Substance use among secondary school adolescents in Gwagwalada Area Council, Abuja, Nigeria

Background: Adolescent substance use is a growing epidemic that is placing heavy burdens on individuals, families and communities hence the stimulus for this study.Aim/Objectives: To determine the prevalence and pattern of substance use among secondary school adolescents in Gwagwalada Area Council, Abuja, Nigeria.Methods: A questionnaire-based, cross-sectional, descriptive study done over a three-month period among secondary school adolescents aged 10 to 18 years old after obtaining appropriate ethical approvals, consent and assent.Results: A total of 1,196 questionnaires were analysed, of which 641 (53.6%) were females and 1,052 (87.96%) from public schools. The overall prevalence rate for lifetime use was 72.7%. The substance with the highest prevalence rates for lifetime, annual and current use was kola nut (44.3%, 24.4 and 11.0%, respectively) and lowest for heroin (0.7%, 0.6% and 0.5%, respectively). There was a statistically significant male preponderance for licit substance use and a non-statistically significant female preponderance for illicit substance use. 507(42.4%) students were single substance users while 363 (30.35%) students were multiple substance users. Age at first use was at ten years of age or less.Conclusion and recommendations: There is need for strengthening substance use prevention programmes and implementing regulatory laws on sale and use of substances. Stiffer penalties for offenders are recommended.Keywords: Prevalence;substance use; adolescent; secondary school; Nigeri

Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos, Nigeria

Background: This study assessed the nutritional knowledge, dietary habits and nutritional status of adult diabetic patients attending teaching hospitals in Lagos State, Nigeria.Methods: A cross-sectional study was conducted among adult diabetic patients attending the out-patient clinics of the two Teaching Hospitals in Lagos. Respondents were recruited from the clinics consecutively until the desired sample size (342) was obtained. A pre-tested interviewer-administered questionnaire was used to collect data. Dietary habits were assessed using food frequency questionnaire and BMI was assessed following standard procedure and compared with the World Health Organization (WHO) standards. Data was analyzed using IBM SPSS (Version 20). Chi-square and fisher’s exact probability test were used to determine the association between variables. The level of significance was set at p-value less than 5%.Results: The mean age of the respondents was 59.6 + 13.0 years. Only 125 (37%) of the respondents had good nutritional knowledge. Majority ate three meals every day, 237 (69.3%) and have had dietary counseling, 255 (74.6%). More than half of the respondents, 202 (59.1%) skipped meals, 80 (23.4%) consumed alcohol while only 42 (12.3%) ate fruits and vegetables daily. The commonest food consumed was processed cereals. Majority of the respondents were overweight or obese (74%). Obesity was associated with being female and not having dietary counseling.Conclusion: Nutritional knowledge and dietary habits were poor while overweight and obesity were high. Dietary counseling will be necessary to improve the dietary pattern and nutritional status of the diabetic patients.Keywords: Nutritional knowledge; Dietary pattern; Body Mass Index; Diabetic patients; Teaching hospitals; Lago

Antifungal effect of Polar and non polar extracts of Aframomum Sceptrum on Two Isolates of Oil Palm

In different parts of the world, attention is being paid to exploitation of higher plants as biodegradable fungicides in the control of most plant pathogenic fungi. Different spices of the Zingiberaceae family have been tested for their antifungal properties, but there exists little or no information on the antifungal potential of a particular member of that family; Aframomum sceptrum on fungal pathogens of some economic important palms in Nigeria. In this study, the phytochemical composition of the seed extracts of this spice was analyzed by standard methods while the antifungal activities of polar and non polar extracts of the spice was tested on two major isolates affecting the Oil palm, Fusarium oxysporum f.sp elaeidis and Hypocrea lixii (IMI 501885) Cold extraction using Acetone, Ethanol, Hexane, Methanol, and Diethylether solvents were used in the seed extract preparation. The broad spectrum fungicide, Mancozeb (80% wettable powder) was used as the positive control while the negative control was Dimethyl sulphoxide. The Dimethyl sulphoxide was also used to reconstitute the solvent extracts by dissolving the extracts and fungicides in appropriate amount of 15 % (v/v) to obtain a concentration of 0.0624g/ml. The phytochemical screening revealed the presence of the following phytochemicals in different quantities; Alkaloids, Terpenoids, Anthraquinones, Flavonoids Tanins, Saponins. Results obtained showed that all the extracts had a significantly higher antifungal effect (p< 0.05) than the broad spectrum fungicide, Mancozeb at 2000ppm. Non polar hexane seed extract had the highest percentage inhibition of 60.26% on Hypocrea lixii (IMI 501885 while the Polar ethanolic extracts with a percentage inhibition of 52.73 % on Fusarium f.sp elaeidis. Amongst all the extracts used in this study, the seed extracts that gave a low percentage inhibition of 42.45% was the non –polar acetone seed extract on Fusarium oxysporum fsp. elaeidis and methanol extract on H .lixii with the least percentage inhibition of 42.31%. The implications of these findings are discussed.Keywords: Oil palm, Antifungal, Phytochemical, DMSO, Pathogen

A pre-COVID-19 assessment of aspects of the school health programme in some selected Nigerian primary schools: implications for school re-opening during the COVID-19 pandemic in developing country contexts.

BACKGROUND: Following the COVID-19 pandemic, school closures were part of the global public health response to limit community spread of the virus. In recent times, there has been an emphasis on safe school re-opening. This concept is likely to differ between developed and developing country settings. There are however no published studies on barriers hindering safe school re-opening within developing country contexts. This study evaluates aspects of the school health program (SHP) in some selected Nigerian schools that might relate to the pandemic control during school re-opening. METHODS: In 2017, we conducted a cross-sectional survey of the SHP of 146 registered primary schools in Gwagwalada Area Council in Abuja, Nigeria. These schools provided services to about 54,562 students. We used direct observational methods and interviewer-administered questionnaires to assess the SHP of each school. We compare SHP characteristics that might relate to COVID-19 control in schools across government-owned (public) and privately-owned (private) schools using a pre-defined framework. RESULTS: Public school to pupil ratios was more than six times that of private schools. Only 6.9% of all surveyed schools employed qualified health personnel. Although 8 in every 10 schools conducted health talks for communicable disease control, the use of temporary isolation and school-based immunization were low at 1.4 and 2.7% respectively. Pipe-borne water access was present in 4 of 10 schools, with public schools having more limited access than private schools (p = 0.009). Similarly, less proportion of public schools had access to soap for handwashing (p < 0.001). Adequate classroom ventilation was present in 63% of surveyed schools, with private schools having more limited ventilation (p < 0.001). CONCLUSIONS: Overcrowding and infrastructural deficits within developing country contexts represent barriers to safe school re-opening during the COVID-19 pandemic. In these settings, there needs to be tailored and innovative strategies which consider local practical realities when designing the COVID-19 control programs during school re-opening

A three year descriptive study of early onset neonatal sepsis in a refugee population on the Thailand Myanmar border.

BACKGROUND: Each year an estimated four million neonates die, the majority in the first week of life. One of the major causes of death is sepsis. Proving the incidence and aetiology of neonatal sepsis is difficult, particularly in resource poor settings where the majority of the deaths occur. METHODS: We conducted a three year observational study of clinically diagnosed early onset (<7 days of age) neonatal sepsis (EONS) in infants born to mothers following antenatal care at the Shoklo Malaria Research Unit clinic in Maela camp for displaced persons on the Thailand-Myanmar border. Episodes of EONS were identified using a clinical case definition. Conventional and molecular microbiological techniques were employed in order to determine underlying aetiology. RESULTS: From April 2009 until April 2012, 187 infants had clinical signs of EONS, giving an incidence rate of 44.8 per 1000 live births (95% CI 38.7-51.5). One blood culture was positive for Escherichia coli, E. coli was detected in the cerebrospinal fluid specimen in this infant, and in an additional two infants, by PCR. Therefore, the incidence of bacteriologically proven EONS was 0.7 per 1000 live births (95% CI 0.1-2.1). No infants enrolled in study died as a direct result of EONS. CONCLUSION: A low incidence of bacteriologically proven EONS was seen in this study, despite a high incidence of clinically diagnosed EONS. The use of molecular diagnostics and nonspecific markers of infection need to be studied in resource poor settings to improve the diagnosis of EONS and rationalise antibiotic use

Acute kidney injury in children

Acute kidney injury (AKI) (previously called acute renal failure) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. The incidence of AKI in children appears to be increasing, and the etiology of AKI over the past decades has shifted from primary renal disease to multifactorial causes, particularly in hospitalized children. Genetic factors may predispose some children to AKI. Renal injury can be divided into pre-renal failure, intrinsic renal disease including vascular insults, and obstructive uropathies. The pathophysiology of hypoxia/ischemia-induced AKI is not well understood, but significant progress in elucidating the cellular, biochemical and molecular events has been made over the past several years. The history, physical examination, and laboratory studies, including urinalysis and radiographic studies, can establish the likely cause(s) of AKI. Many interventions such as ‘renal-dose dopamine’ and diuretic therapy have been shown not to alter the course of AKI. The prognosis of AKI is highly dependent on the underlying etiology of the AKI. Children who have suffered AKI from any cause are at risk for late development of kidney disease several years after the initial insult. Therapeutic interventions in AKI have been largely disappointing, likely due to the complex nature of the pathophysiology of AKI, the fact that the serum creatinine concentration is an insensitive measure of kidney function, and because of co-morbid factors in treated patients. Improved understanding of the pathophysiology of AKI, early biomarkers of AKI, and better classification of AKI are needed for the development of successful therapeutic strategies for the treatment of AKI

Dialysis and pediatric acute kidney injury: choice of renal support modality

Dialytic intervention for infants and children with acute kidney injury (AKI) can take many forms. Whether patients are treated by intermittent hemodialysis, peritoneal dialysis or continuous renal replacement therapy depends on specific patient characteristics. Modality choice is also determined by a variety of factors, including provider preference, available institutional resources, dialytic goals and the specific advantages or disadvantages of each modality. Our approach to AKI has benefited from the derivation and generally accepted defining criteria put forth by the Acute Dialysis Quality Initiative (ADQI) group. These are known as the risk, injury, failure, loss, and end-stage renal disease (RIFLE) criteria. A modified pediatrics RIFLE (pRIFLE) criteria has recently been validated. Common defining criteria will allow comparative investigation into therapeutic benefits of different dialytic interventions. While this is an extremely important development in our approach to AKI, several fundamental questions remain. Of these, arguably, the most important are “When and what type of dialytic modality should be used in the treatment of pediatric AKI?” This review will provide an overview of the limited data with the aim of providing objective guidelines regarding modality choice for pediatric AKI. Comparisons in terms of cost, availability, safety and target group will be reviewed