Pattern of Accidental Childhood Poisoning at the Children Emergency Room of the University of Benin Teaching Hospital, Benin City, Nigeria.

BACKGROUND: Accidental childhood poisoning contributes significantly to childhood morbidity and mortality worldwide. A review of the agents which cause poisoning in our locality from time to time is important in planning prevention strategies and treatment modalities. OBJECTIVE: To document the pattern of accidental childhood poisoning at the Children Emergency Room (CHER) of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. METHODS: A retrospective study in which records of admissions as well as case notes of patients admitted because of ingestion of poisons from October 2011 to June 2014 were obtained. Demographic characteristics, type of poison, where poison was kept, route of poisoning and outcome were extracted from medical records of the patients. RESULTS: Fifty-five (1.44%) patients were admitted for accidental poisoning of a total of 3,822 admissions. Thirty-nine (70.9%) were males while 16 (29.1%) were females. The median and modal age at presentation was two years (range of 0.5-7 years). Route of poisoning was by ingestion in 54 (98.2%) patients. The commonest agent of poisoning was kerosene (32.7%); followed by medicines (18.2%), insecticides (16.4%) and caustic soda (12.7%). Forty-nine (89.1%) patients were discharged home with fatality in one (1.8%). CONCLUSION: Kerosene is still the major agent of poisoning in Benin City, although the prevalence has decreased. Alcohol poisoning has also decreased while ingestion of medicines has increased. The use of beverage and disposable water containers to store poisonous substances and keeping them in easily accessible areas in the home is still rampant. Measures to prevent access of children to these substances will greatly reduce the burden of accidental poisoning.

Emergency Blood Transfusion in Children in a Tertiary Hospital in Nigeria: Indications, Frequency and Outcome.

BACKGROUND: Blood transfusion is a life-saving procedure in paediatric practice. It is important in replacing blood volume in cases of haemorrhage or providing specific blood components as required. However, the procedure carries some risks and complications. The decision to transfuse, frequency of transfusion and the availability of safe blood and blood products are essential determinants of the success of the procedure. Hence, knowledge of the indications and rate of transfusion is important to ensure that blood for transfusion is safe and made available as at when due. OBJECTIVE: To determine the common indications for blood transfusion, the frequency of transfusion and outcome of transfused patients. METHODS: Transfusion records of children admitted into the Children Emergency Room (CHER) of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria from January 2010 to December 2011 were retrieved. Information on the patients' biodata, indications for transfusion, type of blood product and outcome were documented. RESULTS: Within the 24 months under review, a total of 4133 patients were admitted, out of which 655 (15.8%) were transfused. The age of the children ranged between one month and 17 years (median and modal age was 2 years). Commonest indications for transfusion were severe malaria (55.4%), sepsis (11.5%) and sickle cell anaemia [SCA] (4.0%). Whole blood constituted the highest type of blood product utilized (99.7%). Of the 655 patients transfused, 226 (34.5%) had multiple transfusions. The frequency of blood transfusion was 1.2 transfusions per day. Ninety two percent (605) of the patients were discharged from CHER while nine (1.4%) discharged against medical advice. Mortality amongst them was 6.2% (41 patients). The ages of the patients (p = 0.56, C.I. = 0.99, 1.01) and the number of blood transfusions (p = 0.66, C.I.= 0.48, 1.60) were not significant predictors of mortality. CONCLUSION AND RECOMMENDATION: Majority of the patients were transfused following preventable disease conditions. Reduction of the burden of these conditions by good environmental hygiene, use of insecticide treated nets (ITN), indoor residual spraying (IRS), prompt hospital presentation and genetic counselling may greatly reduce the need for blood transfusion in the region.

Comparison of obesity, overweight and elevated blood pressure in children attending public and private primary schools in Benin City, Nigeria.

BACKGROUND: Overweight and obesity in children, and adolescents is on the rise globally. Affected children are prone to cardio-metabolic problems later in life, especially hypertension. The prevalence of obesity/overweight may differ depending on school type. Private schools are attended mostly by children of the affluent, while public schools are attended predominantly by those in the low and middle socio-economic classes. OBJECTIVE: To compare the prevalence of overweight, obesity and elevated blood pressure (BP) in pupils attending public and private primary schools in an urban community in Nigeria. MATERIALS AND METHODS: In this cross sectional study, the BMI and BP of pupils in public and private primary schools, recruited by multistage sampling method, were measured. Their nutritional status was categorized using their BMI percentiles. Analysis was by SPSS. RESULTS: A total of 1466 pupils were recruited, 814(55.5%) were in public schools and 722(49.2%) were males. The prevalence of overweight and obesity was higher in private schools 11.8% and 11.7% compared to public schools 3.3% and 0.9%. The mean systolic BP of pupils in public schools 96.8 ± 12.5 mmHg was higher than that in private schools 95.5 ± 10.2 mmHg, p = 0.032. Distribution of pupils with prehypertension and hypertension between private and public schools was not significantly different. CONCLUSION: The prevalence of overweight and obesity is higher in pupils attending private schools compared to those in public school. Urgent measures are needed to stem this tide through education, weight reduction and physical activity programs, especially in pupils attending private schools.

PREVALENCE OF RHEUMATIC HEART DISEASE AMONG PRIMARY SCHOOL PUPILS IN MID-WESTERN NIGERIA.

OBJECTIVE: To determine the prevalence of RHD among primary school pupils in Egor Local Government Area (LGA) of Edo State of Nigeria. DESIGN: A cross sectional study SETTING: The study was carried out among selected primary pupils in three public and six private schools in Egor LGA, (the smallest governmental unit) in mid-Western Nigeria. SUBJECTS: Using a multistage sampling technique, pupils were selected from public and private primary schools in Egor LGA. They were clinically screened for evidence of RHD by auscultating for significant murmurs. The pupils with significant murmurs then had echocardiographic evaluation to confirm the presence of RHD. MAIN OUTCOMES: Pupils with significant murmurs and pupils with echocardiographically confirmed RHD. RESULTS: Of the 1764 pupils recruited, 900 (51.02%) were females while 864 (48.98%) were males. The mean age of the pupils was 8.86 ± 2.14 years. 1065 (60.37%) and 699 (39.63%) respectively were recruited from public and private schools. Of the 1764 pupils, six (0.34%) had significant murmur. Only one of the six had RHD, giving a prevalence of 0.57/1000 pupils. The pupil with RHD was a male, from public school and in the low socioeconomic class. CONCLUSION: The prevalence of RHD in this study is low compared to similar studies conducted outside the country. The true prevalence may be underestimated since higher prevalence is obtained from echocardiographic based screening compared to clinical screening.