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1.
Niger J Clin Pract ; 19(2): 254-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26856291

RESUMO

BACKGROUND: The clinical course of steroid-sensitive nephrotic syndrome (SSNS) among Nigerian children has rarely been reported; this makes prognostication difficult. OBJECTIVES: The objective was to determine the frequency of relapses including frequent relapses (FR) and steroid-dependence (SD) in a cohort of Nigerian children with SSNS. A secondary objective was to identify clinical and demographic factors associated with relapse in these children. METHODS: Medical records of children with SSNS in a Tertiary Hospital in Nigeria were reviewed. Children with onset of nephrotic syndrome (NS) at age <1-year, follow-up period <12 months and secondary causes of NS were excluded. The relapse status of each child was determined in the 1st and 2nd year after diagnosis and the proportions with no relapse, FR and SD were calculated. RESULTS: Fifty children (68% males; median [range] age at onset of NS 4.8 [1.1-14.9] years) were followed-up for 31.1 (12.1-79.8) months. In the 1st and 2nd year of follow-up, 23 (46%) and 24 (70.6%) children experienced relapse, respectively. In the 1st-year, 0% and 10% had FR and SD while in the 2nd year 2.9% and 11.8% had FR and SD, respectively. Age at onset of NS, gender, time to first remission, serum creatinine or presence of hypertension or microscopic hematuria was not associated with 1st or 2nd year relapse. CONCLUSION: About half and two-thirds of children with NS in our center experience relapse in the 1st and 2nd year of follow-up, respectively; much fewer proportions experienced FR and SD in these periods. None of the commonly reported demographic and clinical factors was associated with NS relapse.


Assuntos
Corticosteroides/uso terapêutico , Glucocorticoides/uso terapêutico , Síndrome Nefrótica/tratamento farmacológico , Prednisolona/uso terapêutico , Adolescente , Corticosteroides/efeitos adversos , Criança , Pré-Escolar , Doença Crônica , Feminino , Glucocorticoides/efeitos adversos , Humanos , Lactente , Masculino , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/epidemiologia , Nigéria/epidemiologia , Prednisolona/efeitos adversos , Recidiva , Estudos Retrospectivos , Esteroides , Resultado do Tratamento
2.
J Pediatr Urol ; 11(6): 338.e1-6, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26264280

RESUMO

INTRODUCTION: Childhood enuresis is common, but the prevalence and factors associated with childhood enuresis in Africa have been poorly described. Furthermore, most studies from the continent have not provided data distinguishing monosymptomatic from non-monosymptomatic enuresis. This distinction is important as it guides enuresis therapy. OBJECTIVES: The primary objective of this study was to determine the prevalence of enuresis in children aged 5-17 years in a community in Nigeria. The secondary objectives were to determine the relative proportions of monosymptomatic and non-monosymptomatic enuresis and identify independent sociodemographic and clinical predictors of enuresis. STUDY DESIGN: Parents or guardians in the community were interviewed using a pretested questionnaire. Standardized definitions were used, as recommended by the International Children's Continence Society. RESULTS: A total of 928 children were included in the study. The prevalence of enuresis or daytime incontinence and enuresis was 28.3% (enuresis 24.4%, and daytime incontinence and enuresis 4%); it decreased with age. Primary and monosymptomatic enuresis were the most common types of enuresis. In multiple logistic regressions, children aged 5-9 years were 10.41 (5.14-21.05) times more likely to have enuresis or daytime incontinence and enuresis compared with those aged 14-17 years. Other predictors of enuresis or daytime incontinence and enuresis were: male gender (OR 1.56 (1.13-2.14)); constipation (OR 2.56 (1.33-4.93)); and a sibling (OR 2.20 (1.58-3.06)) or parent (OR 3.14 (2.13-4.63)) with enuresis. Enuresis or daytime incontinence and enuresis was 1.92 (1.06-3.48) times more likely in fourth-born, or higher, children compared with first-born children. Only parents of nine (3.4%) children with enuresis had consulted a medical doctor about it. DISCUSSION: The high prevalence of childhood enuresis in the present study was consistent with most studies from developing countries and contrasted sharply with the lower rates reported among children in developed countries. Common reasons for this disparity were the influence of socioeconomic status on enuresis rates and the low utilization of effective enuresis therapies in developing countries. Consistent with published literature, monosymptomatic enuresis was the commonest form of enuresis in the present study. Furthermore, younger age, male gender and a family history of enuresis were strongly associated with enuresis. A major limitation of the study was the lack of use of a voiding diary. CONCLUSION: Childhood enuresis was common in the community but parents rarely sought medical attention. Predictors of enuresis were younger age, male gender, constipation, higher birth order, and a family history of enuresis.


Assuntos
Enurese/epidemiologia , Incontinência Urinária/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência
3.
West Afr J Med ; 31(3): 181-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23310939

RESUMO

BACKGROUND: Dialysis provides relief of complications of renal failure. However, the availability, distribution and challenges facing paediatric dialysis service (PDS) in Nigeria are presently unknown. METHODS: Questionnaires were mailed to federal government-funded tertiary hospitals in all 36 states in Nigeria including the Federal Capital Territory (FCT). The characteristics of hospitals providing PDS were compared to those not providing PDS. RESULTS: Thirty-four (34) tertiary hospitals in 31 States and the FCT participated in the study: 28 (82.4%), 22 (64.7%) and 12 (35.3%) had >1000 paediatric admissions per year, >50 paediatric beds and >10 paediatricians respectively. Sixteen (47.1%) provided at least one form of PDS; 2 (12.5%), 5 (31.3%) and 9 (56.3%) hospitals provided peritoneal dialysis (PD), haemodialysis (HD) and both forms, respectively. Centres providing PDS were more likely to be teaching hospitals (p value=0.000), had >10 paediatricians (p value=0.016) and provided dialysis to adults (p value=0.000). Lack of consumables, skilled manpower and high cost were common challenges identified. CONCLUSION: PDS is unavailable in about half of Nigeria. HD is the commonest modality available and most of the hospitals providing PDS are the large hospitals. Common challenges to PDS were lack of dialysis consumables, skilled manpower and high cost.


Assuntos
Acesso aos Serviços de Saúde , Hospitais Públicos/organização & administração , Área Carente de Assistência Médica , Pediatria/organização & administração , Diálise Renal , Insuficiência Renal/terapia , Criança , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Humanos , Nigéria , Pediatria/estatística & dados numéricos
4.
West Afr J Med ; 30(3): 188-92, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22120484

RESUMO

BACKGROUND: Cystatin C has been recognized as a good marker of kidney function but reference ranges have not been determined in Nigerian children. OBJECTIVE: To determine the reference range of serum cystatin C in Nigerian children with no overt signs of kidney disease and to determine and compare the relationship of serum cystatin C and serum creatinine with demographic and anthropometric variables. METHODS: Fifty-nine children aged two years to 16 years with no evidence of overt kidney disease were recruited from the Paediatric Clinics of the Lagos University Teaching Hospital. Serum cystatin C levels were measured using ELISA method while serum creatinine was measured by a rate-blanked and compensated Jaffe method using a Roche/Hitachi 902 auto-analyser. Both were measured using the same serum sample. RESULTS: The mean (±1.96SD) serum cystatin C level was 0.73 (0.41-1.04) mg/L and was similar among male and female children (P=0.640) and between children younger than five years and those five years and older (P=0.596). Unlike cystatin C, serum creatinine was higher among children five years or older. In contrast to serum creatinine, serum cystatin showed no significant correlation with age (r=0.153, P=0.246), weight (r=0.062, P=0.641) and length (r=0.067, P=0.612). CONCLUSION: Serum cystatin C reference range in Nigerian children is similar to that reported for children in other regions of the world and appears to be independent of gender, weight, height, body mass index and age after two years.


Assuntos
Biomarcadores/sangue , Creatinina/sangue , Cistatina C/sangue , Adolescente , Distribuição por Idade , Antropometria , Criança , Pré-Escolar , Estudos de Coortes , Demografia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Nigéria , Valores de Referência , Distribuição por Sexo
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