Gastrointestinal Injuries Following Blunt Abdominal Trauma In Children

Purpose: Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. Patients and Methods: From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. Results: There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and at presentation over 80% had abdominal signs. Diagnosis was mainly by physical examination supported by plain abdominal x-ray in 15 children. All 19 children had laparotomy. There were a total of 23 injuries. Gastric and duodenal injuries accounted for one each. Most of the injuries were in the jejunum and ileum (10 perforations, two contusions with one mesenteric haematoma and one mesenteric tear). There was one caecal perforation and six colonic injuries , one of which was associated with intraperitoneal rectal injury. Five children had other associated injuries (three splenic injuries, one renal injury, one bladder contusion associated with long bone fractures and one severe closed head injury). Treatment included segmental resection with end to end anastomosis, wedge resection with anastomosis, exteriorizations stomas, simple excision of the perforation and closure in two layers (gastric perforation). The total mortality was four (21.1%), two of them due to associated injuries. Conclusion: Gastrointestinal injuries due to blunt abdominal trauma pose a management challenge. Management based on decisions from serial clinical examinations and simple tests without recourse to advance imaging techniques may suffice. Keywords: Gastrointestinal injury, Blunt abdominal trauma, children. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 250-25

Knowledge, Practices and Education of Clients Regarding Breast Cancer Screening Among Health Care Workers in Plateau, North-Central Nigeria

Background/objectives: Majority of the Breast Cancer patients in our environment present at advance stage with poor prognosis. However, screening services like Breast Self Examination (BSE) exist where early diagnose would improve the prognosis. The objectives of the study were to determine the knowledge of Primary Healthcare Centre (PHC) workers regarding breast cancer, BSE, its practice and education of clients.Method: A cross-sectional survey of 182 female PHC Workers of selected LGAs. A multistage sampling technique was used to obtain participants. Information was obtained using an interviewer administered questionnaire and analyzed with Epi info. 3.3.2 Version.Results: Out of the 182 respondents studied, 80(44%) were Community Health Extension workers, 168 (92.3%) of the participants were aware of cancer of the breast. Their main sources of information were during training 63.7% and Media 19.7%. The respondents cited smoking (31.0%) and having a relative with cancer of the breast (31.0%) as risk factors associated with the cancer. Majority (91.7%) of participants knew the cancer could be prevented, although not all could link regular breast examination to the prevention. Most (87.2%) respondents knew how to perform BSE, out of which 75% had educated their clients with regards to breast cancer and BSE. Only 48(36.8%) knew the examination should be done monthly and for the purpose of lump detection.Conclusion: The study revealed high level of awareness with some patchy in-depth knowledge regarding breast cancer and BSE among the respondents. The practice of BSE did not proportionately translate to education of clients. In-service educational programs should target PHC workers who will transfer the knowledge and skills adequately to their clients at the grass roots

Impact Of Health Education On Home Treatment And Prevention Of Malaria In Jengre, North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A preintervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The postintervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P = .012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P < .001), knowledge (P < .001), malaria prevention practice (P = .001), first line treatment option (P = .031) and the type of treatment given to the children with fever (P = .048). Conclusion: Health education impacted positively caregivers' knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level. Keywords: Health education, home treatment, malaria, prevention Annals of African Medicine Vol. 7 (3) 2008: pp. 112-11

Sacrococcygeal teratoma: Clinical characteristics and long-term outcome in Nigerian children

Background/Purpose : The excision of sacrococcygeal teratoma (SCT) may be associated with significant long-term morbidity for the child. We reviewed our experience with SCT in a tertiary health care facility in a developing country with particular interest on the long-term sequelae. Methods : Between January 1990 and May 2008 inclusive, 38 consecutive children with the diagnosis of SCT were identified from the operation register and the Cancer Registry of the Jos University Teaching Hospital. Their clinical presentation, investigation, operative findings, histology report, and outcome were recorded and analyzed. The long-term follow-up of some of the patients were also recorded and analyzed. Results : There were 31 females and 7 males. Twenty-three patients presented during the neonatal period with a median age at presentation of 7 days (range 1-18 days) and a median weight at presentation of 2.8 kg (range 2.0-3.6kg), 10 presented between 1 month and 12 months, while 5 were older than 1 year at presentation. Most of the patients had significantly external tumors. Excision of the tumor was mainly by the sacral route, four had abdominal-sacral excision. Histology was mainly benign; four were malignant at presentation. Four children with malignant disease had chemotherapy in addition to excision of the tumor. Eight had immediate post-operative wound-related complications while three children died, two of the deaths were related to anesthesia, while one died of colostomy complications. Twenty-one (60%) were followed up for a median duration of 6 years (range 1 month-8 years). Two (9.5%) had recurrent disease after primary excision; five (23.8%) had some degree of functional impairment at the follow-up. Conclusion : While SCT is usually benign, recurrence, malignant transformations in patients who present late and long-term functional sequelae are problems that must be tackled by the care givers. A multi-center study may be necessary to characterize this disease in developing countries and assess the long-term functional sequelae in survivors

Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre, North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre- intervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P&lt;.001), knowledge (P&lt;.001), malaria prevention practice (P=.001), first line treatment option (P=.031) and the type of treatment given to the children with fever (P=.048). Conclusion: Health education impacted positively caregivers\u2019 knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level.Contexte: Le paludisme occasionne chaque ann\ue9e 1 million de d\ue9c\ue8s chez les enfants de moins de 5 ans. Il a \ue9t\ue9 d\ue9montr\ue9 que l\u2019am\ue9lioration du traitement \ue0 domicile et le fait d\u2019\ue9viter le retard de prise en charge, par des enseignantes afin de r\ue9agir avec promptitude lorsque leurs enfants ont la fi\ue8vre, peut r\ue9duire les complications et la mortalit\ue9 li\ue9es au paludisme. Cette \ue9tude s\u2019est int\ue9ress\ue9e \ue0 l\u2019impact de l\u2019\ue9ducation \ue0 la sante, sur la connaissance du paludisme, son identification, son traitement et sa pr\ue9vention parmi les donneurs de soins aux enfants de moins de 5 ans \ue0 Jenre dans la r\ue9gion du Centre-Nord du Nigeria. Methode: Il s\u2019agissait d\u2019une \ue9tude d\u2019intervention communautaire men\ue9e en trois \ue9tapes. Au cours de l\u2019\ue9tape pr\ue9c\ue9dant l\u2019intervention, 150 donneurs de soins ont \ue9t\ue9 s\ue9lectionn\ue9s par une m\ue9thode d\u2019\ue9chantillonnage concernant les foyers ayant des enfants de moins de 5 ans. Les informations de base ont \ue9t\ue9 recueillies par un enqu\ueateur \ue0 l\u2019aide d\u2019un questionnaire semi-structure. L\u2019intervention quant a elle a consiste en une s\ue9rie de sessions d\u2019\ue9ducation sanitaire bas\ue9es sur les donn\ue9es de l\u2019\ue9tape pr\ue9c\ue9dant l\u2019intervention. L\u2019\ue9valuation de l\u2019impact post intervention a \ue9t\ue9 effectu\ue9e par l\u2019usage d\u2019une version modifi\ue9e du questionnaire utilise en pr\ue9 intervention. R\ue9sultats: Le paludisme a \ue9t\ue9 identifi\ue9 comme figurant parmi les maladies responsables de fi\ue8vre dans la communaut\ue9 par tous les participants. 61 (40,6%) avaient une bonne connaissance des causes du paludisme, sa transmission, sa pr\ue9vention et son traitement. 26 (56%) des participants ont rapportes une auto m\ue9dication. Un lien statistiquement significatif a \ue9t\ue9 retrouve entre le nombre d\u2019ann\ue9es de scolarisation et le traitement de premi\ue8re intention (p=0,012). 34 (68%) des m\ue8res nt r\ue9agies dans les 8 heures suivant l\u2019acc\ue8s f\ue9brile. L\u2019intervention a eu un effet sur la perception (p&lt;0,001), la connaissance (p&lt;0,001), la pratique de la pr\ue9vention du paludisme (p=0,001), le choix du traitement de premi\ue8re intention (p=0,031) et le type de traitement administr\ue9 pour fi\ue8vre chez l\u2019enfant (p=0,048). Conclusion: L\u2019\ue9ducation sanitaire a eu un impact favorable chez les donneurs de soins sur la connaissance du paludisme et la volont\ue9 d\u2019acc\ue8s au traitement antipaludique chez leurs enfants f\ue9briles. Les informations sur le paludisme devraient \ueatre disponibles chez les donneurs de soins consultant dans les centres de soins sociaux. Les donneurs de soins devraient \ue9galement \ueatre int\ue9gr\ue9s aux activit\ue9s de contr\uf4le du paludisme au niveau communautaire

Awareness of occupational hazards and utilization of PPE amongst welders in Jos metropolis, Nigeria

Background: Welding poses a range of both well-known and subtle hazards to health and safety. These hazards can act quickly or may show up only in the long term. They can be rapidly fatal (electric shock or exposure to cadmium fumes) or have delayed effects (lung changes over time). This study aimed to assess the awareness of occupational hazards and utilization of PPE amongst welders in Jos metropolis.Methods: This was a descriptive, cross-sectional study involving 295 welders in Jos metropolis. An interviewer-administered questionnaire was used to collect data which was entered and analyzed using Epi-info version 3.5.4 statistical software. A probability value of p≤0.05 was considered statistically significant.Results: All the respondents were males with a mean age of 24.6±7.7 years. The study revealed that 293 (99.3%) were aware of occupational hazards in welding. In this study, goggles were the most frequently used PPE 98%, then gloves 65.4%, boots 58%, overalls 36.3%, facemask 30.6% and earplugs 12.9%. A statistically significant (p≤0.05) relationship was found between employment pattern as well as working hours per day and the use of safety devices.Conclusions: The study showed that most of the welders had fair knowledge of welding related health problems, hazards and safety devices, and utilization of safety devices was less than optimal. An educational campaign on workplace hazards, types and proper use of different personal protective devices should be instituted for welders on a regular basis by the welders association, local and state government

Treatment compliance and retention in care among out-patient clients in a tertiary health institution in plateau state North Central Nigeria

Background: Compliance with prescribed treatment and retention in care are key components in the management of chronic diseases which is vital in averting the long term complications that could arise from such conditions. Failure to comply with treatment recommendations is often associated with poor retention in care. In view of this, this study was conducted to determine the level of treatment compliance and retention in care among patients with hypertension and diabetes in Jos University Teaching Hospital.Methods: This was a cross sectional study conducted among 290 eligible respondents between September and November 2017 using quantitative method of data collection. SPSS version 20 was used for data analysis with adjusted odds ratio and 95% confidence interval used as point and interval estimates while p-value of ≤0.05 was considered statistically significant.Results: The mean age of the respondents was 54.5±13.1 years with 43.8% of the respondents found to have satisfactorily complied with prescribed treatment while 117 (40.3%) were uninterruptedly retained in care within the last 6 months' clinic appointments  prior to the study.Conclusions: This study has demonstrated the levels of compliance with treatment and retention in care bringing to bear the need to provide structured interventions targeted at attaining improvement in compliance with treatment and retention in care among individuals on long term care

Male Partners Involvement in Spousal Contraceptive Use: A Perspective of a Contemporary African Setting

Background: Contraceptive use by women is one of the tools used for promoting family health and slowing population growth. Evidence has suggested that contraceptive use in Nigeria is below acceptable levels in spite of the fact that family planning services are readily available, accessible and affordable. The involvement and participation of males in spousal contraceptive use is seen as the driver to achieving better reproductive outcomes. Hence, this study aimed to determine the level of male involvement in spousal contraceptive use so as to provide evidence based and people oriented information on the available male partner support system for contraceptive use and factors influence it.Methodology: This was a cross sectional study conducted among 80 male partners between April and May, 2017 using quantitative method of data collection and SPSS version 20 was used for data analysis.nbsp Crude and adjusted odds ratios as well asnbsp 95% confidence interval were used in this study with a p-value of le 0.05 considered statistically significant.Results: The mean age of the respondents in the study was 40.0 plusmn 10 years with only 13 (16.3%) of the respondents adjudged as being involved in their spousal contraceptive use. Currently use of male contraceptive method was found to significantly influence involvement in spousal contraceptive use (AOR = 7.1 95% CI = 2.1092 ndash 10.5818 P = 0.015). Conclusion: This study has demonstrated a low level of male involvement in spousal contraceptive use hence, relevant male educational intervention on contraception is required