Enteropathogens Associated with the Seasonal Fluctuations in Plasma Sodium and Potassium Levels in Childhood Diarrhoea

This paper aims to assess the clinical; nutritional; microbiological; environmental and socio-economic determinants that have a seasonal distribution; or are potential confounders of a seasonal association of previously described seasonal fluctuations in plasma sodium and potassium concentrations in children with dehydrating diarrhoea. A cross-sectional analytical study was conducted from 15 April 2002 to 14 April 2003 of 350 children aged six weeks to two years admitted to the diarrhoea rehydration unit of a children's hospital in Cape Town. Multiple linear regression analysis showed the plasma sodium levels to be statistically significantly associated with age [-0.3 mmol/l per month of age; 95 confidence interval (CI): -0.2; -0.4]; enterotoxigenic Escherichia coli infection [-2.1 mmol/l; 95 CI: -4; -0.2]; enteropathogenic E. coli infection [-5.1 mmol/l; 95 CI: -7.1; -3.1]; being breastfed [1.9 mmol/l; 95 CI: 0.4; 3.4] and living in a brick house [2.7 mmol/l; 95 CI: 0.8; 4.5]. Plasma potassium levels were associated with duration of diarrhoea before admission [-0.02 mmol/l per day of diarrhoea; 95 CI: -0.01; -0.04]; cryptosporidium infection [-0.3 mmol/l; 95 CI: -0.1; -0.6] and parental education [0.04 mmol/l per year of education; 95 CI: 0.1; 0.01]. Of these; enterotoxigenic and enteropathogenic E. coli and cryptosporidium infections followed seasonal distributions that were similar to those of the electrolyte concentrations. Seasonal fluctuations in plasma sodium and potassium levels are at least partly explained by both enterotoxigenic E. coli and cryptosporidium infections working together. Enterotoxigenic E. coli infection has a larger effect on plasma sodium levels and cryptosporidium infection has a larger effect on plasma potassium levels

Pattern of Psychiatric Inpatient Admission in Ibadan: Implications for Service Organisation and Planning

Introduction: Reports from different parts of the world has shown a seasonal pattern in psychiatric admission. Seasonal changes in climatic and social situations have been attributed. Such audit of psychiatric services is not a popular research venture in Nigeria. Objectives: The study aims to describe the pattern of old psychiatric admissions in a tertiary health facility and the socio-cultural and environmental factors that may influence the pattern. Methods: Data on monthly admissions over a 5-year period were extracted from the admission and discharge records kept by the nursing services unit. The data was processed using Microsoft excel and the pattern over the 5-year period was examined using graphical representations. Results: There were 2140 admissions during the review period; comprising 1138 ( 53.2) females and 1002 males. The mean new admission per month was 34.55 (M:16.7; F:18.96) with a standard deviation of 7.49 for all admissions. There was a seasonal pattern in admission. Some socio-cultural and environmental factors that may explain the pattern were examined. Conclusion: This study suggests a seasonal pattern of psychiatric admission in a tertiary health facility in Ibadan. Recommendations were made on how to make use of the knowledge of the seasonal pattern of admission to mitigate disruptions in workload that may be occasioned by the observed pattern

Appendicitis: Trends in Incidence; Age; Sex; and Seasonal Variations in South-Western Nigeria

Background : Appendicitis is a common clinical condition worldwide. Differences in incidences; sex; age; and seasonal variations have been reported widely; with paucity of information from Nigeria. Aim : To assess the trends in incidence and pattern of variation with age; sex; and seasons of the year. Materials and Methods : A review of the records of all patients with confirmed appendicitis treated in both the LAUTECH Teaching Hospital (LTH) and the Abake Medical Center (AMC); both situated in Osogbo; Nigeria; between January 2003 and December 2008; was done. LTH was a 320-bed University Hospital (with 100 surgical beds); while AMC was a 20-bed surgical center. The age; sex; and month of admission of all the histologically proven cases of appendicitis were retrieved and treated. Analysis was done using simple percentages; Student t or Chi-square tests; where applicable. Results : A total of 299 out of 321 cases of appendicitis recorded during the observed period were confirmed histologically from both hospitals (69.56from LTH). Fifty-two percent were males. It made up 0.94; 1.43; and 1.86of the total hospital admissions in 2004; 2006; and 2008; respectively. There has been an increasing incidence in both sexes almost in a similar pattern. The overall mean age was 25.79 years (M 25.94 and F 25.43 years) with 6below the age of ten and 1.3above 60 years. The highest incidence in males and females occurred in the second and third decades; respectively. Incidences were higher during the rainy season (April to September) 68; P 0.05); with peaks from June to August; when 39.5of all cases presented. Conclusion : The increasing incidence of appendicitis in both sexes in this region may be due to the change to a Western lifestyle. The age distribution has a similar pattern in both sexes and 87are 40 years or less; although the incidence is marginally higher in males. Higher prevalence of infections and allergens from pollens in the rainy season could contribute to a higher incidence of appendicitis

Effects of gender and seasonal variation on the prevalence of bacterial septicemia among young children in Benin city, Nigeria

Aim: To determine the effects of gender and seasonal variations on the prevalence of bacterial septicaemia among children 5 years and younger; and to identify the bacterial agents responsible for septicaemia and their antibiotic susceptibility profiles. Methods: Blood was collected from 1;724 children (967 males and 757 females) aged 1 day to 5 years with clinical signs and symptoms of septicaemia. This study was carried out from 1 January to 31 December 2007 at the University of Benin Teaching Hospital; Benin City; Nigeria. The blood samples were processed to diagnose bacterial septicaemia. Bacterial isolates were identified and susceptibility test was performed using standard techniques. Results: An overall prevalence of 22.10of confirmed bacterial septicaemia was observed in this study. Generally; gender and seasonal variations did not significantly affect the prevalence of bacterial septicaemia; though females (50.57) during the dry season had significantly (p 0.001) higher prevalence than their male counterparts (19.91). Staphylococcus aureus was the predominant bacterial isolate causing septicaemia in both seasons; while Citrobacter freundii was the least frequent. Pseudomonas aeruginosa was not recovered during the dry season. Most isolates were susceptible to gentamicin and cefuroxime; but only 1.44of Staphylococcus aureus strains were susceptible to ceftriaxone. Conclusion: Bacterial septicaemia was observed in 22.1of children 5 years and younger with clinical signs and symptoms of septicaemia. Seasonal variation did not affect the prevalence. Effect of gender was only noticed in the dry season; where females had a higher prevalence than males. Gentamicin and cefuroxime were the most active antibacterial agents. Rational use of antibiotics is advocated

Seasonal variation in admission for heart failure, hypertension and stroke in Uyo, south-eastern Nigeria

Background:Seasonal variation in hospitalization for cardiovascular disease has been described in thetemperate regions of the world as well as in Northern Nigeria. Increase admission rates during the coldseasons have been reported in these areas. No studies have been done in Southern Nigeria. This studyis thus aimed at describing the seasonal variation in admissions for heart failure, uncontrolledhypertension and hypertension related-stroke in Southern Nigeria.Methods:Hospital records of patients admitted to the medical wards of the University of Uyo Hospital(UUTH) with heart failure of all causes, uncontrolled hypertension and hypertension­related stroke(Cerebrovascular accident) between January 1998 and December 2001 were used. Epi-Info 2002software was used to analyze data.Results:Of the 3500 patients admitted during the study period 542 (15.3%) were on account of heartfailure, uncontrolled hypertension and hypertension related cerebrovascular accident (CVA). The meanage of patients was 52±12.8 years. The average monthly admission was eleven (11). More admissionswere recorded in the rainy (cold) season than in the dry (hot) season. The observed difference washowever statistically significant only for heart failure and uncontrolled hypertension (P<.05).Conclusion:Admissions for heart failure and uncontrolled hypertension are therefore more during thewet (cold) season in southern Nigeria. This may be attributed to the high default rate to follow up visitin this season when agriculturalactivity is intense and less attention given to medical care. This leads topoor compliance to medications and clinical deterioration. The already bad road network both in ruraland urban centers also become worse at this time making access to medical care difficult. Facilities andmeasures should thus be put in place to provide adequate medical care for these patients during thatperiod of the yea

Hospital-based study on neonatal tetanus; Buluba Hospital; 1985-1989

Neonatal tetanus is a major cause of morbidity and mortality among neonates in Uganda. A retrospective study has been made of 228 cases of neonatal tetanus seen in Buluba Hospital over the 5-year period of 1985-1989. The number of cases of neonatal tetanus admitted per year to the hospital did not decrease significantly during that period suggesting that the immunization programme aimed at immunization of pregnant women with tetanus toxoid has not had a clear impact. Over 40pc of neonatal tetanus cases came from the two nearest subcounties: Waina and Imanyiro. Over 75pc of admitted cases of neonatal tetanus accounted for 23pc of all deaths among child admissions. More than 90pc of neonatal tetanus cases showed the first symptoms of the illness within the first 14 days of life; the shortest incubation period was 2 days. The average age at onset was 5.6 days and the average age at death was 9.9 days. The need for a more effective immunization programme and more intensified activities to increase the proportion of deliveries attended by trained personnel and improve hygienic conditions during and after deliveries is emphasized