Perception and knowledge of mothers on causes and treatment of rickets associated knee deformity in Ile-Ife, Osun State, Nigeria

This descriptive cross-sectional community-based study was carried out in Ile-Ife; Nigeria to assess the knowledge of mother's on the aetiology of rickets associated knee deformities and the cultural perception of its treatment. Data collection was done using interviewer based semi structured questionnaires. A total of 464 questionnaires were administered with a response rate of 86.9. Over half (59.8; N=241) and 36.5(147) of the mothers were aware of children with knee deformity and rickets; respectively. Ninety-one (22.6) mothers had the correct knowledge and perception of the true meaning of rickets. Rickets associated knee deformity aetiology was wrongly perceived to be mainly hereditary (53.8); cancer (50.9) and bone infection (48.1). Very low proportions of mothers had correct knowledge on the causes of rickets such as inadequate exposure to sunshine (21.3) or inadequate intake of calcium (21.1). The knowledge of aetiology of rickets was influenced by education (P0.02); skilled occupation (P0.0001) and the previous birth of a child with knee deformity from rickets (P0.001). The mother's cultural perceptions of treatment for childhood rickets associated knee deformities was significantly affected by age (P0.001); education; (P0.001); skilled occupation (P0.000); history of knee deformity (P0.04) and mothers with children diagnosed to have knee deformity (P0.004). Lack of finance; poor compliance to treatment; too long treatment periods; lack of information on where to seek for treatment and unaffordable treatment were among the important factors affecting completeness of treatment of knee deformity due to rickets. In conclusion; the awareness of mothers about rickets in Nigeria is still very low. It is a major reason for late presentation or complete failure to seek for adequate treatment of the knee deformity due to rickets. Increase and sustain public health enlightenment programmes are necessary for prevention. Health policy should incorporate free surgical fees for the established knee deformity to encourage community participation in the management of the condition

Factors Infuencing the Outcome of Elective Paediatric Orthopaedic Operations in Ile-Ife; Nigeria

There is a paucity of published data on the types of paediatric orthopaedic conditions that require surgery and factors infl uencing their outcome in most parts of Sub-Saharan Africa. This is a necessary audit to improve paediatric orthopaedic practice. We carried out an audit of all elective orthopaedic operations performed in children at Awolowo University Teaching Hospitals Complex in Ile-Ife, Nigeria from January 2000 through December 2005. The aim was to document the clinical outcomes and the factors that infl uence them. This is with a view to instituting necessary measures to improve paediatric orthopaedic practice in the area. A total of 146 children who had elective operations on 210 limbs were included in the study. Their mean age was 75.6±66.8 months (range 0.3-396 months). The commonest indications for surgery were angular knee deformities (from Blount/'s disease and rickets) and club foot. The mean hospital stay before surgery was 12±8.8 days (range 1-38days). The mean duration of operation was 78.4±36min. (range 30-195 min). The total length of hospitalization was 34.97±19.91 days in males and 41.97±25.15 days in females. Wound infection was the commonest postoperative complication (8.2%). The patient/'s age (P=0.002), indication for surgery (P=0.008), length of preoperative hospital stay (P=0.048), length of operation (P<0.001) and intraoperative blood loss above 200ml (P<0.001) were found to be statistically signifi cant factors adversely affecting the surgical wound outcome. We conclude that most of the factors that predicted poor outcome in this study were patient and environment-related and are preventable. There is need to upgrade facilities in health institutions in Nigeria

Predictive factors for birth trauma in southwestern Nigeria

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors predisposing to birth trauma. A total of 137 neonatal hospital admissions with birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma