Screening for congenital color vision deficiency in primary children in Port Harcourt City; teachers' knowledge and performance.

BACKGROUND: One hundred and thirty teachers were studied to evaluate their knowledge of congenital Color Vision Deficiency (CVD), and their ability to perform the Ishihara color vision test, so as to determine if they can provide color vision screening services for their pupils. METHODS: The teachers were randomly selected from 13 schools in Port Harcourt City (PHC) and given a six hours training workshop on vision disorders in children and congenital color vision screening. They were given a self administered pre and post test questionnaires before and after training respectively. Subsequently, they screened 1,300 of their school pupils for congenital vision deficiency using the Ishihara color vision chart; and their results compared to that of the research team. RESULTS: Female teachers constituted 84.6% and males 15.4% of the study population. Seventy three teachers (53.8%) were from public schools while 46.2% were from private schools. Prior to the training workshop, only 6.2% of teachers had heard of the Ishihara color vision chart and none of the teachers could identify or knew how to use the chart. However with training there was significant improvement in knowledge of CVD. Comparison of the teachers' performance of color vision screening using the Ishihara chart to that of the research team showed a sensitivity of 67.6% with a specificity of 99.1%. The prevalence of congenital color vision deficiency in the 1,300 primary school screened was 2.6%, with males having a significantly higher prevalence than females. CONCLUSION: The study thus concludes that congenital color vision deficiency is prevalent amongst primary school children in Port Harcourt City, and with training, teachers can effectively perform color vision screening, and as such modify their teaching methods to accommodate the child with color vision deficiency.

Development and validation of standardized clinical summary format.

BACKGROUND: The use of a structured guideline in medical education to reach a diagnosis provides accurate information which is relatively free from bias. The purpose of this paper is to assess the performance of medical students using unstructured and structured format in case summary. METHODS: One hundred and sixty- nine medical students in Part III MB; BS Programme in the University of Port Harcourt were studied. There were 83 students in Paediatics [SP] and 86 students in Obstetrics and Gynaecology [SOG] postings. The students had video recorded presentation of three clinical cases comprising of two paediatrics [PC1&PC2] and one surgical case [SC3]. The summary for the first case [PC1] was done using an unstructured format, while the second case [PC2] was done with both unstructured PC2a and structured PC2b format. The Surgical case [SC3] was done using only the structured format. The discrete pieces of important information in each case were quantified and scored by trained assessors. PC1and SC3 had a total of 16 points each while PC2 had a total of 24 points. RESULT: The pre-exposed SOG students scored significantly higher than none-exposed SPG students in PC1 and SC3; P<0.05. In PC2 75.1% students scored above 12 points using structured summary format compared to 38.5% students with unstructured format , P<0.05. The students had significantly higher score using structured format in SC3 than PC1. CONCLUSION: The use of structured summary format enabled better case summary than unstructured format, and it's transferable across different departments.

Growth pattern of exclusively breastfed infants in the first six months of life: a study of babies delivered at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.

BACKGROUND: Some authors demonstrate that exclusively breastfed infants have growth patterns comparable with the NCHS standards while others conclude that exclusively breastfed infants grow slower. These conflicting results informed the need for this study to aid the paediatricians and health workers to justify or condemn the recommendation of exclusive breastfeeding for six months. This was a prospective longitudinal study carried out to determine the growth pattern of exclusively breastfed infants in the first 6 months of life and compare them with the International, National Centre for Health Statistics (NCHS/WHO) reference and the Local, Janes' Elite Standards. METHOD: Using weight, length and occipito-frontal circumference as indices, 530 infants were recruited consecutively by convenience sampling over 17 months. Measurements were taken at birth, 2 weeks, 6 weeks, 2 months and subsequently monthly until the end of the 6th month. RESULTS: The exclusively breastfed infants doubled their birth weights at 3 months. The mean weight, OFC and length gains were maximal at 2 months, 2 weeks and 2 months respectively The growth of exclusively breastfed infants compared favourably with the NCHS/WHO reference group and also compared favourably with the Janes' 'Elite' reference group. CONCLUSION: It is concluded that the growth in weight, length and OFC of exclusively breastfed infants appears adequate for the first 6 months of life.

Growth pattern of exclusively breastfed infants in the first six months of life: a study of babies delivered at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

BACKGROUND: Some authors demonstrate that exclusively breastfed infants have growth patterns comparable with the NCHS standards while others conclude that exclusively breastfed infants grow slower. These conflicting results informed the need for this study to aid the paediatricians and health workers to justify or condemn the recommendation of exclusive breastfeeding for six months. This was a prospective longitudinal study carried out to determine the growth pattern of exclusively breastfed infants in the first 6 months of life and compare them with the International, National Centre for Health Statistics (NCHS/WHO) reference and the Local, Janes' Elite Standards. METHODS:Using weight, length and occipito-frontal circumference as indices, 530 infants were recruited consecutively by convenience sampling over 17 months. Measurements were taken at birth, 2 weeks, 6 weeks, 2 months and subsequently monthly until the end of the 6th month.RESULTS: The exclusively breastfed infants doubled their birth weights at 3 months. The mean weight, OFC and length gains were maximal at 2 months, 2 weeks and 2 months respectively. The growth of exclusively breastfed infants compared favourably with the NCHS/WHO reference group and also compared favourably with the Janes' 'Elite' reference group. CONCLUSION:It is concluded that the growth in weight, length and OFC of exclusively breastfed infants appears adequate for the first 6 months of life

Screening for Congenital Color Vision Deficiency in Primary Children in Port Harcourt City; Teachers' knowledge and performance

Background: One hundred and thirty teachers were studied to evaluate their knowledge of congenital Color Vision Deficiency (CVD); and their ability to perform the Ishihara color vision test; so as to determine if they can provide color vision screening services for their pupils. Methods: The teachers were randomly selected from 13 schools in Port Harcourt City (PHC) and given a six hours training workshop on vision disorders in children and congenital color vision screening. They were given a self administered pre and post test questionnaires before and after training respectively. Subsequently; they screened 1;300 of their school pupils for congenital vision deficiency using the Ishihara color vision chart; and their results compared to that of the research team. Results: Female teachers constituted 84.6and males 15.4of the study population. Seventy three teachers (53.8) were from public schools while 46. 2were from private schools. Prior to the training workshop; only 6.2of teachers had heard of the Ishihara color vision chart and none of the teachers could identify or knew how to use the chart. However with training there was significant improvement in knowledge of CVD. Comparison of the teachers' performance of color vision screening using the Ishihara chart to that of the research team showed a sensitivity of 67.6with a specificity of 99.1. The prevalence of congenital color vision deficiency in the 1;300 primary school screened was 2.6; with males having a significantly higher prevalence than females. Conclusion: The study thus concludes that congenital color vision deficiency is prevalent amongst primary school children in Port Harcourt City; and with training; teachers can effectively perform color vision screening; and as such modify their teaching methods to accommodate the child with color vision deficiency

Impaired acidification of urine in children aged two months to two years with acute gastroenteritis complicated by acidosis.

BACKGROUND: In some children with acute gastroenteritis and acidosis, the urine pH may be abnormally high thus simulating distal Renal Tubular Acidosis (dRTA). This inability to acidify urine properly in the presence of metabolic acidosis has been shown to be due to poor delivery of sodium to the distal nephron which prevents full excretion of a hydrogen ion load, instead of an intrinsic defect in the ability of the distal tubule to acidify urine. The aim of this study is to determine the prevalence of transient urinary acidification defect in children aged two months to two years with acute gastroenteritis, dehydration and acidosis, and the relationship between urine pH and urine sodium concentration. METHOD: A prospective study of children aged two months to two years admitted for the treatment of acute gastroenteritis and dehydration at the Children's Emergency Ward (CHEW) of the University of Port Harcourt Teaching Hospital, Rivers State. RESULTS: Of the 196 children (140 males and 56 females) studied with spontaneous acidosis which developed as a result of acute gastroenteritis, seventy-three of them had impaired acidification of urine, giving a prevalence of 37.2%. There was no significant difference in the age, duration of symptoms, degree of acidosis, degree of dehydration and serum potassium concentration between the children with impaired and those with proper urine acidification. Those with impaired acidification of urine however had a significantly lower serum sodium and urine sodium concentrations and a significantly higher urine potassium concentration and urine anion gap than those children with proper urine acidification. All urine samples with sodium concentration less than or equal to 25 mmol/L (52) had urine pH greater than 5.5. CONCLUSION: Mere presence of acidosis and high urine pH should not lead to a diagnosis of Distal Renal Tubular Acidosis (dRTA). The urine anion gap (UAG) should be calculated using the formula: urine [Na+] + [K+] [Cl], and if negative, it suggests a high ammonium excretion, which makes the diagnosis of dRTA unlikely.

Growth pattern of exclusively breastfed infants in the first six months of life: a study of babies delivered at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.

BACKGROUND: Some authors demonstrate that exclusively breastfed infants have growth patterns comparable with the NCHS standards while others conclude that exclusively breastfed infants grow slower. These conflicting results informed the need for this study to aid the paediatricians and health workers to justify or condemn the recommendation of exclusive breastfeeding for six months. This was a prospective longitudinal study carried out to determine the growth pattern of exclusively breastfed infants in the first 6 months of life and compare them with the International, National Centre for Health Statistics (NCHS/WHO) reference and the Local, Janes' Elite Standards. METHODS: Using weight, length and occipito-frontal circumference as indices, 530 infants were recruited consecutively by convenience sampling over 17 months. Measurements were taken at birth, 2 weeks, 6 weeks, 2 months and subsequently monthly until the end of the 6th month. RESULTS: The exclusively breastfed infants doubled their birth weights at 3 months. The mean weight, OFC and length gains were maximal at 2 months, 2 weeks and 2 months respectively. The growth of exclusively breastfed infants compared favourably with the NCHS/WHO reference group and also compared favourably with the Janes' 'Elite' reference group. CONCLUSION: It is concluded that the growth in weight, length and OFC of exclusively breastfed infants appears adequate for the first 6 months of life.

Survey of knowledge of HIV infection among senior secondary school 3 (SSS3) students in Port Harcourt.

BACKGROUND: The objective of this paper is to study the knowledge of the students on Human Immunodeficiency Virus and Acquired Immunodeficiency Deficiency Disease (HIV/AIDS) among third year senior secondary school (SSS3) students in Port Harcourt metropolis. METHOD: This was a cross-sectional survey involving 1800 SSS3 students from thirteen secondary schools in Port Harcourt metropolis, selected by a two-stage stratified sampling technique, using a self administered structured questionnaire. RESULTS: Thirty one percent, 14.4%, 9.1% and 8% of the students studied identified sexual intercourse, blood transfusion, mother to child (vertical) transmission and intravenous drug use, respectively, as modes of transmission of HIV infection. Only 7.1% identified all the listed four modes of transmission of HIV whilst 0.7% of the students identified all the listed preventive methods. The level of knowledge of the students on HIV did not significantly increase with age (p = 0.745). Students from Federal school demonstrated more knowledge than students from state and private schools. Similarly, students from all-male school had more knowledge than students from all-female and co-educational schools. Students from high social class demonstrated more knowledge than those from middle and low social class. CONCLUSION: It is concluded that the knowledge of the students on the transmission and prevention of HIV/AIDS is poor. There is need to intensify HIV/AIDS education programmes among adolescents.

Malaria parasite density and splenic status by ultrasonography in stable sickle-cell anaemia (HbSS) children.

BACKGROUND: To determine the relationship, if any, between malaria parasitaemia, parasite density and presence/size of the spleen, using abdominal ultrasonography in stable sickle cell anaemia subjects aged 6 to 15 years. METHODS: A prospective study of one hundred consecutive sickle cell anaemia (SCA) and 100 matched healthy HbAA controls aged 6 to 15 years was undertaken. The presence of malaria parasite, and parasite density were determined using thick blood film. Splenic status was determined by using abdominal ultrasound. None of the children was symptomatic for malaria. RESULTS: The prevalence of autosplenectomy and splenomegaly were 20% and 27% respectively in SCA subjects compared to 0% and 4% respectively in HbAA controls. Thirty percent and 34% of the SCA and controls respectively had malaria parasitaemia. In SCA subjects, the parasite density ranged from 33 to 4000 per microl with a mean of 1071.10 +/- 895.5 per microl. In HbAA controls, the parasite density ranged from 180 to 5150 per microl with a mean of 1759 +/- 1382.87 per microl. The difference in parasite density between SCA subjects and HbAA was significant p<0.05. The parasite densities were relatively higher among SCA with splenomegaly and normal spleen sizes compared to SCA subjects with autosplenectomy. CONCLUSIONS: The prevalence of malaria parasitaemia is lower in healthy SCA subjects than in HBAA controls. Sickle cell anaemia subjects have lower malaria parasite density. Autosplenectomy may be a positive adaptation in SCA subjects with effective innate immunity to malaria.

Medical journals of Nigeria, quo vadis?

The Nigerian health sector is beset with an underdeveloped Continuing Medical Education (CME) programme, a scarcity of reading materials and the lack of a reading culture. Recent issues of available journals were obtained and read to identify data such as: the ownership and base, presence of mission statement, print quality, administrative and editorial matters, abstract format, CME value of articles, advertisements, subscription information and communication channels and practice. The availability of the journals in the libraries of the three 'first generation' teaching hospitals and accessibility through the Medline were ascertained. Twenty-eight current journals were obtained. Lagos has the highest number of editorial bases. Fifteen journals belong to national medical associations, 2 to regions and 11 to institutions. The journal title was considered appropriate in 13, cover design was good in 15, paper quality was good in 20 and legibility was good in 11 journals. Poor editing was manifested by bad grammar, spelling and punctuation. Six journals contained review articles of good CME value. Eight journals had a full compliment of communication facilities. The existence of a functional independent administrative office or staff was indicated in 7 journals. No journal indicated the dates of submission and acceptance of articles. Twenty-one journals were on the shelf of the library of ABUTH, Zaria. Two journals are accessible through the Medline and another is on-line. Adequate funding and improved management will effectively address most of the problems identified.

Experiences; attitudes and beliefs of secondary school students about breastfeeding

The experiences; knowledge; attitudes and beliefs of 824 teenagers from 18 secondary schools in Enugu and Port Harcourt; about infant feeding and in particular breastfeeding; were investigated; using a questionnaire. The students had good experience of both breast and bottle-feeding as over 75 percent of them had been breast and/or bottle fed and over 80 percent had bottle-fed younger children. The students' knowledge of breastfeeding; breast milk and weaning was poor. Despite their extensive experience with bottle feeding and their poor knowledge of breast milk and breastfeeding; the basic attitudes and beliefs of the students about breastfeeding were positive. To reinforce these positive attitudes and beliefs; it is suggested that formal education on breastfeeding and infant feeding be part of health education programmes in secondary schools. By this means; the breastfeeding culture inherent in the community can be promoted and protected