Blood pressure tracking in urban black South African children: birth to twenty cohort

Background Hypertension is an emerging public health problem in South Africa. Recent evidence from longitudinal studies has shown that hypertension in adulthood can be traced back to childhood. There is scarcity of longitudinal data on paediatric blood pressure (BP) particularly in African populations. The objective of this study is to assess the prevalence of hypertension and evaluate BP tracking between childhood and late adolescence among South African black Children. Methods This study utilized data from the Birth to Twenty cohort, which is comprised of children born in Soweto, Johannesburg in 1990 (N = 3273, 78.5 % black). Data on BP and anthropometry were collected at six follow-up periods between ages 5 and 18 years. Blood pressure status was classified using the Fourth report on National High Blood pressure program in children and adolescents. Pearson correlation coefficients and relative risk ratios (RR) were used to describe tracking of BP between childhood and late adolescence. Results The overall point prevalence ranged from 9.2 to 16.4 % for prehypertension and 8.4 to 24.4 % for hypertension. Tracking coefficients ranged from 0.20 to 0.57 for SBP and 0.17- 0.51 for DBP in both sexes over the 14 years of measurement. The proportion of children who maintained an elevated BP status between childhood, adolescence and age 18 years ranged from 36.1 % at age 5 years to 56.3 % at age 13 years. Risk of having elevated BP at 18 years ranged from; RR: 1.60 (95 % CI: 1.29–2.00) at 5 years to RR: 2.71 (95 % CI: 2.32–3.17) at 14 years of age. Conclusions This study reports high prevalence of elevated BP which tracks from early childhood into late adolescence. These findings emphasize the importance of early identification of children at risk of developing elevated BP and related risk factors plus timely intervention to prevent hypertension in adulthood

Brucellosis as an Emerging Threat in Developing Economies:Lessons from Nigeria

Nigeria is the most populous country in Africa, has a large proportion of the world's poor livestock keepers, and is a hotspot for neglected zoonoses. A review of the 127 accessible publications on brucellosis in Nigeria reveals only scant and fragmented evidence on its spatial and temporal distribution in different epidemiological contexts. The few bacteriological studies conducted demonstrate the existence of Brucella abortus in cattle and sheep, but evidence for B. melitensis in small ruminants is dated and unclear. The bulk of the evidence consists of seroprevalence studies, but test standardization and validation are not always adequately described, and misinterpretations exist with regard to sensitivity and/or specificity and ability to identify the infecting Brucella species. Despite this, early studies suggest that although brucellosis was endemic in extensive nomadic systems, seroprevalence was low, and brucellosis was not perceived as a real burden; recent studies, however, may reflect a changing trend. Concerning human brucellosis, no studies have identified the Brucella species and most reports provide only serological evidence of contact with Brucella in the classical risk groups; some suggest brucellosis misdiagnoses as malaria or other febrile conditions. The investigation of a severe outbreak that occurred in the late 1970s describes the emergence of animal and human disease caused by the settling of previously nomadic populations during the Sahelian drought. There appears to be an increasing risk of re-emergence of brucellosis in sub-Saharan Africa, as a result of the co-existence of pastoralist movements and the increase of intensive management resulting from growing urbanization and food demand. Highly contagious zoonoses like brucellosis pose a threat with far-reaching social and political consequences

Vulva cellulitis and abscess with extension to anterior abdominal wall

Background: Abscesses occur commonly in our environment. However abscesses of the vulva in children are not often seen but they do occur periodically, and there is a paucity of data on its prevalence in our environment.Aim: To present a case of vulva cellulitis and abscess with extension to anterior abdominal wall occurring in a 17- month-old female.Case report: A 17-month-old female presented with fever of one week duration and vulval swelling of four days duration. Her parents were of middle socioeconomic class. An initial diagnosis of a right inguino-labial hernia with a differential diagnosis of Bartholin's cyst was made but was changed to anterior abdominal wall abscess(vulva cellulites and abscess with extension to anterior abdominal wall) when an obviously tender, erythematous, warm swelling appeared in the right iliac region. She received antibiotics and had an incision and drainage of the abscess. She was thereafter discharged in good clinical condition.Conclusion: Cases of vulva cellulitis and abscess are not common in children. A high index of suspicion would be needed to make an early diagnosis. Keywords: Abscess, Vulva cellulitis, Anterior abdominal wall, Childre

Optimization of the Protein Nutritive Value of Wheat/Cassava Breadmix by Supplementing with Limiting Amino-Acids (L-Lysine & L-Methionine)

This study was carried out in line with the National policy on bread to incorporate 10% cassava flour into wheat flour for all bread baked in Nigeria. The objective of this study was to investigate if the addition of 10% cassava flour or more could be accommodated without compromising the nutritive value of bread. The effect of fortifying with limiting amino-acids was also investigated. This study employed a feeding trial and bioassay of tissues from albino rats of Wistar strain, to evaluate the effect of supplementing various levels of wheat/cassava bread mix feed, with 0.1% L-lysine and 0.1% L-methionine. Nine different diet regimens were used with four rats in each diet group. Cassava (100%) diet group was used as the control; and the diets fortified with 0.1% L-lysine and 0.1% Lmethionine used as secondary control. The parameters measured as 'markers' of nutritive value included: body weight changes, food conversion ratio (FCR) and net protein utilisation (NPU). The effects of dietary intake of the various wheat/cassava supplemented diets on haematological indices such as mean corpuscular haemoglobin concentration and biochemical indices such as cortisol, total protein and albumin in the plasma of fed rats were also determined. Results indicated that both 10% and 20% cassava input supported adequate nutritional and biochemical development of the fed rats, although fortification of the diets with 0.1% L-lysine and 0.1% L-methionine resulted in 10 – 20% improvement in all the nutritional indicators measured. Based on the results of this study, it was concluded that incorporation of 20% cassava flour into wheat bread supplemented with L-lysine and L-methionine is nutritionally better than, but haematologically and biochemically comparable to whole wheat bread in rats. Therefore, this findings lend support to the national policy on nutrient fortification and cassava incorporation into wheatbread for the general goal of improving food security in Nigeria.Keywords: Bread fortification, Weanling rat, L-methionine, L-Lysine, haematological indices, biochemical indicesNigerian Journal of Parasitology, Vol. 32 [2] September 2011, pp. 287-29