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.

Hypoglycaemia in Children Aged 1 Month to 10 Years Admitted to the Children's Emergency Centre of Lagos University Teaching Hospital; Nigeria

Background. Hypoglycaemia occurs in many disease states common in the tropics; and may also complicate treatment of malaria. It may contribute significantly to morbidity and mortality. Objectives. To determine the prevalence of and clinical conditions associated with hypoglycaemia. Methods. A total of 430 patients aged 1 month to 10 years were recruited consecutively from the Children's Emergency Centre of Lagos University Teaching Hospital. Clinical and demographic data were entered into a predesigned study proforma. Blood glucose was determined in the laboratory using the glucose oxidase method. Hypoglycaemia was defined as plasma glucose 2.5 mmol/L. Results. The median age of the study subjects was 24 months; with a range of 1.5 - 120 months. A total of 248 patients (57.6) were 24 months old. The mean (standard deviation) blood glucose of all the study subjects was 5.19 (2.05) mmol/L (median 4.9 mmol/L). Twenty-four patients (5.6) were hypoglycaemic. The predominant disease conditions in which hypoglycaemia occurred were severe malaria; multisystemic infections; marasmus; malignancies and gastroenteritis. Mortality was higher in hypoglycaemic patients than in those without hypoglycaemia (33.3 v. 5.4; p0.01). Conclusion. Hypoglycaemia complicates many common childhood illnesses seen in the emergency room and is associated with significant mortality. Hypoglycaemia should be suspected in severely ill children with severe malaria; multisystemic infections; marasmus; malignancies and gastroenteritis

Adherence to Antiretroviral Therapy among HIV-Infected Children Attending a Donor-Funded Clinic at a Tertiary Hospital in Nigeria

Despite their high levels of knowledge about HIV and AIDS; young people ages 15-24 years in South Africa remain disproportionately affected by the epidemic. Young people's continued susceptibility to HIV infection has been consistently linked to intractable higher-risk sexual behaviours. This paper uses multivariate techniques and secondary data from two nationally representative surveys to illuminate individual and socio-structural factors that play a significant role in youths' continued engagement in higher-risk behaviour; despite their high awareness about HIV and AIDS. The findings show that notwithstanding progress in terms of increased condom use and reduced incidence of other sexually transmitted infections; the average age of sexual debut remains low; multiple sexual partnerships are prevalent; and inconsistent condom use is widespread among young people. Factors significantly associated with these risk behaviours occur at the individual and structural levels and include issues of race; gender; poverty and susceptibility to peer pressure. The paper concludes by recommending that future HIV-prevention interventions in South Africa should aim at building resilience among youths by promoting affirmative; supportive interventions that emphasize the potentials of young people