Screening for kidney disease in children on World Kidney Day in Lagos State, Nigeria

Background: Across the world, World Kidney Day (WKD) is marked yearly to increase awareness of kidney diseases. In 2016, its focus was on children for the first time. We report on a WKD screening initiative for kidney disease that was conducted in two public schools in Lagos State, Nigeria.Methods: Participants were recruited after guardians provided signed consent and older children gave assent. Baseline data were obtained which included family history of chronic diseases like sickle cell disease, hypertension, diabetes, renal disease, and the use of herbal medications. Anthropometric parameters such as height, weight and body mass index (BMI) were recorded. Investigations included urinalysis, measurement of serum creatinine and estimation of glomerular filtration rate (eGFR) using the Schwartz formula.Results: A total of 405 children were screened; there were 190 (46.9%) males and 215 females. The children were aged 2 to 17 years with a mean age of 9.1 ± 3.0 years. Over 80% of the children had normal nutritional status. Severe thinness was seen in 22 (6.8%) whereas overweight was present in 10 (3.1%). Only 1 was obese. eGFR was above 90 mL/min/1.73 m2 in 232 (94.3%) of the participants. Hypertension was present in 47 (14.4%), with the highest rate among those 0–8 years old. Proteinuria was detected in 118 (29.2%); none of the children had haematuria. Systolic hypertension, a family history of smoking and the use of herbal medications were associated with proteinuria.Conclusions: The study has highlighted a high rate of proteinuria, associated with the use of herbal medications, hypertension and a family history of smoking. Screening for renal disease in children with appropriate follow-up and timely intervention to avoid progression to end-stage renal disease is imperative

Toilet training practices in Nigerian children

Background. This study reports on toilet training with a focus on the effect of age, methods used, and factors that can affect urinary incontinence in Nigerian children. Methods. This was a cross-sectional hospital-based study carried out in public and private hospitals in South-Western Nigeria. A questionnaire was used to obtain information about toilet training practices from 350 adults, who toilet trained 474 children. Results. The adults had previously toilet trained children 1 - 18 years old. In this study, toilet training commenced at ≤12 months, during the day and night in 40.6% and 33.4% of children, respectively. Of the 350 parents/guardians, 141 (47.7%) commenced toilet training by waking children from their afternoon nap. The most common method was allowing the child to urinate at fixed time intervals, while the least common was a reward/punishment system. Furthermore, age was considered as the most common indicator to commence toilet training. For 36.9% of the children, training lasted 1 - 6 months. Daytime continence was achieved by 33.4% of children at ≤12 months old, and night-time continence was achieved in 29.7% of children between 12 and 18 months old. By 30 months, 91.1% and 86.9% had attained day- and night-time continence, respectively, and only 8.6% of the children were incontinent at night. Conclusion. Assisted infant toilet training is still practised among Nigerian parents despite the influence and the trends in the developed countries. The age at initiation and completion of toilet training was lower than those reported for developed countries

Toilet training practices in Nigerian children

Background. This study reports on toilet training with a focus on the effect of age, methods used, and factors that can affect urinary incontinence in Nigerian children. Methods. This was a cross-sectional hospital-based study carried out in public and private hospitals in South-Western Nigeria. A questionnaire was used to obtain information about toilet training practices from 350 adults, who toilet trained 474 children. Results. The adults had previously toilet trained children 1 - 18 years old. In this study, toilet training commenced at ≤12 months, during the day and night in 40.6% and 33.4% of children, respectively. Of the 350 parents/guardians, 141 (47.7%) commenced toilet training by waking children from their afternoon nap. The most common method was allowing the child to urinate at fixed time intervals, while the least common was a reward/punishment system. Furthermore, age was considered as the most common indicator to commence toilet training. For 36.9% of the children, training lasted 1 - 6 months. Daytime continence was achieved by 33.4% of children at ≤12 months old, and night-time continence was achieved in 29.7% of children between 12 and 18 months old. By 30 months, 91.1% and 86.9% had attained day- and night-time continence, respectively, and only 8.6% of the children were incontinent at night. Conclusion. Assisted infant toilet training is still practised among Nigerian parents despite the influence and the trends in the developed countries. The age at initiation and completion of toilet training was lower than those reported for developed countries

Serum cystatin C levels in Healthy Nigerian neonates: Is there a need for normative values in Nigerian babies?

Cystatin C is an endogenous marker of renal function. Normal reference values have been documented in neonates outside Africa, but no study has been documented in African neonates. With reports that race may affect serum cystatin C values, this study was carried out to generate normal values in apparently healthy term neonates at birth and three days of life neonates in Nigeria. This was a hospital-based prospective study. A cohort of 120 apparently healthy term neonates were recruited at birth. Serum cystatin C was measured from the cord blood at birth and venous blood when they were three days old using enzyme-linked immunosorbent assay (ELISA) method. The mean serum cystatin C values for cord blood and 3rd day venous samples were 1.67 ± 0.52 mg/L and 1.62 ± 0.52 mg/L, respectively (P = 0.87). The cord blood and 3rd day serum cystatin C values for males were 1.67 ± 0.47 mg/L and 1.68 ± 0.51 mg/L, respectively (P = 0.77) and the values for females were 1.68 ± 0.56 mg/L and 1.58 ± 0.52 mg/L, respectively (P = 07.22). The serum cystatin C levels were similar among the different birth weight groups and gestational age (P >0.05). The cord blood and 3rd day serum cystatin C values were similar. Serum cystatin C values were independent of gender and birth weight of neonates. The values of serum cystatin C in Nigerian neonates were comparable to that reported for neonates in other regions of the world. It is recommended that ELISA technique may be reliably used to measure serum cystatin C levels in neonates