Determinants of Timely Initiation of Complementary Feeding among Children Aged 6-24 Months in Sagamu; Nigeria

Background: Poor breastfeeding and complementary feeding practices may contribute to childhood malnutrition in the developing world. Objective: The objective was to examine the determinants of timely initiation of complementary feeding among Nigerian children. Materials and Methods: Using a cross-sectional design; children aged 6-24 months were surveyed in a Nigerian Teaching Hospital. Children with timely initiation of complementary feeding (6-8 months) were compared with children with untimely initiation of complementary feeding early (6 months and 8 months) for clinical and social characteristics using both bivariate and multivariate analysis. Results: Of 156 children; 41; 53.8; and 5.1 had timely; early and delayed initiation of complementary feeding. Complementary feeding was initiated with processed cereals (44.8); locally prepared maize gruel (32.1) and mashed family diet (23.1

Mothers' Knowledge about Birth Asphyxia: The Need to do More!

Background: Health education is an important tool required for reducing the burden of birth asphyxia in the developing world. Objective: The objective of this study was to assess the knowledge of mothers; who received health facility-based antenatal care during their last pregnancy; about birth asphyxia and relate their knowledge to their places of antenatal care. Materials and Methods: A cross-sectional survey of mothers of infants attending the Immunization clinic in a Nigerian Teaching Hospital was done between July and October 2010 using a close-ended questionnaire. Consecutively consenting mothers were enrolled into the study. Results: Out of 354 mothers; 56.5 received counseling about birth asphyxia during antenatal clinic visits in their last pregnancy; 85.5 of attendees of teaching hospital; and 26.4 of attendees of private antenatal clinics received counseling about birth asphyxia. Overall; 38.9 of the respondents had satisfactory knowledge about birth asphyxia; 47.5 of teaching hospital attendees; and 28.1 of private clinic attendees had satisfactory knowledge about birth asphyxia. Lower socioeconomic status; lack of counseling; and nonattendance of teaching hospital antenatal clinic were associated with poor knowledge about birth asphyxia. Conclusion: Most of the mothers surveyed had poor knowledge about the risk factors and sequelae of birth asphyxia. The health system needs to improve health education of expectant mothers about birth asphyxia

Growth Pattern of Schoolchildren in Sagamu, Nigeria Using the CDC Standards and 2007 WHO Standards.

Objective: To compare the median weight, height and body mass index of school children with the 2000 CDC and 2007 WHO reference values. Settings: Schoolchildren in Sagamu, Nigeria. Design: Cross-sectional survey. Methods: Between November and December, 2008, 1690 school children aged 6 to 16 years from 8 primary schools were surveyed using multi-stage sampling methods. The weight, height and body mass index (BMI) were recorded for each child. The Z-scores of the median anthropometric parameters for each age and sex were determined with the LMS statistical method using the values of L, M and S provided on the CDC and WHO charts. Results: The weight, height and BMI Z-scores were less than the reference values provided on the CDC and WHO charts but were generally closer to the WHO standards compared to the CDC standards. The median weight, height and BMI for females generally plotted higher on CDC and WHO chart compared to the males. The prevalence of underweight and stunting were relatively lower while the prevalence of overweight and obesity was relatively higher among children aged 6 to 10 years using the WHO references compared to the CDC reference values. Conclusions: The WHO references would underdiagnose under-nutrition and over-diagnose overweight/ obesity in the population studied.

Neonatal Resuscitation : Knowledge and Practice of Nurses in Western Nigeria

Background. Appropriate resuscitation techniques are crucial to the survival of newborn infants. Objective. To assess knowledge of nurses in western Nigeria about neonatal resuscitation. Method. A cross-sectional survey of the nurses attached to secondary health facilities in western Nigeria was done using a closed-ended questionnaire that tested evaluation and appropriate action aspects of neonatal resuscitation. Results. One hundred and seventy-nine nurses were interviewed. Of these; 72.6had worked in the labour room and the special care baby unit within the last 5 years while only 14.0had attended neonatal resuscitation training course within the last 5 years. Similarly; 31.8; 53.1; 58.1and 35.2had access to radiant warmers; ambu-bags; suction machine and oxygen delivery units; respectively. The knowledge of the respondents was better for evaluation than for appropriate action (95.5v. 49.7). Conclusion. The knowledge of the respondents about appropriate actions to be taken during neonatal resuscitation was poor. Frequent and intensive courses on neonatal resuscitation are highly desired

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.

Comparative Analyses of Childhood Deaths in Sagamu; Nigeria : Implications for the Fourth MDG

Background. The fourth Millennium Development Goal (MDG) aims at reducing childhood deaths in the developing world by 2015. Objective. To examine the pattern of childhood deaths in a Nigerian tertiary hospital which served at least three states of the federation between 1996 and 2015. Method. A retrospective study of paediatric deaths between January 1996 and December 2005. Subjects admitted in the pre- MDG period were compared with those admitted during the MDG period. Results. Of 10 451 paediatric patients admitted; 1 320 (12.6) died but only 1 225 were studied. The male-to-female ratio was 1.4:1. Although the yearly mortality rate ranged from 10.7to 14.9; the overall mortality rate for the pre-MDG period was similar to that for the MDG period (p=0.135). Most deaths (69.1) occurred within 48 hours of hospitalisation. Of the 1 225 patients who died; 57.3were neonates. These neonatal deaths were commonly due to prematurity (34.6); perinatal asphyxia (30.8) and septicaemia (24.8); while severe anaemia was the most common cause of death among infants (20.1) and toddlers (25.1). Severe malaria; severe anaemia; and tetanus formed 33.3of all deaths among children older than 5 years. There was no significant difference in the role of prematurity (p=0.298) and measles (p=0.927) as causes of death before and during the MDG periods. HIV/AIDS (p=0.046) became more common as a result of the HIV pandemic; while severe malaria (p=0.041) became less common as a cause of death during the same period. Conclusion. The childhood mortality rate remained high over the 10-year study period. The deaths were mostly caused by infectious and other preventable conditions. The utilisation of specific target-orientated interventions; such as integrated management of childhood illnesses (IMCI); and primary health care may reduce the number of childhood deaths before 2015

Iatrogenic burns injury complication neonatal resuscitation

A case of iatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury; with surface area coverage of about 4; involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice

Pyogenic meningitis in Ilesa, Nigeria.

This study was conducted in 124 children with meningitis to review the etiology, antimicrobial susceptibility and outcome of disease in a Nigerian tertiary health facility. Of these, 97 (78.27%) were culture positive; in the rest 27(21.8%), diagnosis was based on Gram staining of the CSF. Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus and Escherichia coli were isolated in 33.9%, 33.9%, 5.6%, 2.4%, and 2.4% samples respectively. All the isolates had 100 percent; sensitivity to both ceftriaxone and ciprofloxacin while the sensitivities to penicillin and ampicillin were remarkably low. The mortality was 33/124 (26.6%) while 16/ 91 (17.6%) of the survivors had various neurologic sequelae.

Managing Neonatal Jaundice at the General Practice and Primary Health Care Level: An Overview

Neonatal Jaundice (NNJ) is one of the commonest causes of neonatal morbidity and mortality in the developing world. The physiological form of NNJ occurs in about two thirds of newborns. In addition to this however; are the various pathological forms which apart from being potentially fatal if not well managed; are often very difficult to differentiate from the benign physiological form; except with detailed laboratory investigations. Although the pathological forms of NNJ are ordinarily beyond the facilities usually available to General Practitioners (GPs) in developing countries; it is important that these GPs and the health workers at the primary health care level be well informed about NNJ since they are usually the first set of practitioners to receive babies with this illness. For better case management and reduction of mortality in NNJ; GPs should be able to sort babies with NNJ and manage them according to the severity of the illness. Mothers should be educated against harmful traditional practices which may provoke severe NNJ like the home use of naphthalene-containing balls. Home treatment of NNJ with the various local remedies should also be discouraged since these may not be helpful and may inadvertently cause them to seek medical advice late; with the attendant grave consequences