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%.

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.

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