Socio-economic status, lifestyle and childhood obesity in Gombe.

Background: Childhood obesity is a complex condition resulting from an interplay of genetic predisposition, environmental factors and socio-economic status. The prevalence has been increasing all over the world, probably due to economic transition and rapid urbanization as well as globalisation. This relationship should be well established for Improved Health Planning in Gombe State and Nigeria.Objectives: To establish the prevalence of Childhood Obesity and it`s relationship with the Socio-Economic Status of Parents and guardians.Methodology: Anthropometric measurements of children and adolescents in both public and private schools from primary to secondary levels were taken and their BMI calculated. The socioeconomic statuses of their parents, as well as the lifestyle of the children were assessed.Results: Overweight and obesity were more prevalent in children whose parents belonged to the middle and upper socio-economic class; these children had televisions and computers in their rooms and were driven to schoolConclusion: The picture is completely the reverse of what is obtainable in the developed and industrialised nations where overweight and obesity are more prevalent in children of the lower socio-economic class. Authors` contribution: The first author is the lead researcher and is a staff of Federal Teaching Hospital Gombe while the second author, a staff of University of Maiduguri is the first supervisor who gave guidelines and made corrections. The second and the third authors are members of staff of the University of Melbourne in Australia; the third author provided a template on which the questionaire was based while the fourth author who is also the second supervisor, is a tutor of the European Society for Pediatric Endocrinology; she facilitated the acceptance of the proposal and the sponsorship for the research. The research was carried out in Gombe, the capital of Gombe State in North Eastern NigeriaKeywords: Socio-Economic, Childhood, Obesity, Nigeri

Antimicrobial sensitivity pattern of organisms causing urinary tract infection in children with sickle cell anemia in Maiduguri, Nigeria

Background: Patients with sickle cell disease have increased tendency to develop frequent and severe infections, especially of bones and urinary tract.Objective: The knowledge of antimicrobial sensitivity pattern of common etiological agents will serve as a guide to empiric treatment while results of urine culture and sensitivity are being awaited.Materials and Methods: Antimicrobial sensitivity test was carried out on bacterial isolates from the urine of febrile children with sickle cell anemia (SCA) and children with HbAA in Maiduguri. Urine specimens were collected and cultured by standard methods. Sensitivity to 15 antimicrobials (based on availability of sensitivity disc) was tested using the disc.diffusion technique of stokes.Results: Significant bacteriuria was obtained from 65 (26%) of the 250 children with SCA and 51 (20.4%) of the 250 controls. The isolates were E. coli, Klebsiella, Coliforms, Proteus, Staph aureus and Salmonella. Sensitivity was highest to 3rd generation cephalosporins, followed by the quinolones: ciprofloxacin (86.2%), ofloxacin (83.1%), and peflacine(73.8%). Sensitivity of the organisms to some of the commonly used antibiotics like ampicillin, cotrimoxazole, and nalidixic acid was generally low. In general, the pattern of bacteriuria and their sensitivity in the SCA group was similar to the pattern in the control group.Conclusion: Etiological agents of childhood urinary tract infections (UTI) in this environment are resistant to most of the drugs commonly recommended for its treatment. Amoxicillin/clavulanic acid, cefuroxime, and gentamicin, are recommended as first.line drugs for treatment of UTI while awaiting results of culture and sensitivity. Ceftriaxone andceftazidime should be reserved for case of non response to first.line drugs and severe infections

Significance of Pyuria in the Diagnosis of Urinary Tract Infection in Children with Sickle Cell Anaemia in Maiduguri, Nigeria

Urinary tract infection (UTI) is a significant cause of morbidity and mortality in children, especially in those with sickle cell disease, who are at higher risk of infections. It will be useful to have a simple test which can be used in resource limited health facilities as a means of screening such children for UTI with the view to instituting prompt treatment. This study is carried out to determine the usefulness of significant pyuria in detecting UTI in febrile children with sickle cell anaemia (SCA). Two hundred and fifty febrile children with sickle cell anaemia that attended State Specialist Hospital and University of Maiduguri Teaching Hospital (UMTH) were prospectively studied with their consent. Urine sample was collected using standard procedure, examined for pus cells and was cultured at the Microbiology laboratory of UMTH. The study showed UTI prevalence of 26%. Significant pyuria was found to have sensitivity of 55.4%, specificity of 77.8%, the efficacy of the test was 72.0% and the test has low positive predictive value of 46.8% in detecting bacteriuria in SCA patients. The significant pyuria observed in this study support its usefulness in the diagnosis of UTI among children with SCA especially in communities having limited facilities or personnel for carrying out urine culture.Keywords: Sickle Cell Anaemia, Bacteriuria, Pyuri

Rosai-dorfman disease: report of a rare case of peripheral lymphadenopathy.

Rosai-Dorfman disease (RDD), also called Sinus histiocytosis is an uncommon proliferative disorder of unknown aetiology. Though, the lymph node is the revelation mode of several diseases particularly in the tropics, RDD typically presents with painless bilateral lymphadenopathy in the neck associated with fever and leukocytosis, sometimesmimics lympho-proliferative disorders. Recently research has unveiled gene mutation in the tumour with potential of malignant transformation. Case report:We report case of 4 year old boy who had massive cervical lymphadenopathy with extranodal manifestation of fever. Sepsis screening was negative, while imagingshowed hilar,mediastenal andmesenteric lymph nodes enlargement in addition to massive hepatomegaly. The histology is suggestive of the diagnosis of RDD. The patient was treated with corticosteroids, with remarkable remission. Conclusion: We report the clinicopathological characteristics of RDD in order to increase our awareness of its diagnosis and treatment and to re-emphasize that the disease is rare in our environment

Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents and their antibiotic sensitivity pattern have continued to change (in the same centre over time), hence the need to have undertaken this study.AIMS AND OBJECTIVES: The primary objective of the study was to determine the risk factors influencing the aetiology of neonatal septicaemia at the University of Maiduguri Teaching Hospital.PATIENTS AND METHODS: The study was prospective and all the newborn that had clinical diagnosis of septicaemia were consecutively enrolled and admitted to the Special Care Baby Unit of the Department of Paediatrics of University of Maiduguri Teaching Hospital (UMTH). The patients were appropriately investigated including blood cultures, cerebrospinal fluid cultures and urine culture among others.RESULTS: One hundred and ten neonates were studied, of these 46(42.0%) had positive blood culture, while 64 (58.0%) were blood culture negative. Eighteen (39.1%) of the septicaemic neonates were inborn, while 28 (60.9%) were out born. The incidence of neonatal septicaemia among babies delivered at UMTH was 5.9/1000 live births and the male to female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane (PROM), prematurity and low socioeconomic status of parents among others. Fever was the commonest clinical feature at presentation (87%), others include: poor feeding (64 %), excessive crying (33%), tachypnoea, hepatomegaly were some of the common examination findings. Staphylococcus aureus 16(69.6%) and Streptococcus pyogenes 5(21.8%) were the predominant Gram positive organisms isolated while Escherichia coli 9(39.1%) and Klebsiella Pneumoniae 7(30.4%) were the predominant Gram negative organisms isolated.CONCLUSION: Mortality was high in infection associated with Gram negative organisms and in the presence of conditions/complications like urinary tract infections, tetanus and meningit

Bone marrow invasion by aspergillus specie in a sickle cell trait patient with invasive aspergillosis: a fatal case in association with disseminated intravascular coagulation

Invasive aspergillosis has been predominantly associated with pulmonary infection, particularly amongst immunocompromised individuals. Extrapulmonary infections with Aspergillus specie have been reported rarely irrespective of immune status. Risk factors for invasive aspergillosis include prolonged and severe neutropenia, haematopoietic stem cell and solid organ transplantation, advanced AIDS, and chronic granulomatous disease. The most frequently involved specie is Aspergillus fumigatus that constitutes over 90% of cases, followed by Aspergillus flavus, usually associated with a primary skin infection. Haematogenous spread to the bone causing osteomyelitis is the commonest form of disseminated aspergillosis and a surprisingly high proportion of these patients have no immunosuppression. We present a rare case of bone marrow invasion by Aspergillusspp. in a 3-year-old patient with sickle cell trait and chronic Aspergillosis. Case report: A 3-year-old patient with sickle cell trait was brought to the paediatric unit with recurrent diarrhoea, abdominal distention, weight loss and persistent cough. The child was severely wasted with generalised peripheral lymphadenopathy. She had marked respiratory distress and hepatosplenomegaly but no demonstrable ascites. Haematologic examination revealed leukaemoid reaction (leukocyte count of 44.0 x 10 /L) with monocytosis (10%) and thrombocytopenia (platelet count of 97,000/mm ); no blast cells were seen on blood film. The bone marrow was hypercellular with a myeloid/erythroid ratio of 20:1, consistent with infection. Bone Marrow culture yielded Aspergillus spp. and other results of sepsis work up were negative. Conclusion: Cases of extrapulmonary invasive aspergillosis have been reported rarely in both immunocompetent and immunocompromised patients. Haematogenous spread to the bone is the commonest form of disseminated disease

Distribution of abo blood group, rhesus factor and haemoglobin genotype in Maiduguri Metropolis, North-eastern Nigeria

To establish the frequency distribution of ABO, Rhesus (Rh) blood groups and haemoglobin genotype in Maiduguri metropolis. Methods: A total of four hundred and seventy subjects consisting of males and females were enrolled into the study. The subjects enrolled were university students and patients coming to the haematology department of the university of Maiduguri teaching hospital they were randomly selected and their ABO blood groups, Rhesus D antigen and genotype were determined. Results: The distribution of the blood groups antigen evaluated by our study are as follows; Blood group O were found to be231 (49.1%), blood group B categorized as 104 (22.1%),blood group A91 (19.3%), and blood group AB had the least 46 (9.3%).The Rhesus (Rh D) factor positivity was 399 (85%), and that (Rh D) negativity were71 (15%). The haemoglobin genotype were expressed as HbAA, AS, SS, AC and SC and the study revealed frequencies of AA, 297 (63.2%), AS, 122 (26%), SS,32 (6.8%),AC 12 (2.5%) and SC 07 (1.4%). Conclusion: This study showed that blood group O is predominant than the other blood groups and that blood group AB had the least. Rhesus (D) positivity was 85% as compared to Rhesus (D) negativity of 15%. The haemoglobin genotype showed HbAA had the highest occurrence, while SC had the least

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.info:eu-repo/semantics/publishedVersio

An evaluation of supplemental and routine immunization coverage in maiduguri metropolis, Borno state, Nigeria.

Nigeria is currently the main focus of the polio eradication initiative. Strong routine immunization coverage offers better sustained protection to the most vulnerable age group (0-59 months) Maiduguri is the commercial nerve centre and the seat of government of Borno State. Objective: to evaluate supplement and routine immunization coverage in Maiduguri. Borno Slate. Methods: this is a thirty by seven cluster survey conducted to assess the status of immunization in the metropolis. the WHO standardized EPI questionnaire was used to allow for comparison with other nations. A total of two hundred and ten mothers were interviewed from thirty clusters. Result: The responses revealed a coverage of 78.8 percent for the April 2004 NIDs amongst children 0-59 months of age. Routine immunization coverage for children 12-23 months of age were BCG 45%, DPT-324%, and Measles 20% respectively which is extremely high. Only 20% of the targeted children completed the immunization schedule. Reasons for immunization failure include lack of information by health staff on next dates 51.4%, distance from immunization centre 14.6%, unaware of the need to complete immunization schedule to afford protection for their children 15.9% and other associated reasons 18.1%. Conclusion: the quality of ongoing supplemental immunization is improving, although routine immunization coverage is below the national average of 80%. The metropolitan council and National Programme on Immunization should target caregivers and religious leaders at all level of the metropolis by both tradition and the electronic media on the importance of completing immunization schedules