Dimensional approach to gender dysphoria in Nigeria: Association with socio-demographic and psycho-sexual variables.

Background: Recent changes across the world with respect to gender transitioning of children and adolescents have generated a bio-psycho-socio-cultural discourse among interest groups. Aim: This study sought to examine gender dysphoric symptoms among adolescents and young persons in an African population, using a dimensional approach. Method: A total of 747 primary/secondary school and university students aged 10-24 years were studied using the 27-item Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA). Participants were divided into early, mid- and late adolescents. The composite and domain scores were calculated using the criteria described by Deogracias, and comparison of the median scores was done using Mann-Whitney U-test and Kruskal-Wallis test as appropriate. Dunnett's post-hoc test was used for pairwise comparisons. Results: The prevalence of self-identified transgender and self-reported non-heterosexuals was 0.9% (95%CI: 0.36-1.92) and 18.6% (15.85-21.59), respectively. The participants as a group scored 4.56 out of a possible 5 on the gender dysphoria scale, indicating less gender dysphoric symptoms in this cohort. However, participants in mid- and late adolescents had significantly lower scores when compared with early adolescents (P = 0.009). Self-reported transgender had significantly lower scores in the social (P = 0.001) and socio-legal (P < 0.001) indicators of the scale. Conclusion: The findings of this study, although, preliminary demonstrated less gender dysphoric symptoms in this cohort of Nigerian adolescents and young adults compared to the Western population. Nevertheless, some degree of GD was noticed, revealing that this condition is existent in our society.

Abnormal blood glucose and the relationship with clinical outcome in acutely ill children admitted to the emergency unit of a Nigerian Tertiary Hospital.

BACKGROUND: Dysglycemia (hyper- or hypoglycemia) is frequently seen in acutely ill children and may be associated with poor outcome. OBJECTIVE: To determine and compare clinical characteristics and outcomes of children admitted for acute illnesses presenting with euglycemia and dysglycemia. A prospective cohort study was conducted in Emergency Pediatric Unit (EPU), of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. SUBJECTS AND METHODS: Children aged ≤15 years, admitted for acute illnesses were enrolled consecutively for a 6-month period. An Accu-Chek Active glucometer was used to check blood glucose of subjects at admission, and based on the result; subjects were categorized as either euglycemic or dysglycemic. The clinical characteristics and outcomes (discharged or died) were compared in the two groups. Statistical analysis involved Chi square test and logistic regression. RESULTS: The median age of 376 subjects was 24 months (range: 1-156 months). Forty-four subjects (11.7%) had dysglycemia, consisting of 36 (9.6%) with hyperglycemia, and 8 (2.1%) with hypoglycemia, whereas 332 (88.3%) had euglycemia. The clinical characteristics associated with hyperglycemia were presence of fever (p = 0.001), and convulsion (p = 0.04), whereas hypoglycemia; coma and hepatomegaly (p = 0.01). Forty subjects (40/376, 10.6%) died. The proportion of those that died in the dysglycemic group (10/44, 22.7%) was significantly higher than that in the euglycemic group (30/332, 9%) (p = 0.006). Subjects who had hyperglycemia were 2.6 times less likely to survive (OR = 2.64, 95% CI: 1.02--6.79, P = 0.05) compared to their euglycemic counterparts. Hypoglycemia was not significantly associated with death outcome (p = 0.13). CONCLUSION: Dysglycemia, particularly hyperglycemia, was significantly associated with increased mortality in acutely ill children. We recommend routine bedside glucose estimation for all acutely ill children at admission to the emergency unit, to detect dysglycemia, treat hypoglycemia promptly, monitor closely, and treat aggressively the underlying conditions in children with hyperglycemia to prevent attendant high mortality.

A 6-year review of post-neonatal tetanus at Usmanu Danfodiyo University Teaching Hospital, Sokoto

Background: Tetanus is a vaccine-preventable disease but its incidence has remained unacceptably high in developing countries. Objective: To determine the prevalence, risk factors and outcome of post-neonatal tetanus at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methods: A retrospective descriptive study from 1st January 2010 to 31st December 2015. Children aged 1 month to 15 years diagnosed with post-neonatal tetanus were studied. Information from the admission files was extracted. Data was analysed using SPSS version 20. Results: Total admissions during the study period were 14,458; 61 had post-neonatal tetanus, giving a prevalence of 0.4%. The M: F ratio was 1.5:1. The mean age was 7.4±3.2 years. Fifty-nine (96.7%) were not immunised against tetanus. Portal of entry for the organism was trauma injuries to the foot in 33(54.1%). Thirty-one (50.8%) were discharged, 5(8.2%) DAMA, while 25(41.0%) died, and case fatality was 41.0%. Conclusion: Post-neonatal tetanus is a major cause of morbidity and mortality in Sokoto. There is need for improved health education, sustainability of immunisation programmes and coverage to eradicate this scourge

Pubertal breast development in primary school girls in Sokoto, North-western Nigeria

Background. There is wide variation in normal pubertal timing among various populations. Objectives. To determine the mean age of pubertal stages of breast development and menarche, and the influence of nutrition and ethnicity on pubertal onset in primary school girls in Sokoto, North-Western Nigeria.Methods. A cross-sectional study using a multistage random sampling design was conducted on 994 primary school girls in grades 3 - 6. Weight and height measurements and Tanner breast staging were done. Body mass index (BMI) was calculated, and a BMI-for-age percentile was used to categorise nutritional status. There were four major ethnic groups. P≤0.05 was taken as showing statistical significance. Results. The participants' mean age was 10.23 years (standard deviation (SD) 1.70, range 6 - 15 years). Of the 994 girls, 628 (63.2%) were pre-pubertal, and 366 (36.8%) were pubertal. Of the latter, 158 (15.9%) were in breast stage 2, while 112 (11.3%), 70 (7.0%) and 26 (2.6%) were in breast stages 3, 4 and 5, respectively. The mean ages (SD; range) of pubertal onset and menarche were 10.50 (1.33; 8 - 13), and 12.67 (1.65; 11 - 15), years, respectively. The overnourished (overweight/obese) and Igbo ethnic group girls had early-normal pubertal onset (p=0.006 and p=0.001, respectively). Conclusion. The mean ages of Tanner breast stages 1 - 5 and menarcheal age of girls in Sokoto, North-Western Nigeria, were within the age ranges reported worldwide. Pubertal onset was influenced by nutrition