Epidemiology of Attention Deficit/Hyperactivity Disorder

Attention deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder characterized with attention deficits, hyperactivity, or impulsiveness. The prevalence of ADHD varies from country to country and from various cultural and geographical zones. The pattern and distribution of ADHD also vary with gender and age. It has also been noted that some factors are associated with ADHD. For instance, some central nervous system anomalies had been associated with ADHD. Genetic and environmental risk factors have also been implicated. Some conduct and learning disorders have also been associated with ADHD. Of recent, some cardiac anomalies and behavioral disorders such as enuresis and encopresis have all been associated with children with ADHD

Health‑Care Financing among Patients Admitted for Open‑Heart Surgery in Enugu

Background: Cardiovascular diseases have been noted to be expensive to manage and tend to cause significant morbidity and financial burden to affected individuals and households. Objective: This study aimed to determine the various sources of health financing among patients admitted to UNTH Ituku/Ozalla for open-heart surgery. Methodology: Twenty‑five patients admitted for cardiac surgery over a 6‑month period were selected for the study. A structured  questionnaire was administered to the patients or their caregivers. Data were analyzed using SPSS version 20. Results: There were 25 respondents who were admitted during the study period, this comprised 17 children and 8 adults. Amongthe respondents 24 (96%) paid out of pocket, 1 (4%) was by government tax. The major sources of funds were from personal savings 56% and goodwill from friend’s relations, faith-based organizations (4%), while 36% of the respondents borrowed money for the surgery. Three of the respondents had a form of health insurance, while 22 (88%) had no form of health insurance. The mean monthly income of the households was 86,320 (81,384.7) Naira and the mean monthly food expenditure was 33,200 (15934.76) Naira. About 72% (18) of the subjects knew about the National Health Insurance Scheme (NHIS), 4 (16%) knew about the Voluntary Health Insurance Scheme (VHIS), while 84% did not know about the VHIS. However, about 56% of the subjects were willing to enroll under the NHIS voluntary scheme. The cardiac surgery was catastrophic for 96% of the respondents. Conclusion: Cardiac surgery causes a significant financial burden to individuals and households. Individuals and households should be properly counselled on the benefits of health insurance. The government should increase funding for cardiovascular health and  strengthen the health insurance system. Keywords: Cardiac surgery, cardiovascular disease, health financin

Left ventricular function and cardiac valvar annular dimensions among children with sickle cell anemia compared to those with hemoglobin AA type in Enugu, Nigeria

BackgroundEnumerating the relationship between cardiac structures, function and chamber sizes in children with sickle cell anemia would help in delineating some cardiovascular abnormalities which will aid the Pediatric cardiologist and the cardiac surgeons in a number of decision-making situations.ObjectivesThe objectives of this study are to assess the dimension of cardiac structures and left ventricular function in children with sickle cell anemia in steady state and controls using echocardiography.MethodsA cross-sectional prospective study that assessed cardiac structures and left ventricular function among fifty-one children with sickle cell anemia (HBSS) and compared with fifty children with HB AA type serving as controls.ResultsA significant high proportion of children with sickle cell anemia had abnormal Valvar dimension and left ventricular function above two standard deviations (2-SD) from the mean of the standard population compared to the control group, showing a statistically significant difference (χ2 = 10.42, p= 0.001). All the mean annular valves diameter, left ventricular internal dimension in systole and diastole, inter-sinus distance diameter and sinu-tubular junction diameter are higher in children with sickle cell anemia than controls and this is statistically significant. (p<0.005). ConclusionThis result shows that children with sickle cell anemia have increased valvar size diameter compared with those with normal hemoglobin type. A significantly higher proportion of respondents in type SS group had abnormal left ventricular systolic and diastolic dysfunction when compared with those in type AA grou

Prevalence and socioeconomic correlates of autism among children attending primary and secondary schools in south east Nigeria

Objectives: The objectives of the study were to determine the prevalence and socio-economic determinants of autism among children attending primary and secondary schools in South East, Nigeria. Methods: This was a cross-sectional study that assessed the prevalence and socio-economic pattern of childhood autism among children attending primary and secondary schools in Enugu and Ebonyi states, South East Nigeria. The questionnaire was adapted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000). The study was carried out between June and October, 2014. The schools were selected by listing all the mixed schools in the urban and semi- urban areas by simple random sampling. Results: A total of 721 subjects completed the questionnaire. The age of respondents ranged between 3 and 18 years, with mean age of 12.71 and standard deviation of 3.03 years. Twenty one children fulfilled the criteria for autism giving a prevalence of 2.9%. There is a significant association between age in categories (fishers exact test, p = 0.013) and social class (p=0.033). Conclusion: The prevalence of autism was 2.9%; and the socio-economic characteristics of childhood autism in South East Nigeria are similar to those in other parts of the world

Clinical Profile and Electrolyte Abnormalities in Hospitalized Under‑Five Children with Acute Gastroenteritis in a Tertiary Health Facility

Background: Electrolyte abnormalities constitute the leading causes of morbidity and mortality in younger children with acute gastroenteritis.The aim of the study was to determine the clinical profile and pattern of electrolyte abnormalities in under‑five children hospitalized for acutegastroenteritis from November 1, 2014, to January 31, 2015. Methodology: This was a cross‑sectional descriptive study among hospitalized under‑five children with acute diarrhea who were consecutively recruited from November 1, 2014, to January 31, 2015. Relevant clinical data were obtained, while the physical examination was done on all subjects. Serum electrolytes values were determined using the ion‑selective electrode system and compared with standard reference ranges. The data were analyzed using SPSS version 21.0 with the level of statistical significance set at P < 0.05. Results: A total of 108 under‑five children were studied. The majority (101; 93.5%) were <24 months of age, while 41 (38%) of low socioeconomic class background. Metabolic acidosis was the most common electrolyte abnormality followed by hyponatremia and hypokalemia occurring singly or in combination. The case fatality rate was 13 (12.0%). The electrolyte derangements associated with mortality were hypokalemia and acidosis: 11 (84.6%) each, 9 (69.2%) had hyperchloremia, while 6 (46.2%) were reported to have hyponatremia. Conclusion: Electrolyte derangements are common in under 5 years children with acute diarrhea with increased mortality in those with severe acute malnutrition. Proper health education is needed to ensure adequate nutrition and timely use of low‑osmolar oral rehydration solution as well as early referral of cases with persistent gastrointestinal losses in order to save lives. Keywords: Acute gastroenteritis, electrolyte abnormalities, under‑five childre

Mothers' beliefs about infant teething in Enugu, South-east Nigeria: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Parents and Health Care Workers have traditionally attributed a variety of symptoms to teething in young children. Some of these symptoms may however connote underlying serious medical condition in a child. There is little evidence to support these beliefs despite their implications on management of a symptomatic teething child. This study therefore seeks determine the beliefs and problems mothers associate with teething in Enugu, South-east Nigeria.</p> <p>Findings</p> <p>A cross-sectional survey involving sixty mothers presenting at a Children's clinic in Enugu metropolis using questionnaire. More than 90% of the respondents thought that babies can experience medical problems as a result of teething. The commonest medical problems perceived to be associated with teething were fever (71.7%), loose stools (58.3%) and vomiting (35%).</p> <p>Conclusion</p> <p>Mothers still associate a variety of symptoms of childhood illnesses to teething and this association is not evidence based and could lead to delayed interventions, increased morbidity and mortality of children. It is important therefore that mothers and health workers caring for young children are educated on the need to seek prompt medical attentions in a symptomatic child.</p

Compendium of cardiac diseases among children presenting in tertiary institutions in southern Nigeria: A rising trend

The burden of children with cardiovascular disease is on a rising trend. These rising trends are enhanced by the development of new technology in the diagnosis of cardiac lesions.This article is aimed at documenting the current trends in the occurrence of cardiac disease among children attending tertiary hospitals in Sothern Nigeria. This is a descriptive study which involved four hundred and thirty-nine (439) children who had cardiac disease confirmed with echocardiography from four health institutions, namely; Niger Delta University, Bayelsa, Nigeria; University of Nigeria Teaching Hospital, Enugu, Nigeria; Triple care hospital, Enugu, Nigeria and; Blessed children hospital, Enugu, Nigeria over a five-year period from July 2016 - July 2020.The prevalence of congenital heart disease was 83.6% and only 16.4% being acquired heart disease. Many of the children with congenital cardiac defects have associated features of Down syndrome (trisomy 21) and the frequency was related to the type of defect; 6.4% (28/439). These features of Down syndrome are seen mainly in children with AV canal defect 33.3% (14/42) and least in children with TOF 2.0% (1/51). Zero-point two nine percent (1/439) had dextro-cardia and 0.2% (1/340) had VACTERAL (ano-rectal malformation) association, 0.2 % (1/439) had cleft lip, 1.8% (8/439) had dysmorphism other than down syndrome. Five 62.5% (5/8) of such dysmorphic features were associated with VSD. The majority of the children with cardiac disease were from the middle class 63.6% followed by the higher class 21.9% and the least is from the lower class 14.5%. The prevalence values of heart disease were quite higher than that documented in previous studies. The is a rising prevalence of congenital heart disease (83.6%) and acquired heart disease (16.4%) among children with cardiac disease in southern Nigeria. Extracardiac anomalies were also associated with these trends