Reliability of generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome: a systematic review.

INTRODUCTION: Most of the studies reporting the negative impact of idiopathic nephrotic syndrome on health-related quality of life in children and adolescents were conducted with generic quality-of-life instruments rather than disease-specific instruments. The consistency of these studies' findings using these generic instruments is not well established. AIM: This systematic review aims to determine the reliability of current generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome. METHODS: We searched the PubMed, MEDLINE, EMBASE, and Google Scholar databases for articles published between 2000 and 2020, using appropriate descriptors. We included primary studies that met the eligibility criteria, independently screened their titles and abstracts, and removed all duplicates during the study-selection process. We resolved disagreements until a consensus was reached on study selection. We independently retrieved relevant data, including the generic quality-of-life instruments and the subjects' and controls' aggregate health-related quality of life scores, using a preconceived data-extraction form. RESULTS: Ten original articles were selected for qualitative and quantitative analyses. Some of the studies reported the following significant findings. The mean health-related quality of life scores for children with prevalent and incident nephrotic syndrome were 68.6 (range, 52.6-84.6) and 73.7 (range, 55.9-91.5), respectively. Children with idiopathic nephrotic syndrome and their controls with other chronic diseases had median scores of 65 (interquartile range, 59-68.75) and 62.2 (interquartile range, 58.05-65.78). Patients on oral immunosuppressive drug and intravenous rituximab reportedly had median scores of 76.2 and 72.6 and mean scores of 71.4 (range, 55.4-87.4) and 61.6 (range, 42.1-81.1) respectively for quality-of-life assessment on the 'school functioning domain.' CONCLUSIONS: The health-related quality of life scores in patients with idiopathic nephrotic syndrome are consistently low. Lower scores occur in prolonged disease duration and severe clinical phenotypes, whereas the scores are higher than the scores obtained in other chronic diseases. These consistent findings underscore the reliability of the current generic instruments in assessing health-related quality of life in patients with idiopathic nephrotic syndrome.

COVID-19: Knowledge of Mode of Spread and Preventive Practices among College Adolescents in Nigeria.

BACKGROUND: Corona virus pandemic (COVID 19) has emerged as the single most important topical issue and poses a challenge to medicine. Adolescent school children are exposed to a varying degree. OBJECTIVES: The study is aimed to determine the knowledge of the mode of spread and preventive practices among college adolescents attending six secondary schools in Enugu metropolis. METHODOLOGY: This was a cross-sectional study carried out in 6 secondary schools among 500 college adolescents. A pretested, interviewer-administered questionnaire was used for data collection. RESULTS: Majority of the respondents, 98.4% were aware of COVID-19. Although, a higher proportion of the respondents, 52.0% were aware COVID-19 could be transmitted through contact with infected persons, only a minor proportion of them, 42.4% had a good knowledge of the mode of spread of COVID-19. However, a high proportion of the respondents, 69.2% practiced good preventive measures against COVID-19. Also, respondents whose parents were self-employed were 1.4 times more likely to have good knowledge of the mode of spread of COVID-19 when compared with those whose parents were on paid employment [adjusted odd ratio (AOR) = 1.4, 95% confidence interval (CI): 0.9-2.0]. The respondents whose fathers have attained tertiary education were 1.6 times more likely to have good preventive practices against COVID-19 when compared with those who had secondary school and below (AOR = 1.6, 95% CI: 1.04-2.5). CONCLUSION: Though college adolescents were aware of COVID-19, not a significant proportion practiced good preventive measures against COVID-19. Knowledge of mode of spread and preventive practices were significantly enhanced by fathers' educational status and being a female adolescent child.

Pattern of Female Genital Mutilation among Adolescents Attending Secondary Schools' in Enugu Metropolis.

BACKGROUND: Female genital mutilation (FGM) is a public health menace and it study among adolescents is not exhaustive. OBJECTIVES: The aim is to study the prevalence, pattern, cultural values, health implications and consequences of FGM among adolescent females attending secondary schools in Enugu metropolis. METHODS: A descriptive study involving female adolescents aged 13-21 years recruited by multistage sampling in three Girls Secondary Schools in Enugu Metropolis. RESULTS: Four hundred and fifty (450) questionnaires were distributed and four hundred and fourteen (414) were retrieved. The parents with moderate value for culture and tradition had the highest circumcised respondents (7.8%) (p = 0.056). Majority of the respondents, 93.7% were aware of female circumcision. The major complications of female circumcision according to the respondents were painful urination and menstrual problems. The prevalence of female circumcision among the respondents was 9.4%. A minor proportion of the respondents, 5.8% were of the opinion that all females should be circumcised. Respondents whose fathers attained tertiary education were three times less likely to be circumcised when compared with those whose fathers attained secondary education and less (adjusted odds ratio = 0.3; 95% CI: 0.3-1.5). CONCLUSION: Prevalence of FGM among adolescents aged 13-21 years in Enugu metropolis was 9.4%. Majority of the respondents had good knowledge of FGM, and major complications noted were painful urination and menstrual problems. Fathers education level is a very strong reason for this high awareness of FGM among female adolescents.

Right ventricular function among South East Nigeria children with sickle cell anaemia.

BACKGROUND: Sickle cell anaemia (SCA) is characterized by attendant ischemia-reperfusion injury especially to the heart. METHODS: The aim of this work is to compare the right ventricular function of children with SCA in steady state (subjects) with those with haemoglobin AA genotype (controls), using echocardiography. It is a cross-sectional study, which echocardiographic measurements to assess right ventricular function among children with SCA and their controls. RESULTS: The mean trans annular plane systolic excursion (TAPSE) in subjects, 28.24 ± 5.23 (Z score: 0.258 ± 1.10) was higher than that in control, 25.82 ± 3.59 (Z score: - 0.263 ± 0.80), and the difference in mean was statistically significant, (t = 2.703, p = 0.008). Significantly higher proportion of subjects with sickle cell anaemia had right ventricular dysfunction (Abnormal TAPSE), 25 (50.0%) when compared with those in control, 11 (22.0%), {χ2 = 8.5, p = 0.0035}. A higher proportion of subjects with sickle cell anaemia (25.5%) had Pulmonary hypertension (RVP) when compared with control (2.0%) and the difference in proportions was found to be statistically significant, (χ2 = 11.668, p = 0.001). The prevalence of right ventricular diastolic dysfunction in subjects was 9.8% while control was 0%. CONCLUSION: Children with sickle cell anaemia present with right ventricular dysfunction. Prevalence of right ventricular systolic and diastolic dysfunction were higher in subjects. More of the subjects in this study (25.5%) had pulmonary hypertension.

Willingness of college students aged 10 to 24 years to get vaccinated against COVID-19 disease: a cross-sectional study in South-East Nigeria.

Background: Willingness to be vaccinated against COVID-19 is a topical issue that may change the course and distribution of the pandemic in the country. Objectives: This study was aimed to determine the willingness to receive the COVID-19 vaccine among college adolescents and associated factors. Methodology: This was a cross-sectional study carried out among one thousand college adolescents in six secondary schools in Enugu from April to August 2021. A pretested, self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software version 25. Descriptive statistics were used to describe college adolescents' characteristics. Categorical variables were reported as frequencies and percentages. Predictors of willingness to vaccinate were assessed using binary logistic regression. Results: A minor proportion of the respondents, 13.2% (153) were willing to receive the COVID-19 vaccine. The respondents who were males were 1.6 times more willing to receive the COVID-19 vaccination when compared with those who were females. (AOR=1.6, 95%CI: 1.1- 2.3). The respondents who were aware they could be infected with COVID-19 were twice more likely to receive COVID-19 vaccination when compared with those who felt they could not be infected. (AOR=2.0, 95%CI: 1.1-3.1). The respondents who had good knowledge of COVID-19 vaccination were 2.2 times more likely to receive COVID-19 vaccination when compared with those who had poor knowledge. (AOR=2.2, 955CI: 1.5-3.3). Conclusion: A small fraction of college adolescents were willing to receive the COVID-19 vaccine. Male gender, knowledge of vaccine and possibility of transmitting infection are predictors of willingness to receive the vaccination.

The unique contributions of depression and anxiety to suicidal ideation among Nigerian secondary school students: a cross-sectional survey.

Background: It is important to establish the pattern of suicidal ideation among adolescents with depression and anxiety. This will help the schools prevent possible complete suicide among these groups of adolescents' trough counseling and education. Objectives: This work is therefore aimed at determining the effects of depression and anxiety on adolescent suicide ideation and factors that predict suicidal ideation among adolescents attending secondary school in southeast Nigeria. Methods: A cross-sectional study among 450 secondary school adolescents in Enugu state, Nigeria. Information was obtained using the Columbia suicide severity rating scale and the Hospital Anxiety and Depression Scale (HADS). Chi-square test, correlation analysis and Hierarchical logistic regression were used in the analysis, and the level of statistical significance was determined using a P-value of <0.05. Results: The prevalence of anxiety was 36.4% while that of depression was 30.7%. The prevalence of suicidal ideation was 8.4%. The prevalence of suicidal ideation among adolescents who were <15 years was 8.0% while those who were between 15 - 18 years was 13.5% and those more than 19 years of age was 22.5%. The prevalence of suicidal ideation among adolescents with depression is 21.7% and 78.3 % for those without depression while the prevalence of suicidal ideation among adolescents with anxiety is 20.1% and 79.9 % for those without anxiety. The prevalence of suicidal ideation among the poorest half was 16.4% and 10.2% in the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers (53.3%) than the rural dwellers (46.7%).There was a positive correlation between suicide and age in years and this was found to be statistically significant, (n=450, r=0.107, p=0.023). A significantly higher proportion of respondents who had depression, 21.7% had suicidal ideation when compared with those who were not, (χ 2=12.170, p<0.001). Similarly, a significantly higher proportion of respondents who had an anxiety disorder, (20.1%) had suicidal ideation when compared with those who were not, 9.4%, (χ 2=10.291, p=0.001). The respondents who were 19 years and above had increased suicidal ideation, and the difference in proportions was found to be statistically significant, (χ 2=6.440, p=0.040). A significantly higher proportion of females, 16.6% had suicidal intentions when compared with the males, 7.1%, (χ 2=7.958, p=0.005). Conclusion: There is an increasing prevalence of suicidal ideation among adolescents with a preponderance of older age and female gender. There is a link between depression/anxiety and suicidal ideation. The prevalence of suicidal ideation among the poorest half was higher than that of the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers than the rural dwellers.

Problem gambling among secondary school adolescents in Enugu, Nigeria.

Background: Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction. Objectives: To determine the pattern of problem gambling and factors that predict gambling among adolescents that attended secondary schools in southeast Nigeria. Methodology: This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary school adolescents from eight secondary schools in Enugu State, Nigeria. Results: The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was a weak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a very weak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5; (95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling when compared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8). Conclusion: The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internet addiction. The male respondents were more likely to have problem gambling than their female folk.

Maternal level of awareness and predictors of willingness to vaccinate children against COVID 19; A multi-center study.

BACKGROUND: Several controversies surround mothers' willingness to vaccinate against the COVID-19 pandemic especially when mortality is not frequently reported in children.Objectives: This study aimed to ascertain the willingness of mothers of children attending two institutions in Southeast Nigeria to accept the COVID-19 vaccine and factors that may be associated with their choices. METHODOLOGY: This was a cross-sectional study carried out among 577 mothers who presented with their children in two tertiary health institutions in southeast Nigeria. RESULTS: Majority of the respondents (93.9%) were aware of the COVID-19 vaccine. Majority of the respondents, 89.4%, noted that children were not in high priority groups for COVID-19 vaccination in Nigeria. Only 6.9% of the respondents intend to receive the COVID-19 vaccination. Also, a minor proportion of the respondents (4.9%) were willing to vaccinate their children with the COVID-19 vaccine. The odds of receiving the Covid-19 vaccine were four times greater in those who believed that they could be infected than in those who believed that they could not be infected (AOR = 4.0. 95% CI:1.8-8.7). The odds of receiving the Covid-19 vaccine were six times greater in those who were aware of someone that died from COVID-19 than in those who did not know anyone who died from COVID-19 (AOR = 5.7, 95% CI: 2.1-15.8). CONCLUSION: A high level of awareness but low acceptance level for COVID-19 vaccination for mothers and their children was noted. Socioeconomic class, maternal age, and level of education did not influence the willingness of the mother to receive COVID vaccination. Having a belief of possibility of infection with the COVID-19 as well as being aware of someone who died from the disease were important positive variables that could predict vaccine acceptance from this study.

Serum folate levels in children on long-term anti-seizure medication in a Nigerian tertiary center-Implications for practice and public health.

BACKGROUND: Epilepsy is the most common childhood neurological disorder in Nigeria. Treatment of epilepsy is long-term and sometimes lifelong with anti-seizure medications. There are conflicting reports on the effect of anti-seizure medications on serum folate. There is therefore a need to determine the effect of a commonly used anti-seizure medication's on serum folate levels of children. This would provide an evidence-based consideration for folic acid supplementation in children on anti-seizure medication as has been suggested by some studies. STUDY OBJECTIVES: To determine whether serum folate levels were lower in children taking long-term carbamazepine or sodium valproate, compared to a control group. METHODS: Serum folic acid levels were measured from well-nourished children between the ages of 1-17 years on carbamazepine and sodium valproate monotherapy and their age/sex-matched controls, using spectrophotometry. RESULTS: The mean serum folate levels of patients on carbamazepine (43) and sodium valproate (22) were 0.032 mg/l ± 0.009 and 0.028 mg/l ± 0.008, respectively. The mean folate levels of the controls were 0.046 mg/l ± 0.03 (p = 0 001). No statistically significant difference was observed between the serum folate levels of children on the two anti-seizure medications, that is, carbamazepine and valproate. CONCLUSION: The children on treatment with carbamazepine and sodium valproate for more than 6 months had statistically significantly lower serum levels of folic acid compared to the standard reference range and controls. The serum folate levels of children on carbamazepine were not statistically different from those on sodium valproate.

Maternal perception of masking in children as a preventive strategy for COVID-19 in Nigeria: A multicentre study.

BACKGROUND: The use of face masks by children for the prevention of COVID 19 is still controversial, especially with regards to who should wear the face mask and at what age. OBJECTIVES: The study aimed to ascertain the perception of mothers on masking in children as a preventive strategy for COVID-19. METHODOLOGY: This was a cross-sectional study carried out in two health institutions among 387 mothers who presented with their children for the first time in the hospital during the COVID 19 pandemic. A pretested, semi-structured, interviewer-administered questionnaire which was designed by the researchers was used for data collection. RESULTS: Minority (44.7%) of the mothers perceived masking in children as an appropriate measure for the prevention of COVID-19. The frequent reasons given by majority (55.3%) of the mothers for the inappropriateness of face mask in children included perceived difficulty in breathing (38.5%) and the child's readiness to pull it off (29.3%). A significantly higher proportion of the children whose mothers were 35 years and above, 64.2% would wear face masks when compared with 31.7% of those whose mothers were < 30 years of age (χ2 = 28.632, p<0.001). Similarly, a significantly higher proportion (51.0%) of the children who were more than one year of age would wear a face mask when compared with 20.5% of those aged eight days to one year (χ2 = 19.441, p<0.001). The children whose mothers were <30 years were about four times less likely to wear a face mask when compared with those whose mothers were aged 35 years and above. (AOR = 0.273; 95%CI: 0.155-0.478). The children whose fathers have attained tertiary education were about twice less likely to wear face masks when compared with those whose fathers have attained secondary education and less. (AOR = 0.554; 95%CI: 0.334-0.919). Mothers' perception of COVID-19 had no significant influence on children's use of face mask (χ2 = 2.337, p = 0.127). CONCLUSION: Maternal perception of masking in children as an appropriate strategy for preventing COVID-19 is adjudged low in this study. Right perception is significantly enhanced by maternal educational status, employment and marital status.

Influence of gender on prevalence of overweight and obesity in Nigerian schoolchildren and adolescents.

Overweight and obesity are serious health concerns for children. However, only a few studies have investigated the influence of gender on prevalence of overweight and obesity in children and adolescents in Nigeria. The objective of this study was to investigate gender influence on prevalence of overweight and obesity among Nigerian school children and adolescents. Information on age and gender of the participants was collected from the school register. Data on height, weight and BMI was collected using standard techniques. A total of 9,014 children and adolescents (male = 4392; female = 4622), aged 2-18 years, from 28 randomly selected schools were analyzed. Overweight and obesity were determined using the International Obesity Task Force cut-off points by age and gender. Males had higher BMI than females at age group 2-6 years, whereas females had higher BMI than males at age groups 11-14 years and 15-18 years. Females had significantly higher prevalence of overweight (P < 0.05) than males at age group 11-14 and 15-18 years. However, there was no gender difference in the prevalence of obesity from childhood through adolescence. In conclusion, BMI is larger in males in early childhood but larger in females in during adolescence. More female adolescents are at risk of obesity than males.