Hypokalaemia in children hospitalised for diarrhoea and malnutrition in Calabar, Nigeria.

OBJECTIVE: To describe the acid base and electrolyte pattern of morbidity and mortality in children with diarrhoea and protein energy malnutrition. SETTING: The diarrhoea treatment and training unit of the university of Calabar teaching hospital was used for the study. DESIGN/METHODS: It was a prospective study in which consecutive children below the age of 15 years with protein energy malnutrition and diarrhoeal diseases admitted into the DTU were screened for acid base and serum electrolyte abnormalities. The study was carried out over a two year period from January 1997 to December 1998. RESULTS: Hypokalaemia was seen in 45 (23.4%) patients. This was second to acidosis. Metabolic acidosis was the commonest abnormality in this study and was seen in 108(56.3%) of the patients included in the study. There was hyponatraemia in 25(13%). Hypochloraemia in 8(4.2%) and hypernatraemia in 6(3.1%) of the patients respectively. CONCLUSION: This study has shown that hypokalaemia is a common electrolyte abnormality in children with severe protein energy malnutrition and diarrhoeal diseases. There is need to encourage the use of readily available interventions such as the UNICEF and WHO oral rehydration solution in patients with diarrhoea and/or severe protein energy malnutrition to reduce morbidity and mortality from acid base and electrolyte disturbances.

Methaemoglobin profile in malaria infected children in Calabar.

BACKGROUND: Malaria infection interferes with haemoglobin by disruption of red blood cells and by conversion of haemoglobin to methaemoglobin. This study was to determine the relationship between malaria and the concentration of methaemoglobin using malaria patients. METHODS: Severe malaria-infected children of ages 11 months to 15 years recruited from the children emergency room of University of Calabar Teaching Hospital (UCTH) were used for the study while 62 age--sex matched apparently healthy school children and children that visited the child welfare clinic of UCTH were screened and used as controls. Malaria detection and identifications using WHO procedure were employed. Methaemoglobin (Met Hb) levels were determined using the method of Evelyn and Malloy. RESULTS: The mean MetHb value for malaria-infected children was higher (3.2 +/- 0.8%) than that of the non- malaria infected subjects (1.5 +/- 0.5%). The difference was significant (p < 0.001). Patients with severe malaria parasitaemia had markedly raised MetHb values of 4.0 +/- 0.9% as compared to the values for mild/moderate infected cases (2.9 +/- 0.6%). The difference was statistically significant (p < 0.001). CONCLUSION: This study has demonstrated high level of MetHb value in subjects with severe malaria parasitaemia. It's role in the symptomatology and complications of malaria infection, especially in malaria anaemia should be examined in details. Routine estimation of MetHb in malaria patients is suggested.

Hypofibronectinaemia and severity of sickle cell anaemia in Nigeria.

Plasma fibronectin levels in sickle cell anaemia and apparently healthy Nigerians were investigated to determine any correlation with disease severity. A cheaper in-house plasma fibronectin assay was also developed that could be adapted for use in Africa and elsewhere. Plasma fibronectin assay was concurrently carried out using the newly developed inhibition enzyme-linked immunosorbent assay (ELISA) and a commercial competitive binding ELISA. The in-house assay compared favourably with that of the commercial kit. The mean plasma fibronectin levels in sickle cell anaemia subjects were significantly lower than that of control subjects (P < 0.001). Plasma fibronectin concentration could therefore be useful in assessing the severity of sickle cell anaemia.