Severe acute malnutrition in a population of hospitalized under-five nigerian children.

AIMS AND OBJECTIVES: This study was to determine the prevalence and socio- clinical factors associated with severe acute malnutrition (SAM) among hospitalized under-five children. PATIENTS AND METHOD: A cross-sectional survey of children aged less than 59 months was carried out at the Children's Ward of the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria using the 2006 WHO criteria for SAM. RESULTS: A total of 208 children were studied. Overall, 64.9% had normal nutrition while 18.3% had SAM. Of the 38 children with SAM, 68.4% were hospitalised primarily for severe protein-energy malnutrition using the Wellcome classification. Low maternal education (84.2% vs 65.2%; p = 0.025), non-exclusive breastfeeding (84.2% vs 61.5%; p = 0.009), untimely commencement of weaning (77.8% vs 47.1%; p = 0.006), cessation of breastfeeding before the age of 12 months (45.5% vs 0.0%; p < 0.0001) and presence of infections (84.2% vs 58.5%; p = 0.004) were associated with SAM. Multivariate analysis identified presence of infections (OR = 4.9; p = 0.002), non- exclusive breastfeeding (OR = 1.1; p = 0.048) and low maternal education (OR = 2.1; p = 0.02) as strong determinants of SAM. CONCLUSION: The prevalence of SAM among hospitalized Under-Fives was high. This justifies the routine use of the WHO diagnostic criteria at the community level for early detection of at-risk children.

Prevalence of prediabetes in secondary school students in Port Harcourt, Nigeria

This study aimed to assess the prevalence of prediabetes using impaired fasting glucose (IFG) in secondary school students aged 10 to 19 years in Port Harcourt; Nigeria; and to determine associated risk factors. Fasting blood glucose (FBG); blood pressure (BP); and body mass index (BMI) was measured. All students who had a FBG of 5.6 - 6.9mmol/l were asked to undergo an oral glucose tolerance test (OGTT). A total of 880 students were studied. The prevalence of IFG using the International Society for Paediatric and Adolescent Diabetes (ISPAD) criteria was 17% and prevalence was comparatively higher in subjects who were obese; had systolic prehypertension or diastolic hypertension; as well as a family history of diabetes. There was; however; no statistical association between the BMI percentile categories; BP category; sex and age category; or family history of diabetes and occurrence of IFG. The prevalence of IFG was 4% using the World Health Organization (WHO) criteria. Only one child had diabetes. Sixty-six (42%) students who had IFG had an OGTT; of which 10(15%) had IGT. We conclude that prediabetes is common in this population; and screening should be considered; at least in those with obesity or a family history in diabetes

Determinants of Timely Initiation of Complementary Feeding among Children Aged 6-24 Months in Sagamu; Nigeria

Background: Poor breastfeeding and complementary feeding practices may contribute to childhood malnutrition in the developing world. Objective: The objective was to examine the determinants of timely initiation of complementary feeding among Nigerian children. Materials and Methods: Using a cross-sectional design; children aged 6-24 months were surveyed in a Nigerian Teaching Hospital. Children with timely initiation of complementary feeding (6-8 months) were compared with children with untimely initiation of complementary feeding early (6 months and 8 months) for clinical and social characteristics using both bivariate and multivariate analysis. Results: Of 156 children; 41; 53.8; and 5.1 had timely; early and delayed initiation of complementary feeding. Complementary feeding was initiated with processed cereals (44.8); locally prepared maize gruel (32.1) and mashed family diet (23.1

Determinants of timely initiation of complementary feeding among children aged 6-24 months in Sagamu, Nigeria.

BACKGROUND: Poor breastfeeding and complementary feeding practices may contribute to childhood malnutrition in the developing world. OBJECTIVE: The objective was to examine the determinants of timely initiation of complementary feeding among Nigerian children. MATERIALS AND METHODS: Using a cross-sectional design, children aged 6-24 months were surveyed in a Nigerian Teaching Hospital. Children with timely initiation of complementary feeding (6-8 months) were compared with children with untimely initiation of complementary feeding early (<6 months and >8 months) for clinical and social characteristics using both bivariate and multivariate analysis. RESULTS: Of 156 children, 41%, 53.8%, and 5.1% had timely, early and delayed initiation of complementary feeding. Complementary feeding was initiated with processed cereals (44.8%), locally prepared maize gruel (32.1%) and mashed family diet (23.1%). Bivariate analysis showed significant association between timely initiation of complementary and orthodox maternity care, no prelacteal feeding, exclusive breastfeeding, no siblings and first birth order. Parental education was not associated with timely initiation of complementary feeding. Multivariate analysis identified orthodox maternity care, exclusive breastfeeding and no siblings as independent predictors of timely initiation of complementary feeding. CONCLUSION: Complementary feeding is most frequently initiated earlier than 6 months in this population. Good breastfeeding practices may influence timely initiation of complementary feeding. Interventions should be targeted at the entire population irrespective of educational and socioeconomic status.

Growth in prepubertal Nigerian children is highly dependent on socio-economic status.

AIM: To relate height, weight and body mass index (BMI) of prepubertal children in Sagamu, Nigeria, to parental socio-economic class (SEC). METHODS: Cross-sectional study of 1606 children aged 5-11 years from eight public and eight private primary schools. Height, weight and BMI from 1557 prepubertal children were standardized using two references: US-CDC birth cohorts 1929-1974 and Swedish birth cohort 1974. RESULTS: Children in private schools were taller and heavier than those in public schools (p < 0.0001). Most children (73.2%) belonged to lower SEC, 17.6% to middle and 9.2% to upper. HeightSDS , weightSDS and BMISDS increased with increasing parental SEC. Upper SEC children were taller and heavier with higher BMIs than those from lower SEC (p < 0.0001). HeightSDS , weightSDS and BMISDS were below '0' in all SEC and gender groups (all p < 0.002). Younger children were taller and heavier than the older (p < 0.0001). CONCLUSION: Fathers/mothers with higher education/occupation had taller and heavier children with higher BMI than other groups. Children in private schools were taller and heavier than children in public schools. Disparities in parental SEC still constrain optimal child growth in Nigeria: whereas height and weight of children of upper SEC were close to the US-CDC29-74 reference mean, they were still below Swedish74 reference mean representing more optimal growth.

Neonatal Resuscitation : Knowledge and Practice of Nurses in Western Nigeria

Background. Appropriate resuscitation techniques are crucial to the survival of newborn infants. Objective. To assess knowledge of nurses in western Nigeria about neonatal resuscitation. Method. A cross-sectional survey of the nurses attached to secondary health facilities in western Nigeria was done using a closed-ended questionnaire that tested evaluation and appropriate action aspects of neonatal resuscitation. Results. One hundred and seventy-nine nurses were interviewed. Of these; 72.6had worked in the labour room and the special care baby unit within the last 5 years while only 14.0had attended neonatal resuscitation training course within the last 5 years. Similarly; 31.8; 53.1; 58.1and 35.2had access to radiant warmers; ambu-bags; suction machine and oxygen delivery units; respectively. The knowledge of the respondents was better for evaluation than for appropriate action (95.5v. 49.7). Conclusion. The knowledge of the respondents about appropriate actions to be taken during neonatal resuscitation was poor. Frequent and intensive courses on neonatal resuscitation are highly desired

Comparative Analyses of Childhood Deaths in Sagamu; Nigeria : Implications for the Fourth MDG

Background. The fourth Millennium Development Goal (MDG) aims at reducing childhood deaths in the developing world by 2015. Objective. To examine the pattern of childhood deaths in a Nigerian tertiary hospital which served at least three states of the federation between 1996 and 2015. Method. A retrospective study of paediatric deaths between January 1996 and December 2005. Subjects admitted in the pre- MDG period were compared with those admitted during the MDG period. Results. Of 10 451 paediatric patients admitted; 1 320 (12.6) died but only 1 225 were studied. The male-to-female ratio was 1.4:1. Although the yearly mortality rate ranged from 10.7to 14.9; the overall mortality rate for the pre-MDG period was similar to that for the MDG period (p=0.135). Most deaths (69.1) occurred within 48 hours of hospitalisation. Of the 1 225 patients who died; 57.3were neonates. These neonatal deaths were commonly due to prematurity (34.6); perinatal asphyxia (30.8) and septicaemia (24.8); while severe anaemia was the most common cause of death among infants (20.1) and toddlers (25.1). Severe malaria; severe anaemia; and tetanus formed 33.3of all deaths among children older than 5 years. There was no significant difference in the role of prematurity (p=0.298) and measles (p=0.927) as causes of death before and during the MDG periods. HIV/AIDS (p=0.046) became more common as a result of the HIV pandemic; while severe malaria (p=0.041) became less common as a cause of death during the same period. Conclusion. The childhood mortality rate remained high over the 10-year study period. The deaths were mostly caused by infectious and other preventable conditions. The utilisation of specific target-orientated interventions; such as integrated management of childhood illnesses (IMCI); and primary health care may reduce the number of childhood deaths before 2015

The energy value for and nutritive value of para-rubber seed for rats.

The digestible (DE) and metabolizable energy (ME) of full-fat and defatted rubber seed meals (FRS and DRS) were determined with weanling albino rats fed diets in which the meals replaced either 20 or 40% glucose monohydrate in the reference diet. The nutritive value of both FRS and DRS included at 10, 20 and 30% of the diet as substitutes for groundnut meal and yellow maize was studied with 56, 28-day-old albino rats of the Wistar strain. The trial lasted 28 days. Nutrient digestion and nitrogen retention were studied at the end of the second week on test. The DE and ME for FRS were on average 24.7 +/- 1.30 and 21.7 +/- 0.80 hy/g dry matter and those for DRS were 15.3 +/- 0.97 and 13.8 +/- 0.46 hy/g dry matter. Incorporation of rubber seed meals at increasing levels in the diet significantly depressed gains and worsened feed/gain ratio (P < 0.01), the diet containing 30% FRS or 20 and 30% DRS being significantly inferior to the control and the diet with 10% FRS or DRS. Significantly (P < 0.01) superior gains but not feed intake and efficiency were obtained for FRS compared to DRS. Percent intake -N retained also decreased with increasing rubber seed levels in the diet. Except for the significantly (P < 0.05) higher crude fibre digestibility of the control diet compared with those containing 20 or 30% FRS or DRS, the digestibilities of other nutrients were not significantly different.

The interactive effects of lima bean (Phaseolus lunatus) trypsin inhibitor, hemagglutinin and cyanide on some hepatic dehydrogenases, ornithine carbamoyltransferase and intestinal disaccharidases in weanling rats.

The interactive effects of lima bean trypsin inhibitor (TI), hemagglutinin (Hgg) and cyanide (CN) when fed at the same degree of activity as found in the raw lima bean (RLB) were assessed in weanling rats using hepatic glutamate dehydrogenase (GLDH), isocitrate dehydrogenase (ICDH), ornithine carbamoyltransferase (OCT) and intestinal disaccharidases activities as the response criteria. Whereas RLB significantly (P less than 0.05) increased hepatic GLDH and decreased ICDH activities respectively, dietary CN, TI and Hgg whether acting individually or jointly had no significant influence on GLDH. Only the CN-containing diets significantly (P less than 0.05) elevated ICDH activity when compared with the control. Raw lima bean significantly (P less than 0.05) depressed OCT activity while neither the individual nor collective effects of these factors were significant. Dietary CN + TI + Hgg interaction depressed maltase activity to approximately the same extent as RLB in all the intestinal regions. These factors had neither individual nor collective effects on sucrase in the small intestine. Lactase activity in the small intestine was influenced only by the RLB diet, while CN + Hgg, and CN + TI + Hgg dietary combinations induced significant (P less than 0.05) elevations in the activities of cellobiase when compared with the control. Although synergism of action is indicated in a number of instances, it is suggested that these factors may need to combine with others within the bean, perhaps synergistically, to elicit comparable anti-nutritional influences as the RLB.

Effects of sex, age, and body weight on the growth of selected organs and body parts of indigenous Nigerian pigs.

The absolute and relative growth of the head, spleen, kidney fat, stomach, and intestine were studied for 64 intact male, castrated male, and female indigenous Nigerian pigs each. Highly significant (P less than 0.001) sex, age, and sex X age interactions were obtained for the absolute and relative weights of some of the organs and body parts. The results indicate that the organ and part growth was particularly rapid between birth and 280 days of age, but stabilized beyond that time. The average growth coefficient 'b' obtained from the linearized form Y = axb of the growth equation varied between 0.819 for the head and 1.677 for the kidney fat and agreed with relevant values reported in the literature. They confirmed the sequential anterior-posterior growth pattern of organs and body parts in different anatomical regions of the body. A comparison of the allometric and quadratic models used indicated that the organ/body part growth was better described by body weight than by age.

Aspects of linear growth of muscles in the indigenous Nigerian pig.

The development of the length of 2 spinal column, 7 hind limb, and 4 fore limb muscles of one body half were investigated in 64 female, male, and castrated male indigenous Nigerian pigs each from birth to 627 days of age. While the muscle lengths increased significantly (P less than 0.001) with age, non-significant sex influences (P greater than 0.05) were obtained except for M. gastrocnemius and M. infraspinatus. The rate of longitudinal growth in muscles was greatest between the birth and 112 days of age. The ratio of linear equivalence (cubic root) of the muscle weights to muscle lengths indicated the proportionate increase in transverse growth relative to longitudinal growth. Generally, these ratios were higher in the earlier than in the later phase of growth and stabilized between 112 and 448 days post natal. Linear modelling of the growth gave highest values for male and lowest values for castrated animals. Muscle length growth was more closely related to body weight than to chronological age. Estimates of the longissimus dorsi muscle diameter were highly related to the body weight (R2 = 0.96), with intact male pigs exhibiting the highest growth potential in this parameter.

The influence of dietary methionine, protein, and energy levels on glutamic-oxalacetate and glutamic-pyruvate transaminases of chicken.

The variations were tested in dietary methionine, protein, and caloric density on the glutamic-oxalacetate transaminase (GOT) and glutamic-pyruvate transaminase (GTP). The GOT was not affected by the protein and methionine levels either in the plasma or liver. Plasma GTP tended to increase (P less than 0.01) between 0.28% and 0.44% methionine levels in experiment I and between 0.26% and 0.50% in experiment 2. In the liver, the GTP activity was similar in both experiments. The interaction between methionine + cystine and protein was significant in their effect on the GTP activity. This enzyme decreased in the plasma with increasing methionine + cystine level, while it increased with increasing protein level. The GTP activity was negatively correlated (r = -0.52) with the energy level in the liver. From the trends of the GTP activity, the minimum and optimum methionine levels in broiler diets can be derived.

Pathological observations on rats dosed with limabean and cowpea hemagglutinins.

The toxic effects of cowpea and limabean extracts containing hemagglutinins and pathological changes in organs of weanling and growing rats were investigated. Livers of weanling rats injected with limabean hemagglutinin mean lethal dose (MLD), showed marked congestion of the sinusoids. Livers of growing rats thus inoculated, including those given the lethal and sublethal doses of cowpea hemagglutinin, did not show any marked lesions. There was evidence of marked congestion of the medullary sinusoids in the spleen and of the glomeruli in the kidney of weanling and growing rats inoculated with either the sublethal doses of limabean hemagglutinin or lethal doses of cowpea and limabean hemagglutinins. Slight hemorrhages were observed in the intestinal walls of weanling rats while slight thickening of the alveolar septa took place in the lungs of rats dosed with the lethal and sublethal doses of cowpea hemagglutinin. The testis, brain and heart of weanling and growing rats were unaffected by hemagglutinin treatment.

Effect of hemagglutinin extracts on acetylcholinesterase activity in some brain areas of weanling rats.

Two trials involving male and female weanling albino rats (Wistar strain) were conducted to investigate the effects of cowpea and limabean hemagglutinin extracts on acetylcholinesterase (AChE) activity in different parts of the brain. The results show that AChE activity varies with brain region. Cowpea hemagglutinin significantly inhibited AChE activity in the pons of male and female rats, while limabean hemagglutinin significantly inhibited AChE activities in the pons of both male and female rats, in the hippocampus of female rats and in the medulla, cerebellum and midbrain of male rats. Inhibition of AChE activities was more pronounced in male or female rats inoculated with a mean lethal dose of either phytohemagglutinin, than in those inoculated with a sublethal dose.

Haemoglobin values and some biochemical parameters of different breeds and sexes of pigs in a tropical humid environment.

The serum values were determined of haemoglobin (Hb), total protein, uric acid, citrulline, and transaminases (SGOT and SGPT) in 47 boars and non-pregnant gilts of six breeds: eight pure Large Whites (LW), seven pure Durocs (DR), eight Landraces (LR), eight indigenous (IND), eight three-way crosses (LW X DR X Hampshire), and eight two-way crosses (LW X DR). The urea values of the serum were influenced significantly (P less than 0.01) by the breed and sex, the levels of Hb and SGOT were only affected by the breed. Besides, a significant (P less than 0.01) influence was found of the sex on the uric acid values. The total serum protein and the SGPT activities were not significantly affected by either breed or sex.