Blood pressure pattern and the relationship with body mass index among apparently healthy secondaryschool students in Sokoto metropolis, Nigeria

Background. Childhood obesity may result in the premature onset of cardiovascular risk factors, particularly hypertension, hence the need for proper screening. However, blood pressure (BP) is measured only once in most studies in Nigeria, probably because of difficulties in returning to the study areas for repeat measurement.Objective. To determine the BP pattern and assess its relationship with body mass index (BMI) in apparently healthy secondary-school students aged 10 - 18 years in Sokoto metropolis, Nigeria.Methods. This study was descriptive and cross-sectional, and carried out between 13 October 2014 and 30 January 2015. In total, 800students from 6 schools were selected through multistage sampling. BP was measured on three separate days according to the National High Blood Pressure Education Program charts. BMI was categorised according to the Centers for Disease Control charts. The relationship of BP level with BMI was determined.Results. There were 424 (53.0%) males and 376 (47.0%) females, with a ratio of approximately 1:1. BP increased with age. The mean systolic and diastolic BP was significantly higher in females than males (systolic 113.1 mmHg v. 110.5 mmHg, and diastolic 69.0 mmHg v. 66.5 mmHg, respectively; p=0.01). Females had a higher mean BMI than males (18.7 kg/m2 v. 17.9 kg/m2, respectively; p<0.01). BP increased as the BMI percentile increased (p<0.001). The prevalence rates of hypertension were 6.1%, 3.5% and 3.1% at the first, second and third screenings, respectively, while the corresponding prevalence rates of prehypertension were 14.3%, 8.4% and 7.1%. The prevalence of obesity and overweight was 0.3% and 5.9%, respectively.Conclusion. The prevalence rate of prehypertension and hypertension reduced with subsequent measurements, and the prevalence rates of overweight and obesity were low. However, higher BP levels were associated with higher BMI, supporting its predictive significance for elevated BP

Prevalence of Uncomplicated Malaria in a Paediatrics Outpatient Department of a Tertiary Health Institution in Sokoto; Nigeria

Background: Malaria remains one of the major tropical health challenges in the world today. It accounts for more than 80of estimated 1.5 - 3 million deaths of children annually especially those aged 5 years and below. There is paucity of data on the prevalence of uncomplicated malaria in children in Sokoto. Objectives: To determine the prevalence of uncomplicated malaria in children aged 0 - 15 years. Methods: The health registers and outpatient cards of children aged 0 - 15 years that presented to the Paediatrics Outpatient Department/Clinic of Usmanu Danfodiyo University Teaching Hospital; Sokoto; Nigeria; between 1st June 2007 and 31st May 2009 were studied retrospectively. Information of the patients with regards to their age; gender; presenting features; date of presentation at the clinic; and diagnosis of malaria (clinical and parasitological) were extracted from the registers and case records and analyzed. Results: During the study period; a total of 15;909 children aged 0 - 15 years were seen in our clinic. Of this number; 7;224 had clinical and parasitological diagnosis of uncomplicated malaria giving a prevalence rate of 45.4.those aged 5 years and below were 5;782 (49.6) while the remaining 1;442 (34.0) were aged above 5 years. Males were 4;068 (56.3) while the females were 3;156 (43.7) with M: F ratio of 1.3:1. The main presenting symptoms were fever (100); reduced appetite (80.5); reduced activity (75) and chills (74). The main presenting signs were pyrexia (84.5); splenomegaly (38) and hepatomegaly (14). Malaria was the leading cause of paediatrics outpatient clinic attendance followed by acute respiratory infection and diarrhoeal disease. Though malaria occurred throughout the year; majority of the cases were seen during the raining and early dry reasons. Conclusion: Malaria is partly meso-endemic and hyper endemic in the studied area and children aged 5-years and below are the most susceptible. It is therefore; recommended that more efforts should be put in place towards malaria control and prevention particularly in this age group

Paediatrics HIV/AIDS: Clinical Presentation and Practical Management Challenges in Sokoto; Nigeria

Background: Implications of continuing HIV/AIDS pandemic in Nigeria is very grave for children. Lack of financial resources means care of children with HIV/AIDS is exceedingly difficult to provide. We described the clinical pattern and highlight the problems in the management of HIV/AIDS in children seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH); Sokoto; Nigeria over a two-year period. Methods: This prospective study was carried out between 1st January 2001 and 31st December 2002. The clinical presentation of each patient satisfying the WHO diagnostic criteria for paediatrics HIV/AIDS; admitted consecutively into our Emergency Paediatrics Unit (EPU) was documented. Laboratory diagnosis was by Enzyme linked immunosorbent assay (ELISA) for HIV- I and HIV- II in affected children and their mothers while confirmatory test was by Western blot. Treatment of each patient was individualised. Results: A total of 41 children with HIV/AIDS were admitted into EPU over the study period. There were 22 males and 19 females with ratio of 1.2:1. Age ranged from 0.25 years to 14 years with mean (SD) of 1.5 (2.2) years. Forty - one (97.6) patients were aged 5 years and below. Modes of transmission were vertical in 40 (97.6); while 1 (2.4) was by homosexual abuse. The commonest clinical feature was weight loss in 41 (100); followed by fever (one month) 39 (95); chronic diarrhoea 39 (95); recurrent cough 37 (90) and oro-pharyngeal candidiasis 35 (85) in that order. Thirty- six (87.8) patients had protein - energy malnutrition (PEM); marasmus constituting 58. Thirtytwo (78) patients were in WHO clinical stage 3 while the remaining 9 (22) patients were in stage 4. The main types of infections were oral candidiasis; pneumonia; malaria; septicaemia; urinary tract infections; and tuberculosis. Case fatality rate was 91. Highly active antiretroviral therapy (HAART) was not freely available to children during the period of our study. Conclusion: The mortality of these antiretroviral naive HIV/AIDS children was very high. It is anticipated that current availability of HAART to children free of charge would improve the outcome of HIV/AIDS in this group