Echocardiographic Left Ventricular Hypertrophy and Geometric Patterns in Patients with Sickle Cell Anaemia.

BACKGROUND: Left ventricular hypertrophy (LVH) is a common complication in patients with sickle cell anaemia (SCA), and it has been associated with systolic and diastolic dysfunction, and sudden death. There is a wide variation in the reported prevalence of LVH in patients with SCA, partly due to the varying criteria applied, and the impact of small weight and body surface area (BSA) in SCA patients. We used four different criteria to determine echocardiographic LVH and geometric patterns in patients with steady-state SCA. Left ventricular hypertrophy was defined by LVM, LVM indexed to BSA, LVM indexed to height and LVM indexed to height2.7 using gender-specific reference values. Left ventricular geometry was determined using LVH and relative wall thickness. RESULTS: Eighty-two patients with steady-state SCA, aged 18years and above were studied from January 2018 to April 2018. The median [IQR] age of the patients was 23 [10] years. Forty-seven (57.3%) were females. The prevalence of LVH was highest when LVM was indexed to BSA (80.5%), followed by LVM indexed to height (73.2%). Comparable prevalences of 68.3% and 69.5% were observed using LVM and LVM indexed to height2.7, respectively. The prevalence of LVH was similar in males and females for all the criteria. CONCLUSION: The prevalence of LVH is high among patients with steady-state SCA irrespective of the criteria applied. The most prevalent geometric pattern was eccentric LVH. Indexing to BSA might result in over-estimation of LVH given the relatively small BSA in patients with SCA. Indexing to height 2.7 might give a more accurate estimate of LVH.

CONTEXTE: L'hypertrophie ventriculaire gauche (HVG) est une complication fréquente chez les patients atteints d'anémie falciforme (ACS), et elle a été associée à un dysfonctionnement systolique et diastolique, ainsi qu'à une mort subite. La prévalence de l'HVG chez les patients atteints d'anémie falciforme varie considérablement, en partie à cause des différents critères appliqués et de l'impact du petit poids et de la surface corporelle (BSA) des patients atteints d'anémie falciforme. Nous avons utilisé quatre critères différents pour déterminer l'HVG échocardiographique et les schémas géométriques chez les patients atteints d'ACS à l'état stable. L'hypertrophie ventriculaire gauche a été définie par la MVL, la MVL indexée sur la surface corporelle, la MVL indexée sur la taille et la MVL indexée sur la taille2,7 en utilisant des valeurs de référence spécifiques au sexe. La géométrie du ventricule gauche a été déterminée en utilisant l'HVG et l'épaisseur relative de la paroi. RÉSULTATS: Quatre-vingts deux patients atteints d'ACS à l'état stable, âgés de 18 ans et plus ont été étudiés de janvier 2018 à avril 2018. L'âge médian [IQR] des patients était de 23 [10] ans. Quarantesept (57,3 %) étaient des femmes. La prévalence de l'HVG était la plus élevée lorsque la MVL était indexée sur la BSA (80,5 %), suivie de la MVL indexée sur la taille (73,2 %). Une prévalence comparable de 68,3 % et 69,5 % a été observée en utilisant la MVL et la MVL indexée sur la taille2,7, respectivement. La prévalence de l'HVG est similaire chez les hommes et les femmes pour tous les critères. CONCLUSION: La prévalence de l'HVG est élevée chez les patients atteints d'ACS à l'état stable, quel que soit le critère appliqué. Le modèle géométrique le plus répandu est l'HVG excentrique. L'indexation à la BSA pourrait entraîner une surestimation de l'HVG étant donné la BSA relativement faible chez les patients atteints d'ACS. L'indexation à la taille 2,7 pourrait donner une estimation plus précise de l'HVG. Mots clés: Hypertrophie ventriculaire gauche; Géométrie ventriculaire gauche; Drépanocytose ; Échocardiographie.

Lifetime prevalence and knowledge of snakebite among graduates in Nigeria.

BACKGROUND: Given the lack of studies on snakebite envenoming knowledge in the general population, we examined the lifetime prevalence of snakebite and knowledge of snakebite and its prevention and first aid among recent Nigerian graduates in national service. METHODS: This questionnaire-based cross-sectional study involved 351 consenting national youth corps members at a rural orientation camp in Kano, Nigeria. RESULTS: Participants' mean age was 25.3±2.4 y. There were slightly more males (50.7%). Most attended universities (77.8%) and were mainly from the southwest (24.5%) and northeast (24.5%) geopolitical regions and the Yoruba tribe (24.7%). Their lifetime prevalence of snakebite was 4%. Their mean overall knowledge score was 6.8±3.1 out of 20. Only 0.9% had adequate knowledge. Gender (male; 7.2±3.1, t=2.83, p=0.0049), tribe (Yoruba; 7.5±2.9, F=2.968, p=0.0320), region (Southwest; 7.6±3.0, F=2.5289, p=0.0289) and nearly bitten by snake (7.8 ± 2.7, t=3.60, p=0.0004) were significantly associated with a higher mean knowledge score. CONCLUSIONS: Their lifetime prevalence of snakebites is significant, while knowledge of snakebite is very inadequate. However, the national service camp activities period provides an opportunity for educational intervention needed to raise their knowledge to optimal levels that will enable them serve as better snakebite prevention agents, as they will be working in rural communities where snakebite might be prevalent.

Prevalence, severity, and correlates of erectile dysfunction among male adult patients of a primary care clinic in North-West Nigeria.

Background: Erectile dysfunction (ED) is a common sexual problem that profoundly affects intimate relationships. It is poorly studied in North-western Nigeria. Objectives: To assess the prevalence, severity and predictors of ED among adult males attending a primary care clinic in Northwest Nigeria. Methods: A cross-section of 392 males (aged ≥25 years) were randomly selected from attendees of a family medicine clinic in Kano, Nigeria. Information regarding their biodata, lifestyle factors, and clinical characteristics was obtained using a structured questionnaire. The International Index of Erectile Function Questionnaire (version 5) and Patient Health Questionnaire-2 assessed ED and depression, respectively. Results: The participants' mean age was 45±14.1 years (range: 26-86 years). Most participants were married (88.8%), had one sexual partner (71.7%), had tertiary education (44.4%) and were traders (49.7%). The prevalence of ED was 52.3% (205/392) [comprising mild (36.0%), mild-to-moderate (14.3%), moderate (1.5%) and severe (0.5%)]. Age, body mass index (BMI), marital status, number of sexual partners, monthly income, type of exercise, hypertension history, blood pressure reading, antihypertensive and peptic ulcer drug use were associated with ED (P<0.05). However, age (≥50years) (OR= 1.91, 95%CI [1.28-2.85], P=0.001) and overweight/obesity (OR =1.81, 95%CI [1.18-2.77], P=0.007) were the predictors of ED in this population. Conclusion: ED prevalence was high, although mainly of the mild form. Age (≥50years) and overweight/obesity predicted ED. Hence, the need for early screening, objective grading of ED, identification of modifiable risk factors (e.g., overweight/obesity) and commencing proper treatment and prevention in this setting.

Etiology of Persistent Microalbuminuria in Nigeria (P_MICRO study): protocol and study design.

BACKGROUND: Microalbuminuria is an independent risk factor for cardiovascular and kidney disease and a predictor of end organ damage, both in the general population and in persons with HIV (PWH). Microalbuminuria is also an important risk factor for mortality in PWH treated with antiretroviral therapy (ART). In the ongoing Renal Risk Reduction (R3) study in Nigeria, we identified a high prevalence of microalbuminuria confirmed by two measurements 4-8 weeks apart in ART-experienced, virologically suppressed PWH. Although Stage 1 or 2 hypertension and exposure to potentially nephrotoxic antiretroviral medications were common in R3 participants, other traditional risk factors for albuminuria and kidney disease, including diabetes, APOL1 high-risk genotype, and smoking were rare. Co-infection with endemic pathogens may also be significant contributors to albuminuria, but co-infections were not evaluated in the R3 study population. METHODS: In Aim 1, we will cross-sectionally compare the prevalence of albuminuria and established kidney disease risk factors in a cohort of PWH to age- and sex-matched HIV-negative adults presenting for routine care at the Aminu Kano Teaching Hospital in Kano, Nigeria. We will leverage stored specimens from 2500 R3 participants and enroll an additional 500 PLWH recently initiated on ART (≤ 24 months) and 750 age- and sex-matched HIV-negative adults to determine the contribution of HIV, hypertension, and other comorbid medical conditions to prevalent albuminuria. In Aim 2, we will follow a cohort of 1000 HIV-positive, ART-treated and 500 HIV-negative normoalbuminuric adults for 30 months to evaluate the incidence and predictors of albuminuria. DISCUSSION: The findings from this study will support the development of interventions to prevent or address microalbuminuria in PWH to reduce kidney and cardiovascular morbidity and mortality. Such interventions might include more intensive monitoring and treatment of traditional risk factors, the provision of renin-angiotensin aldosterone system or sodium-glucose cotransporter-2 inhibitors, consideration of changes in ART regimen, and screening and treatment for relevant co-infections.

Two decades of neuroscience publication trends in Africa.

Neuroscience research in Africa remains sparse. Devising new policies to boost Africa's neuroscience landscape is imperative, but these must be based on accurate data on research outputs which is largely lacking. Such data must reflect the heterogeneity of research environments across the continent's 54 countries. Here, we analyse neuroscience publications affiliated with African institutions between 1996 and 2017. Of 12,326 PubMed indexed publications, 5,219 show clear evidence that the work was performed in Africa and led by African-based researchers - on average ~5 per country and year. From here, we extract information on journals and citations, funding, international coauthorships and techniques used. For reference, we also extract the same metrics from 220 randomly selected publications each from the UK, USA, Australia, Japan and Brazil. Our dataset provides insights into the current state of African neuroscience research in a global context.

Prevalence and predictors of clinic appointment non-adherence among adults with poorly controlled hypertension in a primary care setting.

Objectives: To assess the prevalence and predictors of non-adherence to clinic appointments in adult patients with poorly controlled hypertension. Design: A descriptive cross-sectional study. Setting: A primary care setting (family medicine clinic) overseen by family physicians in Kano, Nigeria. Participants: Two hundred and thirty-four randomly selected patients, aged ≥ 18 years with a diagnosis of hypertension, who had been on treatment for ≥1 year and had a current blood pressure of ≥140/90 mmHg were included. Main outcome measures: Non-adherence to clinic appointment among participants. Results: Participants' mean age was 55±12.2 years (range: 23-85 years); they were predominantly females (163, 69.7%). Sixty (25.6%) participants were non-adherent to clinic-appointments. Being employed (OR [Odds ratio] =2.92, 95%CI [confident interval] =1.52-5.65, P=0.002), inability of participants or their children to pay the medical bills (OR=2.92,95%CI=1.42-6.00, P=0.004), and systolic blood pressure (SBP) of <160mmHg (OR=0.43, 95%CI=0.22-0.86, P=0.018) were predictors of clinic appointment non-adherence. Conclusions: The prevalence of non-adherence to clinic appointments was high. Being employed, patients or their children's inability to pay medical bills, and higher SBP were predictors of non-adherence to clinic appointments. Therefore, more studies are needed on effective interventions to reduce non-adherence to clinic appointments in this setting.

Bone marrow invasion by aspergillus specie in a sickle cell trait patient with invasive aspergillosis: a fatal case in association with disseminated intravascular coagulation

Background: Invasive aspergillosis has been predominantly associated with pulmonary infection, particularly amongst immunocompromised individuals. Extrapulmonary infections with Aspergillus specie have been reported rarely irrespective of immune status. Risk factors for invasive aspergillosis include prolonged and severe neutropenia, haematopoietic stem cell and solid organ transplantation, advanced AIDS, and chronic granulomatous disease. The most frequently involved specie is Aspergillus fumigatus that constitutes over 90% of cases, followed by Aspergillus flavus, usually associated with a primary skin infection. Haematogenous spread to the bone causing osteomyelitis is the commonest form of disseminated aspergillosis and a surprisingly high proportion of these patients have no immunosuppression. We present a rare case of bone marrow invasion by Aspergillusspp. in a 3-year-old patient with sickle cell trait and chronic Aspergillosis. Case report: A 3-year-old patient with sickle cell trait was brought to the paediatric unit with recurrent diarrhoea, abdominal distention, weight loss and persistent cough. The child was severely wasted with generalised peripheral lymphadenopathy. She had marked respiratory distress and hepatosplenomegaly but no demonstrable ascites. Haematologic examination revealed leukaemoid reaction (leukocyte count of 44.0 x 109/L) with monocytosis (10%) and thrombocytopenia (platelet count of 97,000/mm3); no blast cells were seen on blood film. The bone marrow was hypercellular with a myeloid/erythroid ratio of 20:1, consistent with infection. Bone Marrow culture yielded Aspergillus spp. and other results of sepsis work up were negative. Conclusion: Cases of extrapulmonary invasive aspergillosis have been reported rarely in both immunocompetent and immunocompromised patients. Haematogenous spread to the bone is the commonest form of disseminated disease

Chronic Kidney Disease amongst Sickle Cell Anaemia Patients at the University of Maiduguri Teaching Hospital, Northeastern Nigeria: A Study of Prevalence and Risk Factors.

BACKGROUND: Involvement of the kidneys in patients with sickle cell anaemia is a well recognised chronic complication. This study seeks to determine the prevalence of chronic kidney disease in patients with homozygous sickle cell disease (HbSS) and to identify risk factors associated with its development. METHODOLOGY: The subjects consisted of adolescents and adults with HbSS recruited sequentially from the adult haematology outpatient clinic and Daycare ward of the unit. Clinical variables including age at diagnosis of SCA, the frequency of vaso-occlusive crisis and transfusion therapy, as well as laboratory data including haematological profile and renal function tests were obtained. The glomerular filtration rate was estimated (eGFR) using the 'modification of diet in renal disease' (MDRD) formula. RESULTS: Two hundred and eighty-four HbSS patients were recruited. The prevalence of CKD amongst them was 38.9%. Further stratification of the patients based on eGFR showed that sixty-nine (26.8%) had hyperfiltration; 35 (13.6%) stage 1 CKD; 53 (20.6%) stage 2 CKD; 33 (12.8%) stage 3a CKD; 28 (10.9%) stage 3b CKD; 30 (11.7%) stage 4 CKD and 9 (3.5%) had end stage renal disease. There was significant association between eGFR and clinical parameters such as age (r -0.353, p=0.000), SBP (r -0.148, p= 0.021), DBP (r -0.213, p=0.001) and total number of blood received (r -0.276, p=0.000); and laboratory parameters such as PCV (r 0.371, p=0.000); urea ( r 0.527, p=000); creatinine (r 0.625, p=0.000) and uric acid ( r -0.419, p=0.000). CONCLUSIONS: The present study has revealed a high prevalence of CKD amongst patients with SCA in our region. Clinical and laboratory predictors of CKD using eGFR were identified to include age, SBP, number of units of blood transfusion, PCV, urea, creatinine and uric acid levels.

Knowledge of venomous snakes, snakebite first aid, treatment, and prevention among clinicians in northern Nigeria: a cross-sectional multicentre study.

Background: Snakebite envenoming causes considerable morbidity and mortality in northern Nigeria. The clinician's knowledge of snakebite impacts outcome. We assessed clinicians' knowledge of snakebite envenoming to highlight knowledge and practice gaps for possible intervention to improve snakebite outcomes. Methods: This was a cross-sectional multicentre study of 374 doctors selected from the accident and emergency, internal medicine, family medicine/general outpatient, paediatrics and surgery departments of nine tertiary hospitals in northern Nigeria using a multistage sampling technique. A self-administered questionnaire was used to assess their sociodemographics, knowledge of common venomous snakes, snakebite first aid, snake antivenom treatment and prevention. Results: The respondents' mean age was 35.6±5.8 y. They were predominantly males (70.6%) from urban hospitals (71.9%), from the northwest region (35.3%), in family medicine/general outpatient departments (33.4%), of <10 years working experience (66.3%) and had previous experience in snakebite management (78.3%). Although their mean overall knowledge score was 70.2±12.6%, only 52.9% had an adequate overall knowledge score. Most had adequate knowledge of snakebite clinical features (62.3%), first aid (75.7%) and preventive measures (97.1%), but only 50.8% and 25.1% had adequate knowledge of snake species that caused most injuries/deaths and anti-snake venom treatment, respectively. Overall knowledge predictors were ≥10 y working experience (odd ratio [OR] 1.72 [95% confidence interval {CI} 1.07 to 2.76]), urban hospital setting (OR 0.58 [95% CI 0.35 to 0.96]), surgery department (OR 0.44 [95% CI 0.24 to 0.81]), northwest/north-central region (OR 2.36 [95% CI 1.46 to 3.82]) and previous experience in snakebite management (OR 2.55 [95% CI 1.49 to 4.36]). Conclusions: Overall knowledge was low. Improvements in overall knowledge may require clinicians' exposure to snakebite management and training of accident and emergency clinicians in the region.

High Reticulocyte Count with Abnormal Red Blood Cell Morphology in Normal Wistar Rats after Garlic Administration.

Despite the high acceptability of Allium sativa (Garlic) as a remedy for many diseases as earlier stated by manyresearchers, previous studies have shown that chronic and unregulated consumption of garlic may result to intra vascularhaemolytic anaemia in rats. The present study was conducted to examine the effect of crude extract of garlic on microscopicstatus of red blood cells and some other haematological indices of normal albino rats. The animals were grouped into two;group 1 were normal animals treated with water while group 2 were normal animals administered 150mg/kg body weight ofcrude extract of garlic on alternate days for three weeks. At the end of three weeks treatment, blood samples obtained fromthe tail vein of the rats were used for haematological indices and erythrocyte morphology. The values obtained wereexpressed as Mean± SEM and compared using student t test. The results showed that there was no significant difference inthe PCV which was 43.20 ± 0.80% and 45.00 ± 0.36% in both control and experimental groups respectively. However, theRBCs were significantly decreased (P< 0.05) from 166.80 ± 3.44 x106 µL-1 in the control group to 87.80 ± 9.34 x106 µL-1 inthe treatment group. The percentage reticulocyte counts on the other hand significantly increased from 2.60±4.25% in controlgroup to 11.20± 16.4% in treated group. Fragmented RBCs with a lot of schistocytes with adequate platelets were seen onperipheral blood film of crude garlic treated rats as compared to control. Our results suggested intravascular haemolysis andnumerous reticulocytes on blood film confirmed our view on bone marrow response. The presence of schistocytes andacanthocytes may be an indication that the liver is involved in the observed effect.

Spectrum of haematologic malignancies and survival outcomes of adult lymphomas in Maiduguri, north eastern Nigeria--a fourteen year review.

BACKGROUND: The incidence of Haematologic malignancies has been shown to vary according to gender, age, geographic region, and histologic subtypes, while cure rates can vary according to region and may be impacted by treatment availability and access to care. METHOD: This was an institution based review of data from the Medical Records Department, Department of Haematology and Cancer Registry of the Histopathology Department of the University of Maiduguri Teaching Hospital between January 1998 and December 2011. The aim was to study the spectrum of Haematologic malignancies and the survival pattern of adult lymphomas in this region and to compare our findings to studies reported elsewhere. RESULTS: The Haematologic malignancies represented 6.05% of all cancer cases seen and 0.31% of hospital admissions. Among the Haematologic malignancies, Non-Hodgkins Lymphoma (NHL) was the most frequent, constituting 51.3% while others include: Hodgkins Lymphoma (HL), 26.7% Chronic Myeloid Leukaemia (CML), 5.5%, Acute Myeloblastic leukaemia (AML), 4.2% Multiple Myeloma (MM), 4.2% Acute Lymphoblastic leukaemia (ALL), 3.8%, Chronic Lymphocytic Leukaemia (CLL), 3.4% Myelodysplastic Syndrome (MDS), 0.4% and Chronic Myelofibrosis 0.4%. Haematologic malignancies are more common in younger age group and also more common in males than females. Lymphomas are particularly common in young adults and the incidence tends to fall after 70 years. Similarly, the characteristic bimodal age incidence for HL found in western world has not been seen in this study. The histological subtypes for both NHL and HL are similar to the pattern reported elsewhere. Default rate was high and we found a strong association between cycles of chemotherapy given and survival in lymphoma patients. CONCLUSION: This study has shown that Haematologic malignancies are not uncommon in our environment. There is need to provide basic facilities and training for immunophenotyping and immunohistochemistry in all cancer treatment centers across the country. Cytotoxic drugs must be subsidized and also be made readily available to all patients with Haematologic malignancies.

Discriminatory attitudes towards patients with HIV/AIDS by dental professionals in Nigeria.

AIMS AND OBJECTIVES: The study sought to investigate whether there are discriminatory practices towards HIV/AIDS patients among dental professionals in Nigeria, how receptive are dental professionals and institutions to treating People Living With Aids (PLWA), and what underlying factors if any that may contribute to any discriminatory practices. METHODS AND MATERIALS: It was a cross-sectional study conducted in one randomly selected State in each of the six geo-political zones of Nigeria. Data collection was by self administered questionnaire. The questionnaire asked about demographic information, general knowledge of HIV/AIDS, adequacy of infection control, fear of occupational exposure, attitudes towards HIV positive patients and areas of need for further training. A total of 75 dental professionals participated in the study. RESULTS: The results of the study suggest that significant number of dental professionals in Nigeria reported attitudes and behaviour towards HIV patients which are discriminatory. CONCLUSION: Further efforts should be made to promote accessibility of discrimination-free quality oral and dental care to this population.

Pre-treatment tumour lysis syndrome and acute renal failure in adult Nigerians with Burkitt's lymphoma: report of three cases and literature review.

Pre-treatment tumour lysis syndrome (pre-TTLS) is not an unusual clinical entity in high-grade lymphomas and lymphoblastic leukaemias. The overall incidence and frequency is unknown and to the best of our knowledge none has been published in Nigeria involving adult females with advanced stage Burkitt's lymphoma (ASBL). Three of the reported cases had pre-TTLS complicated by acute renal failure (ARF). The first two cases had a complete reversal of the ARF with aggressive supportive management and slow introduction of cytotoxic chemotherapy whereas the third case died of ARF due to delay in commencement of aggressive supportive management, chemotherapy and haemodialysis due to financial constraint. This paper stresses the importance of aggressive supportive management and slow introduction of cytotoxic chemotherapy in patients with a stage C and/or stage D Burkitt's lymphoma presenting with pre-TTLS.

Traditional oral health practices among Kanuri women of Borno State, Nigeria.

A structured questionnaire was administered on 495 women (urban 339, rural 156) from two LGAs of Borno State, Nigeria, using the interviewer method. The age range of the subjects was 12 to 80 years with a mean age (+/- SD) of 35.7 +/- 13.44 years. Majority (83.5%) did not have any formal education. Oral hygiene tools used by the respondents included toothbrush/paste 36 (7.9%), chewing stick 250 (54.9%), charcoal 159 (34.9%) and ordinary water 10 (2.2%). Of those using chewing sticks; 168 (67.2%) use Salvadora persica, 36 (14.4%) use Azadirachta indica and 46 (18.4%) use Eucalyptus camaldulensis. Forty (8.1%) of the respondents do not clean their teeth at all. Strong association was found between choice of teeth cleaning material and educational level (P=0.000). Three hundred and one (60.8%) of the respondents stain their teeth with flowers of Solanum incanum or Nicotania tabacum while, 218 (44.0%) perform tattooing of lip or gingivae and of this number 213 (97.7%) performed tattooing before marriage. Tattooing is usually performed without local anaesthesia with thorns of Balanites aegyptiaca and a mixture of charcoal & seeds of Acacia nilotica var. tomentosa as pigments. It is concluded that traditional oral health practices still constitute important part of the lifestyle in the study population.

Jaw fractures in Nigerian children: an analysis of 102 cases.

OBJECTIVES: To present the prevalence and pattern of jaw fractures in children aged 15 years and below attending two hospitals serving as referral centres for facial injuries in North Eastern Nigeria. DESIGN: Retrospective Cross Sectional Study. SETTINGS: Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria. SUBJECTS: One hundred and two patients with jaw fractures aged 15 years and below. MAIN OUTCOME MEASURES: Aetiological factors and pattern of jaw fractufes in children aged 15 years and below. RESULTS: We retrospectively reviewed 102 patients with jaw fractures aged 15 years and below seen over a five year period at two referral centres in Maiduguri, Northeastern Nigeria. This constituted 9.5% of the total 1,074 cases of maxillofacial injuries managed during the period. The male to female ratio was 7.5:1 and there was a male responderance in all age groups. The main causes of fractures were road traffic accident (n = 55, 53.7%) followed by falls (n = 26, 25%). Other etiological factors such as fights, sports and gunshots accounted for the remaining cases. The mandible was the commonest site with the body commonly fractured (n = 74, 72.5%). No Le Fort III fractures were identified in this study. CONCLUSION: Despite some limitations to our data, such as exclusion of patients who attended private clinics and lack of modern diagnostic methods, this report shows that there is obvious need for concern about the high prevalence of maxillofacial injuries in children caused by road traffic accidents in North Eastern Nigeria.