Influence of social disadvantage among children admitted to the pediatric emergency unit of a tertiary Hospital in Nigeria.

Background: Social disadvantage has an influence on the health of individuals. In developed countries, the prevalence, pattern of social disadvantage, and the outcome of admissions in socially disadvantaged children are under-studied. Aim: To determine the prevalence of social disadvantage, pattern of diseases, and illness outcomes among socially disadvantaged children. Patients and Methods: This was a prospective hospital-based study involving 400 patients who presented at the pediatric emergency unit (PEU) of a tertiary hospital in Southwest Nigeria. Information on socio-demography and history of illness was obtained from consecutive children using a proforma. The data was analyzed using SPSS version 20. Results: The 400 participants comprised 276 male and 124 female giving a ratio of 2.2:1. Their age range was 1-14 years; the mean ± SD age was 4.6 ± 2.3. Three hundred (75%) of the children were socially disadvantaged. The social factors associated with social disadvantage were low income, unemployment of mothers, polygamous setting, single parenting, rural residence, and low registration for health insurance. There was a significant association between social disadvantage and the development of malaria (P = 0.03), pneumonia (P = 0.01), septicemia (P = 0.03), diarrhea diseases (P = 0.04), neonatal jaundice (P = 0.04), meningitis (P = 0.04), and protein-energy malnutrition (P = 0.003). Death was significantly worse among the children who are socially disadvantaged (P = 0.0001). Conclusion: Many children admitted to the PEU in Osogbo are socially disadvantaged. Children of low-income parents, unemployed mother, single parent, residents of rural places, and those without health insurance are more vulnerable to developing infectious disease as well as neonatal jaundice and protein-energy malnutrition. Socially disadvantage increases the risk of poor illness outcome (death).

Pattern of attention deficit hyperactivity disorder among primary school children in Ile-Ife, South-West, Nigeria.

BACKGROUND: One of the most common neurodevelopmental problems affecting behavior of children all over the world is attention deficit hyperactivity disorder (ADHD). Studies on ADHD prevalence in Africa used either parents' or teachers' disruptive behavioral disorder rating scale (DBDRS) to diagnose ADHD, but this study diagnose ADHD using both parents and teachers DBDRS simultaneously among primary school pupils in Ile-Ife. MATERIALS AND METHODS: The study was conducted among 1,385 primary school pupils in Ile-Ife using multistage random sampling. The parents' and teachers' DBDRS were used simultaneously to screen children who had ADHD. RESULTS: Sixty-five (4.7%) of the pupils had ADHD. Among the 65 pupils with ADHD, 28 (43%) had the inattentive subtype, 25 (38.5%) had the combined subtype, whereas 12 (18.5%) had hyperactive/impulsive subtype. The prevalence of ADHD was significantly higher in the younger age group than the older age groups (χ2 = 7.153, P = 0.007). There was no significant association found between the prevalence of ADHD and the social class (χ2 = 3.852, P = 0.146). CONCLUSION: ADHD prevalence of 4.7% was found among the children in Ile-Ife. Assessment of children for ADHD was done by parents at home and teachers in the school with DBDRS. The inattentive subtype was the most common and the hyperactive subtype was the least seen in the study. Early diagnosis and treatment of this disorder will bring better outcome in the children.

Latrogenic burns injury complicating neonatal resuscitation.

A case ofiatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury, with surface area coverage of about 4%, involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice.

Iatrogenic burns injury complication neonatal resuscitation

A case of iatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury; with surface area coverage of about 4; involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice

Post partum emotional distress in mothers of preterm infants: a controlled study.

OBJECTIVE: To investigate whether mothers of preterm infants experience more psychological distress than mothers of normal full term infants in the immediate postpartum period. DESIGN: Cross sectional prospective study of postpartal women using the Beck Depression Inventory (BDI) and the GHQ-30. SETTING: Neonatal intensive care units and the obstetric units of Wesley Guild Hospital, Ilesa and Multipurpose Health Centre, Ilesa (These are component Units of Obafemi Awolowo University Teaching Hospitals Complex, Osun State Nigeria). RESULTS: Of the 60 postnatal women recruited into the study, 33 mothers of preterm neonates formed the index group and 27 mothers of full term normal infants constituted the control group. More mothers of preterm neonates (27.3%) had GHQ-30 scores which categorised them as having significant emotional distress than mothers of full term normal infants (3.7%). Similarly more mothers of preterm neonates (15.1%) were more depressed than mothers of full term normal infants (3.7%). These differences were found to be statistically significant when the mean scores of the two groups on the instruments swere compared. CONCLUSION: These problems are not usually detected nor appropriately referred by the paediatrician/obstetrician to the psychiatrist. This has a number of implications for preventive psychiatry. A multidisciplinary approach is therefore essential in the detection and management of these problems.

Incidence of bacteraemia among children with severe anaemia in Wesley Guild Hospital, Ilesa, Nigeria.

One-hundred-and-fifty-two severely anaemic patients, aged 6 months to 14 years were studied with a view to ascertaining the incidence of bacteraemia in them. Haemoglobin genotype AA was seen in 68 (45 per cent) of the patients, 38 (25 per cent) patients were of haemoglobin genotype SS; 35 (23 per cent) patients were of haemoglobin genotype AS; three (2 per cent) patients were of haemoglobin genotype AC and eight (5 per cent) patients were of haemoglobin genotype SC. Positive blood cultures were obtained in a total of 15 (10 per cent) patients. Of these 15 patients, 10 (22 per cent) patients were sicklers (9 HbSS; 1 HbSC) of a total of 46 sicklers studied. The remaining five (5 per cent) patients that had positive blood cultures were non-sicklers out of a total of 106 non-sicklers studied. There was a statistically significant difference between the sicklers and non-sicklers who had positive blood cultures (P < 0.05). The presence or absence of positive blood culture did not correlate with the severity of anaemia in either the sicklers or the non-sicklers. It is suggested that any severe anaemic patient with clinical features suggestive of sickle cell anaemia must have a blood culture done in the course of management. An 'identify at all costs' approach should not apply to severe anaemic children who are non-sicklers. The yield is low and cost high, clinicians should be selective in deciding in which patients blood cultures are warranted.