Socio-economic status, lifestyle and childhood obesity in Gombe.

Background: Childhood obesity is a complex condition resulting from an interplay of genetic predisposition, environmental factors and socio-economic status. The prevalence has been increasing all over the world, probably due to economic transition and rapid urbanization as well as globalisation. This relationship should be well established for Improved Health Planning in Gombe State and Nigeria.Objectives: To establish the prevalence of Childhood Obesity and it`s relationship with the Socio-Economic Status of Parents and guardians.Methodology: Anthropometric measurements of children and adolescents in both public and private schools from primary to secondary levels were taken and their BMI calculated. The socioeconomic statuses of their parents, as well as the lifestyle of the children were assessed.Results: Overweight and obesity were more prevalent in children whose parents belonged to the middle and upper socio-economic class; these children had televisions and computers in their rooms and were driven to schoolConclusion: The picture is completely the reverse of what is obtainable in the developed and industrialised nations where overweight and obesity are more prevalent in children of the lower socio-economic class. Authors` contribution: The first author is the lead researcher and is a staff of Federal Teaching Hospital Gombe while the second author, a staff of University of Maiduguri is the first supervisor who gave guidelines and made corrections. The second and the third authors are members of staff of the University of Melbourne in Australia; the third author provided a template on which the questionaire was based while the fourth author who is also the second supervisor, is a tutor of the European Society for Pediatric Endocrinology; she facilitated the acceptance of the proposal and the sponsorship for the research. The research was carried out in Gombe, the capital of Gombe State in North Eastern NigeriaKeywords: Socio-Economic, Childhood, Obesity, Nigeri

Causes of stillbirth in a community survey in Gombe State

Background: Perinatal mortality rate is very high in North Eastern Nigeria mainly due to a large number of still births. The causes and factors related need to be identified so as to proffer solutions with a view to improving obstetric practice and perinatal survival.Objectives: To identify the causes and factors related to stillbirths in Dukku Local Government Area of Gombe state.Methodology: A prospective study that was both hospital and community based, in which parturients were recruited in their last trimester and followed up till delivery. The fetal outcome was recorded and still birth rate calculated.Results: Five hundred and two parturient mothers were recruited. They delivered a total of 520 babies, amongst whom were eighteen sets of twins; five hundred of these were live births. There were 20 still births, giving a stillbirth rate of 38.5/1000. Causes of stillbirth include unbooked and early pregnanacies as well as deliveries unattended to by trained health personnel.Conclusion: Lack of antenatal Care, home delivery and teenage pregnancy were important factors contributing to high still birth rate in Dukku LGA of Gombe State.Key Words: Stillbirth, Perinatal, Mortality

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Socio-economic status, lifestyle and childhood obesity in Gombe.

Background: Childhood obesity is a complex condition resulting from an inter play of genetic predisposition, environmental factors and socio-economic status. The prevalence has been increasing all over the world, probably due to economic transition and rapid urbanization as well as globalisation. This relationship should be well established for Improved Health Planning in Gombe State and Nigeria. Objectives: To establish the prevalence of Childhood Obesity and it`s relationship with the Socio-Economic Status of Parents and guardians. Methodology:Anthropometric measurements of children and adolescents in both public and private schools from primary to secondary levels were taken and their BMI calculated. The socioeconomic statuses of their parents, as well as the lifestyle of the children were assessed. Results: Overweight and obesity were more prevalent in children whose parents belonged to the middle and upper socio-economic class; these children had televisions and computers in their rooms and were driven to school Conclusion: The picture is completely the reverse of what is obtainable in the developed and industrialised nations where overweight and obesity are more prevalent in children of the lower socio-economic class. Authors` contribution: The first author is the lead researcher and is a staff of Federal Teaching Hospital Gombe while the second author, a staff of University of Maiduguri is the first supervisor who gave guidelines and made corrections. The second and the third authors are members of staff of the University of Melbourne in Australia; the third author provided a template on which the questionaire was based while the fourth author who is also the second supervisor, is a tutor of the European Society for Pediatric Endocrinology; she facilitated the acceptance of the proposal and the sponsorship for the research. The research was carried out in Gombe, the capital of Gombe State in North Eastern Nigeri

Socio-economic status, lifestyle and childhood obesity in Gombe.

Background: Childhood obesity is a complex condition resulting from an interplay of genetic predisposition, environmental factors and socio-economic status. The prevalence has been increasing all over the world, probably due to economic transition and rapid urbanization as well as globalisation. This relationship should be well established for Improved Health Planning in Gombe State and Nigeria.Objectives: To establish the prevalence of Childhood Obesity and it`s relationship with the Socio-Economic Status of Parents and guardians.Methodology: Anthropometric measurements of children and adolescents in both public and private schools from primary to secondary levels were taken and their BMI calculated. The socioeconomic statuses of their parents, as well as the lifestyle of the children were assessed.Results: Overweight and obesity were more prevalent in children whose parents belonged to the middle and upper socio-economic class; these children had televisions and computers in their rooms and were driven to schoolConclusion: The picture is completely the reverse of what is obtainable in the developed and industrialised nations where overweight and obesity are more prevalent in children of the lower socio-economic class. Authors` contribution: The first author is the lead researcher and is a staff of Federal Teaching Hospital Gombe while the second author, a staff of University of Maiduguri is the first supervisor who gave guidelines and made corrections. The second and the third authors are members of staff of the University of Melbourne in Australia; the third author provided a template on which the questionaire was based while the fourth author who is also the second supervisor, is a tutor of the European Society for Pediatric Endocrinology; she facilitated the acceptance of the proposal and the sponsorship for the research. The research was carried out in Gombe, the capital of Gombe State in North Eastern NigeriaKeywords: Socio-Economic, Childhood, Obesity, Nigeria</jats:p

Causes of stillbirth in a community survey in Gombe State

Background: Perinatal mortality rate is very high in North Eastern Nigeria mainly due to a large number of still births. The causes and factors related need to be identified so as to proffer solutions with a view to improving obstetric practice and perinatal survival. Objectives: To identify the causes and factors related to stillbirths in Dukku Local Government Area of Gombe state. Methodology: A prospective study that was both hospital and community based, in which parturients were recruited in their last trimester and followed up till delivery. The fetal outcome was recorded and still birth rate calculated. Results: Five hundred and two parturient mothers were recruited. They delivered a total of 520 babies, amongst whom were eighteen sets of twins; five hundred of these were live births. There were 20 still births, giving a stillbirth rate of 38.5/1000. Causes of stillbirth include unbooked and early pregnanacies as well as deliveries unattended to by trained health personnel. Conclusion: Lack of antenatal Care, home delivery and teenage pregnancy were important factors contributing to high still birth rate in Dukku LGA of Gombe State

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

BACKGROUND: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. METHODS: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. FINDINGS: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36-39) and median bodyweight at presentation was 2·8 kg (2·3-3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88-4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59-2·79], p<0·0001), sepsis at presentation (1·20 [1·04-1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4-5 vs ASA 1-2, 1·82 [1·40-2·35], p<0·0001; ASA 3 vs ASA 1-2, 1·58, [1·30-1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02-1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41-2·71], p=0·0001; parenteral nutrition 1·35, [1·05-1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47-0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50-0·86], p=0·0024) or percutaneous central line (0·69 [0·48-1·00], p=0·049) were associated with lower mortality. INTERPRETATION: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030. FUNDING: Wellcome Trust