Seroprevalence and Correlates of Hepatitis C Virus Infection in Secondary School Children in Enugu; Nigeria

Background: Although children comprise a small fraction of the burden of hepatitis C virus (HCV) infections; which is a major global health challenge; a significant number of them develop chronic HCV infection and are at risk of its complications. Aim: The aim of the current study was to determine the prevalence and associated factors of HCV infection in school children in Enugu urban. Subjects and Methods: This was a cross-sectional seroepidemiological study involving children aged 10-18 years selected using multistage systematic sampling in Enugu metropolis; Southeast Nigeria. The anti-HCV was tested using a 3rd generation enzyme-linked immunosorbent assay. Data were analyzed using SPSS Version 16.0 with the level of significance set atP 0.05. Results: Four hundred and twenty children were selected and screened comprising 210 (50.0%) males and females. The seroprevalence of anti-HCV was 4 (1.0%). Three (75%) out of the four positive cases for the anti-HCV were females while one was a male giving a male to female ratio of 0.3-1. Traditional scarifications/tattoos were the putative risk factors observed to be significantly associated with anti-HCV seropositivity. Conclusion: This study has demonstrated an anti-HCV seroprevalence of 1.0% among children aged 10-18 years in Enugu with traditional scarification as the predominant associated risk factor. Proper health education including school health education and promotion of behavioral change among the public on the practice of safe scarifications/tattoos should be encouraged in our setting

Prevalence of Human Immunodeficiency Virus Transmission among Transfused Children with Sickle Cell Anemia in Enugu Nigeria

Background: There are a number of routes for human immuno-deficiency virus (HIV) transmission in children. Blood transfusion-related HIV is still common in developing countries like Nigeria especially among high risk children such as those who require repeated blood transfusions. Aim: The aim of this study was to find the prevalence of HIV among transfused children with sickle cell anemia in Enugu. Subjects and Methods: This is a descriptive cross-sectional study conducted at the Sickle Cell Clinic of the University of Nigeria Teaching Hospital; Enugu Sixty-nine transfused children with SCA were enrolled after obtaining consent from their caregivers and assent from older children. Non transfused children matched for age; sex; and social status with the subjects served as control. Voluntary counseling and testing were then provided. Relevant data were obtained using pretested questionnaire. Statistical Package for Social Science (SPSS) version 11 (Chicago; IL) was used for data analysis. The chi-square was used to test for significant association of categorical variables and a P-value of less than 0.05 accepted as significant. Results: HIV antibodies were found in 2.9 (2/69) of the subjects and in 1.6 (1/64) of the control (P = 0.604). All the infected individuals among the subjects were males; had only been transfused once and were from the lower socioeconomic class. The only infected child from the control group was a 7-year-old male and he probably acquired it through vertical transmission since the mother also tested positive to HIV antibody. Conclusions: Blood transfusion is still a risk factor for HIV transmission among children with sickle cell anemia in Nigeria. Strategies that will ensure improved blood transfusion safety at health facilities need to be strengthened

Assessment of Clinical Features and Haematocrit Levels in Detection of Hypoxaemia in Sick Children

This cross-sectional study was to determine the prevalence of hypoxaemia among sick children in EnuguState University Teaching Hospital, Enugu, Nigeria and correlate it with clinical features and haematocrit levels.Ninety-two (92) sick children aged 2­48 months hospitalised at the teaching hospital were recruited after obtaining consent from their carers.The prevalence of hypoxaemia in this study, defined by oxygen saturation of less than 90%, was 13%, and was not dependent on age or sex. A higher proportion of subjects with hypoxaemia had tachypnoea (81.8%),compared with those without (18.2%) (χ² = 1.69; p=0.19).The sensitivity of using tachypnoea alone to predict hypoxaemia was 18.4% while the specificity was 92.3%.The presence of hypoxaemia predicted poor outcome 66.7% of those that died had hypoxaemia. The difference was statistically significant (χ2= 17.9; p=0.00).Tachypnoea had a poor sensitivity although good specificity in predicting hypoxaemia. Presence of hypoxaemia connotes poor prognosis. We recommend that finger pulse oximeters, which are cost effective,should be routinely available at hospitals in developing countries, so that hypoxaemia can be detected earlier and more intensive management instituted

Awareness and Use of Insecticide-Treated Bed Nets among Children Attending Outpatient Clinic at UNTH; Enugu - the Need for an Effective Mobilization Process

Background: The promotion of insecticide-treated net (ITN) can be a key approach towards the reduction of morbidity and mortality from malaria. Objective: To determine the proportion of mothers using insecticide treated nets for their children and reasons for nonuse. Study design: Prospective hospital-based study. Method: Consecutive mothers attending the children's out patient clinic of UNTH; Ituku-Ozalla; Enugu; whose children presented with fever without localizing focus were interviewed with the aid of an open-ended structured questionnaire. Results: Awareness of ITN was found in 184 (80) of the 230 mothers interviewed; while only 48 (26.1) use it for their children. There was statistically significant difference in terms of ITN awareness between the highly educated mothers and those with lower educational qualification (p=0.000) but; in terms of ITN usage; there was no significant difference between the two groups (p=0.40). Socio economic class did not influence the use of ITN (p=0.153). A greater number; 56 (41.2) have no reason for non-use. Reasons for nonuse include use of windows and door nets 22 (16.2) and not convenient to spread 18 (13.2). Conclusion: There was a high awareness of ITN; which did not influence usage

Evaluation of Sexual Maturity among Adolescent Male Sickle Cell Anaemia Patients: the Usefulness of Testicular Volume Estimation

Use of Tanner stages i.e. Sexual Maturity Rating; (SMR); in evaluation of sexual maturity has gained widespread acceptance. Tanner staging assesses pubic hair growth and increase in genital sizes; the latter of which is best reflected by the increase in testicular size. Testicular volume increases is thought to be the most sensitive clinical indication of onset and progress of puberty. It has been argued that the initial stage of sexual development may be missed if testicular volume is not assessed. We explored usefulness of testicular volume estimation for assessing sexual maturity among adolescent male sickle cell anaemia (SCA) patients. Methods: We conducted a cross-sectional case-control study evaluating sexual maturation of male patients with sickle cell anaemia and those with HbAA genotype. Tanner staging and testicular volume assessment were both used as models for evaluating stages of sexual maturation among SCA patients and their normal counterparts matched for age and socioeconomic status. Results: SCA patients demonstrated delay in onset and completion of sexual maturation. Testicular volumes (TV) of subjects were smaller than those of controls but when related to stages of sexual maturity; there was no statistically significant difference between both groups. The correlation coefficients between various stages of sexual maturity and TV suggest strong associations. Conclusion: Testicular volume increase is shown as a reasonably good predictor of onset and progression of sexual maturity in both SCA subjects and their healthy controls

Demographic and Sociocultural Characteristics of Sickle Anaemia Children with Positive Hepatitis B Surface Antigenaemia in a Tertiary Health Facility in Enugu

Hepatitis B virus infection is contracted through contact with body fluid of infected persons. Patientswith sickle cell anaemia (SCA); a common haematological disorder inNigeria; have tendencies to visit traditional healerswho administer scarifications and ritualmarks thatmay expose themtoHBVinfection. To determine the demographic and socio-cultural characteristics of children with SCA infected withHBVat theUniversity ofNigeriaTeachingHospital Enugu. Two hundred and twenty one children aged 6months to 17years with SCA were recruited consecutively from October 2004 to April 2005. They were screened for HBsAg using ELISA method. There was no statistically difference in hepatitis B surface antigenaemia among different age group (P=0.907). Social class did not significantly influence the prevalence of HBsAg among subjects (p=0.887). socio-cultural practices like circumcision and scarification did not influence the prevalence of HBsAg; (p=0.636) (p=0.771) respectively. Significantly highernumber of people fromlowest socioeconomic class practice scarification (p=0.0001). Demographic and sociocultural factors do not appear to influence the prevalence of HBsAg among childrenwith SCAinEnugu;Nigeria. Sickle cell anaemia; Hepatitis B surface antigenaemia; Demographic; Sociocultural characteristic

Sociodemographic Differences in the Distribution of Hepatitis C Virus Antibodies among Children with Sickle Cell Anemia in Enugu; South East Nigeria

Background:Hepatitis C virus (HCV) has become an important cause of chronic liver disease and liver cancer worldwide. A study of the sociodemographic differences in the distribution of HCV antibodies (Anti-HCV) among those at risk will broaden knowledge of the problem among patients in this part of the country. Objective: To determine the sociodemographic differences in the distribution of HCV antibodies among transfused children with sickle cell anaemia (SCA) in Enugu and compare it with their non- transfused counterparts. Methodology: The study was conducted among two hundred and sixty-nine children with SCA attending the paediatrics sickle cell clinic at University of Nigeria Teaching Hospital (UNTH) Enugu; 136 transfused SCA patients as subjects and 133 age and sex matched non-transfused SCA as controls were studied. Results: There was no statistically significant difference in the age and sex distribution of the anti-HCV positive subjects and controls P 0.05. Majority of the subjects (66.7) and control (71.4) who tested positive were in lower socio-economic class. Conclusion: HCV infection is not uncommon in children with SCA. There is no significant difference in the sociodemographic characteristics of the HCV positive subjects and controls