Knowledge, Acceptance and Practice of Zinc Therapy in Acute Diarrhoea Among Paediatric Doctors in Nigeria

Background: WHO and UNICEF recommend zinc therapy in children with acute diarrhoea, however adherence to the recommendation varies from country to country. Objective: To determine the knowledge, acceptance and practice of zinc use in childhood diarrhoea among paediatric doctors in Nigeria. Methods: Every third sitting part icipant during the 42 Paediatric Association of Nigeria Conference was requested to complete a questionnaire if they were either a paediatric resident doctor or consultant working in Nigeria. Results: Of the 153 questionnaires distributed, 93 (60.8%) were returned and 85 met the study criteria. Over half (57.6%) of the respondents were consultant paediatricians and 84.7% (49 of 85) practise in tertiary or teaching hospitals, mostly in the southern part of Nigeria (70.8%). About half (44.3%) of the respondents managed more than 10 diarrhoeal cases every month. All except one respondent (84 of 85) agreed with the WHO / UNICEF recommendation and 86.9% (73 of 85) reported prescribing zinc for acute diarrhoea in the past year; 67.1% (49 out of 73) prescribed it always for acute diarrhoea. Knowledge of the effects of zinc on acute diarrhoea was high. There was no significant difference between the paediatric residents and the consultants in both knowledge and practice of zinc therapy. Conclusion: The use of zinc as an adjunct in the management of acute diarrhoea is acceptable and practised by most paediatric residents and consultants in Nigeria.Key Words: acute diarrhoea, knowledge, practice,WHO,zin

Prevalence and pattern of intestinal parasites among pupils of private and public primary schools in an urban centre, Nigeria

Background: Intestinal parasitic infection is highly prevalent among children in the tropics. Identifying the most at risk group and subsequent targeted intervention will lead to cost effective and easy to implement control programme. We thus aim to determine the prevalence and pattern of intestinal parasite among pupils from public and private schools.Material and Method: This was a cross-sectional survey. Participants were recruited through multistage stratified random sampling. Information were collected using a questionnaire and early morning freshly passed stool sample was collected and processed from each participating pupil. Stool microscopy was done using saline and iodine preparations. Eggs were counted using Stoll’s method. Data obtained was analyzed using EPI INFO version 3.5.1.Results: Four hundred and twenty  pupils were studied, 210 pupils from each school type. Prevalence of 78.1% and 17.1% were recorded for the public and private schools respectively. The pupils from the public schools were 17.23 times more likely to have intestinal parasitic infestation compared to those from private schools (OR =17.23, 95% CI = 10.6-28.01, p = <0.0001). Ascaris lumbricoides was the most frequent isolate in both the public (62.8%) and private (66.7%) schools. The prevalence of multiple parasitic infestation was 14.8% in the public schools and none in the private schools. Socioeconomic status and source of water were the main factors with significant effect on the prevalence of intestinal parasite (p<0.0001).Conclusion: Intestinal parasitic infestation remains a very common health issue among the children particularly in the public schools. Distribution of free antiparasitic drugs to pupils at the beginning of every term should be incorporated into the school health program.Key words: Intestinal Parasites, Ascaris lumbricoides, public school, private school, socioeconomic status

Awareness and use of Gross Motor Function Classification System (GMFCS) by health professionals in a developing country

Introduction The degree of disability in children with Cerebral Palsy (CP) can be evaluated with the Gross Motor Function Classification System (GMFCS), a valid tool which was designed for such purposes. However, there appears to be paucity of data on the awareness and use of the GMFCS particularly in the Sub-Saharan continent where the condition is still prevalent. Thus, this study aims to describe awareness, use, merits and demerits of the GMFCS system as perceived by health professionals who take care of children with CP.Methods: This was a cross sectional study of health professionals from three Nigerian teaching hospitals. Information obtained via structured questionnaire were demographic data, years of qualification, years of experience of working with children with CP, awareness, use, merits and demerits of the GMFCS. Factors associated with use of the GMFCS were also evaluated with the Chi-square analysis.Results: 78 health professionals participated in the study and majority (58.9%) were doctors. 55 (70.5%) of the study participants were aware of the GMFCS but only 33(42.3%) were using it. The nurses were neither aware of the system nor using it. A higher proportion of therapists (65.4%) were familiar with the system compared to the doctors (54.3%) . The location of practice was significantly associated with the use of the GMFCS (p=0.013). More doctors noted the merits and demerits of the system compared to the therapists.Conclusion: Though health professionals were aware of the GMFCS only a small proportion was using this vital tool in the clinical setting. Thus, there is the need to create more awareness on GMFCS and its clinical utility, and the training of nurses should be of paramount importance in the developing country.Key words: Awareness, cerebral palsy, gross motor function classification system, developing countr

Postural hypotension in type 1 diabetes: The influence of glycemic control and duration of illness

Background: Postural hypotension (PH) indicates the presence of cardiac autonomic neuropathy and in diabetes mellitus (DM) is associated with adverse outcome. Nonetheless, PH has been rarely characterized in young persons in Sub‑saharan Africa where suboptimal care of DM is prevalent.Aims: The aim of the study was to determine the prevalence of PH in young patients with type 1DM and its relationship with the duration of DM and glycemic control.Settings and Design: It was a cross‑sectional, case control study carried out in the pediatric out‑patient clinic.Materials and Methods: Each study participant had blood pressure (BP) measured in the supine and standing positions. Glycated hemoglobin (HbA1c) levels were determined and disease duration was documented. Statistical Analysis: The mean BP in the different positions was determined. The occurrence of PH, duration of disease and HbA1c levels was determined with logistic regression analysis.Results: A total of 26 diabetic subjects and 26 age and sex matched controls were studied. 12 (46.2%) diabetic subjects had evidence of PH while none of the controls had PH. Diabetic subjects with PH had significantly longer duration of DM than those diabetics without PH (6.79 ± 4.81 vs. 2.83 ± 2.36, P = 0.023). The mean HbA1c level was similar in both groups of diabetic subjects (9.79 ± 2.07 vs. 9.17 ± 2.35). On logistic regression, age, duration of disease, HbA1c level and body mass index were not significant predictors of PH.Conclusion: PH is common in young persons with type 1 DM, with higher frequency in those with long standing disease.Key words: Diabetes mellitus, duration, glycemic control, postural hypotensio

Qualitative and quantitative phytochemical evaluation of Quassia undulata (Guill. & Perr.) D. Dietr. leaves using different solvent polarities

This study investigated solvent effects on the phytochemical composition of Quassia undulata leaves a medicinal plant used in treating arrays of diseases including fever and cough. The leaves were collected, washed, air-dried, pulverized and evaluated for some inherent phytochemicals using four different solvent systems based on their polarities. The solvents are methanol, acetone, ethyl acetate and chloroform. The methanol extract was found to have the highest number of secondary metabolites (saponins, tannins, flavonoids, steroids, coumarins, anthraquinones, alkaloids and phenols). None of the extracts tested positive for the presence of phlobatannins, terpenoids and emodins. The methanol extract was further analyzed quantitatively for some of the determined phytochemicals. Tannins had a concentration of 3.131 mg of catechin equivalents per 100 mg sample (mg CE/100g), alkaloids - 5.200 %, total phenolics - 11.828 mg of gallic acid equivalents per gram of extract (mg GAE/g), flavonoids - 8.074 mg of quercetin equivalents per gram of extract (mg QE/g) while 0.673 % saponins were detected. The presence of these secondary metabolites might justify the ethnomedicinal uses of Quassia undulata leaves as their bioactivity has been found to be dependent on the solvent used for extraction

Maternal multimorbidity and preterm birth in Scotland : an observational record-linkage study

This work was funded by Northwood Charitable Trust and by the Strategic Priority Fund “Tackling multimorbidity at scale” programme (grant number MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.Background Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB. Methods This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR). Results Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82). Conclusions Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed.Publisher PDFPeer reviewe

Depression and physical activity in a sample of nigerian adolescents: levels, relationships and predictors

<p>Abstract</p> <p>Background</p> <p>Physical inactivity is related to many morbidities but the evidence of its link with depression in adolescents needs further investigation in view of the existing conflicting reports.</p> <p>Methods</p> <p>The data for this cross-sectional study were collected from 1,100 Nigerian adolescents aged 12-17 years. Depressive symptomatology and physical activity were assessed using the Children's Depression Inventory (CDI) and the Physical Activity Questionnaire-Adolescent version (PAQ-A) respectively. Independent t tests, Pearson's Moment Correlation and Multi-level logistic regression analyses for individual and school area influences were carried out on the data at p < 0.05.</p> <p>Results</p> <p>The mean age of the participants was 15.20 ± 1.435 years. The prevalence of mild to moderate depression was 23.8%, definite depression was 5.7% and low physical activity was 53.8%. More severe depressive symptoms were linked with lower levels of physical activity (r = -0.82, p < 0.001) and moderate physical activity was linked with reduced risk of depressive symptoms (OR = 0.42, 95% CI = 0.29-0.71). The odds of having depressive symptoms were higher in older adolescents (OR = 2.16, 95% CI = 1.81-3.44) and in females (OR = 2.92, 95% CI = 1.82-3.54). Females had a higher risk of low physical activity than male adolescents (OR = 2.91, 95% CI = 1.51-4.26). Being in Senior Secondary class three was a significant predictor of depressive symptoms (OR = 3.4, 95% CI = 2.55-4.37) and low physical activity.</p> <p>Conclusions</p> <p>A sizable burden of depression and low physical activity existed among the studied adolescents and these were linked to both individual and school factors. Future studies should examine the effects of physical activity among clinical samples of adolescents with depression.</p

Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria

BACKGROUND: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states. METHODS: Face-to-face interviews were conducted for 624 consenting students who were randomly selected from eighteen secondary schools using an 83-item structured questionnaire. Data were collected on demographic profile, reproductive health knowledge, sexual behavior and experience of sexual coercion. RESULTS: The mean age of the respondents was 16.5 years. There were slightly more males (52%) than females (48%). Students' knowledge about reproductive health was generally low even though girls had better knowledge than boys. Thirteen percent of the entire students had had sexual experience; significantly more males (19%) than females (6%) had done so (p < 0.001). Among boys the age at sexual debut ranged from 10–26 with a mean of 15.7 and median of 16. By contrast, the age at first sex among girls ranged from 10 to 18 years with a mean and median of 16.1 and 17 years respectively. Only 24% of those who were sexually active used a condom during their last sexual encounter. Overall 11% of the students reported that they had been tricked into having sex, 9% had experienced unwanted touch of breast and backside, and 5% reported rape. CONCLUSION: Students low reproductive health knowledge and involvement in risky sexual activities predispose them to undesirable reproductive health outcomes

Socialization in Adults with Intellectual Disability: The Effects of Gender, Mental Illness, Setting Type, and Level of Intellectual Disability

Introduction The goal of this study was to examine socialization in adults with intellectual disability in relation to gender, level of intellectual disability, mental illness, and setting type. Methods The sample consisted of 120 participants (60 males and 60 females), aged between 20 and 56 years, divided into two groups: 1. participants with intellectual disability without the diagnosis of mental illness (ID only) and 2. participants with dual diagnosis (intellectual disability and mental illness). Socialization subscale from the Vineland Adaptive Behavior Scale was used for the assessment of socialization. Results Level of intellectual disability and mental illness had significant effects on socialization scores. In addition to this, interaction effect of gender and level of intellectual disability had a significant effect on socialization. Setting type did not have a significant effect on socialization. Conclusion These results can be very useful in identifying participants with intellectual disability who might need additional individualized support programs in the area of socialization.This is the peer‐reviewed version of the article: Djordjevic, M.; Glumbić, N.; Memisevic, H. Socialization in Adults with Intellectual Disability: The Effects of Gender, Mental Illness, Setting Type, and Level of Intellectual Disability. Journal of Mental Health Research in Intellectual Disabilities 2020, 13 (4), 364–383. [https://doi.org/10.1080/19315864.2020.1815914