Vitamin D status and hospitalisation for childhood acute lower respiratory tract infections in Nigeria.

BACKGROUND: Acute lower respiratory tract infection (ALRTI) is the leading cause of childhood deaths in most developing countries, including Nigeria. Vitamin D is associated with innate immunity and may play a role in the control of infections. Case-control studies, including a small study from Nigeria, show inconsistent results for the association between vitamin D status and risk of ALRTI. AIMS: To examine the relationship between vitamin D status and hospitalization for ALRTI in Nigerian children. METHODS: Fifty children aged 2-60 months hospitalised with ALRTI were studied prospectively. ALRTI was diagnosed on the basis of modified WHO criteria. Each patient was matched with controls for age and gender. The controls were enrolled either from children attending well-child clinics or general clinics without evidence of respiratory infection or admitted to the hospital for elective surgery. A structured questionnaire collected data on demography, health, diet, duration of exposure to sunlight and percentage of body surface exposed to sunlight (according to type of clothing) while outdoors, and potential risk factors for ALRTI. Serum 25-hydroxyvitamin D [25(OH)D] concentration was measured using a chemiluminescenceimmuno-assay. The differences between cases and controls in serum 25(OH)D concentrations, association between vitamin D status and ALRTI and risk factors for vitamin D deficiency were assessed. RESULTS: Mean (SD) 25(OH)D concentrations in patients and controls were similar [61·5 (25·8) vs 63·1 (22·9) nmol/L,P = 0·95].25% of all 100 subjects studied had serum 25(OH)D<50 nmol/L. In a multiple conditional logistic regression model, only lower percentage of body surface area exposed to sunlight was associated with increased risk of ALRTI. The percentage of body surface area exposed to sunlight while outdoors (P = 0·028) and vitamin D supplement use (P = 0·009) were independent determinants of vitamin D deficiency in the overall study population. CONCLUSIONS: ALRTI was not associated with vitamin D status, but was associated with less exposure to sunlight. Exposure to sunlight and vitamin D supplementation contributed to vitamin D status in this population.

Congenital long-QT syndrome in a Nigerian child: a case report.

CASE REPORT: We describe the clinical manifestation and the challenges of diagnosing Long QT syndrome, type 1 (LQTS1), in an 8-year old girl who presented at the Paediatric Cardiology Clinic with syncopal attacks following dancing and excitement. Her initial ECG showed normal QT interval of 380msec (QTc=440 msec), but later, increased to 410 msec (QTc=520 msec) following epinephrine challenge test. CONCLUSION: The challenges with the diagnosis of LQTS1 in children in resource-constrained setting and the need for vigilance in children with syncopal attacks and other cardiac events with normal QT intervals on an electrocardiogram are thus highlighted.

Review of childhood measles admissions at the National Hospital, Abuja.

BACKGROUND: The global disease burden from measles as a vaccine preventable disease remains high despite decades of interventions by various organs and agencies. OBJECTIVES: To determine the prevalence and outcome of childhood cases of measles admitted into the children's emergency ward of the National hospital and highlight the possible contributing factors. DESIGN: Retrospective. SUBJECTS: A total number of 43 children with measles presenting at the National Hospital Abuja, seen over a 40 months period; January 2002 and April 2005. METHODS: Cases-folders of patients seen at the Emergency Paediatric Unit (EPU) of the National Hospital Abuja during the period under review with the clinical diagnosis of measles were reviewed. RESULTS: The children were aged between seven to 12months, with 25 (58.1%) age 24months and below. Twenty three (53.5%) of the subjects had received prior measles vaccination. History of contact with cases of acute measles was present in 26 (60.5%). Associated protein energy malnutrition (PEM) was found in 30 (69.8%) with 28 (65.1 %) parents of these children being of lower social economic classes (III, IV &V). Recorded complications included gastroenteritis, bronchopneumonia, laryngo-tracheo-bronchitis as part of croup syndrome, tuberculosis, and otitis media. Three fatalities (7.0%) were record in this review, all in association with bronchopneumonia. CONCLUSION: Measles with its complications still present as a fatal illness even among vaccinated children.

Review of Childhood Measles Admissions at the National Hospital, Abuja

Background: The global disease burden from measles as a vaccine preventable disease remains high despite decades of interventions by various organs and agencies. Objectives: To determine the prevalence and outcome of childhood cases of measles admitted into the children's emergency ward of the National hospital and highlight the possible contributing factors. Design: Retrospective. Subjects : A total number of 43 children with measles presenting at the National Hospital Abuja; seen over a 40 months period; January 2002 and April 2005. Methods: Cases-folders of patients seen at the Emergency Paediatric Unit (EPU) of the National Hospital Abuja during the period under review with the clinical diagnosis of measles were reviewed. Results: The children were aged between seven to 12months; with 25 (58.1) age 24 months and below. Twenty three (53.5) of the subjects had received prior measles vaccination. History of contact with cases of acute measles was present in 26 (60.5). Associated protein energy malnutrition (PEM) was found in 30 (69.8) with 28 (65.1) parents of these children being of lower social economic classes (III; IV etV). Recorded complications included gastroenteritis; bronchopneumonia; laryngo-tracheo-bronchitis as part of croup syndrome; tuberculosis; and otitis media. Three fatalities (7.0) were record in this review; all in association with bronchopneumonia. Conclusion : Measles with its complications still present as a fatal illness even among vaccinated children