Serum total adiponectin in healthy pre-pubertal nigerian school children.

BACKGROUND: Adiponectin is an excellent insulin sensitizer. It also possesses anti-inflammatory and anti-atherogenic properties that play a crucial role in the pathogenesis of cardio-metabolic disorders. Evaluating adiponectin distribution in children and factors that modulate its blood level is critical for advancing knowledge in its future role in managing associated non-communicable diseases. AIM: To investigate the adiponectin profile in apparently healthy pre-pubertal Nigerian school children. METHODS: This is a cross-sectional study comprising 125 randomly recruited pupils from eight primary schools in Nnewi located in Anambra State, Nigeria. Anthropometric values were taken and venous blood samples assayed for adiponectin using Enzyme-linked immunosorbent assay (ELISA) kits. Analysis of data was done with SPSS software version 22 and R programming software. The level of significance set at P < 0.05. RESULTS: We enrolled a total number of 125 children, which comprised of 68 (54.4%) males and 57 (45.6%) females with a male to female ratio of 1.2:1. The mean age of all the subjects was 7.7 ± 2.0 years. The mean serum adiponectin level of all the participants was 4.67 ± 2.2 ng/mL with a range of 1.9 ng/mL to 10.0 ng/mL. Adiponectin was slightly higher in females than males (4.93 ± 2.4 ng/mL vs 4.45 ± 2.0 ng/mL, respectively; P = 0.223). In males, an inverse relationship was observed between adiponectin and increasing age, whereas in females, a positive correlation was noted (P = 0.637 vs P = 0.639, respectively). The body mass index (BMI) correlated negatively with adiponectin in all the subjects and across both the genders, but these were not statistically significant. CONCLUSION: Adiponectin varies with sex, age and BMI in pre-pubertal Nigerian children with normal BMI. Further local studies are needed to elucidate its role in the management of associated disease states.

Malaria parasitaemia among febrile under-five children at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria.

Background: Malaria is an infectious disease caused by Plasmodium and transmitted by the bite of an infected female Anopheles mosquito. It continues to be a global challenge with about half of the world's population being at risk of the disease and under­5 children being the most vulnerable. Aims and Obejectives: To determine the prevalence of malaria parasitaemia and some associated symptoms among febrile under-five children presenting at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. Materials and Methods: A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through interviewer administered questionnaire. They were physically examine and blood sample was collected from each of them. The Blood smear was Giemsa stained and examined microscopically for malaria parasite. Result: There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Those in the age range of 12-23 months and 24-35 months constitute the highest number (23%) each. Forty-seven (23.5%) came from the rural area while 153(76.5%) came from the urban area. Average number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1-30 0 days. Body temperature ranged from 35.9-40.4 C with average of 37.7+0.8oC. Forty (20%) were positive to microscopy. Those in the age range of 47-59 months have the highest prevalence of malaria. Parasite density ranged from 40-136,000/µL with a mean of 18,687.2+3360/µL. All the children who are positive by microcopy had Plasmodium falciparium as the specie causing malaria. Conclusion: Malaria parasitaemia among these under-5 children is 20%.

Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS)

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Admission profile and management of community acquired pneumonia in Nigeria--5 year experience in a tertiary hospital.

BACKGROUND: Studies examining the prevalence, baseline characteristics and outcome of patients admitted with Community Acquired Pneumonia (CAP) are not readily available in Nigeria. This study aims to evaluate the management of CAP at a tertiary hospital in Nigeria with a view to determining the prevalence, characteristics, severity and outcome of the admitted patients. METHODS: We retrospectively collected data from 160 admitted patients with final diagnosis of CAP who met the inclusion criteria. Data relating to their age, gender, clinical details, severity assessment using CURB65 score, laboratory results, initial antibiotics prescribed, and outcome (length of stay, hospital mortality) were collected. Descriptive statistics of demographic and clinical variables were calculated and presented as frequencies, percentage, means, standard deviation and range. RESULTS: CAP accounted for 2.5% of all medical admissions during the study period. The mean age of the admitted patients was 52.9 ± 18.98 years with about 35% of the patients being at least 65 years and above. Sputum culture, Fasting blood sugar and HIV screening were requested for in 49(30.6%), 50(31.3%) 56(35%) patients respectively. None of the patients had severity score documented on admission and only 32(20%) patients had severity score of ≥ 3 when calculated. Commonly prescribed antibiotics were a combination of intravenous ceftriaxone and metronidazole. Hospital mortality rate was 11.9% CONCLUSION: We suggest multicenter prospective studies to determine the prevalence and burden of CAP in Nigeria. There is need for an improved assessment and appropriate use of guidelines in the management of patients presenting with CAP.

Respiratory symptoms and ventilatory function tests in Nigerians with HIV infection.

BACKGROUND: The impact of the human immunodeficiency virus (HIV) infection on the respiratory system of Africans has been little studied. This study aimed to determine the pattern of respiratory symptoms and ventilatory functions in HIV infected Nigerians. METHODS: In this cross sectional study, Respiratory symptoms frequency, Forced vital capacity (FVC), Forced expiratory volume in one second (FEV(1)), FEV(1)/FVC ratio, Forced expiratory flow between 25% and 75% of FVC, were determined in 100 HIV positive subjects and compared with values in 100 HIV negative controls. RESULTS: HIV positive patients had significantly more respiratory symptoms and lower ventilatory function tests values compared to the matched controls (p<0.05). HIV patients with at least one respiratory symptom and those with CD4 count less than 200 cells/µl had lower ventilatory function values than their counterparts. 32% of the HIV patients had restrictive ventilatory functional impairment. (p<0.05). Using regression analysis, factors like HIV status, CD4 count and presence of respiratory symptoms were found to be associated with impairment in ventilatory functions. CONCLUSIONS: HIV infected patients had more frequent respiratory symptoms and lower ventilatory function values. Further lung function studies and CT scanning in HIV positive patients especially in those with respiratory symptoms are indicated.

Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria.

The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 - 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing contraceptive practices needs to be encouraged especially in women whose menstruation has returned.

The pattern of home treatment of malaria in under-fives in south eastern Nigeria.

Malaria remains a major public health problem in most countries of the tropics with high morbidity and mortality. The toll of the disease is highest on the under-fives. The actions mothers take in the management of children with malaria is important in the fight to check the malaria scourge. A cross sectional survey was carried out in two states in southeast Nigeria--Abia and Anambra states. A multi-stage sampling technique was used to select the subjects. One thousand two hundred and sixty mothers with children under five years of age were selected from 6 Local Government Areas in the two states. Trained interviewers were used to conduct the survey. The mean age of the mothers was 30.51 +/- 6.76. Over 95% (1016) of the respondents had at least a primary school education. The first line of actions mothers took when their under-five children had malaria showed that 54.5% (687) of them either procured medicines from the patent medicine dealers or used medicines that were in the home. The two most commonly used drugs for malaria treatment for under-fives were chloroquine 65.4% (824) and pyrimethamine/sulfadoxine 12.3% (155). Between 11.5% and 46% of the mothers used correct doses of chloroquine syrup while 5.3% and 11.5% of them used correct doses of chloroquine tablets. The proportion of mothers that used correct doses of pyrimethamine/sulfadoxine tablets was comparatively higher (36.4% and 75%) than the others. Large proportion of mothers (61%) who manage malaria at home, do so inappropriately. Proper health education needs to be set up to enlighten the populace on mode of home treatment for malaria in order to reduce the disease burden on families.

Drug treatment of common childhood symptoms in Nnewi: what mothers do?

OBJECTIVES: To determine how mothers treat common childhood symptoms before hospital attendance in Nnewi. MATERIALS AND METHODS: Information was obtained from 211 consecutive mothers on their children's presenting symptoms, drugs administered, source of the drugs, persons who prescribed the drugs, number of drugs administered, prior to hospital attendance through a structured questionnaire administered by the authors. RESULTS: A combination of fever, cough and catarrh topped the list of presenting symptoms in 87 (41%) of the patients while fever and diarrhea had the least frequency of 16 (7.6%). One hundred and five or 52% of the mothers decided on the drugs that were administered followed by patent medicine dealers who accounted for 59 or 29.2%. Trained health professionals whom mothers consulted before bringing their children to hospital were responsible for 28 (13.8%) of the prescriptions. Patent medicine stores were the sources of 90.6% of the drugs while health facilities accounted for 8.4%. The frequency chart of prescribed drugs were analgesics 166 (34.9%), hematinics 88 (18.5%), antibiotics and antimalarials 81 (17.1%) and 74 (15.6%) respectively while antidiarrheoals and ORT were least administered with 7 (1.5%) and 1 (0.2%) respectively. The children received an average of 2.7 drugs per prescription. CONCLUSION: With the high prescription rate of mothers for sick children at home, there is need for effective methods to educate mothers on the use and potential dangers of home medication.

Tuberculin reaction among healthy BCG vaccinated primary school, children in Nnewi, south eastern Nigeria.

OBJECTIVE: To assess the Mantoux test reaction pattern in healthy BCG vaccinated Primary School Children aged 6 -10 years in Nnewi, South -East Nigeria. MATERIALS AND METHODS: Four primary schools were randomly selected out of 43 government owned primary schools in the town. The entire BCG vaccinated pupils in each school were the sample frame. Mantoux test was administered in 662 pupils that met the inclusion criteria and had their results read 72 hours later. RESULTS: Three groups of children were identified: First group of 470 (75.6%) were negative, 76 (12.2%) had intermediate reaction, while 76 (12.2%) had positive Mantoux test. Increasing age, sex, presence of BCG scar and age at vaccination did not affect the pattern of Mantoux test reaction. CONCLUSION: The result indicates that the use of Mantoux test in the diagnosis of Tuberculosis may not be affected by BCG vaccination at birth and therefore, BCG vaccination at birth should be continued.

Drug Treatment Of Common Childhood Symptoms In Nnewi South Eastern Nigeria: What Mothers Do?

OBJECTIVES: To determine how mothers treat common childhood symptoms before hospital attendance in Nnewi. MATERIALS AND METHODS: Information was obtained from 211 consecutive mothers on their children's presenting symptoms; drugs administered; source of the drugs; persons who prescribed the drugs; number of drugs administered; prior to hospital attendance through a structured questionnaire administered by the authors. RESULTS: A combination of fever; cough and catarrh topped the list of presenting symptoms in 87 (41) of the patients while fever and diarrhea had the least frequency of 16 (7.6). One hundred and five or 52 of the mothers decided on the drugs that were administered followed by patent medicine dealers who accounted for 59 or 29.2. Trained health professionals whom mothers consulted before bringing their children to hospital were responsible for 28 (13.8) of the prescriptions. Patent medicine stores were the sources of 90.6 of the drugs while health facilities accounted for 8.4. The frequency chart of prescribed drugs were analgesics 166 (34.9); hematinics 88 (18.5); antibiotics and antimalarials 81 (17.1) and 74 (15.6) respectively while antidiarrheoals and ORT were least administered with 7 (1.5) and 1 (0.2) respectively. The children received an average of 2.7 drugs per prescription. CONCLUSION: With the high prescription rate of mothers for sick children at home; there is need for effective methods to educate mothers on the use and potential dangers of home medication

Tuberculin Reaction Among Healthy BCG Vaccinated Primary School Children In Nnewi; South Eastern Nigeria

Objective: To assess the Mantoux test reaction pattern in healthy BCG vaccinated Primary School Children aged 6 -10 years in Nnewi; South-East Nigeria. Materials and methods:Four Primary Schools were randomly selected out of 43 government owned primary schools in the town. The entire BCG vaccinated pupils in each school were the sample frame. Mantoux test was administered in 662 pupils that met the inclusion criteria and had their results read 72 hours later. Results: Three groups of children were identified: First group of 470 (75.6) were negative; 76 (12.2) had intermediate reaction; while 76 (12.2) had positive Mantoux test. Increasing age; sex; presence of BCG scar and age at vaccination did not affect the pattern of Mantoux test reaction. Conclusion: The result indicates that the use of Mantoux test in the diagnosis of Tuberculosis may not be affected by BCG vaccination at birth and therefore; BCG vaccination at birth should be continued

HIV/AIDS awareness and sexual practices among undergraduates in Enugu, Nigeria.

OBJECTIVE: To assess the knowledge of HIV/AIDS among Nigeria undergraduates and to determine how the knowledge has influenced their sexual behaviour. MATERIALS AND METHODS: A pre-tested self - administered questionnaire survey of a random sample of undergraduates of two University Campuses in Enugu, Nigeria. RESULTS: All the 505 respondents had heard of HIV/AIDS. The respondents exhibited a high knowledge of HIV/AIDS. For the 348 (68.9% ) respondents who had ever had sexual intercourse, the mean number of sexual partners, which they had before and after they became aware of HIV/AIDS did not differ significantly 93.2+ 1.7 versus 2.9+1.5; p = 0.3). However, there was a significant tendency towards a more consistent condom use after the respondents became aware of HIV/AIDS. On univariate logistic regression, being married (OR=2.8, <0.001), previous risky sexual behaviour (OR= 2.5, <0.0001) and being more than 20 years old (OR=1.4, p < 0.02) (but not respondents' level of knowledge of HIV/AIDS etc) were significant predictors of risky sexual behaviour after the respondents became aware of HIV/AIDS. On multivariate logistic regression - previous risky sexual behaviour (OR =2.5, <0.00001) and being married (OR = 2.1, p< 0.001) remained significant. CONCLUSION: High knowledge of HIV/AIDS has no correlation with subsequent sexual behaviour among Nigerian undergraduates.

Breast feeding practices in Onitsha South Eastern Nigeria - 2 years after baby friendly initiative

"Objective: To study the impact of ""baby friendly hospital initiative"" on breast feeding practices in Onitsha South Eastern Nigeria; 2 years after introduction. Setting: Holy Rosary Maternity Hospital Onitsha. Materials and methods: A structured questionnaire was used to collect data from 178 breast feeding mothers on maternal age; mothers' educational attainment; attendance at breast talks; and acceptance of exclusive breast feeding. Information was also obtained on feeding in the post natal ward; breast feeding practices at 6 weeks; 10 weeks; 14 weeks; 6 months; 9 months; 12 months; 18 months and 24 months post delivery. The data obtained was analyzed. Results: Breast feeding practices was studied among 178 breast feeding mothers attending the infant welfare clinics of Holy Rosary Maternity Hospital Onitsha; 2 years after it was made a ""Baby Friendly Hospital"". A total of 145 or 81.4 of the mothers were between the ages of 20 and 34 years; and all of them had some level of formal education with 59 of them acquiring secondary education. About one third or 33.1 of them were full time housewives while the rest engaged in one form of professional activity. While two thirds or 67.4 of the mothers attended breast feeding talk sessions 89 had knowledge of breast feeding support group and utilized their services during ante natal visits. Seventy three percent initiated breast feeding within less than an hour of delivery. All most all the mothers (99.4) established breast feeding by the time they were leaving the hospital on discharge and continued breast feeding up to 6 weeks post discharge. This proportion dropped to 84.3 at 12 months and to 1.1 at 24 months. Exclusive breast feeding rate fell from 99.4 on discharge to 3.9 at 6 months; while ""on-demand"" was practiced by 99.9 of the study population. Conclusion: We therefore recommend that the Campaign on Baby Friendly Initiative activities should continue and be strengthened to effect the ""The ten steps to successful breast feeding."