ABSTRACT
Background: Several clinical manifestations of sickle cell anaemia (SCA) have been associated with zinc deficiency. Determining the zinc status of children with SCA in Nigeria, a country that accounts for the highest burden of the disease worldwide, will provide a template that could assist in critically appraising the need or otherwise for zinc supplementation or fortification programmes in these children. Methods: This was a cross-sectional comparative study conducted at the Jos University Teaching Hospital, Jos, Nigeria among 700 children (350 SCA patients and 350 age and sex matched hemoglobin AA controls). Serum zinc was analysed using the atomic absorption spectrophotometry. Results: The median serum zinc concentration of children with SCA was 6(3-7) µmol/l and it was significantly lower than that of the controls 8(4-9) µmol/l, p = 0.04. The prevalence of zinc deficiency in this study was 67% in children with SCA compared with 34% in the control group, (p<0.0001). The proportion of zinc deficient patients was more among children from lower socio economic class (68.5%, 35.5%) than in the upper socio economic class (38.5%, 16.3%) in both cases and controls groups respectively. Conclusion: There is a high prevalence of zinc deficiency in the study population especially among those with sickle cell anaemia. Zinc supplementation or fortification should be considered as part of intervention strategies to improve the zinc status of these children particularly those with sickle cell anaemia
Subject(s)
Anemia, Sickle Cell , Child , Nigeria , ZincABSTRACT
Background: Induction of labour (IOL) is a common procedure that remains a relevant Obstetric procedure. The maternal and perinatal outcomes are paramount hence the need to review the intervention in order to implement needed change. Objectives: To determine incidence, indications, outcome and complications of induction of labour at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Methods: This was a retrospective study reviewing 584 women who had IOL in JUTH from January 2004 to December 2007. Parameters selected for review include parity, gestation age, outcome and cervical state prior to IOL. Results: Four hundred and eighty women had vaginal deliveries (82.2%). There were fifty two induced on account of antepartum Intra Uterine Foetal Deaths (IUFD), while 1.5% of the deliveries ended up as still births, 10.5% had birth asphyxia and neonatology review and care. Thirty two patients had various complications after IOL. There were no maternal mortalities. Conclusion: Parity and presence of IUFD were found to influence the outcome of IOL.
ABSTRACT
Background: Even though there has been some decline in childhood mortality, figures still remain high in sub- Saharan Africa. The pattern of morbidity and mortality in health care institutions may be a reflection of the disease burden of the community which it serves and will facilitate prevention/ control strategies. This study was conducted to determine the pattern of paediatric morbidity and mortality in a secondary level hospital in a sub – urban area in Jos, North – central Nigeria. Materials and Methods: This retrospective study is a review of paediatric admissions into the Vom Christian Hospital. Relevant data on all children who were admitted into the Vom Christian Hospital between May 2012 and April 2013 with medical conditions were retrieved from the admissions records. Data were entered into excel spread sheet and analyzed using Epi info 7. A p< 0.05 was considered statistically significant. Results: A total of 334 children aged between one day and 15 years were admitted during the period, out of which 235 (70.4%) were children less than 5 years old. Infections (221, 66.2%) were the major causes of morbidity. Out of all the 334 admissions, 304(91%) were discharged, 7 (2.1%) left against medical advice, 6(1.8%) were referred, while 17 (5.1%) died. Malaria was the commonest cause of morbidity (102, 30.5%) and mortality (6, 35.3%). Severe protein energy malnutrition had the highest case fatality rate (25%). Conclusion: The burden of paediatric morbidity and mortality is in children under 5 years and are mainly preventable. An emphasis on malaria eradication and child survival strategies will help to reduce childhood morbidity and mortality.
ABSTRACT
Background: Nonadherence to antiretroviral therapy (ART) may encourage the development of resistance to antiretroviral drugs (ARVs). Poor adherence is known to be associated with ART failure which could compromise the benefits of ART in children. Therefore; it is important to identify the reasons why children on ART may fail to take their ARVs. In this study; we described the characteristics of human immunodeficiency virus-1 (HIV-1) infected children with ART nonadherence as well as the reasons for their nonadherence. Methodology: A retrospective cohort study in which data on 580 HIV-1 infected children enrolled on ART between February 2006 and December 2010 at the pediatric HIV clinic of the Jos University Teaching Hospital; Jos; was analyzed. Subjects were aged 2 months to 15 years. Information on adherence was obtained by child or caregiver self-report. They also had repeated adherence counseling during each clinic follow-up visit and were taught the use of alarm clocks daily for reminding them of when the next ARV dose will be due. Results: There were 30 (5.2) children with non-adherence to ART. Among children with nonadherence; majority were: Children aged 1-10 years (76.7); males (53.3) and did not know their diagnosis of HIV (90.9). The odds of nonadherence was two times higher among children who failed first-line ART compared with those who did not (odds ratio [95 confidence interval]; 2.28 [1.03-5.02]; P = 0.04). The most common reason for nonadherence was: Forgot to take medications (46.7). Conclusion: The low rate of nonadherence to ART in this study could be attributed to repeated adherence counseling during each clinic follow-up visit and the use of alarm clocks daily for reminders on when the next ARV dose will be due