Childhood Hearing Impairment: How do Parents Feel about it?

"Hearing impairment or deafness is a major disabling condition worldwide. The etiology of hearing loss range from congenital to acquired; and includes common and preventable childhood infections like otitis media and meningoencephalitis. The morbidity and burden of hearing impairment on the children and their parents is enormous. This is because affected children have developmental delay in many domains including speech; cognition as well as behavioural and other aspects of psychosocial development. Early identification and effective treatment of hearing loss improves language; other forms of communication; and cognitive skills. This study was carried out to evaluate and ascertain the perception and attitude of parents of children with hearing impairment.Material and Method: This was a questionnaire based study of parents' perception and attitude about children with hearing impairment in the Port-Harcourt metropolis from 1st June 2011 to 31st May 2012.Results: Thirty seven parents of children with hearing impairment were studied. The parents demonstrated different attitudes towards the children. Majority; 34(94.59) of them felt sad; others expressed anger. Twenty seven (72.97) felt hearing loss was due to punishment from the ""gods"" for an evil deed by a family member. The attitude and feelings of parents included sadness; self-blame and anger. Parents also believe that immediate cause is spiritual.Conclusion: The public should be enlightened about common preventable causes so as to correct all negative attitudes about hearing loss/ impairment."

Pattern of paediatric neurological disorders in port harcourt, Nigeria.

BACKGROUND: Paediatric Neurological disorders in developing countries are very challenging. This is due to its chronicity, late presentation and unavailability of modern diagnostic facilities in developing countries like Nigeria. Lack of these modern technology and manpower contribute significantly to increased morbidity and mortality. This study demonstrates the pattern of neurological disorders and the challenges in management in a developing country. MATERIALS AND METHOD: This was a retrospective hospital based analysis of neurological disorders seen in the Paediatric neurology unit of the University of Port Harcourt Teaching hospital, Nigeria from January 2004 to December 2009. Descriptive statistics was used to present the result. RESULT: A total of 35,473 patients were seen in the Paediatric unit. Of these 2,379 had neurological disorders. This gave a prevalence of 6.7% of Paediatric neurological disorders. There were 1,431 males and 948 females (male: female ratio of 1.51:1.0). The age ranged from 3 months to 15 years. The age group 1->5 years accounted for the most affected age group constituting 87.7%. The most frequent Paediatric neurological disorders were epilepsy (24.6%), cerebral palsy (15.4%), and central nervous system infections (9.5%). CONCLUSIONSRECOMMENDATION: Wide spectrum of neurological disorders occur in our environment. The high incidence of epilepsy and cerebral palsy suggests that effort should be geared towards educating the populace about early diagnosis and prompt management.

Parents' Perception on Use of Insecticide-Treated Bed Net in Port Harcourt

Background: Insecticide treated bed nets (ITN) are protective against malaria; but they are poorly utilized. The utilization of the nets; especially by the under fives; will depend on their caregivers' awareness of the net and their perception of its usefulness. The study therefore aims to evaluate awareness and utilization of ITN . Methods: This was a descriptive hospital-based study. It involved the distribution of 15-itemed questionnaires to 212 parents (with at least one under five aged child); who brought their children to the Paediatrics outpatient clinic of University of Port Harcourt Teaching Hospital. Questions asked covered: the awareness of ITN; the number of ITN owned by each participant and the number of under fives who slept under ITN the night preceding the interview. Results: A total of 212 parents participated in this study. Male to female ratio was 1:4. One hundred and eighty nine (89.2) participants had heard of ITN. The two most common advantages opined by the participants were that it prevents malaria (42.0) and mosquito bite (38.2). The commonest identified side effects was that it causes heat (45.8) and 113(53.3) participants owned at least one ITN. Only 45 (21.2) participants said their under fives slept under ITN on the night preceding the interview. Conclusion: There is a fair awareness of the use of ITNs for malaria control; however there is poor utilization of the nets by the under five aged children in Port Harcourt

Bronchopulmonary dysplasia in a premature infant--case report and literature review.

BACKGROUND: Bronchopulmonary dysplasia is an important cause of morbidity and mortality in premature infants. The aim of this study is to present a premature, extremely low birth weight infant with bronchopulmonary dysplasia. METHOD: A review of the case records of a child with recurrent respiratory distress and the relevant literature. RESULTS: A preterm, extremely low birth weight baby (birth weight was 0.8 Kg), delivered by emergency caesarian section for previous caesarian section and prolonged rupture of fetal membranes at 27 weeks gestational age. She had spontaneous breathing at birth (APGAR scores were 8 in one minute and 10 in 5 minutes). She developed respiratory distress with cyanosis and became oxygen dependent from the second week of life. Examination revealed severe dyspnoea with grunting respiration, tachypnoea, cyanosis and crackles in the lung fields. Chest X-ray showed hyperinflation, right lower zone patchy consolidation with obliteration of the costophrenic angle. Echocardiography was however normal. She was successively managed with intermittent oxygen, dexamethasone, salbutamol and antibiotics (ceftriaxone). She was nursed in the incubator for 3 months. There was no episode of apneic attack throughout admission. She responded to treatment and was discharged home on intermittent oxygen therapy and nebulisation. The weight on discharge was 1.6 kg. At 6 months of age, she is still having recurrent respiratory distress andsupplemental oxygen at home. She is regular to follow up with recurrent episodes of wheeze requiring admissions. CONCLUSION: Bronchopulmonary dysplasia should be suspected in a premature extremely low birth weight infant with early recurrent respiratory distress.

Neurofibromatosis in Children as Seen in the University of Port Harcourt Teaching Hospital

Background: Neurofibromatosis (NF) is transmitted as an autosomal dominant trait but 50of new cases appear because of mutation. The disease can be confounded by a broad spectrum of complications; such as various kinds of osseous lesions; stenosis of the renal arteries; optic glioma; and learning disabilities and disfigurement. Aim : To determine the prevalence; pattern of presentation and outcome of neurofibromatosis in children in the University of Port Harcourt Teaching Hospital. Method: This was a prospective study done from 1st June 2004 to 30th May 2009. All the children who presented with neurofibromatosis over the 5- year period were studied. Data collected included age; sex; and reasons for presentation. Definitive diagnosis was made using the National Institute of Health Diagnostic Criteria. Data was entered into excel and analyzed using SPSS. Simple statistics; frequency and percentages were used. Results: The total number of children seen over the period of study was 12;443 children. Out of these; 18(0.19) had neurofibromatosis. All (100) had the type 1 variety. None had type 2 variety. The patients' ages ranged between 5 and 16 years. There was a positive family history in 13 (72.2) of them. All the patients had cafe au- lait spots. Clinically the predominant forms of the neurofibromas were cutaneous 15(83.3); subcutaneous 10(55.6); and plexiform 5(27.8). None of the patients died. Five cases with huge masses causing pain and disfigurement had surgical intervention. Conclusion: Neurofibromatosis is not rare in this environment. This neurocutaneous inherited genetic disorder is a common cause of morbidity. Multidisciplinary management reduces the disease burden borne by affected individuals

Pattern and clinical presentation of congenital heart diseases in Port-Harcourt.

INTRODUCTION: Congenital heart disease is an important cause of morbidity and mortality in infancy and accounts for two thirds of all birth defects. This study was done to obtain the pattern and clinical presentation of congenital heart diseases in the University of Port-Harcourt Teaching Hospital Teaching Hospital, Port-Harcourt, Nigeria. METHOD: This was a prospective hospital based study of children up to the age of 16 years admitted into the Paediatric Cardiology Unit of the University of Port-Harcourt Teaching Hospital with clinical and echocardiographic features compatible with congenital heart disease. RESULTS: A total 41 patients with congenital heart disease were managed from 1st January 2007 to 30th June 2008 in the Paediatric Cardiology Unit of the University of Port-Harcourt Teaching Hospital. There were 18 males and 23 females giving a ratio 1:1.3. Majority 33 (80.5%) of the cases were acyanotic congenital heart disease. Thirty (73.2%) of the cases seen were infants. Ventricular septal defect was the most prominent congenital heart disease accounting for 34.1% of all cases. Tetralogy of Fallot was the most common cyanotic congenital heart disease and accounted for 87.5%. Fast breathing and poor weight gain were the commonest mode of clinicalpresentation. CONCLUSION: Congenital heart diseases are not uncommon in our environment. The modes of presentation are protean, therefore high index of suspicion, early diagnosis, close monitoring and timely intervention is required in all cases. This will go a long way in reducing the morbidity and mortality associated with it.

Acute flaccid paralysis: a misdiagnosis of poliomyelitis.

BACKGROUND: When the goal of eradication of poliomyelitis was set in 1988, the need for active surveillance for acute flaccid paralysis (AFP) became necessary. This has led to the realisation that although the number of polio endemic countries decreased from 125 in 1988 to 6 in 2004, Nigeria is still one of the high transmission areas for the wild virus. The objective of this paper was to review the need for acute flaccid paralysis surveillance by presenting two cases. METHOD: The case records of two children treated at the University of Port Harcourt Teaching Hospital in 2006 with acute onset of flaccid paralysis were retrieved for presentation. RESULT: Two girls aged 6 years and 13 years presented with sudden onset of flaccid paralysis for which the clinical diagnoses included poliomyelitis. Their stool specimens taken within 2 weeks of onset of symptoms showed no poliovirus. They initially deteriorated clinically but recovered with little or no residual paralysis. CONCLUSION: The need to rule out causes other than polio in all acutely paralysed children is hereby highlighted. All polio eradication strategies should continue to be effectively implemented if we must attain the goal of polio eradication.

Mortality pattern in children: a hospital based study in Nigeria.

BACKGROUND: Hospital based data on mortality pattern is a reflection of what is obtainable in a community at large. Therefore, data obtained from such review is usually beneficial in re-evaluating existing services and in improving facilities and patient care. The aim of this study was to evaluate the mortality pattern of children admitted into the children medical wards of the University of Port-Harcourt Teaching Hospital from Jan 2007 to December 2008. MATERIALS AND METHODS: This was a retrospective study. The case files of all patients aged one month to 16 years, admitted into the paediatric wards of University of Port-Harcourt Teaching Hospital, Port-Harcourt, Nigeria over a 2 year period were reviewed. Neonatal and surgical cases were excluded. RESULTS: There were 2,174 admissions during the study period. Sixty one of the total number of admissions died in the children medical wards giving a mortality rate of 2.8%. The youngest child was 2 months and the oldest 10 years. Fifty two (80.3%) were under 5 years. There was male preponderance. Most of the deaths occurred between April and September. The commonest causes of death were HIV/AIDS and bronchopneumonia in the under five age group; while in those above 5 years of age malignancies and HIV/AIDS were the predominant causes. CONCLUSION: Effective HIV/AIDS control measures will significantly reduce child mortality in our community. Also there is need to have a closer look at the potential risk for malignancies. Health intervention programmes such as integrated management of childhood illnesses and primary health care, which have been shown to reduce childhood deaths significantly, need to be intensified in order to achieve the MDG 4 by 2015.

Trends in diarrhoeal disease in a southern Nigerian coastal city.

BACKGROUND: Among the goals set at the 1990 World Summit was the reduction of diarrhoeal disease incidence by 50% and its mortality by 25% by 2000. However, despite all efforts, diarrhoeal disease remains a significant contributor to under-five morbidity and mortality in developing countries. OBJECTIVE: This study aimed at determining the role of diarrhoeal diseases in paediatric disease burden at a University Teaching Hospital. METHODS: Data on children with diarrhoeal diseases admitted into the Children Emergency Ward (CHEW) or were attended to at the Diarrhoeal Training Unit (DTU) between 1999 and 2005 were analysed retrospectively. RESULTS: There were 9901 admissions of which 1080(10.91%) had diarrhoea. Diarrhoeal diseases accounted for 8.2% to 15% of the total yearly admissions with a statistically significantly increased contribution between 2003 and 2005 (chi(2)=33.58, df=6, p<0.0001). The children consisted of 628(58.1%) males and 452(41.9%) females; all aged 1 to 180 months; mean 21.3 + or - 26.9 months. Of these 539(49.9%) were infants and 988(91.48%), under fives. The degrees of dehydration were mild in 150(13.9%) children, moderate in 854(79.1%) and severe in 76(7%). During the period, 25 (2.5%) diarrhoea-related deaths occurred. In 2005, 745 children with diarrhoea received care in the DTU compared to 184 admitted for diarrhoea in CHEW. CONCLUSION: Diarrhoea continues to contribute significantly to childhood morbidity. Well-known preventive strategies should be employed on a wide scale to reduce its current burden.

Sexual Lifestyle of Long-Distance Drivers in Port Harcourt Metropolis

Background: Long-distance drivers are away from home for days and often times they visit roadside hotels for food; rest; leisure; alcohol; and become prey for commercial sex workers. Aim: To determine the current sexual life style of long distance drivers from Port Harcourt to western and northern parts of Nigeria. Methods: A descriptive cross- sectional survey of long distance drivers to western and northern parts of Nigeria in five motor parks in Port Harcourt metropolis was conducted. The drivers were involved in questionnaire-based interview from 1st February to 31st July 2007. Results: Ninety-four long journey drivers were studied. Sixty-one (64.9) were married with children while 33(35.1) were single. The respondents all had multiple sexual partners ranging from 2-5; with an average of three during the past one year. Twenty-six (27.7) admitted use of condom. Most [81(86.2)] of the sexual practices were vaginal. Forty-three (45.7) of the respondents drank alcohol when on long distance journey while 28(29.8) admitted having sexually transmitted diseases during the past one year. Eighty-one (86.2) of the respondents had knowledge of HIV/AIDS. Conclusion: The results of this study suggest that long-journey drivers are important in spreading sexually transmitted and HIV infections in this country. There is therefore; need to find effective strategies to persuade long journey drivers to change their risky sexual behaviour

Poliomyelitis: Pattern and Treatment Outcome in Niger Delta; Nigeria

Background: Poliovirus is an enterovirus in the family of Picornaviridae and consists of three antigenic types; 1; 2; and 3. All three types cause paralysis. It is a major cause of musculoskeletal deformity in many African communities including Nigeria. The deformities include muscle weakness; contractures; grotesque foot deformities and angular deformities around the knee; amongst others. Aim: To highlight 20 children with musculoskeletal deformities due to poliomyelitis treated in a private hospital in Port Harcourt. Methods: Twenty children with musculoskeletal deformities due to poliomyelitis were retrospectively studied. Results: The patients' ages ranged from1 to 16 years; with 95of them under 15 years of age. More than 50of the study group had poor immunisation status as 6 of them were unimmunised (30) and 5 (25) of them were incompletely immunised. Even though all school strata were represented; most of them were not schooling. The commonest deformity was contracture of the knees (100) and muscle wasting in the affected limbs. All of them had loss of muscle power in the lower limbs. Surgical correction was achieved by soft tissue release in 95of them and osteotomy in 5. The outcome was good; as acceptable extension of the knee was achieved post operatively. Conclusion: The musculoskeletal abnormalities of poliomyelitis contribute highly to physical disability. All patients affected by paralytic poliomyelitis become disabled to some extent and this increases the disease burden in Nigeria

Prevalence of skin diseases in Nigerian children--(the University of Port Harcourt Teaching Hospital) experience.

BACKGROUND: Skin diseases are frequently encountered in the tropics and are a serious cause of morbidity, disfigurement and distress in all age groups. The aim of this study is to determine prevalence and common dermatological conditions encountered in UPTH. METHODS: Children aged 0-16 years attending the dermatology clinic in UPTH from June 2005 to November 2007 were prospectively studied. RESULTS: A total of 1,226 skin disorders were seen, 247 (20.1%) were children aged 0-16 years. Skin disorder was commoner in females 139 (56.3%) than males 108 (43.7%). Papular urticaria 36 (14.6%), atopic dermatitis 34 (13.8%) and tinea 31(12.6%) were the most commonly observed childhood skin diseases. CONCLUSIONS: Skin diseases such as papular urticaria and atopic dermatitis are important dermatological problems in our environment. Implementation of public health policies and improvement in personal hygiene would reduce the prevalence of skin diseases in Nigerian children.

Prevalence of skin diseases in Nigerian Children: - (The University of Port Harcourt Teaching Hospital) Experience

Background: Skin diseases are frequently encountered in the tropics and are a serious cause of morbidity, disfigurement and distress in all age groups. The aim of this study is to determine prevalence and common dermatological conditions encountered in UPTH. Methods: Children aged 0-16 years attending the dermatology clinic in UPTH from June 2005 to November 2007 were prospectively studied. Results: A total of 1,226 skin disorders were seen, 247 (20.1%) were children aged 0-16 years. Skin disorder was commoner in females 139(56.3%) than males 108(43.7%). Papular urticaria 36(14.6%), atopic dermatitis 34(13.8%) and tinea 31(12.6%) were the most commonly observed childhood skin diseases. Conclusions: Skin diseases such as papular urticaria and atopic dermatitis are important dermatological problems in our environment. Implementation of public health policies and improvement in personal hygiene would reduce the prevalence of skin diseases in Nigerian children