Relationship between age and location of the apex beat among apparently healthy Nigerian children

Background: Normal location of apex beat varies with age in children. Location of apex beat is an integral part of routine cardiovascular system examination in clinical practice. However, there is paucity of literature on apex beat location in Nigerian children. Objective: The aim of this study was to locate apex beat position in apparently healthy Nigerian children from birth to ten years, and to relate the location with age. Subjects and Methods: This was a cross sectional study carried out in Sagamu, Nigeria. A sample size of two hundred and thirty-seven was calculated from a previous study. Hence two hundred and thirty-seven apparently healthy Nigerian children who satisfied the inclusion criteria were enrolled for the study. Apex beat location in the intercostal space was determined and distance of apex beat from the midline, midclavicular line and nipple lines were measured. The measured distances were related to age using linear regression and Pearson correlation. Results: The mean distance of apex beat from the midline from birth to 10 years ranged from 2.3cm to 6.4cm. The distance of apex beat from the midline increased progressively with age. In children up to the age of three years, the apex beat was in the 4th left intercostals space. In 91.7%, 51.3% and 14.3% of children aged four, five and six years respectively, the apex beat was present in the 4th left intercostal space. Above six years, it was located in the 5th left intercostals space. Conclusion: The location of the apex beat from the midline was strongly related with age Thus, the distance of apex beat from the midline can be predicted from age in months.Keywords:  Apex beat, Children, Mid-clavicular line, Nigeria, Nipple lin

Relationship between anthropometric parameters and the location of apex beat in children

Background: Childhood growth is characterized by changes in anthropometric parameters. The location of the apex beat may besimilarly influenced by growth.Objectives: The objective of this study was to determine any relationshipbetween the location of the apex beat and anthropometric parameters.Subjects and Methods: This crosssectional survey was carried out inSagamu, Nigeria. Apparently healthy children were randomly selected for the study. Apex beat location in the intercostal space was determined and distance from the midline was recorded. Weight and length/height were also recorded while Body Mass Index (BMI) and Body Surface Area (BSA) were calculated.Results: A total of 237 children aged 12 hours to 10 years were surveyed.The mean distance of the apex beat from the midline from birth to 10 years ranged from 2.3cm to 6.4cm. The mean distance of apex beat from the midline increased progressively with weight, height, chest circumference and BSA but not with BMI. Strong correlations were observed betweendistance of apex beat from the midline and weight (r = 0.850, p .0.001); height (r = 0.867, p .0.001); chest circumference (r = 0.833, p . 0.001); BSA (r = 0.862, p . 0.001) but not with Body Mass Index (r = 0.019, p = 0.774).Conclusion: The location of the apex beat in children was stronglyinfluenced by growth as suggested by anthropometric parameters.Key words: Anthropometry, apex beat, children, mid-clavicular line,nipple lin

Paediatrician workforce in Nigeria and impact on child health

Objective: To determine the number and distribution of paediatricians in Nigeria. It also aims to determine the association between paediatrician workforce and under five mortality (U5MR) and immunization coverageacross the six geopolitical zones of the country.Methods: The part II fellowship examination pass list of the West African College of Physicians and the National Postgraduate Medical College and the register and financial records of the Paediatric Association of Nigeria were searched for the purpose of the study. Using a structured questionnaire, personal and professional data was obtained frommembers at the 2011 Annual Paediatric Association of Nigeria Conference or via the Association’s website, email network and phone calls to Departments of Paediatrics in institutions (private and public) across the Country. Data on the paediatricians residing within Nigeria was then extracted from the comprehensive database and subsequently analyzed.Population data, mortality and immunization rates were obtained from the National Population Commission census and their most recent National Demographic health survey in Nigeria. Correlations were drawn betweennumber of paediatricians and U5MR and diphtheria-pertussistetanus(DPT) vaccine coverage.Results: There were 492 practicing paediatricians in Nigeria at theend of year 2011, comprising 282 (57.3%) males and 210 (42.7%)females; 476 (96.7%). Majority (84.7%) worked for the governmentwith 97% of them in hospital settings, mostly tertiary centres (344=88%). Lagos State had the highest number (85; 17.9%) of practicing paediatricians followed by the Federal Capital Territory with 37 (7.8%) paediatricians. More than two thirds of the paediatricians (336; 70.6%) were practicing in the southern part of the country. The average child:p a e d i a t r i c i a n r a t i o wa s 157,878:1for the country. TheNorth East zone had the highest chi ld- to-pa ediat r ician rat io (718,412:1) while South West had the lowest ratio (95,682:1).Higher absolute numbers of paediatricians in each zone were associatedwi th lower U5MR (Spearman ñ=-0.94, p=0.0048), accounting for 84% of the variability among zones. Higher ratios of child-to-paediatrician were significantly associated with higher U5MR (Spearman ñ=0.82, p=0.04,linear R2=0.73) and marginally with lower DPT coverage by geopoliticalzone (Spearman ñ=-0.77, p=0.07, linear R2=0.59).Conclusion: The study reveals that the number of paediatricians inNigeria is grossly inadequate with a huge child-to-paediatrician ratio.There is also an uneven distribution of the paediatricians with higher numbers in the southern states. Zones of the country with lower child-to-paediatrician ratios also experienced lower U5MR. There is a need to train more paediatricians in Nigeria and promote an even distribution of the paediatrician workforceKey words: Paediatrician, workforce, child-to-paediatrician ratio, under-5 mortality, immunization, childhealth, Nigeri

Mothers and childhood pneumonia: What should the focus of public campaigns be?

Background: Prompt administration of antibiotics to children with pneumonia significantly reduces the probability of death. However this requires early identification of such children in the community.In a country such as Nigeria with one of the highest pneumoniarelateddeaths, what do mothers know about pneumonia, and what should be the content of public campaign messages?Methods: A structured questionnaire was administered to mothers  attending paediatric clinics of Lagos University Teaching Hospital seekingtheir knowledge about the definition, causes, risk factors and symptomsof childhood pneumonia.Results: One hundred and seven (107) consecutive mothers participatedin the study. The majority (97; 90.6%) had at least secondary education,were married (96; 89.7%) and professed to be either Christiansor Muslims (105; 98.1%). Prior to the study, 16 (15%) had notheard about pneumonia. About half of the participants correctly identifiedfast/difficult breathing as suggestive of pneumonia. Threequartersreported exposure to cold as the cause of childhood pneumonia. Minimizing exposure to cold and wearing warm clothes were thetwo commonest reported ways of preventing pneumonia (75.8% and49.5% of the mothers respectively); in contrast hand washing, exclusivebreastfeeding and limiting exposure to sick persons with cough and catarrhwere the least mentioned. The proportion of mothers who correctlyidentified fast/difficult breathing as suggestive of pneumoniawas similar irrespective of educational status or source of pneumoniainformation.Conclusion: Mothers’ knowledge of childhood pneumonia is low. Publiccampaigns on pneumonia should focus on raising awareness aboutgerms as cause of pneumonia, immunization, hand washing and exclusivebreastfeeding as potent preventive strategies and fast/difficult breathing as a feature of pneumonia

Community knowledge, attitude and practice of childhood immunization in Southwest Nigeria: Data from a Paediatric Association of Nigeria town hall meeting

Background: Vaccine preventable diseases account for 22% of under-five deaths in Nigeria and poor knowledge and attitude have been responsible for non-vaccination of children. This study aimed to assess the knowledge,attitude and practice of childhood immunization among community members in Ile-Ife.Methods: Quantitative data (using an interviewer-administered questionnaire) was collected from a convenience sample of 36 adultresidents who attended a town hall meeting with the PaediatricAssociation of Nigeria. Two focus group discussions were also conductedamong sub-samples of male and female respondents.Results: The mean age of respondents was 43.2 ± 11.9 years with amale to female ratio of 1:0.7. Most had secondary education (63.9%)and had children (91.7%). Most of the respondents understood whatimmunization was and knew the benefits but were unaware of severalof the specific types of immunization. There were erroneous beliefs about the contraindications for immunization and mothers were entrusted with the sole responsibility of getting children immunized. Although most of therespondents had immunized their children, they identified laziness ofmothers, negative attitude of health workers and logistics problemsat facilities as barriers to patronage of immunization services.Conclusion: This study identified knowledge gaps and negative attitudestowards childhood immunization. We therefore recommend a community-wide health education intervention with emphasis on substantial male involvement in immunizations and improvement inimmunization service delivery.Key words: Community, knowledge, attitude, childhood immunization

Problematic social media use: results from a large-scale nationally representative adolescent sample

Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs

Trait emotional intelligence and problematic social media use among adults: the mediating role of social media use motives

There are many contributing factors to problematic social media use including personality differences, psychosocial factors, and specific use motivations. The present study (N = 444 emerging adults, 75% women) investigated the direct and indirect relationships between trait emotional intelligence and problematic social media use via social media use motives by testing a complex mediation model. Path analyses suggested that trait emotional intelligence was directly and indirectly associated with problematic social media use via two social media use motives: (i) expressing or presenting a more popular self, and (ii) passing time. Results of the present study indicate that trait emotional intelligence may have a role in the motives for using social media as well as the development and maintenance of problematic social media use. Moreover, future studies should focus mediator risk factors between trait emotional intelligence and problematic social media use

Immunisation coverage at a primary health care level in Nigeria

Deaths from vaccine-preventable diseases continue to contribute significantly to infant mortality, hence the global drive against their eradication, especially neonatal tetanus and poliomyelitis. This study set out to evaluate the level of awareness and utilization of childhood and maternal tetanus and childhood immunisation programmes at a Primary Health Centre, Atelowo in Osogbo, Nigeria. The immunisation record was evaluated with regards to the pattern of maternal tetanus toxoid (TT) administration and childhood immunisation. There were 209 mother-baby pairs and of these, 18 (8.6) had BCG vaccination, 49 (23.4%); DPT1/OPV1, 47 (22.5%); DPT2/OPV2 and 23 (11%); DPT3/OPV3. No infant received OPV0. Only 9 (4.3%) of 209 babies were immunised against measles. Concerning maternal TT administration, 109 (52.2%) and 74 (35.4%) had TT1 and TT2, respectively. A general apathy towards immunisation was observed, with only 4.3% of babies being available by nine months of age; the same trend was noticed with maternal immunization. Therefore suggested is a house-to-house campaign for immunization and a restructuring of the monitoring systems of the programmes. Sahel Medical Journal Vol.7(2) 2004: 59-6

Study on prevalence and nutritional effect of Helminthis infection in pre-school rural children in Nigeria

Helminthiasis and malnutrition have remained major problems especially in the tropics. In view of this, this study sets out to determine the relationship between Helminthic infection and nutritional status of preschool children in the rural area where majority of them live as well as the prevalence of Helminthic infection. The study was a community-based cross sectional survey. Three hundred and five children attending a daycare centre and pre-primary home lessons in a rural community- Ode Remo, Ikenne Local Government, Ogun State, Nigeria were recruited for the study. Out of these, fecal samples from only two hundred and twenty-six of them were considered suitable for analysis. Saline suspension of stool specimens from the children was examined under the microscope. The stool specimens were positive for intestinal helminth in 116 cases (51.3%). Of this, the majority with positive yield, forty-eight (41.3%) was from age group 48-60 months. Eighty-six (74.1%) of the children whose stool was positive for helminth were malnourished. Ascaris lumbricoides was the commonest intestinal helminth in 38.1% of the cases. There is a strong association between parasitic infection and malnutrition (χ2=13.84, p value=0.02). In conclusion, helminthiasis remains a common health problem among preschool children in the rural area. Its association with malnutrition dictates that urgent steps need to be taken to prevent children from being infested if under-five mortality is to be reduced. This may be achieved through improvement in sanitary conditions of the environment, and nutrition of the child.Nigerian Medical Practitioner Vol. 54 (1) 2008: pp.16-2

A descriptive job analysis of doctors as primary health care co-ordinators in south western Nigeria

No Abstract.Keywords: primary care coordinators; training; preventive care; curative care; job practiceAnnals of Ibadan Postgraduate Medicine Vol. 4 (1) 2006: pp. 42-4