Prevalence and Determinants of the use of Enema in under-five children in Akwa Ibom State

Background: Use of enema in children across clinical and community settings are associated with risks. This study seeks to determine the prevalence of enema practice in under-five children, substances used as enema and the reasons for enema practice by mothers. Materials and Methods: This was a descriptive cross sectional study among 252 consecutively recruited mothers of under-five children attending immunization/well babies clinics in 2 health centres in Akwa Ibom state using a semi-structured self and interviewer administered questionnaire for data collection. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 17.0 at a level of significance of P<0.05. Results: One hundred and sixty-nine (67.1%) respondents had ever given enema to their children. Mothers (69.2%) administered enema to their children which most often (72.8%) was recommended to them by others. Herbal enema was preferred to chemical and plain water enema. Common reasons for enema administration were in preparation for administration of antimalarial to ensure its effectiveness (60.4%), to relief constipation (49.7%) and abdominal pains (46.7%) and treatment of fevers (41.4%). Predictors of enema practice were age of the child (OR 0.4, 95% CI 0.212-0.765, p=0.005) and ethnic origin of the mothers (OR 9.4,95% CI 4.024-22.104, p<0.001). Conclusion: The practice of enema is common in the study area. Health practitioners should be aware of this practice in the communities, seek for this history during clinical consultation and make concerted effort in educating the mothers and other caregivers against this practice.

Challenges of Case Management of COVID-19 in University of Uyo Teaching Hospital: A One-Year Experience

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) is a global pandemic. Older people and those with poorly controlled co-morbidities have higher risk of mortality. This study was conducted to highlight the clinical features, challenges of management and outcome for the patients we have seen in our centre over the past one year. METHODS: This was a retrospective cross-sectional study involving all patients admitted in the COVID-19 Isolation unit of University of Uyo Teaching Hospital (UUTH) from June, 2020­May, 2021. Clinical and laboratory information were obtained from the patient case notes. Ethical clearance for the conduct of the study was obtained from the Ethics committee, UUTH, Uyo. Data was analysed with STATA version 13. RESULTS: Thirty-three (37.9%) patients were COVID-19 PCR positive. The mean ± SD age of COVID-19 PCR positive patients was 57.3 ± 13.4 years with majority (69.7%) being above 50 years. There was a male preponderance (75%). Eleven (34.4%) patients died while 21(65.6%) were discharged. The highest co-morbidity associated with COVID-19 mortality was diabetes mellitus (7 out of 11; 63.6%). There was a poor uptake of supportive investigations for the management of COVID-19 patients. A raised body temperature (P=0.0006), a low SPO2(0.00004), high respiratory rate (0.0009) on admission and shorter duration of admission (0.0002), were associated with mortality. CONCLUSION: The presence of co-morbidities, fever, low SPO2 and high respiratory rates on admission are associated with increased mortality from COVID-19 disease. A paucity of supportive investigations was a major challenge to COVID-19 management. We therefore recommend the strengthening of our laboratory capacity.