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.

Outcomes of Paediatrics HIV care at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu after ten years of service

Background: Antiretroviral therapy is associated with improved survival among HIV-infected children. In Nigeria, HIV treatment scale up was extended to children over a decade ago. This poses new challenges of sustained quality care. Aim: To determine the outcomes for HIV infected children and factors that influenced retention in care at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu.Methods: This was a study of HIV-infected children seen between September 2004 and October 2015 and at the Paediatric HIV clinic of the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu. Data collected include socio-demographics, HAART regimen and outcomes. Data analysis were done with Statistical Package for Social Sciences (SPSS) version 19 (Chicago IL).Results: Five hundred and nineteen of 555 enrolled children with complete data were included in the data analysis. Two hundred and sixty-seven (51.4%) were females. Three hundred and thirty-nine participants (65.3%) were still in care, 12345 (23.7%) had been lost to follow up, or 22 (4.2%) dead while 35 (6.87%) were transferred out to other health facilities or into the adult ART clinic. Factors associated with retention in care were both parents being HIV positive (p<0.0001), commencement of HAART (p<0.0001) and HIV disclosure status of the child (Fisher's exact Test =0.003).Conclusions: About a quarter of our HIV-infected children were lost to follow up. Prompt initiation of HAART and HIV disclosure will positively influence retention in care

HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

AIMS: To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. METHODS: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. RESULTS: Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. CONCLUSIONS: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

Practice of Asthma Management among Doctors in South-East Nigeria

The major role of airway inflammation in childhood asthma has been recognised for more than a decade; and anti-inflammatory drugs now form the mainstay of treatment. In order to optimise treatment and achieve a better outcome; different guidelines have been introduced for asthma management. Examining the practice of the medical practitioners who manage asthma will help establish the gaps and provide informed advice on the current national and international guidelines. Our objective was to investigate the appropriate treatment of acute bronchial asthma by medical practitioners in south-east Nigeria. Two hundred and eighty-five doctors were interviewed using a structured questionnaire. Evaluation for differences in asthma management by doctors with different years of practice and heath facilities was carried out. Results were analysed with Epi info version 3.5. We concluded that management based on newer trends in childhood asthma management and adherence to management guidelines is less common among doctors that work in non-tertiary health facilities and among doctors that graduated more than 15 years ago or less than 5 years ago. This needs to be improved for optimal management of these patients. The need for regular continuing medical education for all doctors cannot be over emphasised