Health Care Seeking Behavior among Caregivers of Sick Children Who Had Cerebral Malaria in Northwestern Nigeria

Cerebral malaria is a significant cause of childhood morbidity in our region. The challenges of effective management include time and quality of treatment. The study appraised the health care seeking behavior of caregivers of sick children who developed cerebral malaria, in Zaria, northwestern Nigeria. Caregivers indentified were parents 29 (87.9%) and grandparents 4 (12.1%). Most of them were in the upper social classes. Health care options utilized before presentation at our facility were formal health facility 24 (72.7%), patent medicine seller 12 (36.4%), home treatment 10 (30.3%), and herbal concoction 6 (18.2%) with majority 24 (72.7%) using more than one option. Antimalarial therapy was instituted in 25 (75.6%) of the cases. Mortality was significantly associated with the use of herbal concoction, treatment at a formal health facility and patent medicine seller, multiple convulsions, age less than 5 years, and noninstitution of antimalarial therapy before presentation. The study showed use of inappropriate health care options by caregivers and highlighted the need to pursue an awareness drive among caregivers on the use of health care options

A complicated pregnancy in an adult with HNF4A p.R63W-associated fanconi syndrome

Renal Fanconi syndrome (RFS) is characterised by generalised dysfunction of the proximal renal tubules, resulting in excessive urinary loss of solutes, most notably bicarbonate, and type II (proximal) renal tubular acidosis. It is a rare condition, and literature around its management through pregnancy is limited. We present the management of a 37-year-old woman with RFS secondary to the HNF4A p.R63W mutation, through her third pregnancy. She presented at 28 + 5 weeks with dehydration, low serum bicarbonate, and profound metabolic acidosis. Daily infusions of sodium bicarbonate were necessary, and the requirements increased throughout the pregnancy. She also demonstrated both fasting hypoglycaemia and episodes of postprandial hyperglycaemia which required complex management. Due to concerns around fetal health, an elective caesarean section was performed at 34 weeks, delivering a healthy baby girl. This case highlights the potential complexity of pregnancy in patients with RFS and the need for a multidisciplinary approach to its management

Prevalence and sociodemographic determinants of developmental delay: a cross-sectional study of under-five Nigerian children

Background: developmental problems or delays are preventable and others may be ameliorated by interventions. Developmental delay and factors associated with it therefore need to be identified in order for early and appropriate interventions to be instituted. This study therefore aimed to determine the prevalence of developmental delay among under-fives and identify the sociodemographic factors associated with the delay.Methods: Four hundred and fifteen Nigerian children, aged 6- 59 months were assessed for development using the Schedule of Growing Skills II tool. Developmental quotient below threshold point of 85% in a developmental domain was used to define developmental delay.Results: Of the 415 children assessed, 147 (35.4%) had delay in the various developmental domains. The highest prevalence was in the manipulative domain (25.8%) followed by visual (17.1%), cognitive skill (13.5%), hearing and language (6.3%), interactive social (5.8%), self-care social (4.4%) and speech and language (4.1%). Low maternal education was significantly associated with delay in locomotive domain (4.3%; OR=5.00; 95% CI=1.04-23.84), manipulative domain (32.4%; OR=1.89; Most 95% CI=1.21-2.95), visual domain (22.9%; OR=2.11; 95% CI=1.25-3.55), speech and language (6.4%; OR=3.03; 95% CI=1.05-8.75), interactive social (8%; OR=3.05; 95% CI=1.32-7.04), self-care social (6.9%; OR=3.30; 95% CI=1.15-9.43), cognitive (17.6%; OR=1.89; 95% CI= 1.07-3.35). Birth order and household size also had significant association with delay in various domains. There was no significant association between socioeconomic class and developmental delay in any of the domains.Conclusion: The study showed that developmental delay was relatively common among under-five children in North-West Nigeria; and has a strong association with some sociodemographic factors. There is need to screen children for developmental delay for early intervention.Keywords: Child Development, Developmental Delay, Developmental Domain, Developmental Skills, Under-Fives, Sociodemograhic factor

Assessment of the heterogeneity and petrophysical evaluation of reservoirs in the “Akbar Field”, Niger Delta, Nigeria

Abstract This study involved the use of well logs from four wells (JAP-1–4) to evaluate the reservoirs’ quality and to determine the clay distribution trends of the reservoirs using the neutron–density crossplot in the “Akbar Field” Coastal Swamp depobelt, Niger Delta. The results of the analysis show that a total of fifteen (15) reservoirs (A1–A15) were delineated and they are relatively laterally continuous. There is an increase in reservoir thickness as the delta prograded, giving rise to good sand development down-dip at the shallow and intermediate intervals. From the interpreted gamma ray log motifs, it was observed that reservoirs A1–A5, A8, A10 and A12–A14 are tidal channels; A7 and A11 are fluvial channels; A9 and A15 are shoreface sands, while only A6 is of coastal plain deposit. The reservoir porosities show good–excellent values that range from 0.15 to 0.38 v/v (15–38%) except in JAP-1 well where reservoirs A4, A5 and A9–A11 have poor to fair value of 0.11 v/v (11%). Also, the permeability values are good to excellent (1866.24–75873.41 md), except for the few sands in JAP-1 well that are low (3.42–72.82). Additionally, the neutron–density crossplots show that the reservoirs contain mainly laminated and structural clays with few dispersed clays. Despite the presence of these three clay types, the reservoir qualities of the reservoirs are not relatively affected. Although the horizontal fluid flow may not have been affected, the vertical flow could be impaired due to the presence of numerous laminated clay/shale baffles compartmentalizing the reservoirs

Care of the Child with Special Health Care Needs: A Report on 2 Nigerian Children with Muscular Dystrophy

Care of the child with special health care needs is gradually becoming a significant public health issue. To identify what these special health care needs are in our environment, 2 children presenting with clinical features of Duchenne Muscular Dystrophy were studied. This crippling neuromuscular disorder has no cure at the moment and death is common in the 2nd decade of life. Issues concerning health care identified in this study included poor growth and development of the children, over dependence on family members for care, limited resources available to these families and very scarce community support. Establishment of a special health care needs department, to provide coordinated and comprehensive services, is advocated in our health care delivery system. Keywords: Special Health Care Needs, Muscular Dystrophy Annals of Nigerian Medicine Vol. 2 (2) 2006: pp. 29-3