Simple Vision Screening in Lower Primary School Children in Port Harcourt City

Background: Vision disorders are significant causes of morbidity worldwide and in children; can lead to life long visual impairment or blindness. Thus; the impact on a child's education and life if not detected and ameliorated on time; can constitute a huge socio-economic burden to the child; family and community. Aim: To determine the prevalence of reduced vision in lower primary school children in Port Harcourt city. Methods: A multi-staged sampling technique was used to select 1;234 lower primary school pupils from 12 schools in Port Harcourt for visual screening. Visual acuity (VA) measurements using Snelling's charts; and a basic eye examination using a pen torch was carried out in all the pupils. Vision was regarded as reduced if VA is 6/18; in which case a pinhole was presented to the affected eye and VA repeated; to check for presence of refractive error. Results: A total of 1;234 school children were screened; 73 pupils had reduced vision in one or both eyes giving a prevalence of 5.9. Refractive errors accounted for 72.6of cases of reduced vision. Gross external eye abnormalities accounted for 9.6of cases of reduced vision; with corneal opacity and nystagmus being the most commonly seen. Conclusion: Reduced vision is an important cause of visual disability in primary school pupils in Port Harcourt city; mostly due to correctable refractive errors. There is therefore a need for routine vision screening of all pupils; especially on commencement of school for early detection and treatment; to prevent life long visual disability

Pattern of endocrine diseases in children at the University of Port Harcourt Teaching Hospital

Background: Endocrine disorders (ED) vary greatly in their prevalence according to age and gender. Although most of these disorders are uncommon; they usually run a chronic course; contributing to long term morbidity and ultimately mortality if not recognized and treated early. Aim: To determine; the pattern of ED in children seen at the University of Port Harcourt Teaching Hospital (UPTH). Methods: We reviewed the case files of patients seen in the Paediatric Endocrinology clinic of the UPTH from July 2001 to July 2007.The information obtained were patients' characteristics; diagnosis; management and outcome. Diagnosis of each disorder was based on clinical features; relevant laboratory investigations and imaging studies. Results: Thirty patients were seen with various endocrine disorders. They comprised 13 (43.3) males and 17 (56.7) females with a M: F ratio of 1:1.3. Their ages ranged from 10 months to 16 years. Diabetes mellitus (DM) was the commonest disorder seen in 14 (46.7) patients. This was followed by disorders of puberty and thyroid gland in 12 (40) and 4 (13.3) patients respectively. Delayed puberty was the commonest disorder of puberty seen in 4(33.3) of the patients. This was followed by premature thelarche and gynaecomastia in 3(25) patients each. One female (8.3) had precocious puberty. The patients with diabetes had Type 1 DM and all except for one patient received insulin injection. There was delay in the diagnosis of congenital hypothyroidism and lack of drugs for the treatment of some pubertal disorders in our environment. Conclusion: This study shows that endocrine disorders do occur in children in our environment. A high index of suspicion is therefore required for early diagnosis. There is also need for provision of hormone therapy (HT) for children with pubertal disorders in Nigeria

Screening for Congenital Color Vision Deficiency in Primary Children in Port Harcourt City; Teachers' knowledge and performance

Background: One hundred and thirty teachers were studied to evaluate their knowledge of congenital Color Vision Deficiency (CVD); and their ability to perform the Ishihara color vision test; so as to determine if they can provide color vision screening services for their pupils. Methods: The teachers were randomly selected from 13 schools in Port Harcourt City (PHC) and given a six hours training workshop on vision disorders in children and congenital color vision screening. They were given a self administered pre and post test questionnaires before and after training respectively. Subsequently; they screened 1;300 of their school pupils for congenital vision deficiency using the Ishihara color vision chart; and their results compared to that of the research team. Results: Female teachers constituted 84.6and males 15.4of the study population. Seventy three teachers (53.8) were from public schools while 46. 2were from private schools. Prior to the training workshop; only 6.2of teachers had heard of the Ishihara color vision chart and none of the teachers could identify or knew how to use the chart. However with training there was significant improvement in knowledge of CVD. Comparison of the teachers' performance of color vision screening using the Ishihara chart to that of the research team showed a sensitivity of 67.6with a specificity of 99.1. The prevalence of congenital color vision deficiency in the 1;300 primary school screened was 2.6; with males having a significantly higher prevalence than females. Conclusion: The study thus concludes that congenital color vision deficiency is prevalent amongst primary school children in Port Harcourt City; and with training; teachers can effectively perform color vision screening; and as such modify their teaching methods to accommodate the child with color vision deficiency

Double diabetes: an emerging disease in children and young adults

Background: Studies in most countries have shown an increasing incidence of diabetes mellitus in children and young adults. Double diabetes is a newly recognized problem in children with different diagnostic and therapeutic measures. Methods: A review of over 30 literature obtained from Google; PUBMED search and journal publications on ""double diabetes"" was done to determine the incidence; pathophysiology; pathogenesis; diagnostic criteria; treatment and prevention of double diabetes in children and young adults. Results: Most of the reports on double diabetes were from western countries and Asia. Type 1 diabetes resulting from antibodies to the insulin-producing pancreatic beta cell was more prevalent in children. However; with increasing obesity the incidence of type 2 diabetes resulting from insulin resistance was high in children and young adults. Most patients with double diabetes were established type 1 diabetics; who while on insulin and on hypercaloric diet developed obesity especially during puberty and hence associated type 2 diabetes. The incidence was more in black than in white children. They presented with some clinical and laboratory features of both types 1 and 2 diabetes. Some authors advocated treatment with both insulin and oral hypoglycaemic drugs mainly metformin to improve insulin sensitivity. Prevention of childhood obesity by encouraging physical activities and dietary control would prevent double diabetes. Conclusion: Double diabetes is increasing in children and young adults. A high index of suspicion is required in obese children with diabetes

Nocturnal enuresis among secondary school students in Port Harcourt, Nigeria

Background: Enuresis is a common problem in children. The impact upon the lives of children and their families is often underestimated. Aim: The study was to determine the prevalence; causes and effect of enuresis among students in Port Harcourt. Methods : A survey of junior and senior students from 2 secondary schools in Port Harcourt Local Government area was done using self-administered questionnaire. Results: A total of 491 students between the ages of 10-21years were studied. There were 248 (50.5) females and 243(49.5) males. Nocturnal enuresis (NE) was reported in 124(25.3) students; out of which 59(47.6) had primary NE. NE was significantly more in males than in females and in those from polygamous homes(c2=7.29; df = 1; p0.01 and c2 ) students. Non-organic causes of secondary NE include parental separation 12 (9.7); divorce 16 (12.9) and death in the family 4 (3.2). Enuresis affected 75 (60.5) of the students; as well as their parents. Fifty (40.3) students felt embarrassed about bedwetting and in 27 (21.8) students the parents were very angry and had to beat them. Treatment offered included prayers in 44 (35.6) and waking at night in 15 (12.1). Conclusion: Enuresis is a common problem among secondary students in Port Harcourt. Secondary nocturnal enuresis is more prevalent; and stressful to both the sufferer and the parents