Assessment of asthma control and lung function in asthmatic children in Sokoto, North Western Nigeria

Objectives: This study aimed at assessing asthma control using Global Initiative for Asthma (GINA) asthma assessment, and determining its relationship with lung function parameters among asthmatic children in Usmanu Danfodiyo University Teaching hospital, Sokoto.Materials and Methods: This was a cross-sectional study among 60 children with asthma diagnosed based on GINA guidelines. It was conducted over a period of 4 months. The GINA asthma control assessment was administered to assess asthma control. Lung function was done using a portable spirometer.Results: Males accounted for 58.3% of the study population with M: F of 1.4:1 and median age of 9.47 years, with majority from urban domicile (91.7%). Well-controlled asthma accounted for 50.0% while 35.0% had partly controlled asthma and 15.0% had poorly controlled asthma. The median FEV1/FVC among the study participants was 0.856 (IQR: 0.170). There was no relationship between asthma control and LF parameters (FEV1: r = 0.044, P = 0.736, FVC: r = 0.010, P = 0.941, FEV1/FVC: r = 0.122, P = 0.352, and PEFR: r = 0.015, P = 0.911).Conclusion:Majority of the study participants had well-controlled asthma and no relationship was found between asthma control and lung function. Thus, serial monitoring of LF in addition to uniformly agreed standardized assessment of asthma control is required to objectively evaluate asthma control in children

Assessing Oral Health Knowledge and Practices: A Study of Mothers and Children in Northwestern Nigeria

Purpose – To explore the knowledge, attitude, and practices regarding oral and dental health for mothers of children aged 6 months to 8 years and older children aged above 8 years to 15 years seeking healthcare in a tertiary health facility in the Sokoto metropolis. Design/methods/approach – A cross-sectional study was conducted between February and April 2022. Subjects included mothers of 6 months to < 8 years and children aged 8 to 15 years presenting with minor illnesses to the General outpatient clinic. A structured questionnaire and focus group discussion guide were used to collect the information. Data was analyzed using IBM SPSS version 25. Findings – Out of 238 participants, 128 children were 6 months to <8 years, while 110 were above 8 to 15 years old. Less than half of mothers, 46.9%, had inadequate knowledge, while 20.3% had adequate practices. Among the older children in this study, the proportion of those with good knowledge, attitude, and practice level of oral health was 60%, 61.8%, and 32.7%. There was a significant moderate positive correlation between knowledge and attitude scores but not practice for the 2 groups. Mothers’ education and fathers’ occupation were significantly related to good scores (p=<0.05). Mothers of children with primary teeth and older children with permanent teeth in this study all had poor oral and dental health practices. More awareness programs should be conducted in the community to target those with poor practices. Increasing female education and empowerment is also essential in this regard. Research implications/limitations – This research implies that from an early age, it is necessary to check oral and dental health to prevent infectious diseases. Originality/value – Oral and dental health is an essential aspect of primary health care and is a situation in which the mouth, teeth, and gums are healthy and free from any diseases. Parents, especially mothers, are responsible for maintaining good oral hygiene practices and inculcating good oral hygiene habits in children. Paper Type Research paper

Do home circumstances affect asthma control in children from a developing country?

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Medicine Johannesburg, August 2013Asthma control is a central focus of the updated version of the GINA Guidelines, in which clinicians are encouraged to concentrate on assessment of control, defined by symptoms, lung function and the presence or history of exacerbations. Control is of critical importance in asthma and is now more important than the actual level of severity. Measures of asthma control do not necessarily perform well and all of them need to be looked at as a whole as studies have shown. Many factors have been found to be associated with poor asthma control ranging from concomitant rhinitis and co morbidities to poor compliance with medications or inappropriate inhaler technique in addition to home or environmental factors. Several factors around the home of asthmatic patients contribute to poor asthma control which includes parental smoking or smoking by other relatives within the home, biomass fuel exposure, exposure to aeroallergens and animal danders which all leads to failure in achieving control despite adequate drug therapy. This cross sectional study was conducted in 115 asthmatics children with the aim of determining the level of asthma control and home circumstances that contributes to poor asthma control. Most patients were males and blacks with 55.65% of patients having controlled asthma. Use of biomass fuel was uncommon in this study and none of the home circumstances was found to be associated with poor asthma control in this study. Day time and nocturnal asthma symptoms were significantly associated with poor asthma control. Good adherence to medications was found to be associated with asthma control similar association was not seen with good inhaler technique. The higher the FEV1 percent predicted the better the asthma control. Day time and nocturnal asthma symptoms were associated with FEV1. Results from this study need confirmation in a representative population study. Further longitudinal study is required to see if home circumstances may affect asthma control in patients that had controlled asthma

Ectopic pelvic kidney in a neonate in Gusau, Zamfara, North Western Nigeria

Ectopic kidney occurs as a result of cessation in migration of kidneys to their usual position in the lumbar region. Several cases have been reported worldwide, however only one case of ectopic kidney in infant has been reported in North Western Nigeria which was not a pelvic kidney. We present an incidental case of unilateral ectopic pelvic kidney managed in our facility. A 28-day-old male infant presented with a week history of crying while defecating and fever. He had normal abdominal findings. Abdominal ultra sound scan revealed a unilateral left ectopic pelvic kidney with no associated abnormalities. Full blood count showed elevated white blood cell count predominately neutrophils. He was managed as a case of neonatal sepsis with antibiotics. A thorough antenatal ultrasonography and early neonatal ultrasound are required for early diagnosis. Asymptomatic and noncomplicated cases are managed conservatively

Familial athrogryposis multiplex congenita in Gusau, Nigeria: Case report and review of the literature

Arthrogryposis multiplex congenita (AMC) is characterized by contractions of multiple joints present at birth with fat or fibrous tissue partially or totally replacing muscles. The etiology is from the interplay of genetic and environmental factors. A 2-day-old male term neonate presented with a history of multiple contractures in all limbs since birth, fever, and vomiting of 1-day duration. An older sibling, a male child had similar multiple contractures in all limbs and died a few days after birth. A maternal aunt had a male child with multiple contractures of all limbs who also died a few days after birth. Parents are young and not related. Our case had multiple contractures and specific posture involving all the limbs; however no cardiac or neurological abnormality was observed. He was managed as a case of neonatal sepsis with AMC (likely X-linked) with antibiotics and had plaster of Paris applied on the lower limbs. He did well and was discharged home to be followed up at the clinic. He, however, did not come for follow-up and died at home at the age of 10 weeks. Arthrogryposis is a common congenital presentation which requires comprehensive musculoskeletal evaluation and genetic consultation. Early rehabilitation requires the involvement of the parents or guardians and a multidisciplinary approach. This is to optimize possibility of making a diagnosis and providing parents with accurate information regarding the likelihood of recurrence. However, accurate information on recurrence is only possible when the cause of the AMC in any patient/family under investigation is identified

Burden and outcome of respiratory morbidities among children and adolescents with sickle cell disease-A retrospective review of emergency presentations in some Nigerian tertiary institutions.

BackgroundDespite the huge burden of sickle cell disease (SCD) among Nigerian children, the burden and outcome of respiratory illnesses remain undocumented. Thus, we aimed to describe the spectrum and outcome of respiratory illnesses among SCD childrenand adolescentadmissions in ten Nigerian tertiary hospitals.MethodA retrospective review of the SCD admission records of children and adolescents with a confirmed diagnosis of respiratory illnesses from 2012 to 2021 in ten tertiary health facilities across five geopolitical zones in Nigeria was conducted. The data, collectedbetween March and June 2023, included the age, sex, diagnosis, complications, duration and outcome of hospitalization.ResultsOf the 72,333 paediatric admissions, 7,256 (10.0%) had SCD; the proportion of SCD from the total admission ranged from 2.1 to 16.3% in the facilities. Of the 7,256 children and adolescents with SCD, 1,213 (16.7%) had respiratory morbidities. Lower respiratory disease was the most common (70.0%) respiratory entity and the majority were pneumonia (40.1.0%), followed by acute chest syndrome (26.7%). Seventeen (1.4%) patients died; all had lower respiratory diseases [(acute chest syndrome ACS (11, 64.7%), pneumonia; 5, 29.4%, and asthma (1, 5.9%). Based on the proportion of deaths among overall SCD, the 17 death cases contributed 9.4% (95% CI 5.9 to 14.5). Factors associated with deaths included duration of hospitalization less than 72 hours and lower respiratory tract diseases.ConclusionSickle cell disease is a major contributor to hospitalization among Nigerian children and adolescents, with high respiratory morbidity and mortality. Pneumonia and acute chest syndrome were associated with mortality, andthe highest risk of death within the first 72 hours