Factors associated with substance use among secondary school adolescents in gwagwalada area council, Abuja, Nigeria

Adolescents use substances for various reasons such as for pleasure, stress and anger management. Many factors have been reported to influence adolescent substance use. However, there is paucity of reports from this part of Nigeria.AIM/OBJECTIVES: To identify the socio-demographic factors associated with substance use among secondary school adolescents in Gwagwalada Area Council.MATERIALS AND METHODS: A cross-sectional, descriptive, questionnaire-based, study was carried out in secondary schools among adolescents aged 10 years to 18 years who met the inclusion criteria and after appropriate ethical approval had been obtained.RESULTS: One thousand, one hundred and ninety-six student-filled questionnaires were analysed. The mean age of the students was 14.54 years ± SD 2.28. The students' religion, family structure, residence and type of school were associated with licit substance use while their religion, family structure and residence were associated with illicit substance use (P =<0.05). There was also statistically significant relationships between frequency in participation in religious activities and tobacco use (P = <0.01) and birth order and cocaine andhallucinogen use at P = 0.014 and P = 0.018, respectively.CONCLUSION AND RECOMMENDATION: Several factors were associated with adolescent substance use in this study. It is recommended that more in-depth studies be done to determine causality

Factors Associated with Bacteraemia in Febrile; Non-Neonatal Children 5 Years Old at the Paediatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital; Nigeria

Background. Fever is one of the most common presenting symptoms in the emergency room. Bacteraemia can be a cause of febrile illness in children and can have a fatal outcome if untreated. Therefore; it is important to identify factors associated with bacteraemia in febrile children in order to aid its early diagnosis and prompt treatment. Objectives. To determine the factors associated with bacteraemia among febrile; non-neonatal; under-five children seen in the Children's Clinic of the University of Port Harcourt Teaching Hospital; Nigeria. Methods. Febrile children aged 29 days - 59 months who presented at the outpatient clinic and whose parents gave consent were recruited between September 2010 and January 2011. Information on their age; gender; weight; symptoms; physical examination and blood culture results was collected and analysed.Results. A total of 362 children were studied. The prevalence rate of bacteraemia was 11.5% and 22.2% in moderately and severely malnourished children; respectively (p=0.010). Children with systemic inflammatory response syndrome (SIRS) had the highest bacteraemia prevalence rate (66.7%; p0.001); while children with focal infection and children with fever without other symptoms or signs had bacteraemia rates of 7.1% and 3.7%; respectively. There was no significant relationship between the magnitude of fever and bacteraemia (p0.050).Conclusion. Blood cultures should be performed in febrile children who are malnourished or who have SIRS. Antibiotics should also be commenced while blood culture results are awaited

Human immunodeficiency virus-associated nephropathy (HIVAN) in Nigerian children.

Human immunodeficiency virus-associated nephropathy (HIVAN) has rarely been reported in African children. In this single-center study, we analyzed ten children diagnosed with HIVAN from January 2000 to October 2006. There were eight boys and two girls, with a male:female ratio of 4:1. Their ages were from 5 months to 15 years (mean 6.8+/-6.2 years), with a peak age of 5-9 years. The presenting complaints included generalized edema (60%) and hypertension (50%). All patients had proteinuria on urine dipstick, with four (40%) at nephrotic range (proteinuria >or=500 mg/dl). Nine (90%) patients were in renal failure, with elevated serum creatinine (6.3-24 mg/dl) and serum urea (70-120 mg/dl). Renal disease was the first manifestation of HIV infection in six patients, whereas the diagnosis was made on autopsy in three. The duration from HIV infection to development of HIVAN ranged from 5 months to 10 years. CD4(+) cell count, done in only three patients due to financial constraints, was below 200/mm(3). The kidneys were hyperechoic on abdominal ultrasound in all patients, and three (30%) showed grossly enlarged kidneys. Histology of renal tissues available by autopsy in three patients showed mainly collapsing focal segmental glomerulosclerosis. Treatments given were angiotensin-converting enzyme (ACE) inhibitors and highly active antiretroviral therapy (HAART) in four and two patients, respectively, and one patient underwent peritoneal dialysis. On outcome analysis, seven (70%) patients died, two were lost to follow-up, and one was alive on HAART therapy at the writing of this article. In conclusion, HIVAN occurs in Nigeria children, and the mortality is very high from uremia.

Kocher-Debre-Semelaigne syndrome: a case report.

BACKGROUND: Kocher-Debre-Semelaigne (KDS) syndrome is a myopathy of hypothyroidism associated with pseudohypertrophy in infancy or childhood. There are few reported cases of KDS syndrome in the literature. STUDY DESIGN: We present a 5-year-old boy with poor growth and delayed dental and motor development. There was no family history. On examination he had coarse facies, large protruding tongue, athletic build, short stature and mental retardation. The diagnosis of KDS syndrome was based on laboratory and radiologic evidence of congenital hypothyroidism and muscle enlargement. He was started on L-thyroxine at the dose of 4ug/kg/day, and he has shown marked increase in alertness with regressing muscle bulk after 4 weeks of treatment. A short review of the literature is also presented.

Acute renal failure in Nigerian children: Port Harcourt experience.

Acute renal failure (ARF) is a significant cause of morbidity and mortality in children. It may be pre-renal, intrinsic, or post-renal (obstructive) in aetiology. ARF was investigated in children in the south-southern part of Nigeria to determine the prevalence, aetiology, management and outcome of ARF. A retrospective review of data from all children from birth to 16 years of age admitted into the Department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH), with the diagnosis of ARF over an 18 year period (January 1985 to December 2003) was performed. Information was obtained about the age, sex, clinical features, blood pressure, laboratory and radiological investigations, aetiology, and treatment received including dialysis. Information on the outcome, factors influencing outcome, and possible causes of death were reviewed. There were 211 patients, 138 (65.4%) males and 73 (34.6%) females (M:F, 1.9:1), with a hospital prevalence of 11.7 cases/year. The patients were aged 5 days to 16 years (mean 5.6+/-4.7 years). Oliguria was the most common clinical presentation in 184 (87.2%) patients. Hypertension was seen in only 39 (18.5%) patients. The causes were age-related. The neonates had ARF from severe birth asphyxia 27 (35.5%), septicaemia 17 (22.4%), with tetanus 4 (5.3%) and congenital malformations 11 (14.5%). Sixty-one (28.9%) and 29 (13.7%) patients had ARF from gastroenteritis and malaria respectively. The patients with leukaemia were all more than 10 years old and had acute lymphoblastic leukaemia. Two patients (1.9%) had Burkitts lymphoma involving the abdomen and 3 patients had HIVAN. 112 (53%) patients had anaemia with a mean haematocrit of 20.25+/-6.9%. Dialysis was indicated in 108 patients, but only 24 patients (22.2%) had peritoneal dialysis (PD), because of financial constraints and lack of dialysis equipment. Mortality rate was 40.5%. The causes of death were uraemia 60 (70.6%), overwhelming infection 5 (5.9%), and recurrent anaemia 20 (23.5%). Hypertension (X2 15.7, P<0.001) and lack of dialysis (X2 7.96, P<0.01) significantly affected outcome. Other factors associated with demise were delayed presentation (58.8%), use of herbal treatment (35%), and unaffordability of treatment (40%). ARF is a significant cause of mortality in Nigerian children. The patients are not adequately managed because of poverty and lack of facilities for dialysis. The causes of ARF in our environment are preventable, and should be expected.

Renal vein thrombosis in the neonate: a case report and review of the literature.

We report a case of bilateral renal vein thrombosis in a neonate, and reviewed available literature. The neonate was a macrosomic male born to a mother with glycosuria in pregnancy. There was delay in commencing breasttfeeding for up to 36 hours due to lack of lactation by themother. Clinical and laboratory examination showed enlarged palpable kidneys and azotemia. Diagnosis of bilateral renal vein thrombosis was confirmed by renal ultrasonography. The child is being managed conservatively. Measures aimed at prevention of the disease because of its poor outcome were highlighted.