RESUMO
Background: Obesity results mainly from changes in diet and physical activity and currently being regarded as a global epidemic. It comes at a cost, affecting physical, social and psychological health and having deleterious impact on psychological development, academic and social performance of an affected child. The aim is to determine the burden of psychosocial disorders among the overweight and obese children in our environment. Methods: A descriptive cross sectional study carried out among secondary school children aged 10-18 years in Enugu metropolis. Sampling involved stratified and multi-staged methods. The height and weight of selected subjects were measured and their BMI calculated. An adapted, semi-structured, self-administered questionnaire was used. Information sought included socio-demographics and psychometric measurements. Data was analyzed using SPSS version 19. Analytical test of significance was done using Chi square test at p value of ≤ 0.05. Results: Of 200 students studied, 136 (68%) were females and 64 (32%) were males. Most (157) were in the age range of 10-14 years old. Sixty seven were overweight while 133 were obese with most of the children’s parents belonging to the upper socioeconomic class. One hundred and nineteen of them had one emotional and/or social problem of depression, anxiety, low self-esteem, discrimination and stigma, giving a prevalence rate of 59.5%. Thirty five (54.7%) males and 81 (61.8%) females had at least one emotional and/or social problem (χ2 = 0.905, p = 0.342). Between the children aged 10-14 and 15-18 years, 56.1% and 72.1% respectively experienced at least one psychosocial disorder (χ2 = 3.605, p = 0.058). Emotional and social disorders was commoner among the upper class and difference was statistically significant (χ2 = 6.375, p = 0.041). Conclusion: The burden of emotional disorders among overweight and obese children in Enugu metropolis is high. Socioeconomic class is associated with emotional disorders.
RESUMO
Background: Hepatitis B Virus (HBV) co-infection is prevalent among HIV infected individuals because of shared routes and mechanisms of transmission. The multidimensional immunosuppression from HIV infection causes impaired spontaneous recovery from an acute HBV infection; predisposing to chronic infection which is worsened by younger age at infection. Co-infection increases the risk of HBV replication; hepatotoxicity and liver related deaths from Highly Active Antiretroviral Therapy (HAART). The study was undertaken to highlight the burden of co-infection among HIV positive children in Enugu; determine the associated risk factors and compare the effect of co-infection between co-infected and non-co-infected children using liver enzyme and CD4 counts. Materials and Methods: A cross sectional study was carried out among HIV positive children attending the Paediatric ARV clinic of the University of Nigeria Teaching Hospital; Ituku-Ozalla. A total of 140 HIV infected children aged 18 months to 15 years were recruited. An interviewer questionnaire was administered. Hepatitis B surface antigen (HBsAg) was determined using Determine test Kit. Baseline and recent CD4 counts/CD4% were retrieved from the patients' folders. Results: Fourteen (10%) were positive for HBsAg. The highest prevalence of HBsAg was observed among children aged 11- 15 years. The higher the socioeconomic class the less likely the HBsAg positivity. Seven (50%) of the co-infected children had elevated baseline ALT compared with 57 (45.2%) of non-co-infected children though the difference was not statistically significant (t = 0.6; P = 0.56). After the initiation of HAART; 10 (76.9%) of the co-infected and 18 (15.1%) of the non-co-infected children had elevated ALT. The baseline median CD4 count among children = 6 years was 230 cells/mm3 and 360 cells/mm3 respectively among the co-infected and nonco- infected; (P = 0.67). However; in children = 5 years; it was 25% and 15 % respectively (P =0.06). Conclusion: HBV co-infection among HIV infected children is common in our environment; and co-infection is associated with impaired immunity and probably liver enzyme derangement