RESUMO
Background: Several clinical manifestations of sickle cell anaemia (SCA) have been associated with zinc deficiency. Determining the zinc status of children with SCA in Nigeria, a country that accounts for the highest burden of the disease worldwide, will provide a template that could assist in critically appraising the need or otherwise for zinc supplementation or fortification programmes in these children. Methods: This was a cross-sectional comparative study conducted at the Jos University Teaching Hospital, Jos, Nigeria among 700 children (350 SCA patients and 350 age and sex matched hemoglobin AA controls). Serum zinc was analysed using the atomic absorption spectrophotometry. Results: The median serum zinc concentration of children with SCA was 6(3-7) µmol/l and it was significantly lower than that of the controls 8(4-9) µmol/l, p = 0.04. The prevalence of zinc deficiency in this study was 67% in children with SCA compared with 34% in the control group, (p<0.0001). The proportion of zinc deficient patients was more among children from lower socio economic class (68.5%, 35.5%) than in the upper socio economic class (38.5%, 16.3%) in both cases and controls groups respectively. Conclusion: There is a high prevalence of zinc deficiency in the study population especially among those with sickle cell anaemia. Zinc supplementation or fortification should be considered as part of intervention strategies to improve the zinc status of these children particularly those with sickle cell anaemia
Assuntos
Anemia Falciforme , Criança , Nigéria , ZincoRESUMO
Background: There are over 143 million orphans globally, however, sub-Saharan Africa/Asian regions account for over 80% of the global burden (143 million orphans), Nigeria inclusive with over 10 million orphans. This has caused a crisis of shelter, as more children drift towards institutional care rather than staying in communities that are laden with a high prevalence of poverty (70% in Nigeria). This development is not the best practice in the care of Orphans and vulnerable children (OVC) based on national policy of OVC care which recommends Household rather than institutional care. Since studies have shown that Institutional care has a negative impact on a child, the place of placement is thus crucial to the outcome of vulnerable children (VC) which can easily be assessed by measuring the Quality of life (QOL). The aim of this study is to compare the QOL of VC living in Household against those living in Institutions. Methods: A cross-sectional comparative study involving 202 VC (aged 6-18 years) was conducted. VC were sampled using the multistage sampling technique across two orphanages and three communities located in suburban areas in Jos East, Jos North and Jos South Local Government Area. Outcome Measure: Quality of Life was determined using the WHOQOL BY (brief for youth) tool after validity and reliability test was done. The total score was transformed into a score of 1-100, with higher score implying higher QOL. Data generated were processed and analyzed using the EPI info version 3.5.1 statistical software. A score < -1 standard deviation (SD) from mean was considered poor, ±1 SD to -1 SD was considered fair and > ±1 SD was considered good. The student t-test was used for comparison of means while chi-square test or fisher exact test was used for comparison of categorical variables. In all statistical tests a p values ≤ 0.05 was considered significant. Results: The QOL score for the study population ranged between 47.2 to 95.2, the mean QOL was 75.2±8.1. The median and mode were both equal (QOL score of 75.2). Comparatively, IVC had higher mean QOL score of 76.9±7.0 compared to HVC 73.3±8.9 (p=0.002). IVC had higher scores compared to HVC in the following domain: psychological (p=0.05), social (p=0.004) and environmental (p=0.002). Conclusion: The QOL of VC in Institution is better than children in suburban Households in Jos Nigeria. IVC are better psychosocially and environmentally. However, a Qualitative study is needed for more depth.