Prevalence and Pattern of Mental Illness among School Age Children Seen at the University of Port Harcourt Teaching Hospital: A Six Year Study

Background: A sound mental health in school age children is critical for good academic achievements and a better transition from childhood to adulthood. The increasing prevalence of mental illness in school age children, especially the adolescents, is of great public health concern globally.Aim: The aim of this study therefore was to determine the prevalence and pattern of mental health disorders among school age children seen at the University of Port Harcourt Teaching Hospital (UPTH).Methodology: Consent for the study was obtained from the research ethical committee of the hospital. Medical case notes of all patients aged 5years to 18 years seen in the clinic by Consultant Child and adolescent Psychiatrists from 2015 to 2019 were retrieved and thoroughly reviewed. Data was analyzed using the SPSS version 20 statistical package and results presented using descriptive and analytical methods.Results: Out of 7,856 patients seen in the Neuropsychiatry Clinic within the period under review, 408(5.2%) were children aged between 5 to 18 years. Male was higher with 232(56.9%). The most prevalent mental illnesses were anxiety disorders, 58(14.2%), depressive illnesses 46(11.3%), schizophrenic illness 44(10.8%), mental and behavioural abnormality secondary to substance abuse (MABD) 43 (10.5%), bipolar affective disorders 37(9.1%), while conversion disorders was the least with 3 (0.7%).Conclusion: Mental disorders are common among school age children seen in UPTH and often impair the emotional wellbeing of this population. A detailed and well worked out plan of management is needed to provide optimal mental health services to children and adolescents. Well-coordinated mental health services should be inculcated into the School Health Programme in Nigeria

Awareness and Status of Tetanus Toxoid Vaccination among Female Undergraduate Students in a Nigerian University.

Aims: The study aimed to determine the level of awareness and status of tetanus toxoid (TT) vaccination among female undergraduates in Port Harcourt. Study Design: This was a cross sectional descriptive study carried out among female undergraduate students. Place and Duration of Study: The study was carried out in University of Port Harcourt from 1st to 31st of May 2014. Methodology: A pre-tested questionnaire was administered to 512 female students selected through a Multi-Staged sampling technique. Information sought included socio-demographics awareness of TT vaccine, knowledge of the vaccination campaign for women of childbearing age and TT vaccination status. Data was analyzed using epi info version 7.1.3.3. Results: A total of 512 students participated in the study; mean age was 22±2.79 years. Four hundred and eighty five (94.7%) and 409 (79.9%) students had heard of tetanus and TT vaccine respectively. Commonest sources of information were health workers. 33.8% knew the target population for the TT vaccination campaign and 18.2% knew that the correct number of doses of TT is 5 doses. Two hundred and ninety eight (58.2%) and 10 (2%) students had received at least 1 dose and 5 doses of TT respectively. Students who had knowledge of the target population for TT vaccination campaign (OR=2.14, p=0.003) and those who were confident in the effectiveness of TT (OR=2.41, p<0.001) were twice more likely to receive at least a dose of TT vaccine. Conclusion: There was poor knowledge of TT vaccination campaign for women of childbearing age and very poor coverage of TT5 among the female undergraduate students in Port Harcourt. Female undergraduate students should be reached during TT vaccination campaigns.

Knowledge, Attitude and Practice towards Neonatal Jaundice among Community Health Workers in Southern Nigeria.

Aim: The study aimed to assess the knowledge of community Health Workers (CHWs) on neonatal jaundice (NNJ), exploring their perceptions, knowledge and practices. Study Design: It was a cross sectional study of randomly selected CHWs who were attending a child health workshop in Southern Nigeria. Place and Duration of Study: The study was carried out during a workshop in Yenegoa Local Government Area, Bayelsa State, Nigeria. Methods: Simple structured questionnaires were distributed to all health workers who gave consent to participate in the study. These were retrieved by the authors as soon as they were filled. Information obtained included biodata, length of practice, knowledge of causes, complications and management of NNJ. Results: There were 200 participants, 91 males and 109 females giving a male to female ratio of 1: 1.2. The mean duration of service was 6.01±4.97 years. 191 (95%) had fair to adequate knowledge of description of NNJ. However only about 25% of respondents had good knowledge of its causes. Antibiotics and glucose water were perceived by 60.4% and 37.5% of CHWs as useful drugs in the management of NNJ, while 82% would recommend sunlight as effective treatment. Work experience was significantly associated with knowledge of the use of EBT and phototherapy in the treatment of NNJ with those less than 5 years having better knowledge than the older ones. Conclusion: CHWs may recognize NNJ but knowledge on causes and treatment is inadequate and may cause potential delays in referral for effective treatment. There is need for regular training and re-training of health workers to ensure effective management and reduce the complications of NNJ.

Insecticide-treated bednet ownership and utilization in Rivers State, Nigeria before a state-wide net distribution campaign.

Background & objectives: Malaria presents a huge health and economic burden to families living in malaria endemic areas. The use of insecticide-treated nets (ITNs) is one of the global strategies in decreasing the malaria burden on vulnerable populations. The use of ITNs reduces clinical malaria by over 50% and all cause mortality in children by 15–30% when the overall population coverage is >70%. This study was aimed at establishing the level of household insecticide-treated bednet ownership and utilization in Rivers State, Nigeria before a statewide scale-up distribution campaign. Study design: A descriptive, cross-sectional study was carried out in the Rivers State in November 2008 among household heads or their proxies to serve as a pre-intervention baseline for the scale-up distribution of insecticide treated bednets in the state. The households were selected by a multi-staged sampling technique: first stage being the selection of Local Government Areas (LGAs) from Senatorial districts, second stage the selection of communities from LGAs and final stage the selection of households. Data were collected using a questionnaire adapted from the WHO/FMoH and analyzed using the Epi-Info version 6.04d statistical software package. Hypothesis tests were conducted to compare summary statistics at 95% significance level. Results: A total of 811 household heads or their proxies were interviewed. Their age ranged between 20 and 70 yr, with a mean of 47.96 ± 4.39 yr. The study showed that although 552 (68.1%) of the households owned bednets, only 245 (30.2%, 95% CI=27.1–33.5) of them owned long-lasting insecticidal nets (LLINs). Similarly, only 37.2% of those who owned ITNs slept under them the night preceding the survey. Conclusion: Household ITN ownership and utilization were low in the state. Incorporating behavour change communication package as part of the ITN distribution intervention is advocated to increase ITNs utilization in the state.

Parents' Perception on Use of Insecticide-Treated Bed Net in Port Harcourt

Background: Insecticide treated bed nets (ITN) are protective against malaria; but they are poorly utilized. The utilization of the nets; especially by the under fives; will depend on their caregivers' awareness of the net and their perception of its usefulness. The study therefore aims to evaluate awareness and utilization of ITN . Methods: This was a descriptive hospital-based study. It involved the distribution of 15-itemed questionnaires to 212 parents (with at least one under five aged child); who brought their children to the Paediatrics outpatient clinic of University of Port Harcourt Teaching Hospital. Questions asked covered: the awareness of ITN; the number of ITN owned by each participant and the number of under fives who slept under ITN the night preceding the interview. Results: A total of 212 parents participated in this study. Male to female ratio was 1:4. One hundred and eighty nine (89.2) participants had heard of ITN. The two most common advantages opined by the participants were that it prevents malaria (42.0) and mosquito bite (38.2). The commonest identified side effects was that it causes heat (45.8) and 113(53.3) participants owned at least one ITN. Only 45 (21.2) participants said their under fives slept under ITN on the night preceding the interview. Conclusion: There is a fair awareness of the use of ITNs for malaria control; however there is poor utilization of the nets by the under five aged children in Port Harcourt

Evaluation of Health Knowledge of Teachers in Public Primary Schools in Bonny Local Government Area of Rivers State

Background: The noncompulsory nature of health education as a subject in some teacher training colleges and the generalists' position of teachers in primary schools raise concern over the teachers' health knowledge and the accuracy of health information that pupils are given. Aim: The study was undertaken to evaluate the health knowledge of primary school teachers and to assess the effect of short term training on their health knowledge. Methods: This was a school-based intervention study carried out in June 2006. Health knowledge of all teachers from the 20 public primary schools in Bonny Local Government Area of Rivers State was assessed before and after a workshop on school health using a health knowledge assessment test. Scores of 50and more were regarded as pass. Data was analyzed using SPSS version 11 software. Test for statistical significance was done using Chi-square test and student t-test. P value less than 0.05 was regarded as statistically significant. Results: Twenty nine of the 100 participants (29) passed the pre-test. These were holders of University degrees [13 (56.5)]; National Certificate of Education [13 (28.3)] and Teachers' Grade II Certificate (TCII) [3(10)]. Post workshop; health knowledge improved across board as all the teachers passed (p=0.000). Conclusion: The health knowledge of school teachers from public primary schools in Bonny local government area is low. This was worse among those with lower academic qualifications (TCII and below). However this improved following a short term training workshop

Risk factors for atopic dermatitis in southern Puerto Rico

BACKGROUND: Little is known about the risk factors and exposures to aeroallergens in subjects with atopic dermatitis (AD) in Southern Puerto Rico. The objective was to determine the prevalence of skin reactions to aeroallergens and to analyze self-reported risk factors in AD patients and a nonallergic control population. METHODS: A cross-sectional study was conducted which included 726 AD patients and 313 nonallergic control subjects. Skin tests were conducted and a questionnaire was self-applied to all participants. RESULTS: Seventy six percent of the AD patients showed at least one positive skin reactions to aeroallergens. Of these, half had positive skin reactions to dust mites, and one third to Periplaneta americana. A low prevalence of positive skin reactions to dog, cat, plant and fungal allergens was detected. Co-sensitivitity between mites and cockroaches was 30%. The maximum skin reactivity to mites was at 10-19 years of age declining thereafter while skin reactivity to dogs, and plants increased with age. No significant differences in the prevalence of skin reactions was observed between the male and female AD population. CONCLUSIONS. Of the aeroallergens tested, those derived from dust mites are the most frequent sensitizing agents in the AD patients. Data also showed that the mites B. tropicalis and E. maynei are also important sources of sensitization. Our study show that young patients specially those between the age of 10-19 age group are the most allergic. Being female, or having an asthmatic father are significant risk factors associated with allergen sensitivity in the AD population.

Immunoblot analysis and comparative IgE responses of atopic patients to extracts of the domestic mite Blomia tropicalis

BACKGROUND: The domestic mite Blomia tropicalis is found in subtropical and tropical environments, and its clinical importance as a sensitizing agent in allergic disease is widely accepted. OBJECTIVE: To investigate the IgE reactivity to allergens present in extracts of the domestic mite B. tropicalis, and compare the IgE responses to these allergens by asthmatics, patients with atopic dermatitis and allergic rhinitis, as well as nonatopic controls. METHODS: Extracts from B. tropicalis were used for skin tests. The B. tropicalis specific IgE in the serum were measured using the FAST Plus Test and immunoblot analysis. RESULTS: A total of 199 volunteers participated in the study. The data show that 18 out of 29 polypeptide bands present in extracts of this mite species were recognized by the allergic and control sera. Of these allergens, four showed a high IgE binding frequency and had relative molecular weights of 104, 80, 68 and 14 kDa. The 14 kDa allergen demonstrated the highest IgE binding frequency. CONCLUSION: Sera from atopic patients reacted to more allergens than sera from patients controls. Extracts from pure bodies of B. tropicalis contain one immunodominant and three important allergens. A common characteristic between all of the sera tested was the high degree of serum IgE reactivity observed to the 14 kDa allergen.