Challenges of childhood obesity in a developing economy: A review

Background: Obesity once considered a high income country’s malady is now on the rise in most developing countries particularly in urban settings. Most of these emerging economies have been reported to have different shades of under – nutrition coexisting side by side with over-nutrition. It is pertinent therefore that we determine the factors driving the increase in obesity rates in developing countries as they generally lack the infrastructure to adequately handle the associated complications.Objectives: This communication is aimed at reviewing the burden and risk factors for obesity in children in developing countries, double burden of malnutrition, challenges including medical as well as economic costs and sustainable preventive programmes of obesity in our environment with the hope of sensitizing both the health community and policy makers of this emerging epidemic.Methods: We searched relevant literature on the subject published only in English language or translated into English language manually and electronically. The Index Medicus, AJOL, Medline, PUBMED, and HINARI were specifically searched for the period between 1980 and 2014 and reviewed. The following key words were applied in the search: Obesity in childhood, its burden and associated risk factors, complications of obesity in childhood, double burden of malnutrition in developing countries, assessment of obesity, childhood challenges of obesity including its direct and indirect costs in developing countries as well as practical preventive models in developing economies.Results: Several relevant studies were identified. The health as well as economic costs of obesity is diverse. Obesity is the major risk factor for a variety of non – communicable diseases including cardiovascular diseases, type 2 diabetes and malignancies in later life. Also obese children have higher risk of orthopaedic problems and psychological disturbances like low -self esteem and bullying. This can also lead to poor social adjustments among our teeming youths who are the bedrock of our future economy. Most of these diseases cause premature deaths in addition to long term morbidities. Many of these obesity associated complications impose substantial burden on the health care system in developing countries with weak health systems, and if allowed unmitigated the implications are that the cost of its care may overwhelm not only the health budget but also affect the provisions of basic social amenities.Conclusions: Preventive programmes have been shown to reduce the burden of obesity in developed countries. Dearth of data on burden of obesity and its associated complications in children and adolescents still a challenge in most developing economies. Efforts should be made to prevent childhood obesity using multi- pronged approach at population level through targeted education, sustainable interventions related to healthy nutritional practices as well as physical activity promotion.Key words: Challenges; Obesity; Children; Developing Economie

Comparison of actual (measured) weights and heights with the standard formula methods of estimation among children in Enugu

Background: In paediatric practice, weight and height are required for therapeutic and diagnostic interventions. In some circumstances actual anthropometric measurements are not possible and estimates are used. Several formulae are in use for weight and height estimations. The adequacy of these estimates has not been tested for our children. The aim of the current study was to compare the adequacy of formula methods ofweight and height estimation with measured values in children.Materials and Methods: This was a comparative observational study.Children who met the inclusion criteria were selected consecutively and studied over a two month period using a semi-structured questionnaire.Weight and height of each child were measured and recorded to the nearest 0.1kg and 0.1cm respectively using standard protocols. Weight and height for age were also estimated using the universally accepted formulae. Data were analyzed using SPSS 19.0. Paired t- test was used to compare the means of actual and estimated weights and heights according to age. The level of significance was set at p<0.05.Results: A total of 370 children were studied. They were aged one year two months to 12years. Among children .2 years the measured weights and estimated values showed no significant difference. However, in children3-5years, the estimated weights were significantly lower than the measured weights. There was no consistent relationship for children 7.12 years where a different formula was used to estimate weight. For heights, the estimated values were significantly lower than the measured except for two year oldswhere both where almost similar. Scatter diagrams comparing actual and estimated plots showed linear relationship.Conclusion: The current methods of estimation are underestimating weights and heights of children in our environment. There is need for a multi-centre cohort study to test the various formulae in our children.Key words: Measured, Estimated, Weight, Height, Children

Prevalence and pattern of sexual abuse among children attending Ebonyi State University Teaching Hospital, Abakiliki, Ebonyi State

Background: Child sexual abuse is broadly defined as both direct genital contact and indirect interactions such as ‘exposure’ or internet-based activity (for example, the sending of electronic sexual pictures to minors). Though sexual abuse is common, yet many adults are not prepared or unwilling to deal with the problem when faced with it, this could lead tounderreporting of the crime and stigmatizing of the victim.Objectives: To determine the prevalence and pattern of sexual abuse among children attending Ebonyi state university teaching hospital, Abakiliki.Methods: A retrospective study of cases of sexual abuse that presentedin the children outpatient clinics of EBSUTH between the 1st of January and 31st of December 2010.Results: A total of 3750 children attended clinic of which 33 were diagnosed as being sexually abused, giving a prevalence rate of 0.9%.They were 31 (93.9%) females and 2 (6.1) males, most of the reportswere made by the victims 23 (69.7%) and or their parents 9 (27.3%). Most of the reports made happened within one week 15 (45.5%). It is noted that HIV test was done which was negative among 15 (42.4%) children andpositive in one (3%) after twelve weeks.Conclusions: The prevalence or sexual abuse in EBSUTH is 0.9%. This low prevalence could be due to the fact that child sexual abuse is scantly reported because of the stigma attached to it.Key words: child sexual abuse; prevalence; pattern; EBSUT

Assessment of the Factors Responsible For the Use of Illicit Drugs by Medical Students in Sports in a Tertiary Institution in Delta State, Nigeria

The use of illicit drugs in recent times in modern sport has become an issue of growing concern. This study assessed the factors responsible for the use of illicit drugs by medical students in sports in Delta State University Abraka The target population included five departments in the Faculty of Basic Medical Sciences of Delta State University Abraka. A cross-sectional survey design was conducted among 1,436 medical student athletes of the College of Health Sciences of Delta State University Abraka and random sampling technique was used to select a sample size of 143 respondents. A researcher-made confidential questionnaire was the instrument used for the collection of data. A coefficient index score (r) of 0.78 was obtained which ascertained the internal consistency of the instrument was reliable. A total of 120 questionnaires were successfully retrieved and used for data analysis. Mean score and Pearson Product Moment Correlation were adopted as statistical tools for analyzing the obtained data. There was significant (p<0.05) relationship between the age of medical students and their knowledge of illicit drugs used in sports, however, there was no significant (p>0.05) relationship between the gender of the students and their knowledge of illicit drugs used in sports. Similarly, there was no significant (p>0.05) relationship between type of school of medical students and knowledge of illicit drugs used in sports. Findings from the study further equally revealed that there was no significant (p>0.05) relationship between parental background and medical students’ knowledge of use of illicit drugs in sports. Based on the findings of this study, it is obvious age was supported to determine the use of illicit drugs in sports by medical in sports, hence, the need for stringent policies to be censored especially towards the age requirement for medical student participation while adopting adequate measures to curtail the use of illicit drug among medical students. Keywords: Illicit drugs, Sports, Gender, Age, Medical student

Assessment of the Factors Responsible For the Use of Illicit Drugs by Medical Students in Sports in a Tertiary Institution in Delta State, Nigeria

The use of illicit drugs in recent times in modern sport has become an issue of growing concern. This study assessed the factors responsible for the use of illicit drugs by medical students in sports in Delta State University Abraka The target population included five departments in the Faculty of Basic Medical Sciences of Delta State University Abraka. A cross-sectional survey design was conducted among 1,436 medical student athletes of the College of Health Sciences of Delta State University Abraka and random sampling technique was used to select a sample size of 143 respondents. A researcher-made confidential questionnaire was the instrument used for the collection of data. A coefficient index score (r) of 0.78 was obtained which ascertained the internal consistency of the instrument was reliable. A total of 120 questionnaires were successfully retrieved and used for data analysis. Mean score and Pearson Product Moment Correlation were adopted as statistical tools for analyzing the obtained data. There was significant (p<0.05) relationship between the age of medical students and their knowledge of illicit drugs used in sports, however, there was no significant (p>0.05) relationship between the gender of the students and their knowledge of illicit drugs used in sports. Similarly, there was no significant (p>0.05) relationship between type of school of medical students and knowledge of illicit drugs used in sports. Findings from the study further equally revealed that there was no significant (p>0.05) relationship between parental background and medical students\u2019 knowledge of use of illicit drugs in sports. Based on the findings of this study, it is obvious age was supported to determine the use of illicit drugs in sports by medical in sports, hence, the need for stringent policies to be censored especially towards the age requirement for medical student participation while adopting adequate measures to curtail the use of illicit drug among medical students

Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

Human rabies: Still a neglected preventable disease in Nigeria

Background/Objectives: Adequate surveillance and monitoring of dog bite incidents are veritable tools in the determination of the epidemiology of human rabies infections. There is a paucity of data with regards to rabies in Nigeria. Hence, this study was aimed at describing the pattern and outcomes of dog bites and rabies infections among patients presenting to University of Nigeria Teaching Hospital, Ituku‑Ozalla, Enugu.Subjects and Methods: This was a 10‑year (January 1, 2004 to December 31, 2013) observational retrospective study. Case definition of rabies was based on ICD10 criteria, while relevant clinical data were retrieved from individual folders of registered victims using a semi‑structured questionnaire. Data were analyzed using SPSS version 17.0 while the level of statistical significance was set at P < 0.05.Results: A total of 149 cases of dog bites were reported during the period under review, of which 6 (4.0%) had confirmed rabies. Ninety‑six (64.4%) cases presented more than 24 h after the bites. Majority of the offending dogs were stray dogs 86 (57.7%), which attacked their victims unprovoked, in 54.6% of cases. Furthermore, most of the bites were from dogs with unknown history of rabies vaccination 72 (52.3%), while the case fatality rate was 100%.Conclusions: All the cases of rabies reported were as a result of bites from stray dogs with unknown history of rabies vaccinations, and the outcome was 100% fatality in all cases. Efforts should be made to create and strengthen awareness campaigns on control of rabies infections through responsible dog ownership including their regular vaccinations as well as provision and use of prompt postexposure prophylaxis in human cases of dog bites at all levels of health care.Key words: Dog bites, Nigeria, pattern, rabie

Measurement of background ionizing radiation in the federal university of technology owerri, Nigeria using calibrated digital geiger counter

The measurement of the natural ionizing radiation in the Federal University of Technology Owerri, Nigeria was carried out using a well calibrated Digital Geiger Muller counter models GCA – 04w. Measurements were taken randomly in thirty (30) diff erent locations outside the building and thirty (30) locations inside diff erent buildings in the University. Results obtained for outdoor Dose rate ranges from 0.07 μSv/hr to 0.23 μSv/hr with a mean value of 0.144 μSv/hr. While the result for the indoor dose rate ranges from 0.08 μSv/hr to 0.21 μSv/hr with a mean of 0.14 μSv/hr. The highest value recorded for the outdoor radiation is from the university front gate which is .023μSv/hr. While the highest value recorded inside the buildings is from the School of Agriculture and Agricultural Technology (SAAT) which is 0.21 μSv/hr. All these values are lower than the world safely limits of 0.247 μSv/hr. This shows that the risk of ionizing radiation on the staff and students of the Federal University of Technology is minimal

Entrance skin dose on patients undergoing X-ray examinations at Yaba, Lagos State, Nigeria

survey was conducted on the Entrance Skin Dose (ESD) in patients undergoing X-ray examinations [Skull Postero-Anterior (PA), Skull Lateral (LAT), Chest Postero-Anterior (PA), Chest Lateral (LAT), Abdomen Antero-Posterior (AP) and Pelvis Antero-Posterior (AP)] in five hospitals/Xraycentres in Yaba, Lagos State, Nigeria. A total of 258 patients were included in the survey. ESD data of each patient was generated using technical parameters and a Program and Effective Dose was then computed. Results showed that the mean ESD values obtained from this work; 2.41, 1.56, 3.48 and 3.04 mGy for Skull PA, Skull LAT, Abdomen AP and Pelvis AP examinations respectively were lower than the international reference dose values. However, the mean ESD values for Chest PA and Chest LAT examinations obtained from this study, which were 1.07 and 2.28 mGy respectively, were higher than the international reference dose values. The mean Effective Dose value obtained from this study for Chest PA examination was higher than the National Radiological Protection Board (NRPB) and Greek values.Keywords: Entrance Skin Dose, X-ray examination, ionizing radiation, reference dose value

THE RESPONSES OF HEPATIC MONOOXYGENASES OF GUINEA-PIG TO CADMIUM AND NICKEL

When Cd (3.58 mg CdCl2 . H2O/kg, ip) was administered to male guinea pigs 72 h prior to sacrifice, the metal significantly inhibited the aniline 4-hydroxylase (AH) (16%), ethylmorphone N-demethylase (EMND) (26%), and aminopyrine N-demethylase (AMND) (18%) activities and cytochrome P-450 (12%) and cytochrome b5 (10%) levels. Cd did not alter the hepatic microsomal heme level. Cd, however, significantly increased the hepatic microsomal p-nitroanisole O-demethylase (p-NAOD) (53%) activity. When Ni (59.5 mg NiCl2 . 6H2O/kg, sc) was administered to the guinea pigs 16 h prior to sacrifice, the metal significantly depressed AH (49%), p-NAOD (66%), EMND (47%), and AMND (37%) activities, and cytochrome P-450 (15%), cytochrome b5 (24%), and microsomal heme (28%) levels. For the combined treatment, animals received the single dose of Ni 56 h after the single dose of Cd and then were killed 16 h later. In these animals, significant inhibitions were noted in AH (51%), EMND (47%), and AMND (30%) activities, and cytochrome P-450 (15%), cytochrome b5 (26%), and microsomal heme (30%) compared to those of controls. In the case of p-NAOD activity, the influence was in favor of Ni, i.e., the inhibition was about 61% by the combined treatment. These results reveal that: 1. The response of all substrates of hepatic monooxygenases to Cd are not the same, possibly indicating differential regulation of cytochrome P-450 isozymes by Cd; 2. The inhibitory effect of Ni on hepatic monooxygenases is more profound than that of Cd; and 3. The combination of Cd and Ni does not have a synergistic effect of hepatic monooxygenases of the guinea pig.When Cd (3.58 mg CdCl2 . H2O/kg, ip) was administered to male guinea pigs 72 h prior to sacrifice, the metal significantly inhibited the aniline 4-hydroxylase (AH) (16%), ethylmorphone N-demethylase (EMND) (26%), and aminopyrine N-demethylase (AMND) (18%) activities and cytochrome P-450 (12%) and cytochrome b5 (10%) levels. Cd did not alter the hepatic microsomal heme level. Cd, however, significantly increased the hepatic microsomal p-nitroanisole O-demethylase (p-NAOD) (53%) activity. When Ni (59.5 mg NiCl2 . 6H2O/kg, sc) was administered to the guinea pigs 16 h prior to sacrifice, the metal significantly depressed AH (49%), p-NAOD (66%), EMND (47%), and AMND (37%) activities, and cytochrome P-450 (15%), cytochrome b5 (24%), and microsomal heme (28%) levels. For the combined treatment, animals received the single dose of Ni 56 h after the single dose of Cd and then were killed 16 h later. In these animals, significant inhibitions were noted in AH (51%), EMND (47%), and AMND (30%) activities, and cytochrome P-450 (15%), cytochrome b5 (26%), and microsomal heme (30%) compared to those of controls. In the case of p-NAOD activity, the influence was in favor of Ni, i.e., the inhibition was about 61% by the combined treatment. These results reveal that: 1. The response of all substrates of hepatic monooxygenases to Cd are not the same, possibly indicating differential regulation of cytochrome P-450 isozymes by Cd; 2. The inhibitory effect of Ni on hepatic monooxygenases is more profound than that of Cd; and 3. The combination of Cd and Ni does not have a synergistic effect of hepatic monooxygenases of the guinea pig