The influence of maternal anthropometric characteristics on the birth size of term singleton South-East Nigerian newborn infants.

OBJECTIVE: This study examined the usefulness of maternal anthropometry in predicting the birth size of term singleton newborn infants at NAUTH, Nnewi, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 301 mother/newborn infant pairs. RESULTS: The mean birth weight was 3.27 ± 0.60 kg whereas the incidence of low birth weight and fetal macrosomia were 8.0% and 11.3%, respectively. The anthropometric indices varied in their ability to detect newborn babies who experienced abnormal intrauterine growth. The rate of subnormal intrauterine growth was 9.0%, 11.6%m and 18.6% using weight-for-gestational age (GA), ponderal index (PI), and mid-arm circumference (MAC)/occipito-frontal circumference (OFC) criteria, respectively. On the other hand, the rate of excessive intrauterine growth was 16.6% and 12.0% using weight-for-GA and PI criteria, respectively. Apart from maternal height, all the assessed maternal anthropometric parameters had a significant relationship with size at birth. Mothers of newborn infants who experienced subnormal intrauterine growth were more likely to have MAC < 25 cm, intrapartum weight < 65 kg, intrapartum BMI < 25 kg/m2, and rate of third trimester weight gain < 250 g/week. On the other hand, mothers of newborn infants who experienced excessive intrauterine growth were more likely to have MAC > 30 cm, intrapartum BMI ≥ 30 kg/m2, and rate of third trimester weight gain ≥ 500 g/week. Conclusion/Recommendation: Maternal anthropometry is a very useful tool in identifying mothers at risk of having newborn infants who experienced abnormal intrauterine growth. Therefore, its routine application is recommended to enable such mothers benefit from interventions targeted at ensuring optimal intrauterine growth and improved pregnancy outcomes.

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

BACKGROUND: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. OBJECTIVE: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. MATERIALS AND METHODS: A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. RESULTS: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). CONCLUSION: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

The anti-diarrheal and anti-inflammatory effects of hydroethanol extracts of ripe Annona muricata fruit pulp in Wistar rats using curative method.

Objective: The study aimed to determine the anti-diarrheal and anti-inflammatory activities of hydroethanolic extract of ripe Annona muricata fruit pulp (HEAMP) on Wistar rats. Methods: Fifty male Wistar rats were divided into five groups, each for the diarrhea and inflammatory phases. Groups A and B 10 mL/kg of distilled water and 2 mL of castor oil, Groups C, D, and E received 2 mL of castor oil + extract (150, 300, and 600 mg/kg). Groups A and B received 10 mL/kg of distilled water and 0.1 mL of egg white. Groups C, D, and E received the (0.1 mL) egg white and extract (150, 300, and 600 mg/kg). Data were analyzed using SPSS (25) using ANOVA followed by post hoc least significant difference, presented as mean ± standard error of the mean, and values considered significant at P < 0.05. Results: The acute toxicity test of HEAMP is above 5000 mg/kg and rich in flavonoids, saponins, and proteins, with carbohydrates and tannins, and glycosides at moderate levels. Steroids, alkaloids, amino acids, and triterpenoids were absent. Furthermore, 30 min after diarrhea induction, the treated groups significantly increased (P = 0.012) in fecal count compared to Group A. Compared to Group B, the treated groups had a significant decrease in the fecal count at 60, 90, 120, and 150 min. At 30-min, there was a significant increase (P = 0.000) in paw-size in the treated groups compared to Group A. The treated groups had significantly lower edematous paw-size levels from 60 to 150 min compared to Group B. Conclusion: The HEAMP had anti-diarrheal and anti-inflammatory properties and is safe for consumption.

Drug treatment of common childhood symptoms in Nnewi: what mothers do?

OBJECTIVES: To determine how mothers treat common childhood symptoms before hospital attendance in Nnewi. MATERIALS AND METHODS: Information was obtained from 211 consecutive mothers on their children's presenting symptoms, drugs administered, source of the drugs, persons who prescribed the drugs, number of drugs administered, prior to hospital attendance through a structured questionnaire administered by the authors. RESULTS: A combination of fever, cough and catarrh topped the list of presenting symptoms in 87 (41%) of the patients while fever and diarrhea had the least frequency of 16 (7.6%). One hundred and five or 52% of the mothers decided on the drugs that were administered followed by patent medicine dealers who accounted for 59 or 29.2%. Trained health professionals whom mothers consulted before bringing their children to hospital were responsible for 28 (13.8%) of the prescriptions. Patent medicine stores were the sources of 90.6% of the drugs while health facilities accounted for 8.4%. The frequency chart of prescribed drugs were analgesics 166 (34.9%), hematinics 88 (18.5%), antibiotics and antimalarials 81 (17.1%) and 74 (15.6%) respectively while antidiarrheoals and ORT were least administered with 7 (1.5%) and 1 (0.2%) respectively. The children received an average of 2.7 drugs per prescription. CONCLUSION: With the high prescription rate of mothers for sick children at home, there is need for effective methods to educate mothers on the use and potential dangers of home medication.

Determinants of Undernutrition among Primary School Children Residing in Slum Areas of a Nigerian City

Background: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria; characterized by widespread poverty and inequitable distribution of wealth. Objective: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors; and the nutritional status of children residing in a typical urban slum. Materials and Methods: A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified; multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Results: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (?2 = 66.69; P = 0.000). Conclusion: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition

Oral hygiene and nutritional status of children aged 1-7 years in a rural community.

SUMMARY INTRODUCTION: Poor oral hygiene, measles and malnutrition have been implicated as predisposing factors to Acute Necrotizing Ulcerative Gingivitis (ANUG) and cancrum oris, common oral diseases prevalent among children ages 3-6 years in rural communities. OBJECTIVE: The study was aimed at reviewing the oral hygiene, nutritional and immunization status of children 13-84 months of age in a rural community. DESIGN: A cross sectional study. METHODS: Two hundred and thirty seven (237), 168 and 321 children and their parents from Illela, Gada and Gwadabawa respectively were interviewed using a pre-tested questionnaire to record the biodata and social status of the mother and measles immunization status of the children. The oral hygiene status of the children was determined using the plaque/debris index score. Their anthropometric measurements were also recorded. RESULTS: A total of 636 children aged 1-7years were examined. Of these, 8.3% had plaque/debris index of zero. About twenty four percent (23.9%) had plaque/debris index of 1, while 55.2% had plaque/debris index of 2 and 12.6% had plaque/debris index of 3. There was no statistical difference between the females and the males (p=0.333), but a significant difference existed between the age groups (p=0.001). Of the study group, 84.3% were malnourished and only 11.3% were immunized against measles. CONCLUSION: Poor oral hygiene, malnutrition and low measles immunization were common in the community. These conditions predispose to noma. Prompt and adequate intervention programmes such as systematic oral health, immunization and nutrition promotion programmes are urgently needed in these communities.

Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria.

The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 - 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing contraceptive practices needs to be encouraged especially in women whose menstruation has returned.

The prevalence and practice of female genital mutilation in Nnewi, Nigeria: the impact of female education.

Three hundred and twenty-five consecutive live female deliveries at Nnamdi Azikiwe University Teaching Hospital, Nnewi were followed up for 9 months for evidence of any genital mutilation. Their mothers were examined for genital mutilation and a questionnaire based on face-to-face interview of the mothers was also administered. There was no genital mutilation observed among the 200 female babies whose mothers completed the 9 months follow up, The prevalence of genital mutilation among the mothers was 48%. The prevalence of female genital mutilation among the mothers increased with age. The circumcision index C.I. was zero and 3.0 at 16-20 years and 31-35 years age groups, respectively. Also the prevalence decreased with increasing level of education. The circumcision index was 1.0 for mothers at primary level education and least 0.33 at tertiary level of education. There was no relationship with parity. None of the mothers was willing to allow genital mutilation to be performed on her baby but 36% applied local treatment to the clitoris especially powder (28%). Dystocia was the commonest complication in the mothers and the knowledge about female genital mutilation was acquired informally from fellow women. Female education is paramount in the campaign and advocacy against female genital mutilation.

Drug Treatment Of Common Childhood Symptoms In Nnewi South Eastern Nigeria: What Mothers Do?

OBJECTIVES: To determine how mothers treat common childhood symptoms before hospital attendance in Nnewi. MATERIALS AND METHODS: Information was obtained from 211 consecutive mothers on their children's presenting symptoms; drugs administered; source of the drugs; persons who prescribed the drugs; number of drugs administered; prior to hospital attendance through a structured questionnaire administered by the authors. RESULTS: A combination of fever; cough and catarrh topped the list of presenting symptoms in 87 (41) of the patients while fever and diarrhea had the least frequency of 16 (7.6). One hundred and five or 52 of the mothers decided on the drugs that were administered followed by patent medicine dealers who accounted for 59 or 29.2. Trained health professionals whom mothers consulted before bringing their children to hospital were responsible for 28 (13.8) of the prescriptions. Patent medicine stores were the sources of 90.6 of the drugs while health facilities accounted for 8.4. The frequency chart of prescribed drugs were analgesics 166 (34.9); hematinics 88 (18.5); antibiotics and antimalarials 81 (17.1) and 74 (15.6) respectively while antidiarrheoals and ORT were least administered with 7 (1.5) and 1 (0.2) respectively. The children received an average of 2.7 drugs per prescription. CONCLUSION: With the high prescription rate of mothers for sick children at home; there is need for effective methods to educate mothers on the use and potential dangers of home medication

Breast feeding practices in Onitsha South Eastern Nigeria - 2 years after baby friendly initiative

"Objective: To study the impact of ""baby friendly hospital initiative"" on breast feeding practices in Onitsha South Eastern Nigeria; 2 years after introduction. Setting: Holy Rosary Maternity Hospital Onitsha. Materials and methods: A structured questionnaire was used to collect data from 178 breast feeding mothers on maternal age; mothers' educational attainment; attendance at breast talks; and acceptance of exclusive breast feeding. Information was also obtained on feeding in the post natal ward; breast feeding practices at 6 weeks; 10 weeks; 14 weeks; 6 months; 9 months; 12 months; 18 months and 24 months post delivery. The data obtained was analyzed. Results: Breast feeding practices was studied among 178 breast feeding mothers attending the infant welfare clinics of Holy Rosary Maternity Hospital Onitsha; 2 years after it was made a ""Baby Friendly Hospital"". A total of 145 or 81.4 of the mothers were between the ages of 20 and 34 years; and all of them had some level of formal education with 59 of them acquiring secondary education. About one third or 33.1 of them were full time housewives while the rest engaged in one form of professional activity. While two thirds or 67.4 of the mothers attended breast feeding talk sessions 89 had knowledge of breast feeding support group and utilized their services during ante natal visits. Seventy three percent initiated breast feeding within less than an hour of delivery. All most all the mothers (99.4) established breast feeding by the time they were leaving the hospital on discharge and continued breast feeding up to 6 weeks post discharge. This proportion dropped to 84.3 at 12 months and to 1.1 at 24 months. Exclusive breast feeding rate fell from 99.4 on discharge to 3.9 at 6 months; while ""on-demand"" was practiced by 99.9 of the study population. Conclusion: We therefore recommend that the Campaign on Baby Friendly Initiative activities should continue and be strengthened to effect the ""The ten steps to successful breast feeding."