Clinico-demographic factors associated with diarrhoeal disease outcome in under-five children: A Nigerian tertiary hospital experience

Objectives: To determine the proportion of under-5 children presenting with diarrhoeal disease, and the clinico demographic variables associated with the outcome at the emergency paediatric ward (CHER) of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, South- East Nigeria.Methods: Clinical and demographic details of patients with diarrhoeal disease as obtained from the Paediatrics emergency ward log book over an 18month period were analyzed using SPSS and Microsoft excel software packages. The clinical variables (non-parametric) were tested for degree of association with mortality using Spearman's rank correlation. Chi square and Fischer exact test were used to determine presence of significant differences between certain variables. A p value <0.05 was deemed significant. Results: One thousand, one hundred and sixty three out of 1,513 children admitted within the period were aged below 5 years. Acute diarrheal disease accounted for 32% and 38% respectively of morbidity and mortality in these under-five children, with a case fatality rate of 18.3%. The mean age at presentation was 11.96 months with a male to female ratio of 1.4:1. Presentation with fast breathing (Odds Ratio {OR} 2.6), convulsion (OR 2.5), loss of consciousness (OR 4.3), increased severity of dehydration, presence of one or more comorbidities (OR 4.68) and a co-diagnosis of sepsis (OR 3.23) significantly affected the outcome. (p< 0.05 in all these). Educational status of the mothers also significantly affected the outcome. (F=9.08, p=0.023)Conclusion: Intensified effort should be made to sensitize the public about dangers of inappropriate therapy and late hospital presentation of children with diarrhoeal disease. These will reduce mortality-heralding complications

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

Undescended testis at Nnamdi Azikiwe Teaching Hospital; Nnewi; Nigeria : a ten year audit

Introduction: Undescended testis is a global problem; and late diagnosis and treatment can lead to disastrous consequences. We undertook this study to evaluate our management protocol and see how it fits into changing trends in management and compare our results with those obtained in other centers. Material and Methods: A retrospective study of all patients with undescended testes seen and operated at Nnamdi Azikiwe Teaching Hospital; Nnewi; Nigeria during a 10-year period (1993-2003) was carried out. Results: Twenty-seven patients were analysed. 66.7of them were above 2 years of age. Eighteen patients had unilateral crypt-orchidism and 12 patients (44.4) had associated inguinal hernia. The undescended testis was found predominantly in the inguinal region (17 patients) and orchidopexy was done in 16. Half of our patients (51.7) were lost to follow up immediately after the intervention. Conclusion: The late presentation and inability to follow up these patients make the monitoring of such patients very difficult. We suggest that thorough examination of the external genitalia should form part of the normal post-natal check up and that a mass education campaign be undertaken