Domestic Water Sourcing and the Risk of Diarrhoea: a Cross-Sectional survey of a Periurban Community in Jos, Nigeria

Water and sanitation has been identified as an important component of Primary Health Care (PHC) necessitating the World Health Organization to declare 1981-1990 as the international water years. Nigeria is the largest single country in sub Saharan Africa worst hit with about three quarters of its population unable to access safe water. The study aims to examine the association between domestic water sourcing practice and the risk of developing diarrhea. A total of 200 households were studied over an eight week period from 4 June to 31st July 2005 using an interviewer administered questionnaire. Data was analyzed using Epi Info version 3.5.1. Most of the household (80%) were seen to source domestic water from the municipal pipe-borne water supply, while only 5% source water from their own dug-in well only. 27% of the households reported diarrhea in their household in the last six month. The diarrhea was found to have bivariate association with the number of children in the household, the educational level of the household head, and income of household head. No association was found between diarrhea and age of household head. The study showed that there is association between domestic water sourcing practice and the risk of developing diarrhea. It is therefore recommended that high premium be placed on improving access to water and improved household hygiene as a way of helping to curb diarrhea.KeyWords: Diarrhoea, household and morbidity

Pattern of acute respiratory infections in hospitalized children under five years of age in Jos Nigeria

Background: Acute respiratory infections are the commonest cause of acute morbidity in children especially those under five in the developing countries. Clinical diagnosis is of utmost importance considering the unavailability of radiological and microbiological services in most primary care settings in most developing countries.Methodology: Thirty nine children with symptoms of acute respiratoryinfection attending our emergency room over a one year period wererecruited. Each had a CXR and blood culture ordered by the attendingphysician on admission.Results: Thirty nine subjects were admitted with ARI with a hospitalprevalence of 43.5/1000 person per year (39/897). Mean age was18.75+17.23 mo, (Females =25.6+19.1, Males = 13.8+14.2, t=2.2, p=0.03). Bronchiolitis was the commonest ARI seen in infants, tonsillitis in children beyond infancy while pneumonia was seen in all age groups. The cardinal feature of each disease entity was Fever, cough, breathlessness, tachycardia and hypoxemia in those with Pneumonia; Catarrh, nasal congestion and tachypnoea in those with bronchiolitis, while fever and vomiting were seen in those with pharyngotonsilitis.Conclusion: This review highlights the common ARI in our setting.Efforts need to be intensified on the identification of children with ARIin the children emergency room with the aim of prompt and appropriatemanagement in order to meet the MDG targets

Prevalence and risk factors of low birth weight in Jos

This study examines the Prevalence and factors associated with low birthweight (LBW) in Jos.208 babies delivered by 208 women in Jos University Teaching Hospital, (JUTH) were studied over an eight week ( 12th February to 11th April 2003. A cross-sectional study was done and the sample gotten by systematic sampling of all the babies delivered. Mean birth weight of the infants was 3.08±1.319 (range 0.904 to 4.005) kg. The prevalence of LBW was found to be 12.7 %. LBW has bivariate associations with mother's educational status, height, and health problems during pregnancy, use of antenatal care facilities, and gestational age. No association was found between LBW and mother's occupation. Although antenatal care provision is absolutely necessary, intervention approaches that go beyond clinical or primary care settings are also warranted for better nutrition of women. Concerted efforts in health and non-health sectors are necessary for improvement in health and social status of women in order to reduce low birthweight

The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol

Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world. In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns; and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020. The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread “natural experiment” of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported in many countries following early COVID-19 pandemic response measures (‘lockdowns’). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95–0.98, P value <0.0001), second (0.96, 0.92–0.99, 0.03) and third (0.97, 0.94–1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96–1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88–1.14, 0.98), third (0.99, 0.88–1.12, 0.89) and fourth (1.01, 0.87–1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02–1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03–1.15, 0.002), third (1.10, 1.03–1.17, 0.003) and fourth (1.12, 1.05–1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries.

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways

Domestic water sourcing and the risk of diarrhea: a cross-sectional survey of a peri-urban community in Jos, Nigeria

No abstract supplie

Pattern of Childhood Malignancies in Jos, North Central Nigeria

Background: Malignancies constitute an important cause of childhood morbidity and mortality in Nigeria. This study describes the current trend in the spectrum of childhood malignancies in Jos , North Central Nigeria. Methodology: A four-year prospective study of childhood malignancies seen at the Jos University Teaching Hospital (JUTH), Jos was conducted between November 2006 and October 2010. Data collected included patients biodata, type of malignancy, treatment modality and outcome. Results: Ninety two (92) cases of childhood malignancies were seen during the 4year period, accounting for 2.7% of all admissions into the paediatric wards, giving an average of 23 cases per year. Out of this, 54 were males; 38 were females. The most common childhood malignancy was Burkitt's Lymphoma accounting for 48.9%, followed by acute leukemias (13.8%), non-Hodgkin lymphoma (12.8%) and Rhabdomyosarcoma (10.6%). The peak age group of children with cancers was 5-9 years (range 2-17 years). The cancer cure rate was as low as 34% while losses to follow up was 30%, and 26% of the patients died in the course of therapy from advanced disease or complications of therapy. Conclusion: Childhood cancers are not uncommon in our environment. Burkitt's lymphoma was the single most common childhood cancer. Cancer cure rate in our centre is still very low. Mobilization of human and material resources towards childhood cancer management and control is advocated.Key Words Pattern, Childhood malignancies, Chemotherapy, Nigeria

Indications for Blood Transfusion among Children in a Tertiary Hospital in North-Central Nigeria

Background: Anaemia is prevalent among children in our environment, often necessitating blood transfusions. Knowledge of the common reasons for blood transfusion and institution of preventive measures is likely to reduce transfusion rate in the region. We undertook a review of indications for blood transfusion in children at the Jos University Teaching Hospital, Jos. Nigeria, over a 1 year period. Methodology: The case notes of all children aged 1 month to 18 years who received blood transfusion in the unit were reviewed. The patients' biodata, underlying medical condition and the type of blood transfusion were among data analysed. Results: There were 956 paediatric admissions into the Emergency Paediatrics Unit of the hospital, 8.9% (85) had blood transfusions. Sickle cell anaemia (57.7%) and cancer related problems (17.6%) were the most common indications for blood transfusions. Malaria was an uncommon reason for blood transfusion. Conclusion: Blood transfusion is frequently indicated in the paediatric population in our setting, largely due to sickle cell anaemia and cancer related problems. Intensifying efforts at premarital screening and counselling targeted at sickle cell anaemia may reduce the prevalence of this disease, while environmental control may reduce cancer incidence and consequently minimize the need for blood transfusions among our children.Key Words Blood transfusion, sickle cell anaemia, childhood cancers

Methylated spirit versus 4% chlorhexidine gel in neonatal umbilical cord infection: A short report of a randomized, openlabelled, parallel-group trial

Background: Neonatal sepsis is a known leading cause of neonatal morbidity and mortality.Aim: To compare the efficacies of 96% methylated spirit and 4% chlorhexidine (CHX) gel in the treatment of umbilical stump of neonates.Method: This was a randomized, open labelled, parallel group trial of CHX gel and Methylated spirit for neonatal umbilical cord care in Jos, between 2/6/17 and 16/7/17. Inclusion criteria were term, newly born 0 to 6 hours old, with no known risk for sepsis and written informed parental consent. Eligible subjects were randomized to receive methylated spirit or 4% CHX gel. Outcome measures were cord separation time, omphalitis, neonatal sepsis and neonatal mortality by day 28.Results: A total sample of 51 of 58 met enrolment criteria. Thirtytwo (62.7%) where delivered in JUTH, 33(64.7%) were males with a mean birth weight of 3.7kg (CI 3.04 – 3.30). Mean cord separation times were 7.96 ± 4.07)days in the methylated spirit group vs 6.43 ± 3.13days in the CHX comparator group, (p=0.078). Omphalitis was0% vs2(8.3%) and NNS 2 (7.4%)vs2(8.3%) in methylated spirit and CHX treatment groups respectively. There was 1(3.7%) mortality in the methylated spirit treatment group.Conclusion: Methylated spirit and 4% CHX gel have comparable umbilical stump treatment efficacy. Methylated spirit may be a safe alternative in clinical settings where topical 4% CHX gel is unavailable or unsafe.Key words: Methylated spirit, 4% Chlorhexidine gel, mortality, Cord separation time, Neonatal sepsis, Omphaliti