Early Detection of Renal Injury in Children with Sickle Cell Anaemia using Microalbuminuria in a Tertiary Health Institution in Southern Nigeria.

BACKGROUND: Sickle cell anaemia (SCA), one of the causes of morbidity and mortality in children is associated with a large spectrum of systemic complications including sickle cell nephropathy (SCN). Microalbuminuria has been used as a marker of preclinical glomerular damage in these patients. This study aimed at detecting early, renal injury in children with SCA aged 1-17 years, highlighting associations and predictors of microalbuminuria in these children. METHODS: 102 known HbSS children aged 1-17yrears in steady state were recruited into a cross-sectional study. Socio-demographic and clinical findings were recorded. Albuminuria was assayed with spot urine using a quantitative method. Urine creatinine concentration was estimated using the Roche reflotron test strips for quantitative determination of creatinine in blood, serum, plasma and urine. Albumin to creatinine ratio (ACR) was then calculated. Microalbuminuria was defined as ACR of 30-300mg/g. RESULTS: Microalbuminuria was detected in 22.5% of SCA patients in our cohort. Age (p=0.001), gender (p=0.000), packed cell volume (p=0.047) showed a significant relationship with the occurrence of microalbuminuria in this study. Increasing age (OR=1.72, CI=1.22-2.44, p=0.002), female gender (OR=0.09, CI=0.01-0.95, p=0.04) and lower packed cell volume (OR=0.49, CI=0.26-0.90, p=0.02) emerged as independent risk factors associated with the occurrence of microalbuminuria in the study population. CONCLUSION: Renal injury occurs in a high proportion of patients with SCA. Routine screening of all patients with SCA as part of their follow up is therefore recommended to identify patients with early renal injury for proper management.

PREDICTORS OF C-REACTIVE PROTEIN RESPONSE IN CHILDREN INFECTED WITH PLASMODIUM FALCIPARUM MALARIA.

OBJECTIVE: To assess the predictors of C-reactive protein response in plasmodium falciparum malaria as seen in children in a malaria endemic region of Nigeria. DESIGN: A prospective cross-sectional study. SETTING: The Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunisation Centre and Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. SUBJECTS: Three hundred and sixty children aged six to sixty months with microscopically confirmed P. falciparum malaria compared with 360 healthy children without malaria parasitaemia matched for age and gender. RESULTS: The predictors of the C-reactive protein response in malaria (CRP ≥ 10mg/l) were fever (t = 6.867; p = 0.001), malaria parasite count (t = 5.387; p = 0.001), severe anaemia (t = -11.23; p = 0.001) and age. Younger children had a greater CRP response. The logistic regression curve showed a 66.9% sensitivity, 92.1% specificity, positive predictive value, 83.2% and negative predictive value of 82.2% of predicting C-reactive protein response in malaria. CONCLUSION: P. falciparum malaria induces significant CRP responses. Younger children who present with fever, hyperparasitaemia and severe anaemia are more likely to have C-reactive protein response with malaria.

Teachers' knowledge and attitudes towards seizure disorder: a comparative study of urban and rural school teachers in Akwa Ibom State, Nigeria.

BACKGROUND: Knowledge and attitude of school teachers with regard to seizure disorder has an important impact on continuation of schooling of children with seizure disorder. Though school teachers in both rural and urban settings are exposed to the same training, their perception of seizure disorder could be influenced by the environment in which they reside. OBJECTIVES: To determine the knowledge and attitudes of school teachers towards children with seizure disorder, and the influence of urban residence on perception of seizure disorder by the teachers. MATERIALS AND METHODS: A self-administered questionnaire on knowledge and attitudes to seizure disorder were filled by school teachers drawn from both urban and rural settings in Akwa-Ibom State, Nigeria. RESULTS: One-hundred and thirty-two urban school teachers and an equal number of their rural counterparts completed the questionnaire. There were significantly more female teachers in the urban schools whereas the rural schools were dominated by male teachers with male to female ratio of 1:5.6 and 1.2:1, respectively. Majority of the urban (60.6%) and rural (57.6%) school teachers were National Certificate of Education holders. Thirty-eight (28.8%) of urban respondents versus eight (6.1%) of rural respondents thought seizure disorder was caused by evil spirits whereas 60 (45.5%) urban respondents compared to 80 (60.6%) of rural respondents felt seizure disorder was infectious. Majority of the respondents from both urban and rural schools (68.2% and 63.6% respectively) believed that the foam from the mouth of a convulsing child with seizure disorder is the infecting agent. However, 62.1% of urban respondents as well as 45.5% of rural respondents would advise that children with seizure disorder be admitted into special schools. There was no significant difference in the mean overall knowledge and attitudes of school teachers to seizure disorder in the two settings ( P = 0.33 for knowledge and 0.28 for attitudes). Teachers' high level of education however, had a positive influence on their knowledge and attitudes towards children with seizure disorder. CONCLUSION: School teachers in both urban and rural schools exhibited poor knowledge and negative attitudes towards children with seizure disorder. Residing in the urban setting did not have a positive impact on teachers' perception of seizure disorder. Massive health education on seizure disorder is therefore advocated for teachers in both urban and rural schools.

Seroprevalence of HBV and HIV co-infection in children and outcomes following highly active antiretroviral therapy (HAART) in Uyo, South-South Nigeria.

BACKGROUND: Human Immunodeficiency Virus/Hepatitis B Virus (HIV/HBV) co-infection in Nigerian children has emerged as a major concern with the advent of HAART. Its impact on the immune system and liver has not been extensively studied in children. OBJECTIVES: To determine the prevalence of HBV seropositivity among HIV positive children on HAART and its effect on immune response and liver enzymes. METHODS: All consecutive HIV positive children aged two months to seventeen years on HAART constituted the study population. Age and gender; CD4+ count, ALT, creatinine and HBsAg were tested and documented at enrolment and 12months. RESULTS: One hundred and seventy one patients were seen over this period. Seventy-two (43.4%) were males while 94 (56.6%) were females giving a male: female ratio of 1:1.3. The mean age of the patients was 63±43.4 months. Prevalence of HIV/HBV co-infection was 6.02% (95% CI 2.4-9.7). There was no significant effect of HBV status on elevation of ALT levels with 12 months of HAART. Co-infected patients had an odds ratio of achieving immune response of 0.14 (95% CI 0.02-0.79). CONCLUSION: HIV/HBV co-infection rates in our children are comparable to other localities. ALT levels do not worsen with HAART and immune response of the co-infected children on HAART is lower.

Estimation of genetic variability in locally grown pulses (Cajans cajan (L.) Millsp and Vigna unguiculata (L.) Walp): a panacea for sourcing superior genotypes.

The negligence of breeders and farmers to explore and exploit landraces of pulses is worrisome and urgent measures needed to be set in motion to forestall major future crisis, taking into cognizance the high adaptability and nutritive values accredited to them. This study focused on the estimation of genetic variability and heritability of desirable morphological characters in Fiofio (Cajans cajan) and Olaudi and Akidi (Vigna unguiculata) with the aim of conservation. Three landraces of pulses were sown using randomized complete block design. The field experiment was carried out at the University of Calabar Experimental Farm, University of Calabar, Calabar, during 2008-2010 growing season. Phenotypic and genotypic variances and coefficients of variation and genetic advance were estimated on yield and yield-related traits. The results showed that there were considerable variations among the pulses for the traits studied. The result revealed high genetic variability in the number of leaf per plant, leaf area, number of flowers per plant, number of pods per plant and number of seeds per plant. It also showed that genetic variability in pod length and 100-seed weight was low. Heritability estimates obtained in the result were very high though the magnitude of genetic variability in the yield and yield-related traits was not proportional to the heritability estimates. The traits studied also show high genetic advance. These explicitly showed that there are sufficient genetic variations to warrant conservation and improvement in these extinction-threatened pulses studied.

Phytochemistry and heamatological potential of ethanol seed leaf and pulp extracts of Carica papaya (Linn.).

This study was aimed at qualitative evaluation of the ethanol seed, leaf and pulp extracts of C. papaya for bioactive compounds and also to investigate their effect on the haematology in male albino rats. A 3 x 4 factorial experimental layout using randomized complete design was adopted. Results show that the phytochemicals found in seed, leaf and pulp were almost the same but however, in varying proportions. Present result also revealed that there were significant effects (p < 0.05) of the extracts on the heamatology of the treated rats, which was blamed on the varying and different variants ofbioactive compounds found in the extracts they were administered with. Suggestively, C. papaya extracts could be used to enhance the production of selected blood parameters, taking issue of dosage into consideration.

Effect of soybean (Glycine max L.) on the hormonal milieu of male rats.

Effect of soybean (Glycine max) on serum level of some sex hormones: testosterone, follicle stimulating hormone (FSH), luteinizing hormone/interstitial cell stimulating hormone (LH/ICSH), estradiol and prolactin in male rats was investigated. Twenty male albino rats of 12 weeks old with similar body weights were assigned to four groups of 5 rats each and treatment with soybean meal at 100, 200 and 300 mg kg(-1) body weight, respectively daily for 8 weeks. Blood samples collected through cardiac puncture were assayed for levels of hormones. There were dose-dependent effects of the soybean meal on the serum concentration of the hormones. The treatment significantly reduced the levels of testosterone and FSH in the serum while it significantly increased the levels of estradiol, LH/ICSH and prolactin. The results show that soybean (Glycine max) had strong capability to disrupt hormonal functions. Hence, its indiscriminate use could increase the risk of infertility in males.

The Assessment of Heavy Metal and By-Product on Fried Food Sold by Roadside Vendors in Calabar; Nigeria

The assessment of heavy metals (lead and mercury) and by-product (sulphur) on fried food sold by roadside food vendors in Calabar; Nigeria were investigated. The food samples which were covered and uncovered after frying were obtained randomly from 20 street food vendors. The food samples were obtained from 10 busy roads and 10 non- busy roads in Calabar; Nigeria. The busy roads were those roads that recorded more than 20 cars per minute; while the non-busy roads recorded less than 10 cars per minute. The result showed that the busy roads had significant (P0.05) higher depositions of heavy metals and by-products than the non-busy roads. Lead deposits on the food samples was significantly (P0.05) higher than the amount of mercury and significantly (P0.05) higher than the amount of sulphur deposit. The amount of sulphur deposit on the food samples was significantly higher (P0.05) than mecury. The food samples that was uncovered after frying had a significantly higher (P0.05) deposit of heavy metal and by-product than the food samples that were covered after frying. This result suggest that fried foods vended in calabar by the road-side have a serious public health concern

Evaluation of Heavy Metal on Canned Meat and Fish Sold in Calabar; Nigeria

The evaluation of heavy metals in canned meat and fish foods sold in Calabar; Nigeria was investigated. Ten samples from six different brands of canned meat and fish sold in Calabar were obtained from randomly selected markets and grocery shops. Each of the different sample types were then pooled together brand-wise and then evaluated for heavy metal deposits; lead; Mercury; Arsenic and cadmium; using standard techniques. Lead level in canned fish (0.988mg/kg); (0.816mg/kg) in meat were significantly higher (P

Chemical and Biological Evaluation of Fried Plantain Sold by Roadside Vendors in Calabar; Nigeria

The chemical and biological evaluation of fried plantain sold by roadside vendors was investigated. Twentyone male wister albino rats weighing between 35g to 80g were divided into three groups of seven rats each. Group 1 (control) rats were fed with plantain fried with fresh vegetable oil (FVO); Group 2 rats were fed plantain fried with 7 days used oil (degraded oil; DO); and Group 3 rats were fed with plantain fried with degraded oil but treated with antioxidant vitamin C (TDO). After 11 wks of feeding; the rats were anaesthetized with chloroform and dissected. The livers were removed; weighed; crushed and centrifuged in normal saline to obtain homogenates that were used for analysis of total protein and total lipids. The results showed a significant decrease (p

Consumer Awareness of Safe Food Handling by Food Service Establishments in Calabar; Nigeria

Consumer awareness of safe food handling in food service establishments was investigated. The survey was carried out using 500 questionnaires administered at different food establishments in Calabar; Nigeria. The return rate of questionnaires was 74. The survey result revealed that people who eat out regularly claimed that the standard of food hygiene in food establishments was important to them when deciding where to dine. 67of respondents had concerns/ complaints about the hygiene standards of food establishments they used. 78of consumers believed that they have the right to receive information on hygiene standards of eating places. Most would welcome a reliable system to help them judge hygiene standards. About 65thought there was inadequate consumer information on hygiene standard of eating places. If access to information was made easier; 59of respondents claimed they would eat out more often. Respondents preferred the use of scores to inform them on hygiene standards. Generally; consumers claimed to be unaware of food safety standards in food service establishments. The result therefore showed that the Nigerian consumer basically judged food safety in terms of sensory perception and lacked any form of judgment based on microbiological safety

Seasonal occurrence of vibrios in water and shellfish obtained from the Great Kwa River estuary, Calabar, Nigeria.

The prevalence of Vibrio species in shellfish and their seasonal variability in the Great Kwa River estuary (GKWE) were examined. Results revealed a trimodal peak in Vibrio counts, coinciding with meteorological changes and the hot periods of the year. The estuary was constantly faecally polluted, coupled with high rates of infection of shellfish by V. parahaemolyticus 42 (13.6%), V. cholerae non-01 29 (9.4%) and V. alginolyticus 22 (7.1%), thus posing a health risk. The observed seasonal variability and prevalence of Vibrio species infection are of epidemiological significance, and provide a guide for effective control of associated cholera epidemics.

Nocturnal enuresis among secondary school students in Port Harcourt, Nigeria

Background: Enuresis is a common problem in children. The impact upon the lives of children and their families is often underestimated. Aim: The study was to determine the prevalence; causes and effect of enuresis among students in Port Harcourt. Methods : A survey of junior and senior students from 2 secondary schools in Port Harcourt Local Government area was done using self-administered questionnaire. Results: A total of 491 students between the ages of 10-21years were studied. There were 248 (50.5) females and 243(49.5) males. Nocturnal enuresis (NE) was reported in 124(25.3) students; out of which 59(47.6) had primary NE. NE was significantly more in males than in females and in those from polygamous homes(c2=7.29; df = 1; p0.01 and c2 ) students. Non-organic causes of secondary NE include parental separation 12 (9.7); divorce 16 (12.9) and death in the family 4 (3.2). Enuresis affected 75 (60.5) of the students; as well as their parents. Fifty (40.3) students felt embarrassed about bedwetting and in 27 (21.8) students the parents were very angry and had to beat them. Treatment offered included prayers in 44 (35.6) and waking at night in 15 (12.1). Conclusion: Enuresis is a common problem among secondary students in Port Harcourt. Secondary nocturnal enuresis is more prevalent; and stressful to both the sufferer and the parents

AIDS awareness and knowledge among primary school children in Port Harcourt metropolis.

The research was carried out to study the AIDS awareness and knowledge of 462 final year primary school pupils selected by multistage sampling technique from four primary school in Port Harcourt metropolis. Ninety-seven point six percent pupils reported that they had heard of AIDS. Only 47.6% knew the correct meaning of AIDS. among whom 63.2% were in private schools. Fifty nine point one percent knew that AIDS was transmitted sexually and only 1.3% knew about vertical transmission. Between 0.2-28.4% had wrong or no knowledge about the accurate route of transmission of AIDS. Limited and inaccurate knowledge of the preventive measures of AIDS were demonstrated. Sixty eight (23.8%) were not aware of any preventive measures. The pupils main source of information on AIDS was the mass media. Parents contributed to the knowledge in 8.0% of the respondents. There is therefore an urgent need to intensify and expand the ongoing AIDS campaign especially school based AIDS education programmes to primary school pupils before they enter into secondary and tertiary institutions and become influenced by the peers. Informed parents and religious leaders should also be involved in AIDS education in order to improve the knowledge of children and alter their misconceptions about AIDS transmission and prevention.

The knowledge, attitude and use of contraception among secondary school girls in Port Harcourt.

BACKGROUND: Sexual activity is on the increase among teenagers worldwide, with a trend towards early onset. These activities are often unplanned and may lead to unintended pregnancies and sexually transmitted diseases including AIDS. Teenagers in developing countries exhibit little knowledge, and exposure to contraceptives. This study was undertaken to describe the knowledge, attitude and use of contraception among female students in Port Harcourt. METHOD: A self-administered questionnaire was used for the study. Five hundred and thirty four students selected from a female only secondary school in Port Harcourt Local Government Area of Rivers State were studied. RESULTS: The students were aged 8-23 years (mean 15.6 years). Two hundred and sixty four (49.4%) were in junior classes (JSS1-3) and 270 (50.6%) in senior classes (SS1-SS3). Two hundred ninety five (55.2%) of the respondents had heard of at least one contraceptive method. Age and not the academic level significantly influenced the knowledge (p < 0.05). Condom was the commonest method known by the students. Few students (< 10%) had knowledge of the modern contraceptive methods. One hundred and thirty five (25.3%) students believed that contraceptives could be harmful. Among the sexually active girls, only 45.3% had ever used any method of contraception. The use of contraception was more among junior students than senior students (64.5% vs 35.5%) (p < 0.05). CONCLUSIONS: We therefore recommend formal sex education in secondary schools in Port Harcourt, in order to improve the reproductive health knowledge and contraceptive use of sexually active girls. The education program must address students' misconceptions about effective methods of contraception targeting the senior students specifically.

Prevalence of sexual activity and outcome among female secondary school students in Port Harcourt, Nigeria.

Sexual activity among 534 Nigerian female secondary school students was studied using self-administered questionnaire. Prevalence of sexual intercourse was 25.7%. There was no significant difference between the junior (48.2%) and senior (51.8%) students (p > 0.05). Seventeen (12.4%) students had initiated sexual intercourse before 11 years. The frequency of sexual exposure was high, with 34.3% of the students having intercourse more than once in a week. Pregnancy rate among sexually active females was 27.0%, with 24.8% rate of induced abortion. Early sexual health education starting from primary school would be helpful in influencing the reproductive decisions and sexual behaviour of the students, including contraceptive acceptance and usage, to avoid teenage pregnancy. Education of parents is also recommended in order to overcome the cultural barriers that discourage parents from providing sex education to their children at home.