Malaria Diagnosis at the Pediatric Emergency Unit of a Teaching Hospital in Makurdi, North Central Nigeria.

Background: Globally, there were 241 million cases of malaria in 2020, with an estimated 627,000 deaths with Nigeria accounting for 27% of the global malaria cases. In sub-Saharan Africa, testing is low with only 28% of children with a fever receiving medical advice or a rapid diagnostic test in 2021. In Nigeria, there are documented reports of over-diagnosis and over-treatment of malaria in children. Therefore, this study examined the diagnosis of malaria at the Benue State University Teaching Hospital, Makurdi. Methods: A 5-year (2018-2022) retrospective study was carried out at the Emergency Pediatric Unit (EPU). Records of all children presenting to the EPU with an assessment of malaria were retrieved and reviewed. Data was analyzed using SPSS 23. Results: Out of 206 children reviewed, 128 (62.1%) were tested using either malaria RDT or microscopy while 78(37.9%) were not tested. Out of the number tested, 59(46.1%) were negative while 69(53.9%) tested positive, of which 14(20.3%) had uncomplicated malaria while 55(79.7%) had severe malaria. However, while 97.1% (n=67) of the positive cases were treated with IV artesunate, 69.5% (n=41) of those who tested negative and 88.5% (69) of those who were not tested also received IV artesunate. Moreover, while 85.5% (n=59) of those who tested positive received oral artemisinin-based combination therapy (ACT), 72.9% (n=43) of those who tested negative and 67.9% (53) of those who were not tested also received oral ACT. Conclusion: There was over-diagnosis of malaria, and subsequently, over-treatment. Hence continued emphasis on parasitological confirmation of malaria before treatment is recommended.

Burden of COVID-19 Pandemic on Adolescents' Quality of Life: A Cross-Sectional Study among Secondary School Students in North-Central Nigeria.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) has caused millions of mortalities globally. Although the prevalence and fatality rates of COVID-19 among adolescents is low, its impact on their health-related quality of life (HRQoL) is not adequately known. This study was carried out to determine the burden COVID-19 pandemic has on the HRQoL of adolescents. METHODS: A cross-sectional descriptive study was carried out among adolescents in public and private secondary schools in Jos North Local Government Area of Plateau State. A multistage sampling technique was employed to select the schools and recruit the participants in April/May 2021. Data was collected using a self-administered questionnaire containing the participants' socio-demographic characteristics, questions on being burdened by COVID-19 pandemic, and the KIDSCREEN-10 tool for assessing the HRQoL. The data was analyzed using SPSS version 25.0 and a p-value of < 0.05 was regarded as significant. RESULTS: A total of 405 adolescents participated in the study with a mean age of 14.6 ± 2.06 years. Majority (52.8%) of the participants were girls. More than half (53.3%) of the participants reported being burdened by the COVID-19 pandemic. Also, 45.7% of the participants experienced a lower HRQoL. There was a statistically significant association between being burdened by the COVID-19 pandemic and their HRQoL (χ2 = 7.108, p = 0.01). In addition, the participants' HRQoL was significantly associated with their age (χ2= 5.112, p = 0.02). CONCLUSION: This study highlights the significant burden of COVID-19 pandemic on adolescents' wellbeing. Therefore, there is the need to intensify health intervention strategies among adolescents to reduce the physical, emotional, and mental burden imposed by the COVID-19 pandemic in order to optimize their quality of life.

CONTEXTE: La maladie de coronavirus 2019 (COVID-19) a causé des millions de décès dans le monde. Bien que la prévalence et les taux de mortalité du COVID-19 chez les adolescents soient faibles, son impact sur leur qualité de vie liée à la santé (QVLS) n'est pas suffisamment connu. Cette étude a été menée pour déterminer le poids de la pandémie de COVID-19 sur la QVLS des adolescents. MÉTHODES: Une étude descriptive transversale a été menée parmi les adolescents des écoles secondaires publiques et privées de la région de Jos North Local Government Area de l'Etat du Plateau. Une technique d'échantillonnage à plusieurs degrés a été utilisée pour sélectionner les écoles et recruter les participants en avril/mai 2021. Les données ont été collectées à l'aide d'un questionnaire auto-administré contenant les caractéristiques sociodémographiques des participants, des questions sur le fardeau que représente la pandémie de COVID-19, et l'outil KIDSCREEN-10 pour évaluer la qualité de vie. Les données ont été analysées à l'aide de SPSS version 25.0 et une valeur p < 0,05 a été considérée comme significative. RÉSULTATS: Un total de 405 adolescents ont participé à l'étude avec un âge moyen de 14,6 ± 2,06 ans. La majorité (52,8%) des participants étaient des filles. Plus de la moitié (53,3%) des participants ont déclaré être accablés par la pandémie de COVID-19. En outre, 45,7 % des participants ont connu une baisse de leur qualité de vie. Il y avait une association statistiquement significative entre le fait d'être accablé par la pandémie de COVID-19 et leur QVLS (χ2 = 7,108, p = 0,01). De plus, la QVLS des participants était significativement associée à leur âge (χ2 = 5,112, p = 0,02). CONCLUSION: Cette étude met en évidence le poids important de la pandémie de COVID-19 sur le bien-être des adolescents. Il est donc nécessaire d'intensifier les stratégies d'intervention sanitaire auprès des adolescents pour réduire le fardeau physique, émotionnel et mental imposé par la pandémie de COVID-19 afin d'optimiser leur qualité de vie. Mots clés: Adolescents, École secondaire, COV ID-19, Qualité de vie liée à la santé (QVLS), Jos.

Knowledge, Attitude and Practice on Covid-19 among Clinical Healthcare Workers in Bingham University Teaching Hospital (BHUTH) Jos, Plateau State, Nigeria.

BACKGROUND: The ongoing Covid-19 pandemic is now a global health emergency with significant morbidity and mortality among different populations of the world. Healthcare professionals are the people in the front line of situations like this. Their perspectives on the pandemic is critical to their safety and the outcomes in patients they manage. The aim of this study is to assess the knowledge, attitude and practice regarding COVID-19 among clinical healthcare professionals in Bingham University Teaching Hospital (BHUTH) Jos. MATERIALS AND METHODS: A total of 138 clinical health workers from BHUTH completed a questionnaire- based study on the knowledge, attitude and practice on COVID-19 from the April 1st to 30th May 2020. Consecutive sampling method was used for data collection and the distribution of responses was presented as frequencies and percentages. Analysis of Variance (ANOVA) test was used to investigate the level of association among variables at the significance level of p<0.05. RESULTS: The highest mean of correct responses for knowledge were from doctors, pharmacists and nurses with 19.1±2.35, 19.4±1.52 and 18.9±1.73 respectively. The lowest mean was from pharmacist assistant and nurse aids with 17.1±1.81. The difference was statistically significant with Anaysis of Variance (F) of 5.75 and p value of 0.001. The attitude and practice mean were good between the different clinical cadre; however, the difference was not significant. CONCLUSION: There is good knowledge, attitude and practice among the doctors and pharmacists, nurses, nurse assistants and pharmacist assistants. The doctors and pharmacist had better scores. There is the need for regular training and update.

CONTEXTE: La pandémie de Covid-19 en cours est maintenant une urgence sanitaire mondiale avec une morbidité et une mortalité importantes parmi les différentes populations du monde. Les professionnels de la santé sont les personnes en première ligne dans des situations comme celle-ci. Leurs points de vue sur la pandémie sont essentiels à leur sécurité et aux résultats chez les patients qu'ils gèrent. Le but de cette étude est d'évaluer les connaissances, l'attitude et la pratique concernant le COVID-19 parmi les professionnels de la santé cliniques du Bingham University Teaching Hospital (BHUTH) Jos. MATÉRIAUX ET MÉTHODES: Un total de 138 agents de santé cliniques du BHUTH ont terminé une étude basée sur un questionnaire sur les connaissances, l'attitude et la pratique du COVID-19 du 1er avril au 30 mai 2020. La méthode d'échantillonnage consécutif a été utilisée pour la collecte des données et la distribution des réponses a été présentée sous forme de fréquences et de pourcentages. Le test d'analyse de variance (ANOVA) a été utilisé pour étudier le niveau d'association entre les variables au niveau de signification de p <0,05. RÉSULTATS: La moyenne la plus élevée de réponses correctes pour les connaissances était celle des médecins, des pharmaciens et des infirmières avec respectivement 19,1 ± 2,35, 19,4 ± 1,52 et 18,9 ± 1,73. La moyenne la plus faible était celle des assistants pharmaciens et des infirmières auxiliaires avec 17,1 ± 1,81. La différence était statistiquement significative avec F de 5,75 et p de 0,001. L'attitude et la pratique moyenne étaient bonnes entre les différents cadres cliniques; cependant, la différence n'était pas significative. CONCLUSION: Il existe de bonnes connaissances, une bonne attitude et une bonne pratique parmi les médecins et pharmaciens, infirmières, infirmières auxiliaires et pharmaciens assistants. Les médecins et le pharmacien avaient de meilleurs scores. Une formation et une mise à jour régulières sont nécessaires. MOTS CLÉS: COVID-19, connaissances, attitude, pratique, travailleurs de la santé, Nigéria.

Management and Outcome of a Case of Osteogenesis Imperfecta in Benue State University Teaching Hospital, Makurdi, North-Central Nigeria.

Osteogenesis Imperfecta is a genetic disorder of the connective tissue leading to generalised osteoporosis, fragility of the skeletal system and susceptibility to fractures of the long bones and compression of the vertebrae from mild or inconsequential trauma. It is one of the rare diseases known to mankind. It has no definitive cure and treatment is essentially supportive. We present below a preterm male neonate who was seen 5-hours after birth with abnormal posturing, abnormal shape of the head and limbs. There was a positive family history of delivery of a baby with similar history and outcome. A skeletal survey revealed multiple fractures involving the clavicle, humerus, femur, tibia and fibula. He was managed as a case of Osteogenesis Imperfecta. This was the first case out of 1,445 newborns admitted into the Unit. He was discharged after 2-weeks of hospitalisation but died at 6-weeks of age following progressively worsening episodes of respiratory distress.

Human Monkey Pox Virus Infection in Plateau State, North Central Nigeria: A Report of Two Cases.

BACKGROUND: Human Monkey Pox Virus (HMPV) infection is a zoonotic infection that is endemic in the Congo basin and West Africa. Its similarity to smallpox infection, increased susceptibility infection in human populations, lack of a definitive therapy and its potential for use as a bioterrorism tool underscores its public health importance. OBJECTIVE: To describe the characteristics of HMPV infection in Plateau State, North Central Nigeria. METHODS: This was a case study of HMPV infection occurring in two Nigerian adults, seen in 2018, at Bingham University Teaching Hospital in Jos, Plateau State, Nigeria. The cases involved two siblings, and these were the first reported cases in Plateau State of Nigeria, which has an estimated population of 3.5 million persons. The diagnosis was based on a combination of clinical features and positive PCR tests on samples from the skin lesions and blood. RESULTS: The first case, a 20-year-old male, presented with a one week history of fever, headache, pain on swallowing and micturition, and generalised skin lesions. The second case is a 20 year old step brother of the first case, and the primary care provider to first case when he took ill. He also presented with a one-week history of fever, headache, pain on swallowing, and skin lesions which were less intense than in the first case. PCR assays of samples from the skin lesions and blood were positive in both cases. The other comorbidity in both cases was pharyngotonsillitis. Blood, throat, stool, and urine cultures for suspected sepsis and urinary tract infection were all negative. Both cases were admitted and discharged after receiving a course of antibiotics, antihistamine, Non-Steroidal Anti-Inflammatory Drugs, and multivitamins. Universal precautions were observed. CONCLUSION: HMPV infection in our environment underscores the need to strengthen preventive health strategies against this infection.

CONTEXTE: L'infection par le virus de la variole humaine du singe (VMPS) est une zoonose endémique dans le bassin du Congo et en Afrique de l'Ouest. Sa similitude de l'infection variole augmenté l'infection susceptibilité dans les populations humaines, l'absence d'une thérapie définitive et son potentiel d'utilisation comme outil de bioterrorisme souligne son importance pour la santé publique. OBJECTIF: Décrire les caractéristiques de l'infection par le HMPV dans l'État du Plateau, dans le centre-nord du Nigeria. MÉTHODES: Il s'agit d'une étude de cas d'une infection à HMPV survenue chez deux adultes nigérians vus en 2018 à l'hôpital universitaire Bingham de Jos Teaching Hospital à Jos, dans l'État du Plateau, au Nigeria. Les cas impliquaient deux frères et sœurs, et il s'agissait des premiers cas signalés dans l'État du Plateau du Nigeria, dont la population est estimée à 3,5 millions de personnes. Le diagnostic était basé sur une combinaison de caractéristiques cliniques et de tests PCR positifs sur des échantillons provenant des lésions cutanées et du sang. RÉSULTATS: Le premier cas, un homme de 20 ans, s'est présenté avec un historique d'une semaine de fièvre, de maux de tête et de douleurs, de douleur à la déglutition et à la miction, et de lésions cutanées généralisées. Le deuxième cas est un demi-frère de 20 ans du premier cas, et le principal et le fournisseur de soins primaires du premier cas lorsqu'il est tombé malade. Il a également présenté une semaine de fièvre, de maux de tête, de douleur à la déglutition et des lésions cutanées qui étaient moins intenses que dans le premier cas. L' analyse PCR des échantillons de lésions cutanées et de sang étaient positifs dans les deux cas. L''autre comorbidité dans les deux cas était pharyngotonsillite. Les cultures de sang, de la gorge, des selles et de l'urine pour une suspicion de septicémie et d'infection des voies urinaires étaient toutes négatives. Les deux cas ont été admis et ont quitté l'hôpital après avoir reçu une série d'antibiotiques, d'antihistaminiques et de médicaments, d'antibiotiques, d'antihistaminiques, d'anti-inflammatoires non stéroïdiens et des multivitamines. Les précautions universelles ont été observées. CONCLUSION: L'infection par le HMPV dans notre environnement souligne la nécessité de renforcer les stratégies sanitaires préventives contre cette infection. MOTS CLÉS: Virus de la variole du singe humain, Présentation clinique, Nigeria.

Risk Factors Associated with Adolescent Obesity in an Urban Area, North-West Nigeria.

BACKGROUND: Adolescence is a vulnerable period of transition and a time for establishing healthy or risky behaviours. Adolescents constitute the strategic link between a nation's past and the future. Adolescent obesity is an epidemic of global proportions which has affected both industrialized and developing countries. Identifying factors that influence adolescent obesity in our environment would help to strengthen preventive measures, reduce the disease burden, and ultimately improve adult health. METHODS: A cross-sectional study conducted in secondary schools in Kaduna metropolis, North-West Nigeria. The participants were selected using systematic sampling method. Data were collected using a structured interviewer-administered questionnaire. The data were analyzed using SPSS version 20. RESULTS: One hundred and fifty adolescents were recruited into the study. This consisted of 85(56.7%) girls and 65(43.3%) boys. The mean age of the participants was 14.1 ± 2.3 years. The prevalence of overweight and obesity was 21.3% and 14.0% respectively. Factors identified to be associated with the development of obesity included lack of sporting activities (c2 = 8.18, p= 0.04) and the number of hours of sleep daily (c2 = 17.91, p= 0.01). All except one of the obese adolescents consumed snacks/soft drinks, though the relationship between adolescent obesity and consumption of snacks/soft drinks was not statistically significant (c2 = 5.58, p= 0.13). CONCLUSION: Addressing the risk factors associated with adolescent obesity is a key to reversing this global epidemic. Health education on appropriate sleep pattern and engaging in sporting activities should be emphasized in secondary schools.

Impact of Epilepsy on Adolescents in a Rural Nigerian Community: A Case-Control Study.

BACKGROUND: Epilepsy is associated with impaired physical, psychological and social functioning. Assessing its impact on these parameters is important to improving the wellbeing of those with the disorder. OBJECTIVE: To assess the impact of epilepsy on the physical, psychological and social status of adolescents in a rural community. METHODS: Adolescents with epilepsy (Subjects) were identified in a community house to house survey. Controls (adolescents without epilepsy) matched for age and sex were randomly selected from the community. Information obtained from the subjects, controls and their care givers using a structured questionnaire included: Age, Sex, Social Class, Knowledge of epilepsy, Characteristics of epilepsy, Treatment options utilized, Health-Related Quality of Life (HRQOL), Body Mass Index (BMI), Academic performance and Epilepsy related problems. RESULTS: Eighteen subjects, 10.5/1000 of the adolescent (10-19 years) population, had epilepsy. The mean age was 16.7± 2.6 years and 16.3± 2.6 years for the subjects and controls respectively. Most of the subjects were males (83.3%). All the subjects had generalized epilepsy, were on traditional medication and none was on orthodox medical therapy. Occurrence of seizures, cost of accessing orthodox medical treatment and stigma were the major problems identified. Ingestion of traditional medication was the commonest modality for overcoming the major problems identified. Seven (38.8%) were underweight but it was not significant (p>0.05). Epilepsy was significantly associated with impaired HRQOL, academic performance and social relationships (p>0.05). CONCLUSION: Epilepsy had a negative impact on the psychosocial and academic status of adolescents. It highlights the need to provide comprehensive adolescent health and social services in epilepsy management.

Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria.

Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants) attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4%) were returned. Good knowledge (KCAHW score ≥15) was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility (P < 0.05), while poor knowledge (KCAHW score <15) was significant among general practitioners (P < 0.05). The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4) while the least was concerning communication impairments (KCAHW Domain 2). Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.

Natal tooth and cultural impact on its management in a tropical neonatal unit: a case report.

The incidence of natal tooth is uncommon and its management could be fraught with challenges. A 3 day old female presented with features of sepsis and a natal tooth. Treatment for sepsis was permitted and successfully instituted but definitive management of the natal tooth was deferred, for cultural reasons, by the parents. The case documents the occurrence of natal tooth and highlights the impact of cultural beliefs on management of some medical conditions. It underscores the need to develop the relationship between orthodox medical care and cultural beliefs, in susceptible communities, with a view to achieving optimal health care delivery.

A comparative assessment of motor function using the expanded and revised gross motor function classification system and the manual ability classification system in the same children with cerebral palsy in Shika, Zaria, Northwestern Nigeria.

BACKGROUND: Assessment of motor function in children with Cerebral Palsy (CP) is vital to the identification and management of their mobility needs. OBJECTIVE: To compare the Expanded and Revised Gross Motor Function Classification System (GMFCS-E&R) and Manual Ability Classification System (MACS) in the assessment of motor function in children with CP. METHODS: A review of motor activity in children with CP documented at the Departments of Paediatrics and Physiotherapy, Ahmadu Bello University Teaching Hospital, Shika, Zaria, between January 2005 and December 2009. RESULTS: A total of 28 children (16M: 12 F, 1.3:1) with an age range of 4 to 12 years (mean 6.2 ± 2.4 years) were studied. Birth asphyxia (46.43%) and Spastic Hemiplegia (71.43%) were the main identified predisposing factor and clinical type of CP respectively. The GMFCS-E&R identified 13 (46.43%) children with higher levels (I & II) of gross motor function against 4 (14.29%) children identified in the MACS higher levels (p=0.02). Also 6 (21.43%) of the children were identified as being in the GMFCS-E&R lower levels (IV & V) against 16 (57.14%) in MACS lower levels (p=0.00). The difference in the number of children identified as being in level III for GMFCS-E&R 9 (32.14%) and MACS 8 (28.57%) was not significant (p=0.77). Overall correlation between GMFCS-E&R and MACS levels was poor using Kappa statistics (Kappa=0.00). CONCLUSION: The GMFCS-E&R and MACS significantly identified higher and lower levels of motor functions respectively in the same children. The disparity underscores the complexity in assessing the motor function of children with CP.

Febrile seizures in Kaduna, north western Nigeria.

BACKGROUND: Febrile seizure is the most common seizure of childhood and has a good prognosis. However its presentation is fraught with poor management, with grave consequences, in our environment. Thus a review of its current status is important. OBJECTIVE: To review the status of febrile seizures in Kaduna metropolis. MATERIALS AND METHODS: A review of cases seen in the Department of Paediatrics, 44 Nigeria Army Reference Hospital, Kaduna between June 2008 and June 2010. RESULTS: Out of the 635 cases admitted in the department 17 (2.7%) fulfilled the criteria for febrile seizures. There were 11 Males and 6 Females (M: F, 1.8:1). Age range was from 9 months to 5 years with a mean of 2.2 years ± 1.1 and peak age of 3 years. Twelve (70.6%) were in the upper social classes (I-III). Fever, convulsion, catarrh and cough were major presenting symptoms. Incidence of convulsion was least on the 1st day of complaint. Fourteen (82.4%) of the cases were simple febrile seizures while 3 were complex. There was a positive family history in 5 (29.4%) of the cases. Eleven (64.7%) had orthodox medication at home, before presentation, 5 (29.4%) consulted patient medicine sellers and 7 (41.7%) received traditional medication as part of home management. Malaria and acute respiratory infections were the identifiable causes. Standard anti-malaria and anti-biotic therapy were instituted, where indicated. All recovered and were discharged. CONCLUSION: There was a low prevalence of febrile seizures among the hospitalized children and a poor pre-hospitalization management of cases. It highlighted the need for improved community awareness on the prevention and management of febrile seizures.

Computerized tomography of children with seizure disorders.

BACKGROUND: Neuro-imaging is generally considered as part of the evaluation of seizures and epilepsy. There is limited information about its usefulness in our environment. We describe the pattern of CT findings in children with seizures in our environment. METHOD: We carried out a retrospective review of the computerized tomography findings in children with recurrent seizures over a one year period, November 2005 to October 2006. RESULTS: During the study period, 49 infants and children had computerized tomography performed on them out of which 19 had CT done for recurrent seizures. They ranged in age from 4 months to 16 years with 13 of them being boys. Generalized tonic--clonic seizures was the most predominant seizure type, being present in 10 of the 19 (52.6%) children while simple partial seizure, myoclonic jerk and mixed seizure types were present in 2 cases each. Abnormal scan was demonstrated in 10 of the 19 children (52.6%) with 3 of them having double cerebral lesions, giving a total of 13 cerebral lesion demonstrated by the CT scan. Cerebral infarct was the most common lesion demonstrated, being present in 5 of the 13 lesions (38.5%). Others were cerebral atrophy in 4 cases (30.8%), moderate ventricular dilatation 2 (15.4%) and 1 each ofporencephalic cyst, hydrocephalus and linear skull fracture. Of the 10 children with abnormal scan, 90% of them had significant past medical history, with birth asphyxia (44.4%) and meningitis (33.3%) being the commonest significant past medical history in them. CCONCLUSION There is a high incidence of abnormal scan findings in children with seizure disorder in our environment compared to what is obtained from the developed countries. Cerebral infarct appears to be the most common abnormal CT findings in our children with seizures.