Exercise-induced bronchospasm among school children in Gusau, Nigeria.

BACKGROUND: Childhood asthma was said to be rare in Northern Nigeria three decades ago. However, since then, there has been rapid industrial development with increase in especially textile and quarry factories. Hyperresponsiveness of the bronchi of asthmatic children to various challenge tests differentiate them from non-asthmatic children. One of these, the Exercise-Induced Bronchospasm (EIB) which is a reduction in post exercise Peak Expiratory Flow Rate (PEFR), is widely used to define childhood asthma in epidemiological studies. To determine the current prevalence of asthma in childhood in a Northwestern Nigerian town, pupils aged 5-14 years were enrolled in the study. METHODS: A modified ISAAC questionnaire was administered and the subjects trained to use the peak flow meter. Pre exercise PEFR was obtained thereafter they were subjected to a six minute free running exercise challenge test and the best of three post exercise PEFR taken at intervals was obtained. EIB was taken as 15% reduction or more in post-exercise compared to pre-exercise PEFR. RESULTS: The prevalence of EIB was 6.0% (64/1067 subjects) while 12.7% (136/1067) had a history of wheeze. History of wheeze was found to be a sensitive (96.3%) but nonspecific (22.2%) indicator of childhood asthma. The highest prevalence of EIB was among children aged 10-14 years with male: female ratio 1.9:1. The location of the residence of the pupils did not significantly affect the prevalence of EIB. CONCLUSION: The prevalence of childhood asthma in this region is on the increase compared to earlier studies and there should be a high index of suspicion in children with suggestive symptoms who should then undergo further screening tests.

Changing patterns in sensitivity of causative organisms of septicaemia in children: the need for quinolones.

A review of the pattern, and antibiotic sensitivities of blood culture isolates over a 3 year period in children presenting to the Paediatric Unit of Ahmadu Bello University Teaching Hospital, Kaduna is reported. Positive blood culture isolates were obtained in 26.9% of 1,982 children. The most prevalent isolates were Staphylococcus aureus (59.9%), Escherichia coli (16.9%) and Klebsiella (16.3%). There was a striking paucity of isolation of Salmonella typhi (1.3%) and Streptococcus. Sensitivity to commonly used drugs like ampicillin/cloxacillin, genticin, ceftazidime and chloramphenicol was low (8.0-50.0%), with a corresponding delayed fever resolution and prolonged hospital stay. 31.0-83.3% of the isolates were highly sensitive to pefloxacin, norfloxacin and ofloxacin, which were not generally recommended for use in paediatric patients. In two patients with no response to commonly used antibiotics, use of quinolones lysed their fever within 48 hours. This change of antibiotic sensitivity patterns calls for a thorough investigation into the potential role of these quinolones in paediatric chemotherapeutics either singly or in appropriate combinations with existing antibiotics.

Congenital icthyosiform--a case report.

Congenital icthyosis is a rare group of disorders of keratinisation. A case of this condition is reported in order to highlight the clinical features and essential components of management: resuscitation, skincare, nutrition and counselling. This case is reported in order to appraise clinicians of its presence because there was delay in the diagnosis and management due to non-recognition.