Cystatin C-derived estimated glomerular filtration rate in children with sickle cell anaemia.

BACKGROUND: Sickle cell disease is the most common inherited blood disorder in humans and constitutes a major public health burden. It is a multisystemic condition with long-term renal complications. Early detection of sickle cell nephropathy and initiation of appropriate interventions are associated with improved survival and quality of life. This study aimed to compare the cystatin C-derived estimated glomerular filtration rate (GFR) of the study groups and also, to correlate the clinical features of chronic kidney disease (CKD) with decreased GFR in children with sickle cell anaemia (SCA). METHODS: This hospital-based cross-sectional analytic study recruited 86 SCA subjects in steady-state and 86 age and sex-matched healthy HbAA controls aged 1-14 years who attended the Paediatric Haematology and Outpatient clinics of Federal Medical Centre Bida over six months. Data were collected using a semi-structured questionnaire, and participants' length/height, weight, and blood pressure were measured using standard procedures. Blood samples were drawn for serum cystatin C assay via the sandwich enzyme-linked immunosorbent assay (ELISA) technique. Filler's equation was used to calculate the glomerular filtration rate. RESULTS: There was a significant difference in the mean cystatin C-derived GFR between the two groups, i.e. 116 ± 30mL/min/1.73m2 vs. 106 ± 24mL/min/1.73m2 for the SCA and control groups, respectively (p = 0.017). The prevalence of supernormal GFR (i.e. GFR > 140mL/min/1.73m2) and decreased GFR (i.e. GFR < 90mL/min/1.73m2) was 19.8% and 22.1%, respectively, in children with SCA. There was no significant association between the age at diagnosis of SCA, blood transfusions, blood pressure, packed cell volume and presence of peripheral oedema with decreased GFR in the study subjects. CONCLUSIONS: Supernormal GFR is common in children with SCA and there is no significant association between clinical features of CKD with decreased GFR. Regular evaluation of renal function is, however, recommended in children with SCA for early detection and treatment of renal complications in order to halt the progression to end-stage kidney disease (ESKD).

Erratum: KNOWLEDGE, ATTITUDE AND RISK PERCEPTION OF COVID-19 AMONG NIGERIANS.

[This corrects the article on p. 63 in vol. 16, PMID: 35582061.].

KNOWLEDGE, ATTITUDE AND RISK PERCEPTION OF COVID-19 AMONG NIGERIANS.

Background: COVID-19 emerged as a novel disease with global health importance. Personal and collective behaviours have been modified to prevent the spread of this pandemic. This study is aimed to assess the knowledge, attitude and risk perceptions of Nigerians towards COVID-19. Method: A cross-sectional survey was conducted between the 30th of April and 17th of May 2020 with a national representative among Nigerians using a combination of online and interviewer administered questionnaire. Results: A total of 1,135 respondents participated in the study with a slight male preponderance (M: F=1.5:1). The mean age of the participants was 42±12.2 years with the majority (77%) between the ages of 26 and 55 years. The majority were aware of the pandemic, mostly through mass and social media. Most of the respondents demonstrated good knowledge of COVID-19 but the unaware minority (0.6%) were likewise uneducated. Educational status had no significant association with attitude towards hand washing and wearing of face mask (p>0.05). Risk perception was however low to moderate despite their concerns for COVID-19 and lack of trust in the governments' response to the disease. Conclusion: The risk perception of COVID-19 among the respondents is not encouraging, hence more advocacy and public orientation must be done to curb further spread of COVID-19 in our setting.

Effects of call reminders, short message services (SMS) reminders, and SMS immunization facts on childhood routine vaccination timing and completion in Ilorin, Nigeria.

BACKGROUND: Reminders via mobile devices deployed as short message services (SMS) or calls have been identified to be a useful strategy in improving routine immunization uptake in several countries. OBJECTIVE: To identify the timeliness of appointments with reminders (calls or SMS), SMS health education and the routine care, and the vaccination completion rates in Ilorin, Nigeria. METHOD: Mother-infant pairs presenting for the first vaccination appointment were randomized into four (three interventions, one control) groups, each consisting of 140 participants. Intervention groups were reminders via calls (A), SMS reminders (B), immunization fact SMS messages (C) and controls on usual care (D). Reminders were made a day before the appointment while SMS immunization facts were sent at five weeks, nine weeks and eight months. Appropriate timing was defined as the scheduled visit ±3 days. RESULTS: The immunization completion rates after the nine months' visit were 99.2%, 99.3%, 97% and 90.4% for Groups A, B, C and D respectively. Compared with controls, Group A had the highest odds [AOR 8.78 (6.10, 12.63)] of presenting at an appropriate time, followed by Group B [AOR 2.56 (1.96, 3.35)], then Group C [AOR 2.44 (1.87, 3.18)]. CONCLUSION: Reminders/SMS immunization facts improve vaccination completion rates.

Determinants of Timely Presentation for Birth Dose Vaccination at an Immunization Centre in North-central Nigeria.

BACKGROUND: Timely receipt of immunization is an essential prerequisite to ensure early protection of the child. However, a low proportion of children in Nigeria benefit from the timely administration of the birth dose vaccines. OBJECTIVES: These were identification of factors associated with timely presentation and reasons for presentation beyond 24 hours at an immunization centre in Ilorin, Nigeria. METHOD: A descriptive cross-sectional study involving 480 mother-infant pairs was conducted at an immunization centre. Socio-demographic, antenatal care (ANC) and delivery details, infant's birthday and day of presentation for vaccination were recorded. Logistic regression was used to identify factors associated with time to presentation within day one. FINDINGS: 239 (49.8%), 421 (87.7%) and 454 (94.6%) babies were vaccinated within days one, seven and 14 respectively. Post-secondary education level of mothers (OR = 3.60; 95% C.I: 1.30-9.91), antenatal care attendance (OR = 9.55; 95% C.I: 1.75-52.12), and hospital delivery (OR = 6.36; 95% C.I: 1.33-30.38) were associated with presentation within day one. Having correct knowledge of the immunization schedule increased the odds of early presentation by three times, p = 0.025. The commonest reason for presentation after day one for vaccination was weekend/public holiday delivery identified in 83 (35.2%) mother-infant pairs. CONCLUSION: Hospital delivery, attendance at antenatal care, postsecondary education and knowledge of the immunization schedule were factors associated with timely presentation for birth dose vaccination. Strategies to improve timeliness of the birth dose vaccination should target babies delivered outside the hospital as well as during weekends in the hospital. Also, inclusion of immunization into the health education curriculum of schools could be beneficial.

Measles in a tertiary institution in bida, niger state, Nigeria: prevalence, immunization status and mortality pattern.

OBJECTIVES: Measles is a highly infectious immunizable disease with potential for eradication but is still responsible for high mortality among children, particularly in developing nations like Nigeria. This study aims to determine the hospital based prevalence of measles, describe the vaccination status of children managed for measles at the Federal Medical Centre, Bida, Niger state and to identify the parental disposition to measles vaccination. METHODS: This is a cross-sectional study carried out over a period of 18 months beginning from July 2007. All children with a diagnosis of measles made clinically and reinforced with serological test in the WHO Measles, Rubella and Yellow Fever laboratory in Maitama District Hospital, Abuja were recruited. Informed consent was obtained from the parents/care givers. Structured questionnaire was used to obtain information and data analysis was by SPSS version 15. RESULTS: One hundred and nine children were managed for measles, constituting 8% of total admission over the study period. The male to female ratio was 1.2:1. Of the 109 children with measles, 90 (82%) did not receive measles vaccination. Eighty-eight (80%) of the parents or guardian felt vaccination was bad for various reasons. Of the 23 (21.1%) children whose parents or guardians were positively disposed to vaccination, one death was recorded while the remaining seven deaths were recorded among children whose parents were negatively disposed to vaccination. All the deaths were in the non-vaccinated group below 2 years of age. CONCLUSION: Measles is still a major health burden in our community. The majority of affected children were not vaccinated due to negative parental disposition. Continuous health education is required for change the disposition of the parents/guardian and improve vaccination coverage to minimize measles associated morbidity and mortality.

Familial ectrodactyly syndrome in a nigerian child: a case report.

Ectrodactyly, also known as Split-Hand/Split-Foot Malformation (SHFM) is a rare genetic condition characterized by defects of the central elements of the autopod. It has a prevalence of 1:10,000-1:90,000 worldwide. The X-linked and autosomal dominant types have been described. It can occur as an isolated malformation or in combination with other anomalies, such as tibial aplasia, craniofacial defects, and genitourinary abnormalities. Ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC) is an example of ectrodactyly syndrome accompanied by multiple organ defects. Ectrodactyly has been reported in Africa, especially in several families in remote areas of central Africa but there has not been any published work on ectrodactyly in Nigeria. A baby was born in Ilorin, North Central Zone of Nigeria, with an uneventful prenatal and delivery history but was noticed to have malformation of the two hands and the two lower limbs at birth which are replica of the father's malformation. We present this case to highlight familial ectrodactyly in Nigeria and prepare us to improve upon simple prenatal diagnosis and management of the challenges associated with patients with congenital malformation in Nigeria and other developing countries.

Amulets, Bands and Other Traditional Applications seen among Emergency and Neonatal Pediatric Admissions in a Tertiary Centre, Nigeria.

OBJECTIVES: This study aims to investigate the types and indications of amulets, bands and traditional applications among pediatric emergencies and neonatal admissions into the Federal Medical Centre, Bida, Nigeria. METHODS: This was a cross-sectional study conducted between January and July, 2008. Children admitted into the emergency and neonatal units of the institution with traditional applications were recruited. Information on demography, time the application was introduced, the reason, cost implication and belief about the efficacy were obtained using a semi-structured questionnaire. Socio-Economic Class was defined using the Oyedeji Classification. RESULTS: The study was based at Federal Medical Centre, Bida and consisted of 666 children admitted into the hospital via the Emergency pediatric and the Neonatal Unit, with a seven-month period prevalence of 11.4% (76 patients). Of the 76 cases screened for the use traditional applications, only 64 (84.2%) were recruited, the remaining did not agree to participate in the study. The mean age was 493.1±528.5 days. The study group included 37 males and 27 females (sex ratio 1.4:1) aged 11 days to 2920 days. The applications used included neck band (54.7%), ankle band (15.6%) and head paste (15.6%). Reasons for the applications included prevention of childhood illnesses (17.2%), sutures closure (15.6%), as well as warding off evil spirits and convulsions (12.5%). The socio-economic classification was I (1.6%), II (7.8%), III (15.6%), IV (45.3%), and V (29.7%). Sixty (93.0%) parents believed the applications cannot be used with conventional medicine, while 53.1% of the participants, obtained them free of charge. CONCLUSION: The use of traditional applications, often for preventive purposes, is common among pediatric patients, especially of low socio-economic classifications. The majority of users considered them incompatible with simultaneous conventional medical care. This has adverse implications for time to presentation for conventional care and treatment outcomes. Promotive and preventive healthcare interventions are needed to reverse this trend. Future broad-based research is warranted.