Childhood Pneumonia and under-five morbidity and mortality at the University of Port Harcourt Teaching Hospital- a situational analysis

Background: Childhood mortality which remains high in children under the age of 5years is largely due to infectious and other preventable causes such as Human immunodeficiency virus/ Acquired Immunodeficiency Syndrome ((HIV/AIDS), pneumonia and malaria1 . The prevention of pneumonia deaths is therefore an important th approach if the 4th Millennium Development Goal (MDG4) is to be attained.Aim: The aim of this study was to describe the pattern, clinical features, management and complications of pneumonia in under-five children admitted in the University of Port Harcourt Teaching Hospital (UPTH) and to highlight their morbidity and mortality.Methods: This was a retrospective cross sectional descriptive study of children diagnosed with pneumonia who were admitted into the children's wards between January 2007 and December 2009. The case notes of all children diagnosed of pneumonia who were admitted into the paediatric wards as recorded in the ward register, were reviewed.Results: Five hundred and ninety-two children met the inclusion criteria. The yearly number ranged from 107 in 2007 to 213 in 2009. The quarterly distribution showed a peak during the north east wind (harmattan) season. Their ages ranged from <1-168 months (mean age 13.2 months, SD=19.84). Neonates accounted for 24.5% of all cases, while 66.9% were Infants and Under-fives were 97.1%. They were 333(56.3%) males and 251(42.4%) females, with a M: F ratio of 1.3:1. Pneumonia alone was the diagnosis in 127(54 .7%) while 106(45.7 %) had pneumonia plus other associated conditions, the commonest being malaria. Heart failure was the commonest complication 69(29.7%). The children who completed their immunization in infancy according to the National program on immunization schedule were 61.2% of cases, those who were exclusively breast feeding for the first six months of life - 31.9%, while HIV/AIDS was observed in 9.1%. The case fatality rate was 9.0% with 79.2% of them as infants.Conclusion: Pneumonia which is still prevalent in underfives in this environment is associated with significant morbidity and mortality especially among infants. Efforts to address this contributor to under-five morbidity and mortality is required if MDG4 is to be attained.Keywords: Pneumonia, under-five mortality, morbidity, MDG4

WriteSim TCExam - An open source text simulation environment for training novice researchers in scientific writing

BACKGROUND: The ability to write clearly and effectively is of central importance to the scientific enterprise. Encouraged by the success of simulation environments in other biomedical sciences, we developed WriteSim TCExam, an open-source, Web-based, textual simulation environment for teaching effective writing techniques to novice researchers. We shortlisted and modified an existing open source application - TCExam to serve as a textual simulation environment. After testing usability internally in our team, we conducted formal field usability studies with novice researchers. These were followed by formal surveys with researchers fitting the role of administrators and users (novice researchers) RESULTS: The development process was guided by feedback from usability tests within our research team. Online surveys and formal studies, involving members of the Research on Research group and selected novice researchers, show that the application is user-friendly. Additionally it has been used to train 25 novice researchers in scientific writing to date and has generated encouraging results. CONCLUSION: WriteSim TCExam is the first Web-based, open-source textual simulation environment designed to complement traditional scientific writing instruction. While initial reviews by students and educators have been positive, a formal study is needed to measure its benefits in comparison to standard instructional methods

Salt iodisation in Port Harcourt metropolis: a survey of households and markets

Background: Consequent on the recognition of the public health importance of Iodine Deficiency Disorders (IDD), especially in developing countries, the goal of iodising at least 90% of edible salts by 2000 was set at the 1990 World Summit for Children. Aim: To determine the salt iodisation level in Port Harcourt. Methods: In April 2000, using pre-tested questionnaires and MBI field test kits, traders from 8 markets and residents of 2181 households in Port Harcourt were interviewed and samples of their edible salts tested to determine their iodine content. Results: The major salt brands of the 336 market and 2182 household samples were Union Dicon (70.54% and 25.52%) and Cassava (11.9% and1.92%). About 17% of salt samples tested from markets compared to 72.55% from households, were of unknown brands (p=0.00000). Over 99% of samples from markets and households (99.7% and 99.13% respectively) had >30 ppm of iodine. All 27 traders interviewed were ignorant of salt iodisation programme and IDD; 92.6% had seen persons with \'goitre\' but were ignorant of its causes and prevention. Conclusion: Salt iodisation at the point of production has proved effective in increasing the consumption of iodised salts in Port Harcourt despite the widespread ignorance of the programme and its importance in controlling IDD. That most of the salts had >30 ppm of iodine portends the danger of toxicity with long-term use. There is need for close monitoring to ensure the safety of the intervention and its sustainability. Keywords: Universal salt iodisation, Iodine deficiency disorders, Ignorance, Community mobilization Port Harcourt Medical Journal Vol. 2 (1) 2007: pp. 27-3

Review article: Writing a scientific paper: getting to the basics

No Abstract.Nigerian Journal of Medicine Vol. 16 (3) 2007: pp. 212-21

Naphthalene poisonging in Children: a report of two cases

No Abstract. Nigerian Journal of Paediatrics Vol. 33 (2) 2006: pp. 60-6

Upsurge of paediatric tuberculosis in Port Harcourt, Nigeria: Has HIV infection any role?

Background: The Niger Delta region in Southern Nigeria is peculiar, not only for its oil and mineral resources, but also, for the adverse socio-environmental factors, which enhance the occurrence of communicable diseases like tuberculosis and Human Immunodeficiency virus (HIV) infection. Because childhood tuberculous infection is a reflection of ongoing transmission in the community and can be reactivated as adult TB, which in turn maintains a chain of transmission, it is important to determine its incidence in this region. Aims: To describe the pattern of paediatric tuberculosis at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, in the Niger Delta and the role, if any, of HIV co-infection in the cases. Methods: A retrospective analysis of children diagnosed to have tuberculosis, using clinical data, tuberculin test and chest radiography, and managed at the UPTH from January 1, 2002 to October 31, 2005 was done. Results: Out of 13,367 children aged 0-15 years who received care at UPTH during the period under review, 188 had tuberculosis. The median age of the tuberculosis cases was 2 years. Seventy six percent were under-fives and 53.2% HIV seropositive. Pulmonary tuberculosis (80.6%) was the commonest form of the disease. The proportional incidence of tuberculosis and HIV co-infection increased from 0.88% in 2002 to 87.5% in 2005. Conclusions: Tuberculosis and HIV co-infection seems to be an emerging pattern of paediatric tuberculosis infection in Port Harcourt. There is therefore a need to screen all children with tuberculosis for the presence of HIV co-infection. Keywords: Childhood tuberculosis; HIV co-infectionPort Harcourt Medical Journal Vol. 1 (2) 2007: pp.113-11