Psychological Distress among Caregivers of Children Admitted into the Children Emergency Room of a Nigerian Tertiary Hospital.

BACKGROUND: Many caregivers experience significant psychological burden which may impact on the management of a sick child. OBJECTIVE: To determine the prevalence and associated factors of psychological distress among caregivers of children admitted at the Children Emergency Room. METHODS: This was a descriptive cross-sectional study among caregivers of children who were hospitalized for at least 24 hours. The 28-item General Health Questionnaire (GHQ 28) was used to assess the psychological distress among the caregivers. GHQ scores were stated as means ± standard deviation (SD). Chi-square or Fisher's exact test was used to test for association between sociodemographic variables and psychological distress. Mean GHQ scores in the various domains of psychological dysfunction were compared among groups using the independent sample t-test; at p<0.05. RESULTS: Of the 97 caregivers who participated in the study, 96 had their data analyzed. The caregivers were aged 19 to 63 (mean 34.25 (8.46)) years; 86 (89.7%) were females and 48 (50%) had tertiary education. The prevalence of psychological distress among the care givers was 69.8%. Caregivers had high levels of anxiety but low levels of depression. Those with lower educational attainment had higher scores on severe depression domain (p = 0.001). Unemployed caregivers had higher mean scores on the anxiety/insomnia (p = 0.039) and social dysfunction domains (p = 0.031). Those with large family sizes scored higher on the anxiety/insomnia domain (p = 0.03). CONCLUSION: Psychological distress was high among caregivers of children admitted at the children emergency room.

CONTEXTE: De nombreux aidants éprouvent une expérienceimportante charge psychologique pouvant avoir une incidence sur la prise en charge d'un malade enfant. OBJECTIF: Déterminer la prévalence et les facteurs associés de détresse psychologique chez les personnes qui s'occupent d'enfants admis à l'Salle d'urgence pour enfants. MÉTHODES: Il s'agissait d'une étude transversale descriptive parmi les soignants d'enfants qui ont été hospitalisés pendant au moins 24 heures. Le Questionnaire général sur la santé (QGH) en 28 éléments a été utilisé pour évaluer la détresse psychologique chez les soignants. Les scores GHQ étaient indiqué comme moyen ±'écart-type (ET). Chi-carré ou Fisher's le test exact a été utilisé pour tester l'association entre sociodémographiques variables et détresse psychologique. Scores GHQ moyens dans les domaines différentes de dysfonctionnement psychologique ont été comparés entre les groupes à l'aide du test t de l'échantillon indépendant; à p<0.05. RÉSULTATS: Sur les 97 aidants qui ont participé à l'étude, 96 leurs données ont été analysées. Les aidants étaient âgés de 19 à 63 ans (moyenne 34.25 (8.46)) ans; 86 (89.7 %) étaient des femmes et 48 (50 %) avaient l'enseignement supérieur. La prévalence de la détresse psychologique chez les les soignants étaient 69.8 %. Les aidants avaient des niveaux élevés d'anxiété, mais faibles niveaux de dépression. Ceux dont le niveau de scolarité est inférieur avaient des scores plus élevés dans le domaine de la dépression sévère (p = 0.001). Les aidants au chômage avaient des scores moyens plus élevés sur l'anxiété / insomnie (p = 0.039) et les domaines de dysfonctionnement social (p = 0.031). Ceux qui ont les grandes familles ont obtenu des scores plus élevés dans le domaine de l'anxiété / insomnie (p = 0.03). CONCLUSION: La détresse psychologique était élevée chez les aidants naturels des enfants admis à la salle d'urgence des enfants. Mots-clés: Soignant, enfants, urgence, détresse psychologique, Stitués dans la prise en charge des patients atteints de LA COVID-19.

Comparison of age-based weight estimation with actual measured weight in children aged one to twelve years in Enugu.

AIMS: This study was carried out to evaluate the degree of accuracy of age-based weight estimation methods in assessing the weight of the Nigerian child. METHOD: The weights of one thousand, four hundred and fifty-six (1,456) children were measured and compared with the updated Advanced Paediatric Life Support (APLS), Best guess, Nelson and Luscombe & Owen methods. RESULT: The updated APLS, Nelson and Luscombe & Owen methods underestimated the weights in younger children while overestimating in older ones. Best guess overestimated the weights across all ages. The Nelson formula had the best agreement within 10% and 20% of the measured weights among all methods. A linear regression analysis produced an equation for weight estimation: weight (W) = 2.058 Y + 9.925, where W is weight in kilogram and Y is the age in years. CONCLUSION: None of the weight estimation formulae assessed was entirely accurate in our study, though the Nelson method showed superior agreement.

Severe falciparum malaria in children in Enugu, South East Nigeria.

INTRODUCTION: Severe malaria remains one of the leading causes of morbidity and mortality in sub-Saharan Africa and parts of Asia despite several efforts in prevention and management. The prevalence and pattern of presentation may vary from one location to another and from one age group to another. OBJECTIVES: This study was undertaken to review the prevalence and pattern of severe malaria among children presenting in the two tertiary hospitals in Enugu, south-east Nigeria. METHODS: The case records of children presenting with malaria in the two tertiary hospitals in the state were retrieved and the necessary information were obtained using a structured questionnaire. RESULTS: The children aged from 1 month to 184 months (15 years), with a median age of 36 months and mean age of 49.2 ± 42.7 months. About two-thirds (68/102, 66.7%) of the children were under the age of 5 years, with only 6 of them (8.8%) being 6 months and below. There were significantly more males than females (χ2 = 6.48, P = 0.01); with a M:F ratio of 1.55:1. The peak of presentation was from August and November. Prostration, respiratory distress and severe anaemia were the commonest features of severe malaria, while shock, acute renal failure and abnormal bleeding were the least presenting features Of all the features, only severe anaemia was significantly related to age, (χ2 = 5.027, P = 0.02). Sixty-one (59.8%) of the children had one or more co-morbidities. There were 2 deaths, giving a case fatality rate of 1.96%. CONCLUSION: Early presentation will significantly reduce blood transfusions, prolonged admission and death in children with severe malaria.

Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011-2016.

BACKGROUND: The high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact. METHODS: Routine rotavirus surveillance was conducted during 2011-2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA). RESULTS: 2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases. CONCLUSION: The high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program.

The prevalence of allergic diseases among children with asthma: What is the impact on asthma control in South East Nigeria?

BACKGROUND: Allergic diseases are known to occur in children with asthma and its coexistence with asthma may impact on asthma control in affected children living in a low-income country. The study is to determine the allergic profile of children with asthma and the association with asthma control and attendant social risk factors. MATERIALS AND METHODS: This was a cross-sectional study of consecutively enrolled children with physician diagnosed asthma, attending clinics in a tertiary center in Nigeria. The presence of asthma, allergy types, and asthma control levels were determined using the Gobal initiative on asthma (GINA), international study of asthma and allergy in childhood and asthma control test questionnaires, respectively. RESULTS: There were 207 children with asthma enrolled from the Pediatric Asthma Clinic at University of Nigeria Teaching Hospital, Enugu. The median age was 10 years and interquartile range of 7-11 years. There were 127 (61.4%) from middle and high socioeconomic class and 86.5% who lived in the urban areas. Of the study participants, 41.5% had one or more allergy symptoms; rhinitis (33.3%), conjunctivitis (29.0%), and dermatitis (7.2%). Allergy symptoms persisted from infancy in 55.9%. Children from large families had a lower prevalence of allergies. Having any allergy symptom and belonging to a small-sized family were both associated with asthma exacerbations. Most children studied, (69.1%) had their asthma under control. Allergy persistence from infancy and type of allergy were not significantly associated with the level of asthma control. CONCLUSION: Allergic diseases are common in children with asthma in our environment, but did not significantly impact on asthma control. Socioeconomic factors such as urbanization and family size had effects on the achievement of asthma control but not on allergy status.

Accidental Childhood Poisoning in Enugu, South-East, Nigeria.

BACKGROUND: Accidental childhood poisoning is one of the recognized causes of morbidity and mortality in children under the age of 5 years worldwide. The prevalence and type of substance ingested vary from place to place and over time. AIM: This study was conducted with the aim of ascertaining the frequency and pattern of accidental childhood poisoning in Enugu. SUBJECTS AND METHODS: This retrospective study was conducted at the Emergency Paediatric Unit of the University of Nigeria Teaching Hospital, Enugu, South-East, Nigeria from January 2003 to December 2012 (10 years). All the cases of childhood accidental poisoning that presented within the period were reviewed and important information extracted. RESULTS: Sixty-five cases of childhood poisoning were recorded during the 10-year period, giving an incidence rate of 442 per 100,000 children. The mean age was 22.15 ± 11.7 months. Male:female ratio was 1.5:1. The prevalence was higher among those with low socioeconomic background. Kerosene poisoning was the most common agent. The overall mortality rate was 3.1% (2/65). CONCLUSION: Accidental childhood poisoning is common in Enugu, with appreciable mortality, with kerosene being the most common agent. We advocate regulatory policy on proper ways of storing kerosene and other harmful household chemicals and medications.

Accidental Childhood Poisoning in Enugu; South-East; Nigeria

Background: Accidental childhood poisoning is one of the recognized causes of morbidity and mortality in children under the age of 5 years worldwide. The prevalence and type of substance ingested vary from place to place and over time.Aim: This study was conducted with the aim of ascertaining the frequency and pattern of accidental childhood poisoning in Enugu.Subjects and Methods: This retrospective study was conducted at the Emergency Paediatric Unit of the University of Nigeria Teaching Hospital, Enugu, South­East, Nigeria from January 2003 to December 2012 (10 years). All the cases of childhood accidental poisoning that presented within the period were reviewed and important information extracted.Results: Sixty­five cases of childhood poisoning were recorded during the 10­year period, giving an incidence rate of 442 per 100,000 children. The mean age was 22.15 ± 11.7 months. Male:female ratio was 1.5:1. The prevalence was higher among those with low socioeconomic background. Kerosene poisoning was the most common agent. The overall mortality rate was 3.1% (2/65).Conclusion: Accidental childhood poisoning is common in Enugu, with appreciable mortality, with kerosene being the most common agent. We advocate regulatory policy on proper ways of storing kerosene and other harmful household chemicals and medications

A comparison of axillary with rectal thermometry in under 5 children.

BACKGROUND: Body temperature measurement is a crucial clinical assessment in the care of an acutely ill child, especially the under fives. Most temperature measurements in our hospital are done from the axilla. OBJECTIVE: To study the relationship between temperatures taken in the axilla with those taken in the rectum in febrile and afebrile children less than 5 years. MATERIALS AND METHODS: Rectal and axillary temperatures were taken concurrently in 400 febrile and 400 afebrile children aged less than 5 years using mercury-in-glass thermometers. RESULT: The rectal temperature measurements ranged from 38.0 to 41.4°C and 36.4 to 37.9°C in the febrile and afebrile groups of children respectively while the axillary temperatures ranged from 36.7 to 41.0°C and 35.9 to 37.5°C in the febrile and afebrile groups of children, respectively. There were significant differences between the temperatures measured at the two sites in all the age groups studied. There was good positive correlation between the rectal and axillary temperatures. A linear relationship between axillary and rectal temperatures was derived using the simple regression analysis. The equation is: rectal temperature = 0.94×axillary temperature+2.92. CONCLUSION: Although there's good correlation between axillary and rectal temperatures, significant difference exits between them that cannot be explained by the addition of any single value or any particular equation.

Awareness and use of insecticide-treated bed nets among children attending outpatient clinic at UNTH, Enugu - the need for an effective mobilization process.

BACKGROUND: The promotion of insecticide-treated net (ITN) can be a key approach towards the reduction of morbidity and mortality from malaria. OBJECTIVE: To determine the proportion of mothers using insecticide treated nets for their children and reasons for nonuse. STUDY DESIGN: Prospective hospital-based study. METHOD: Consecutive mothers attending the children's out patient clinic of UNTH, Ituku-Ozalla, Enugu, whose children presented with fever without localizing focus were interviewed with the aid of an open-ended structured questionnaire. RESULTS: Awareness of ITN was found in 184 (80%) of the 230 mothers interviewed, while only 48 (26.1%) use it for their children. There was statistically significant difference in terms of ITN awareness between the highly educated mothers and those with lower educational qualification (p = 0.000) but, in terms of ITN usage, there was no significant difference between the two groups (p = 0.40). Socio economic class did not influence the use of ITN (p = 0.153). A greater number; 56 (41.2%) have no reason for non-use. Reasons for nonuse include use of windows and door nets 22 (16.2%) and not convenient to spread 18 (13.2%). CONCLUSION: There was a high awareness of ITN, which did not influence usage.

Awareness and Use of Insecticide-Treated Bed Nets among Children Attending Outpatient Clinic at UNTH; Enugu - the Need for an Effective Mobilization Process

Background: The promotion of insecticide-treated net (ITN) can be a key approach towards the reduction of morbidity and mortality from malaria. Objective: To determine the proportion of mothers using insecticide treated nets for their children and reasons for nonuse. Study design: Prospective hospital-based study. Method: Consecutive mothers attending the children's out patient clinic of UNTH; Ituku-Ozalla; Enugu; whose children presented with fever without localizing focus were interviewed with the aid of an open-ended structured questionnaire. Results: Awareness of ITN was found in 184 (80) of the 230 mothers interviewed; while only 48 (26.1) use it for their children. There was statistically significant difference in terms of ITN awareness between the highly educated mothers and those with lower educational qualification (p=0.000) but; in terms of ITN usage; there was no significant difference between the two groups (p=0.40). Socio economic class did not influence the use of ITN (p=0.153). A greater number; 56 (41.2) have no reason for non-use. Reasons for nonuse include use of windows and door nets 22 (16.2) and not convenient to spread 18 (13.2). Conclusion: There was a high awareness of ITN; which did not influence usage