Head circumference of rural Nigerian children--the effect of malnutrition on brain growth.

OBJECTIVE: To compare head circumference measurements of the well nourished with those of the malnourished children for each sex. DESIGN: Cross sectional. SETTING: Imesi, Ile-Ife village, Nigeria. SUBJECTS: 644 children in the first six years of life. MAIN OUTCOME MEASURES: Head circumference. RESULTS: The mean head circumference values of malnourished children of both sexes fell mostly below the values for their well nourished age mates. The curve for well nourished girls fell by a little below, and for malnourished girls by over two standard deviations below Tanner's 50th percentile curve. For the boys, the curve for the malnourished children fell by over one standard deviation below the curve for their well nourished age mates. CONCLUSION: The significant reductions in head circumferences found in malnourished children may have serious implications for their future performance and achievement. Therefore, sufficient community concern and appropriate world action aimed at eradicating protein energy malnutrition is solicited.

Secular trends in the growth of children aged 0-6 years in a rural Nigerian community.

Cross-sectional anthropometric measurements were taken between 1987 and 1990 in 673 children aged 0-6 years in Imesi Ile village, Nigeria. The height and weight curves obtained fall behind corresponding growth curves in the same community three decades previously. Mid-upper arm circumference values indicated moderate to severe malnutrition in 25.8% of children aged 1-5 years. The heights of 67.1% and weights of 59.7% of the children fell below the third percentile of a Nigerian equivalent of an international reference population standard. Possible reasons for deterioration of the nutritional status of children in the community include the prevailing adverse socio-economic conditions, changes in child rearing practices over the years, persistence of unsatisfactory living conditions and failure to sustain the implementation of innovative programmes previously introduced into the community. It is suggested that present programmes aimed at promoting the health of rural communities should be reviewed to improve sustainability and should be backed up by measures to improve socio-economic and living conditions.

Anthropometric measurement in children aged 0-6 years in a Nigerian village.

Seven hundred and three Nigerian village children in their first six years of life were subjected to anthropometric measurements and physical examination in early 1988. The heights of 66.9% and weights of 60.5% of them fell below the third percentile of a Nigerian equivalent for international reference population standard. Mid upper arm circumference values indicated moderate to severe malnutrition in over 25% of all 1-5 year old children surveyed. Fever, cough, headache and diarrhoea were the commonest symptoms encountered in the children. Mild pallor of the conjunctival mucosa and physical signs of protein energy malnutrition were commonly seen. Fungal and septic skin lesions were present in 11.45 and 11.1% of the children respectively, whilst rhinorrhoea was seen in 4.7%, otitis media in 6% and pharyngotonsillitis in 3.3%. Thirty four (4.8%) of the children had haemic whereas five had pathological murmurs. Dental calculi were present in 15.8%, umbilical herniae in 18.2%, hepatomegaly in 48.2% and splenomegaly in 23% of the children. Seven (1%) had cerebral palsy. The implication is that malnutrition, sickle cell disease, malaria and other infections are the prevailing causes of morbidity in the preschool aged children surveyed. Desirable improvements include upgrading socio-economic and living conditions and instituting appropriate control measures.

Variegate (mixed) porphyria in a Nigerian girl.

A fatal case of variegate (mixed) porphyria in an 11-year-old Nigerian girl is reported. She presented with severe abdominal pain, vomiting, constipation, quadriplegia and cutaneous bullous dermatosis. Remission was temporarily achieved with chlorpromazine, high carbohydrate diet and physiotherapy. She finally died of respiratory paralysis 17 months after diagnosis.