Assessment of extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, federal capital territory, Nigeria

BACKGROUNDPhysical inactivity, a phenomenon that cuts across age groups, is increasingly becoming a menace among children globally. With a rise in the obesity rates among children in the last three decades, lack of physical activity is a cause for major concern among school-aged children. AIMThis study aimed to assess extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, of the Nigerian capital METHODOLOGYA cross-sectional study was conducted among 146 primary schools. Respondents’ interviews and direct observations were used. The findings were entered into a questionnaire adapted from School Health Program Evaluation questionnaire. RESULTWhile 5 (3.4%) of the schools surveyed allotted three periods a week for physical activities/ health education, 106 (72.6%) assigned two periods per week for this. All the schools surveyed observed break periods/ recess. A total of 39(36.8%) private schools, compared with 33(82.5%) public schools, had sports fields (p<0.001). Within the preceding year of the study, one hundred and seventeen (80.1%) of the schools staged drama as a form of periodic extracurricular activity. Inter-house sports was organized by 22(55.0%) public and 19(17.9%) private schools (p<0.001). CONCLUSIONMost of the schools carried out varying forms of extracurricular activities on a daily, weekly or annual basis. Physical activities were more commonly undertaken in public schools. Private schools should be compelled by the appropriate authorities to provide adequate space for sporting and other physical activities. The schools should be made to adopt the recommendations of the World Health Organizatio

Dialysis availability for paediatric acute kidney injury in Nigeria

Background: Dialysis provides prompt treatment for severe acute kidney injury (AKI) and limits morbidity and mortality. This study compared the current dialysis services for paediatric AKI in Nigeria with earlier studies. Methods: Twenty-four of 34 conveniently sampled paediatric nephrology units across Nigeria responded to an online questionnaire.Results: Responding centres (16, 67%) from the six geopolitical zones were urban tertiary federal/state-owned and mainly in the south. Nineteen centres (79%) offered both peritoneal dialysis (PD) and haemodialysis (HD), 4 (17%) provided HD services only, whereas 1 centre offered PD only. Ten (42%) centres also provided dialysis to neonates. Concerning PD consumables, 75% used improvised PD catheters, with the most common (50%) being nasogastric tubes. In 60% of centres, PD catheter insertion was performed by a paediatrician/paediatric nephrologist; 90% used improvised PD fluids, and all performed PD manually. Concerning HD consumables, 10 (44%) facilities ‘sometimes’ have paediatric dialyzers/bloodlines but mostly these are unavailable for children under five. Challenges with dialysis access include financial constraints, lack of paediatric dialyzers/bloodlines and PD fluids (100%, 75% and 75%, respectively). Compared with earlier studies, current facilities providing dual PD/HD services have significantly (P = 0.021) increased but challenges are unchanged.Conclusion: In Nigeria, dialysis services for paediatric AKI have increased with more facilities providing both HD and PD. Whereas HD is mainly available for older children, acute PD remains predominantly improvised. Continuous kidney replacement therapy is unavailable. There is a need for concerted collaboration between the government and healthcare facilities to ensure consistent availability of age-appropriate dialysis machines/consumables and subsidized paediatric dialysis services

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

Summary 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 middleincome 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 lowincome 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 lowincome, 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

Utility of rapid antigen detection test in group A ßhaemolytic streptococcal pharyngitis at a tertiary hospital, Gombe, North-East, Nigeria

Background: Throat swab cultures still remain the gold standard for the confirmation of Group A Streptococcal (GAS) pharyngitis but Rapid Antigen detection Test (RADT) are increasingly becoming popular. Recent studies show RADT can be as sensitive and specific as the throat swab culture. This study aimed to determine the utility of RADT in the diagnosis of GAS pharyngitis in children at the Federal Teaching Hospital Gombe. Methods: A cross-sectional study that included 324 children aged 3- 18 years presenting with sorethroat at the out-patient department, consecutively recruited between April and September 2018. Socio-demographic and clinical findings were document. Throat swab samples were taken for RADT using Encode strep A Rapid antigen test and culture on 5% sheep blood agar. The sensitivity, specificity and positive and negative predictive values of the RADT was determined against throat swab cultures, which is the gold standard. Results: There were 190 (58.6%) females and Male to Female ratio of 1:1.4. The mean age was 8.3± 3.9 years. Only 125 (38.6%) of the participants were from low social class and 162 (62.3%) are from overcrowded households. Sociodemographic factors have no effect on the performance of the RADT, however, the use of antibiotics within 2 weeks prior to presentation significantly affected the performance of the RADT 1.4% (1/64) compared to 28.1% (73/260) for those without prior antibiotics use p<0.001. GAS was isolated in 73 (28.1%) of the children with pharyngitis. The RADT had sensitivity and specificity of 84.6% and 96.2% respectively and a PPV and NPV of 90.4% and 93.6% respectively. Conclusion: The RADT is reasonably sensitive and specific and can be used in the diagnosis of GAS pharyngitis in clinics as a substitute for throat swab cultures

Perception of Substance Use among In-School Adolescents and Key Informants in Gombe State, Nigeria

Background: Substance use has gradually become a global problem resulting in negative effect on the physical, mental and social wellbeing of individuals. This study aimed to determine the perception of adolescents and key informants on substance and illicit drug use in order to control this menace.Methods: A cross-sectional study design employing qualitative method of data collection. Focused Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted. All data generated were collated and analysed using content analysis. Results: The key informants reported that peer influence, male sex and having broken homes were factors that were responsible for substance use. Adolescents also reported that easy access to these substances, the zeal to perform better in school, ability to have more fruitful relationships and ability to confront their parents were some of the reasons they engaged in substance use. Conclusion: This study has therefore implied that adolescents in school have easy access to and engage in substances despite being aware of the complications as it is mostly done to address their social needs.Recommendation: It is therefore recommended that periodic mental health screening should be conducted for adolescents with the support of their parents and guardians in line with school health services in order to identify and manage those with mental problems that could predispose them to use of substances

Factors Associated with Timeliness of Hepatitis B Birth Dose: A Cross-sectional Study in North-Western Nigeria

Highlights: Uptake of hepatitis B birth dose vaccine within 24 hours of birth is low in Katsina, north-western Nigeria. The most common reason for delay presentation for hepatitis B birth dose vaccine is maternal illness.   Abstract: No studies focused on the hepatitis B birth dose (HepB-BD) vaccine since Nigeria adopted the strategy to reduce hepatitis B viral infection. Hence, we determined the uptake of HepB-BD, factors associated with timeliness, and those that contributed to delay. This study was a cross-sectional descriptive study carried out at an immunization post in north-western Nigeria. We recruited 400 mother-infant pairs that presented for the first immunization and obtained relevant information, including socio-demographics and reasons for the delays. Of the 400 infants, 44 (11.0%) received HepB-BD within 24 hours (timeliness), 105 (26.3%) and 274 (68.5%) by day 7 and 14, respectively. Multivariate analysis showed that mothers' education (primary adjusted odds (AOR) 17, 95% CI 1.404, 204.611), secondary AOR 5.9, 95% CI 1.148, 29.895), and tertiary AOR 7.7, 95% CI 1.228, 48.545), and third born AOR 8.2, 1.625, 41.018) were associated with HepB-BD timeliness. Maternal-related factors were the commonest (129; 46.6%) for delayed HepB-BD, with maternal illness the most commonly cited reason (37; 28.7%). This study showed a deficient level of uptake of HepB-BD vaccines among infants. Factors that were associated with timeliness included maternal education and higher birth order. The commonest reason for delayed HepB-BD was maternal illness.</jats:p

Mothers’ preference for routine immunization appointment reminders in Gombe, Gombe State, Nigeria

Background: Globally, under-5 children account for three-quarter of the two million annual deaths caused by vaccine preventable diseases (VPD). The VPD is comparatively higher in developing countries, and in particular, Nigeria where 1 in 5 childhood deaths is VPD-related. This higher mortality has been attributed to inequitable uptake of immunization variably caused by low education, confusion and forgetfulness among others. The millennium mobile phone proliferation has made it a useful reminder tool. We therefore explore access to mobile phone, willingness and predictors of willingness to receive reminder by mothers. Methods: Semi-structured questionnaire was deployed in this cross-sectional study to obtain relevant information from 384 mother-child pairs at the immunization clinic (cluster) over 9 months.Results: A total of 372 (96.9%) and 379 (98.7%) mothers had access to personal and husbands’ phone respectively while 339 (88.3%) mothers showed willingness for a reminder. The factors significantly associated with willingness for immunization reminder were mother’s tertiary education (p=0.008), mother’s unemployment (p=0.011), father’s occupation as senior public servant (p=0.001) and mother’s access to personal phone (p=0.015). Adjusting for confounders, the factors predictive of willingness for immunization reminder were access to personal phone (aOR 11.1, 95% CI 3.160-390.08) and mother’s tertiary education (aOR 2.9, 95% CI 1.822-5, 302).Conclusions: Access to personal phone and improved education are significant tools in enhancing immunization coverage.</jats:p