Management of community acquired pneumonia (CAP) in children: Clinical practice guidelines by the Paediatric Association of Nigeria (PAN

The Paediatric Association of Nigeria first published management guideline for community-acquired pneumonia in 2015 and covered available evidence at that time. This update represents a review of available recent evidence statements regarding the management of pneumonia in children, while at the same time incorporating relevant materials from the first edition of the guideline. The guideline is developed to assist clinicians in the care of children with CAP. The recommendations provided in this guideline may not be the only approach to management, since there are considerable variations among children in the clinical course of CAP.The goal of this guideline is to reduce morbidity and mortality rate of CAP in children by providing recommendations that may be relevant in assisting clinicians to make timely diagnosis and institute appropriate antibiotic therapy of children with CAP. Summarized below are recommendations made in the new 2021 CAP guideline. As part of the recommendations, the quality of the evidence is provided and the grade of the recommendation indicated.The details of the background, methods and evidence summaries that support each of these recommendations can be found in the full text of the guideline.

Impact of COVID-19 pandemic on immunization services in Nigeria; A preliminary report by Paediatric Association of Nigeria (PAN)

Background: Since the onset of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic also known as Coronavirus disease 2019 (COVID-19) beginning in Wuhan, China in December 2019 and spreading to Nigeria in February 2020 (as well as the rest of the world), there have been enormous resultant impact on health, social, emotional and economic aspects lives and services. The disease as well as its mitigation measures have negatively affected other aspects of lives and health services. This paper aims to assess the preliminary effects on immunization services, blow the whistle and suggest measures to limit these effects. Methods: Data was obtained by interviews and use of a structured proforma from Immunization Field Experts/Consultants working with national and international agencies in four states, heads of immunization units, officers in charge of immunization centres and facility immunization records from seven sites across Nigeria. Results: There were disrupted immunization services with total absence of outreach services and campaigns, limited fixed sessions, disease outbreaks, general drop in number of immunized children. These were thought to be due to the lockdown effects, fears, rumours and panic among others. Outright routine vaccines amongst rejections were also reported. Conclusion: Reports suggest that the pandemic and its mitigation measures are affecting immunization services in terms of demand/ access (physical and economic), services and logistics with overall drop in coverage and rise in dropout rates. The effects are still unfolding. It does not appear that health facilities are monitoring and interrogating their data with a view to making specific response action plans. All stakeholders in immunization (Government, non- governmental and professional organizations, the media, traditional / religious institutions) should work to flood the mainstream / social media with positive messages on immunization; monitor immunization progress by ongoing data collection, collation, analysis, interpretation and action; actively counter rumours and anti- vaccine messages and plan for post COVID 19 intensification/ catch- up

Seroprevalence of Hepatitis B Surface Antigenaemia in Children in a Tertiary Health Institution in the Niger Delta of Nigeria

BACKGROUND: There is paucity of data on the seroprevalence of HBV infection in children living in urban areas of the Niger Delta of Nigeria. The aim of this study is to determine the seroprevalence of hepatitis B surface antigenaemia among children presenting to the University of Port Harcourt Teaching Hospital (UPTH), to determine the trend in the seroprevalence of HBsAg over a five-year period and to correlate serological findings to clinical features. METHODS: Serum samples from 251 consecutively recruited children in UPTH aged =16 years were tested for Hepatitis B surface antigen using Clinotech HBsAg kits and confirmed using the Trinity Biotec enzyme linked immunosorbent assay based HBsAg kits. Medical records of the children were also obtained. RESULTS: The overall prevalence of HBsAg among children tested was 12.4%. HBsAg prevalence was highest in the 11-15 years age group (24.5%) and the lowest in the 6-10 years age group (11.0%). There was a statistically significant difference in the prevalence of HB V positivity based on age groups (?2, = 8.47, p = 0.014). Prevalence rate was relatively higher among males (13.7%) compared to females (10.7%). There is a statistically significant trend in the decline of HBsAg prevalence 1999 to 2004 (?2, for trend = 11.38, p = 0.001). The predominant symptoms among children positive for HBsAg were hepatosplenomegaly (75%) and jaundice (64.5%). CONCLUSION: This study indicates a high prevalence of HBsAg among children presenting to a tertiary health facility in Port Harcourt