Evaluation of adolescent medicine sub-specialty training in Nigeria: trainees' perspectives

Objective: To evaluate the extent of coverage of curriculum contents pertinent to Adolescent Medicine; as well as the adequacy of facilities and professionals in Nigeria using residents' viewpoint. Design: A descriptive cross-sectional study. Setting: The Intensive Course in Paediatrics of the National Post-graduate Medical College of Nigeria at the University of Benin Teaching Hospital; Benin City Nigeria. Subjects: One hundred and three paediatric residents from training institutions in all zones of the country. Results: Altogether;68.0% and 32.0% of the participants were from Southern and Northern geopolitical zones respectively. Only 14% of them stated that a rotation in an AM unit is a part of training in their centres. None specified its duration. Coverage of AM topics; physical facilities and trainers were rated as inadequate by 77.0%; 82.8% and 70.8% of the respondents respectively. Residents from north were more likely to rate interview/ confidentiality in AM as covered (either partly or well) than their colleagues from the South; (p 0.01; OR= 5.3, 95% CI = 1.5-19.5). We found no difference between federal and state residents' perceived adequacy of AM training. Conclusion: AM in paediatric residency programme in Nigeria is still an unmet challenge. There is a need for a revision of the training curriculum to specify mandatory duration of clinical rotation in AM units

Association of malarial parasitaemia with dehydrating diarrhoea in Nigerian children.

Records of 402 children--216 (53.7%) males and 186 (46.3%) females--aged 1-36 month(s), admitted to the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital, Benin city, Nigeria, during July 1993-June 1996, were reviewed to document the relationship between dehydration and malaria parasitaemia. There was a significant association between severity of dehydration and malaria parasitaemia (p < 0.0001). Association of parasitaemia (p < 0.006) with dehydration (p < 0.0001) was significantly more marked in patients with acute watery diarrhoea than in those with persistent and bloody diarrhoea. Parasitaemia was demonstrated in 50.5% of those not initially suspected to have malaria. Parasitaemia was also significantly associated with fever (p < 0.001) and fever coexisting with vomiting (p < 0.01). The prevalence of malaria-associated diarrhoea was 61.7%. More infants (75.6%) than older children had diarrhoea. It was concluded that the prevalence of malaria-associated diarrhoea was high and that children with dehydration are more likely to manifest malaria parasitaemia.