Dietary habits, physical activity and sleep pattern among in-school adolescents in Lagos, Nigeria

Background: Overnutrition has been documented at epidemic levels in children and adults. The associated risk factors may include poor dietary habits, sedentary behaviour, inadequate sleep and low parental education. Objective: To describe dietary habits, physical activity and sleep patterns among secondary school adolescents. Methods: A cross-sectional study of 1,120 adolescents recruited from public and private secondary schools in Lagos, Nigeria, was carried out to study the dietary habits, sleep patterns and physical activity in relation to nutritional status. Results: Ten per cent of the adolescents skipped breakfast, while 28% had fruits on up to five days of the week. Eleven per cent had a sweetened drink every day, while 20 % had a sweetened drink on most days of the week. One out of four (26%) adolescents had more than two hours of screen time daily, and only 5% engaged in sporting activities up to five times weekly. One-third of the students slept for less than six hours daily and experienced sleeping difficulties. Multivariate analysis showed that females were twice as likely not to participate in sports (OR = 2.38, CI = 1.3-4.37, p = 0.002 and to have a higher intake of confectionaries (OR = 1.47, CI = 1.07-2.04, p = 0.01. Conclusion: Poor dietary habits, inadequate physical activity and insufficient sleep were observed among secondary school adolescents. A multi-pronged approach to improve these behaviours is recommended

Frecuencia de enfermedad cardíaca congénita en niños con Síndrome de Down: ¿cuál es la influencia de la edad materna? / 1 OCCURRENCE OF CONGENITAL HEART DISEASE AMONG CHILDREN WITH DOWN SYNDROME: WHAT IS THE INFLUENCE OF MATERNAL AGE ?

La frecuencia del síndrome de Down es fuertemente dependiente de la edad materna y la incidencia varia según las edades maternas. Esta incidencia puede diferir de un país a otro de acuerdo a los factores sociales y ambientales predominantes en tales países. Este estudio pretende documentar la prevalencia de defectos cardíacos congénitos en pacientes con síndrome de Down, identificar la asociación entre la edad materna y la frecuencia de enfermedades cardíacas congénitas en estos sujetos. Métodos: El estudio fue prospectivo, cruzado-sectorial y consecutivo, involucrando a sujetos de dos centros los cuales eran un hospital terciario hospital vado y un centro cardiológico principal. Los niños con características clínicas de síndrome de Down fueron sometidos a ecocardiografías transtorácicas efectuadas por un cardiólogo. Resultados: Un total de 195 pacientes con síndrome de Down cuyas edades abarcaban entre 1 día a 12 años, fueron estudiados. La edad media + SD fue 241.03 + 529.71 días y la relación masculino a femenino de 1.04.1. El promedio de la edad materna iba desde los 19 a los 44 años con una edad media +SD de 32.36 + 5.43 años . Hasta el 16.9 % tenían un corazón estructuralmente normal. El defecto más común fue el defecto septal aurículoventricular 24.1 % . No hubo una asociación significativa entre la edad materna y la frecuencia de defectos cardíacos congénitos en estos sujetos. Conclusión: La incidencia de enfermedad cardíaca congénita es alta en los sujetos con síndrome de Down. Los defectos aurículoventriculares fueron los defectos cardíacos más comunes en estos sujetos. La incidencia de defectos cardíacos congénitos en los sujetos fue decreciendo de la edad materna de 36 años y por encima. La evaluación cardíaca rutinaria incluyendo la ecocardiografía se recomienda a todos los pacientes con síndrome de Down.

Summary The occurrence of Down syndrome is strongly dependent on maternal age and incidence varies at various maternal ages. This incidence may differ from one country to another according to the social and environmental factors predominant in such countries. The study aims to document the prevalence of congenital heart defects in patients with Down syndrome, identify the association between maternal age and occurrence of congenital heart disease among these subjects. Methods. The study was prospective, cross-sectional and consecutive, involving subjects from two centers which were, a tertiary hospital a private hospital and a major cardiology center. Children with clinical features of Down syndrome had transthoracic echocardiography done by a cardiologist. Results. A total of 195 patients with Down syndrome with their ages between 1 day to 12 years. The mean age + SD were 241.03 + 529.71 days and male to female ratio of 1.04.1. The mother´s age range was from 19 to 44 years with a mean age of + SD of 32.36+ 5.43 years. Up to 16.9 % had structurally normal heart. The most common heart defect was atrioventricular septal defect 24.1 %. There was no significant association between maternal age and occurrence of congenital heart defects in the subjects. Conclusion. The incidence of congenital heart disease is high among subjects with Down syndrome. Atrioventricular defects were the commonest cardiac defect among the subjects. The incidence of congenital heart defect in the subjects was decreasing from maternal age 36 years and above. Routine cardiac evaluation including echocardiography is recommended for all patients with Down syndrome

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

Micturitional Dryness and Attitude of Parents Towards Enuresis in Children Attending Outpatient unit of a Tertiary Hospital in Abeokuta; Southwest Nigeria

Background: There is significant variability of the age at which children achieve dryness. Objectives: We determine the age at achievement of micturational dryness and attitude of parents about enuresis among urban Nigerian children. Method: A total of 346 questionnaires were administered to parents of children between the ages of 12 - 180 months who came for routine paediatric care at the outpatient unit of Federal Medical Centre; Abeokuta. Results: At age 36 months; 86 (51.8) and 34 (20.5) out of 166 children had achieved dryness at daytime and night time respectively. Achievement of dryness was significantly related to low maternal education (p = 0.022) and low social class (p= 0.009). Twenty-four (26.7) children had nocturnal enuresis. Four (4.4) of these children also had diurnal enuresis. All the parents/guardians were aware about enuresis but only 9.8correctly identified it as a health problem. Even though none of the children with enuresis ever visited health facility for their problem; a statistically significant proportion of the parents desire to discuss with health practitioners (p = 0.015). Conclusions: The proportion of children achieving dryness by age 36 months is very small when compared with children from developed parts of the world. There is also a high prevalence of enuresis which are not reported. Therefore; health workers in the tropics should as a routine enquire about enuresis in their daily paediatric care particularly for those children from polygamous homes and high social class

The influence of socioeconomic status on the hemoglobin level and anthropometry of sickle cell anemia patients in steady state at the Lagos University Teaching Hospital

Background: Sickle cell anemia (SCA) has multisystemic manifestations and is associated with severe morbidity and high mortality. It commonly affects growth leading to wasting and stunting. Aims and Objectives: This study aimed to determine the influence of socioeconomic status on the nutritional status using anthropometric measurements and steady-state hemoglobin; of children with homozygous SCA; aged 1 year to 10 years in steady state at the Lagos University Teaching Hospital. Materials and Methods: This is a cross-sectional study involving 100 children with SCA and 100 age-; sex-; and social class-matched controls that fulfilled the inclusion criteria. Social class was assessed using educational attainment and occupation of parents. Hemoglobin concentration was determined using the oxy-hemoglobin method. Results: This study demonstrated a significantly lower mean weight and weight-for-height in the SCA patients than those of controls (P 0.001). By contrast; this study did not demonstrate any statistical significant difference in the mean height and mean body mass index of SCA patients and controls (P 0.1). However; SCA patients had significantly lower values than controls in each of the social classes. Conclusion: Poor socioeconomic status has an adverse effect on the nutritional status and hemoglobin of SCA patients

Do working children have worse academic performance?

OBJECTIVE: To examine the effect of child labor on school children's academic performance. METHODS: Primary school children engaged in child labor were compared with age, sex and school-matched controls for absence from school and scores obtained at sessional examination in English language, Mathematics, Sciences and Social studies. RESULTS: There was no significant difference in the mean rate of school absence (p = 0.80), mean aggregate examination scores (p = 0.1) and proportion of class repeaters (p = 0.16) among working school children and the controls. However, a significantly higher proportion of the controls had high (>75%) average examination scores compared with the working school children (p = 0.017). Similarly, the controls performed better than working school children in each of four core subjects but significant differences were observed only in Social Studies and Science (p = 0.006 and 0.001 respectively). CONCLUSION: There is some undermining of academic performance among children who combine schooling with child labor despite comparable school absence with the controls.

Ultrasonographic measurements of the hepatobiliary axis of children with sickle cell anaemia in steady state

Sickle cell anaemia is associated with structural manifestations in the hepatobiliary axis but these manifestations have not been sufficiently examined in Nigerian or African children. This study wasconducted to evaluate the results of ultrasono-graphic measurements of the hepatobiliary axis of children with sickle cell anaemia in a Nigerian teaching hospital. One hundred and twenty children with Hb SS in steady state aged between 12 months and 15 years and sixty children with Hb AA matched by age and sex (as controls) were consecutively recruited from April through November 2002. Past and present medical histories were obtained and physical examination and abdominal ultrasonography were performed. The mean liver span; the common hepatic duct and common bile duct diameters; the longitudinal and transverse dimensions (but not the wall thickness) of the gallbladder were significantly higher in test subjects than controls (p 0.05). Multiple regression showed that age correlated significantly with all the studied ultrasound scan (USS) measurements (p 0.05). Recurrent episodes of abdominal pain correlated with gallbladder wall thickness (p