Intussusception in children under five years of age in Enugu, Nigeria.

INTRODUCTION: intussusception is the invagination of a segment of the bowel into a distal segment. It occurs predominantly in infants worldwide. Following documentation of increased incidence after introduction of the first rotavirus vaccine (Rotashield, Wyeth-Lederle), it has become a standard recommendation to maintain surveillance for intussusception as newer rotavirus vaccines are introduced into EPI. Nigeria plans to introduce rotavirus vaccine in 2020. Pre-vaccine introduction surveillance will serve as a baseline to understand the epidemiology of intussusception in Nigeria. METHODS: from 2013 to 2017, prospective enrolment of under five children with intussusception was done following the WHO protocol and using the WHO case report form. Only children who met the Pan American Health Organization/World Health Organization (PAHO/WHO) protocol case definition for intussusception were enrolled. These children were monitored until discharge or death. Clinical features and outcome were recorded in the case report form. RESULTS: a total of 63 cases were enrolled, with age range of 3 to 42 months (median: 6 months, IQR: 5-9 months). Majority were within 4-6 months and 96% were < 12 months old. There were 41 males and 22 females (male to female ratio of 1.9:1). Duration of symptoms before presentation ranged from 2 hours to 15 days (median: 72 hours). Fifty-seven patients had abdominal ultrasound and 52 patients (83%) had surgery. Case fatality rate was 9% and duration of hospitalization ranged from 1 to 30 days (median 10 days, IQR 8-15 days). CONCLUSION: intussusception occurred most commonly in infants but well beyond the proposed age for rotavirus vaccination in the population studied. Late presentation and surgical intervention were common. This data provides a good baseline description of the epidemiology of intussusception.

Distracted Driving and Cell Phone use by Nigerian Road Users: A Cross-sectional Study.

Background: This study ascertained the level of distraction attributable to cell phone by drivers in Enugu. Methodology: This study was conducted in Enugu, Nigeria using a validated structured questionnaire randomly administered to drivers in different locations in the city. Study period was 2 months and different forms of distraction while driving were tested. Result: There were 500 participants in the study. 306(61.2%) were males and 194(38.8%) were females. The mean age of respondents was 43.85±9.89 years. Ninety-nine percent of respondents were aware of the ban on use of cell phones while driving but as much as 97.8% of the drivers still use cell phones while driving. Conclusion: Level of distracted driving in Enugu is quite high and this has the potential to cause serious road crashes which can impact negatively on the lives of the people. The need for concerted effort to educate people on the dangers of cell phone use while driving cannot be over emphasized. Key Lessons: - There is a paucity of literature on distracted driving in Nigeria even with the high incidence of Road Traffic Accident.- Awareness of laws on distracted driving is not the challenge rather it is compliance. There is need for ways of enforcing the existing laws on distracted driving as mere knowledge of the provisions of the law does not ensure compliance.- Enforcement of laws on distracted driving will play a preventive role in reducing the incidence of RTAs and its associated health implications.