Morbidity pattern of underfives with moderate acute malnutrition in southern Nigeria

Background:Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described. Objective: To describe the morbidity pattern of underfives with MAM.Method: Across sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers'brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. Avalidated proforma was used to obtain the biodata and symptoms of common illnesses in the children. Ageneral physical examination, anthropometric measurements and systemic examination were performed. Results: Atotal of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss

Therapeutic potential of concurrent administration of Hippocratea africana and Eremomastax speciosa in the treatment of Plasmodium berghei infected mice

Context: Despite the commonness of polyherbal therapy among the locals in the treatment of malaria in Nigeria, there are no adequate data on the therapeutic potentials and safety profile of these herbal combinations. The use of these plants in combination in the treatment of suspected and confirmed malaria infection is very common among the Niger Delta dwellers in Nigeria. Aim: To evaluate the therapeutic potential of co-administration of Hippocratea Africana, a medicinal plant with well documented antimalarial properties, and Eremomastax speciosa, a tropical plant with well reported antianaemic potential and haematoprotective properties. Materials and Methods: Thirty albino mice, whose weights ranged between 32 - 37g, were divided into five groups having six mice in each. Clinical features, weight changes and parasite clearance were evaluated to determine therapeutic potential of treatments. An inoculum which consisted of 5 x 107 Plasmodium berghei infested erythrocytes per ml of blood from a donor mouse with 64% parasitaemia was injected into each mouse by intraperitoneal route. The mice were kept at room temperature of 28.0 ± 20C for 7 days for the parasite to develop. A non-parasitized mice group served as normal control. After parasitaemia was confirmed using standard procedure, 200mg/kg and 300mg/Kg body weights of Hippocratea Africana root bark and Eremomastax speciosa leaf extracts respectively, were administered by oral routes to the respective groups of mice for 6 days. A parasitized group was treated with fixed doses of 3mg/kg body weight of Artemether and 18mg/kg body weight of Lumefantrine. Another parasitized group was left untreated. Results: Mice treated concurrently with the extracts of H. africana and E. speciosa showed a significant improvement in clinical signs in comparison to the untreated group. The mean body weights of mice administered both extracts was significantly (P < 0.05) increased when compared to the parasitized untreated mice and those treated with extracts separately. The mice treated concurrently with the two extracts also showed significant (P < 0.05) reduction in percentage parasitaemia and significant (P < 0.05) increase in percentage parasite clearance comparable to that of Artemether-lumefantrine. The parasitized untreated group recorded 50% mortality, while the group treated concurrently with the two extracts did not record any mortality.

Facility-Based Treatment of Under Five Diarrhoea in Cross River State: A Clinical Audit

Introduction: Diarrhoea is the second leading cause of under-five mortality globally and ranks second among the top 10 priority child health problems in Nigeria. The World Health Organization (WHO) has recommended some cost-effective; evidence- based interventions for diarrhoea case management. It is needful to evaluate the current practice in the treatment of diarrhoea in under-fives in health facilities in the country.Objective: To determine the extent to which current treatment practice for diarrhoea in underfives conforms to the WHO recommendation.Method: A clinical audit was conducted between May and June 2013 in 32 health facilities in the Southern Senatorial district of Cross River State; Nigeria. Trained field workers extracted information from patients' case records using a validated audit tool. Treatment was checked as appropriate; inappropriate; wrong or none; based on prescription on patients' case records.Result: Of the 370 case records audited; prescription for diarrhoea was appropriate in 40 (10.8%); inappropriate in 231 (62.4%); wrong in 82 (22.2%) and no prescription was made in 17 (4.6%).Conclusion: Treatment of diarrhoea in under-fives in health facilities in the State is suboptimum. Retraining of health workers on the current WHO and UNICEF treatment guidelines is highly recommended