Internet addiction during the COVID-19 pandemic among adolescents in southeast Nigeria and implications for adolescent care in the post-pandemic era: A cross-sectional study.

Objectives: This study aimed to determine the prevalence and associated factors of internet addiction amongst adolescents in Southeast Nigeria during the coronavirus disease 2019 (COVID-19) era. Methods: A cross-sectional study was carried out in 10 randomly selected secondary schools, 2 (one urban and one rural) each from Abia, Anambra, Ebonyi Enugu and Imo states of southeastern Nigeria between July and August 2021. Data on demographic variables were collected using a structured self-administered questionnaire. Young's Internet Addiction Test was used to assess the extent of internet use. Analysis was done using the IBM SPSS Statistics version 23. The level of significance was set at a p-value of <0.05. Results: The mean age of the respondents was 16.2 ± 1.8 years and the male: female ratio was 1:1.6. Most of the adolescents (61.1%) used the internet for academic purposes, while 32.8% used it for social interactions and the majority (51.5%) used their phones. The prevalence of internet addiction was 88.1% (24.9% had mild, 59.6% had moderate, while 3.6% had severe addiction) and a good proportion of the respondents (81.1%) perceived addiction as bad. Internet addiction was significantly associated with the respondent's age (p = 0.043), mother's level of education (p = 0.023), family size (p = 0.021), place of residence (p = 0.035), alcohol intake (p = 0.017), smoking (p = 0.015), substance use (p = 0.001) as well as the duration of internet use (p < 0.001). Internet addiction was predicted by the male gender (adjusted odds ratio (AOR): 2.054; confidence interval (CI): 1.200-3.518), early adolescent age group (10-13 years) (AOR: 0.115; C1: 0.015-0.895) as well as the duration of internet use (AOR: 0.301; CI: 0.189-0.479). Conclusions: The prevalence of internet addiction among adolescents during the COVID-19 pandemic era was high. The predictors of addiction were the male gender, early adolescent age group and duration of internet use.

Assessment of breastfeeding techniques in Enugu, South-East Nigeria.

Background: Good breastfeeding technique is important in ensuring adequate milk delivery and preventing breastfeeding problems. Exclusive breastfeeding rate is quite low, and requisite skills regarding proper positioning and attachment of an infant while breastfeeding appears lacking among mothers in Nigeria. This study was undertaken to assess breastfeeding techniques of mothers attending the well-child clinics of two tertiary hospitals in southeast Nigeria. Materials and Methods: This cross-sectional descriptive study of 396 mother and child pairs who attend the well child clinics of two tertiary hospitals in Enugu (Enugu state University Teaching Hospital and University of Nigeria Teaching Hospital) between September 2018 and February 2019. An interviewer administered, well-structured pro forma was used to collect data while mothers were observed closely as they breastfed and scored using the World Health Organization criteria. Data were analyzed using SPSS version 22. Results: Most of the mothers studied (357; 90.2%) attended ante-natal care, and 365 (92.2%) of the deliveries were assisted by a health worker. Only 194 (49%) of mothers practiced good breastfeeding techniques. Maternal age (20-30 years) (P < 0.001, odds ratio [OR] 0.464), attendance to antenatal clinic (P < 0.001; OR 8.336), health education and demonstration on breastfeeding techniques before and after delivery (P = 0.001) and maternal level of education (χ2 = 13.173, P = 0.001) but not parity (P = 0.386; OR 1.192) were significantly associated with good breastfeeding techniques. Conclusion: There are suboptimal breastfeeding techniques among mothers. Increased awareness creation and regular demonstration of breastfeeding techniques are needed.

RésuméContexte: Une bonne technique d'allaitement est importante pour assurer une livraison adéquate du lait et prévenir les problèmes d'allaitement. Exclusive le taux d'allaitement est assez faible, et les compétences requises en ce qui concerne le positionnement et l'attachement appropriés d'un nourrisson pendant l'allaitement semblent manqué chez les mères au Nigéria. Cette étude a été entreprise pour évaluer les techniques d'allaitement des mères qui fréquentent les cliniques hôpitaux tertiaires dans le sud-est du Nigeria. Matériaux et méthodes: Cette étude descriptive transversale de 396 couples de mères et d'enfants assister aux cliniques pour enfants de deux hôpitaux tertiaires à Enugu (Hôpital universitaire d'Enseignement de l'Université d'Enugu et Université du Nigeria Enseignement hôpital) entre septembre 2018 et février 2019. Un intervieweur administré, bien structuré pro forma a été utilisé pour recueillir des données les mères ont été observées de près au fur et à mesure qu'elles allaitaient et scorelaient selon les critères de l'Organisation mondiale de la santé. Les données ont été analysées à l'aide du SPSS version 22. Résultats: La plupart des mères étudiées (357; 90,2 %) soins prénatals, et 365 (92,2 %) des livraisons ont été assistées par un travailleur de la santé. Seulement 194 (49%) des mères pratiquaient de bonnes techniques d'allaitement. Âge maternel (20­30 ans) (P 0,001, rapport de cotes [OR] 0.464), présence à la clinique prénatale (P 0,001; OU 8.336), éducation à la santé et démonstration sur les techniques d'allaitement avant et après (P = 0,001) et le niveau d'éducation maternel (2 = 13,173, P = 0,001) mais pas la parité (P = 0,386; OR 1.192) ont été significativement associés avec de bonnes techniques d'allaitement. Conclusion: Il existe des techniques d'allaitement sous-optimales chez les mères. Création accrue de sensibilisation et une démonstration régulière des techniques d'allaitement sont nécessaires.

Challenges of Diagnosing Pediatric Posterior Reversible Encephalopathy Syndrome in Resource Poor Settings: A Narrative Review.

Posterior reversible encephalopathy syndrome (PRES) is a rare clinical syndrome that has been observed in different age groups, including pediatric patients. Identified triggers of PRES in both children and adults have included immunosuppressive and cytotoxic agents, organ transplantation, severe sepsis, blood transfusion, or evidence of human immunodeficiency virus-1 (HIV-1). Its clinical and radiological courses have been reported as mostly benign and reversible over days to weeks. Computed tomography (CT) scans are helpful in diagnosis, but magnetic resonance imaging (MRI) remains the gold standard. Unfortunately, because of the prohibitive costs of such medical equipment, diagnosis remains a challenge in developing countries. There is a dearth of information about pediatric PRES in resource-poor settings. This narrative aims to draw attention to the possible existence of PRES in children and to identify factors responsible for the difficulty in making the diagnosis. This review will hopefully increase awareness of PRES among pediatricians in order to make early diagnosis and institute appropriate management of this condition.

Impact of zinc on sexual maturation of female sickle cell anemia (SCA) children in Enugu, Southeast Nigeria.

Adolescence is an important developmental period of childhood. Good health and adequate nutrition consisting major food constituents and trace elements like zinc are fundamental for optimal sexual maturation. To determine the relationship between zinc levels and pattern of breast and pubic hair development, as well as menarcheal age of female SCA children aged 6-18 years and their matched controls with hemoglobin genotype AA. Cross sectional, case-control study. Information on biodata, age at menarche, medical and drug history as well as 24-hour dietary recall was documented using interviewer administered questionnaire. Sexual maturation was assessed using Tanner staging and zinc levels determined using Atomic absorption spectrophotometer. Eighty-one subjects were compared with 81 controls. There was significant delay in the mean age of attainment of various Tanner stages of breast and pubic hair in the subjects. Mean age of 14.81 ± 1.07 years at menarche in subjects was significantly higher than 12.62 ± 1.18 years in controls (p = 0.001). Serum zinc of 58.01 ± 10.58 µg/dl in subjects was significantly lower than 68.37 ± 8.67 µg/dl in controls (p = 0.001). Serum zinc levels were found to have a significant positive relationship with stages of sexual maturation and mean age at menarche. Reduced serum zinc in children with SCA was associated with delayed sexual maturation.