version 20. Results: A total of 483 cases of children with severe malaria were managed. The median age was 4.0 (2.5-8.0) years. Males were 261 (54.0%). In the wet season, 375 (77.6%) cases were recorded, while 108 (22.4%) cases occurred during the dry season. The odds of malaria occurring during the wet season were 2.057 (95% CI, 1.613-2.622). Temperature patterns were not related to malaria cases. Malaria cases showed significant moderate positive cross-correlation at 2- and 3-months lag for the rainfall pattern (best cross-correlation occurred at 3 months lag with a coefficient of 0.598, p = 0.045). Conclusion: This study demonstrated marked seasonality of childhood severe malaria infection with 77% of cases during the wet season. Malaria was associated with only rainfall at a 2 to 3 months lag amongst the climatic variables. We recommend the urgent implementation of seasonal malaria chemoprophylaxis.

Molecular Docking, QSAR and Microscopic Studies of Anti-trypanosomal Compounds from the Pathogen Box.

BACKGROUND: Trypanosoma brucei (T. brucei) is the cause of the deadly human African trypanosomiasis (HAT) with a case fatality ratio of 10%. OBJECTIVE: Targeting the essential Trypanosomal glucose metabolism pathway through the inhibition of phosphoglycerate kinase (PGK) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a valid strategy for anti-T. brucei drug development. METHODS: Here, quantitative structure activity relationship, molecular docking and microscopic studies were used to describe the mode of inhibition of selected compounds from the pathogen box PGK and GAPDH. RESULTS: We identified 4 hit compounds from the pathogen box with optimal binding and chemical interactions. Notably, it was identified that interacting charge surface and atomic mass were key aspects of both PGK and GAPDH inhibition. Also, novel anti-trypanosomal compounds were identified from the pathogen box and their half maximal inhibitory concentrations were described. CONCLUSION: Our study presents new anti-trypanosomal compounds with optimal pharmacological profiles and an optimization strategy for improving target specificity in the rational design of novel anti-trypanosomal compounds.

Diabetic-ketoacidosis in a nine-year-old child with homozygous sickle cell anaemia: a rare case report.

Sickle cell anaemia (SCA) and type 1 diabetes mellitus (type 1 DM) are chronic medical conditions whose co-existence is uncommon in childhood. Furthermore, complications of SCA such as mesenteric crisis typically present with abdominal pain, which is also common in children with diabetic ketoacidosis (DKA) and this may possess diagnostic challenge. Herewith in, we report a rare case of a nine-year-old child with homozygous sickle cell anaemia, who presented with features of mesenteric crisis and diabetic ketoacidosis. The DKA was diagnosed based on the presence of hyperglycaemia (32.2 mmol/L), ketonaemia (4.6 mmol/L) and acidosis (11.6 mmol/L). The fluids deficit was corrected over 24 hours, with improvement in the vaso-occlusive crises (VOC) without precipitating cerebral oedema.

Iron-deficiency anemia with lithobezoar (pica): a rare cause of intestinal obstruction in a 5-year-old Nigerian child.

BACKGROUND: Despite a high prevalence of iron-deficiency anemia (IDA) in developing countries such as Nigeria, intestinal obstruction secondary to lithobezoar (an accumulation of ingested stones within the gastrointestinal tract) is uncommon. CASE PRESENTATION: Herein, we report a case of acute intestinal obstruction secondary to ingestion of large pebbles and IDA in a 5-year-old Nigerian boy. The patient was managed conservatively with the use of laxatives and a rectal wash-out, and the pebbles were excreted over 3 days. Oral iron therapy was also commenced with cessation of pica. DISCUSSION: Although the direction of causal relationship between pica and IDA remains debatable, routine screening for iron deficiency among children with lithobezoar is recommended. Besides managing complications associated with lithobezoar, such as intestinal obstruction, prompt initiation of iron therapy among those who present with features of iron deficiency may be beneficial.