C-Reactive Protein and Covid-19 Severity: A Systematic Review.

BACKGROUND: COVID-19 clinical course has been quite unpredictable and efforts have been made to identify reliable markers that will help in early disease progression, prognosis and severity detection. Objective: This study thus aimed to provide evidence that will guide clinical management by reviewing studies that assessed CRP concentration and COVID-19 severity/outcome. METHODS: Three electronic databases, PubMed/Medline, Google Scholar, and JSTOR were searched to identify studies available online as at 1st September 2020 which assessed COVID-19 clinical outcome and CRP concentration. The search strategy involved words combination like "C-reactive protein" OR "inflammatory markers" OR "acute phase reactants" and "coronavirus 2019" OR ''COVID-19" OR "2019-nCoV" OR "SARS-CoV-2". RESULTS: Sixty-one articles were systematically reviewed out of 812 studies identified after duplicates were removed. The 61 studies comprised 13,891 COVID-19 patients made of 7,840 (56.4%) males and 6,051 (43.6%) females. All the papers revised were observational studies except one case-control and they cut across fifteen countries. The result of the review demonstrated that the severe cases had higher levels of C - reactive protein when compared to the mild cases in all the studies (100%). The increase in C-reactive protein was statistically significant in 78.7% of the cases. CONCLUSION: High levels of CRP are associated with COVID-19 severity. Highlights: Severe cases of COVID-19 is characterized with higher CRP levels. COVID-19 cases should be screened regularly for CRP to monitor severity.

Contexte: L'évolution clinique du COVID-19 a été assez imprévisible et des efforts ont été faits pour identifier des marqueurs fiables qui aideront à la progression précoce de la maladie, au pronostic et à la détection de la gravité. Objectif : Cette étude visait donc à fournir des preuves qui guideront la gestion clinique en passant en revue les études qui ont évalué la concentration de CRP et la gravité/l'issue du COVID-19. Méthodes: Trois bases de données électroniques, PubMed/Medline, Google Scholar et JSTOR, ont été consultées pour identifier les études disponibles en ligne au 1er septembre 2020 qui évaluaient le résultat clinique du COVID-19 et la concentration de CRP. La stratégie de recherche comportait des combinaisons de mots comme "protéine Créactive" OU "marqueurs inflammatoires" OU "réactifs de phase aiguë" et "coronavirus 2019" OU "COVID-19" OU "2019-nCoV" OU "SARS-CoV-2". Résultats: Soixante et un articles ont été systématiquement examinés sur les 812 études identifiées après suppression des doublons. Les 61 études comprenaient 13 891 patients atteints de COVID-19, dont 7 840 (56,4 %) hommes et 6 051 (43,6 %) femmes. Tous les articles examinés étaient des études d'observation, à l'exception d'un cas-témoin, et ils couvraient quinze pays. Le résultat de l'examen a démontré que les cas graves avaient des niveaux plus élevés de protéine C-réactive par rapport aux cas légers dans toutes les études (100%). L'augmentation de la protéine C-réactive était statistiquement significative dans 78,7% des cas. Conclusion: Des niveaux élevés de CRP sont associés à la sévérité du COVID-19. Mots clés: Protéine C-réactive, COVID-19, SRAS-COV-2 et Coronavirus. Points forts: Les cas graves de COVID-19 sont caractérisés par des niveaux de CRP plus élevés. · Les cas de COVID-19 doivent faire l'objet d'un dépistage régulier de la CRP afin de surveiller la gravité de la maladie.

Risk Factors for Acute Respiratory Tract Infections in Under-Five Children in Enugu Southeast Nigeria

Background: Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under-five children of the developing world. The prevalence of ARIs is determined individually or collectively by a number of factors which may be prevalent in our environment. Aim: The present study is aimed to determine the risk factors that affect the prevalence of ARIs in under-five children in Enugu. Subjects and Methods: A cross-sectional study of 436 under-five children diagnosed with ARI was carried out in three hospitals in Enugu. Participants were consecutively enrolled after being diagnosed as a case of ARI. Structured pro foma was used to collect sociodemographic characteristics; anthropometric data and risk profile. Data were analyzed using Epi info version 6.0 and significant probability value was 5 . Results: A total of 436 patients were enrolled for the study 224 males and 212 females M: F 1.06:1. The mean age of the population was 18.75(13.38) months and there were 31.6 (138/436) cases of pneumonia 6.9 (30/436) cases of bronchiolitis and 61.5 (268/436) cases of acute upper respiratory tract infections. Children less than 20 months accounted for 60.9 (84/138 cases) of pneumonia; 86.7 (26/30 cases) of bronchiolitis; and 64.5 (173/268 cases) of acute upper respiratory tract infections. Pneumonia was noted in about 75.7 (56/74) of inadequately nourished children compared to 22.6 (82/362) in adequately nourished children. Other risk factors identified in the study include inadequate breast feeding; poor immunization statues; attendance to daycare centers; large family size; poor parental educational statues; parental smoking; living in the urban area and use of biofuels. Conclusion: ARIs are affected by socio-demographic and socio-cultural risk factors; which can be modified with simple strategies. It is recommended that control program for ARIs should be multifaceted with a strong political will

Cerebral palsy among children seen in the neurology clinic of Federal Medical Centre (FMC), Asaba.

Cerebral palsy (CP) is a non-progressive disorder of motor function caused by irreversible damage to the immature brain. The disorder may be associated with seizure, mental retardation, visual and hearing defects. This study was designed to determine the types of CP, the risk factors and the co-morbidities associated with the disorder. Records of patients who were seen in the neurology clinic were kept for two years (June 2009-July 2011). Medical history and examination were essentially used to determine risk factors, antenatal care and co-morbidities. Data was analyzed using SPSS soft-ware. CP made up 45 % of 60 neurological cases and 0.006 % of 4,873 patients seen in the clinic with a male to female ratio of 1.1:1. Birth asphyxia was the commonest risk factor for the development of the disorder while seizure disorder among others was the commonest co-morbid state.

Culture and biomedical care in Africa: the influence of culture on biomedical care in a traditional African society, Nigeria, West Africa.

BACKGROUND: Biomedical Care in Africa and the influence of culture on the health-seeking behaviour of Africans can not be underestimated; many African cultures have different understanding of the causes of disease which more often affect our public health system, policy, planning and implementations. The traditional African healer unlike a doctor trained in western biomedicine, looks for the cause of the patient's ailments as misfortune in relationship between the patient and the social, natural and spiritual environments. The complexity of African society with different cultural and religious practices also reflects on the people's attitude and understanding of their health matters. This paper is an overview of the cultural influence on biomedical care in a traditional African society, Nigeria, West Africa. METHODS: A research on the patients' health seeking behaviour and Primary Health Care service organization in 10 health centres in the five eastern states of the Federal Republic of Nigeria was carried out using a multistage cross-sectional study. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth semi- structured interview was also conducted. RESULT: We observed there is underutilization of health care services at the primary level because most people do not accept the model of health care system provided for them. Most people believe diseases are caused by supernatural beings, the handiwork of neighbours or vengeance from an offended god as a result of transgressions committed in the past by an individual or parents. This group of people therefore prefers seeking traditional medicine to seeking orthodox medicine and often ends up in the hands of witch doctors who claim to have cure to almost all the diseases. CONCLUSION: Biomedical care in Africa is influence by culture because of different understanding of what ailment is and also due to limited knowledge of health matters, poverty and ignorance. There is a need therefore to focus on health out-reach programme, communication and enlightment campaign in Africa especially in the rural areas that are more vulnerable and are burdened with many of these diseases.

Environmental health assessment of primary schools in southeastern Nigeria: implication for a healthy school environment in developing countries.

In this cross-sectional descriptive study, we used a validated school health program evaluation scale (SHPE) to assess the environmental health status of primary schools in Ebonyi State, southeastern Nigeria. Parameters assessed included water supply, sewage and refuse disposal, school building ventilation, lighting and seating, as well as the availability of toilet tissue, basins for washing hands, regular cleaning of toilets, and so forth. Of all the schools assessed, only two schools, both private, attained the minimum acceptable SHPE score of 57. The mean SHPE score of the private schools (50.40) was significantly higher than that of the public schools (28.69) (t-test, p=.00). Policy reforms are needed that would ensure a healthy primary school environment in Nigeria and in other developing countries with similar settings.