Upper body segment to lower body segment and arm span to height ratios among children with sickle cell anaemia in Lagos

Objective: To determine ratios of upper body segment to lower body segment and arm span to height in the sickle cell anaemia patientsBackground: Sickle cell anaemia may adversely affect linear growth and body proportions.Methods: Height, upper segment and arm span were measured in100 sickle cell anaemia patients aged eight months to 15 years and100 age/sex matched controls. Lower body segment length, upper body segment to lower body segment ratio, and arm-span to height ratio were derived.Results: Sickle cell anaemia subjects older than 10 years had significantly shorter upper body segment than controls (p = 0.035 and p = 0.004 for males and females respectively). The mean upper segment/lower segment ratio decreased with age among primary subjects (SS) and AAcontrols. In comparison with AA controls, female sickle cell anaemia subjects older than 10years had significantly lower mean upper bodysegment to lower body segment ratio (p = 0.005). Mean arm span was significantly shorter in male sickle cell anaemia patients older than 5 years (p = 0.034 at 5 to 10 years and p = 0.029 at . 10 years) and in females older than 10 years than in controls (p = 0.025). The mean arm  span/height ratio was lower in sickle cell anaemia subjects than controls, except in males younger than five years.Conclusions: Sickle cell anaemia patients older than 10 years haveshorter mean upper segment. In this age group, females also hadsignificantly lower upper segment to lower segment ratio.Keywords: sickle cell anaemia, upper body segment, lower body segment, rati

IRON DEFICIENCY ANAEMIA AMONG PRE-SCHOOL CHILDREN WITH SICKLE CELL ANAEMIA: STILL A RARE DIAGNOSIS?

Background: The frequent need for blood transfusion in children with SCA creates the impression that IDA is rare in this class of children. Objectives: The objective of the study is to determine the prevalence of IDA in a population of under-five children with SCA in Lagos, Nigeria. Methodology: Serum iron, total iron binding capacity, transferrin saturation and serum ferritin were assayed in 97 under-five children with SCA and 97 age/sex matched controls. The diagnosis of IDA was established based on the following criteria: haemoglobin <11.0 g/dl plus two or more of the following: MCV <70fl, transferrin saturation (Ts) <16% or serum ferritin (SF) <25ng/dL Results: Overall prevalence of IDA was significantly higher among AA controls. In the younger age group, the prevalence of IDA was significantly higher among HbAA controls while in the older age group the odds of having IDA was three times higher among HbSS subjects but the difference was not statistically significant. Two of the three SCA children with IDA have history of previous blood transfusion. Conclusion: IDA is uncommon in pre-school aged children with SCA. A multi-centre study is necessary to yield large number of transfused subjects to examine the effects of blood transfusion on prevalence of IDA

Ethical Issues And Challenges Of Managing Severe Anaemia In Jehovah Witness Paediatric Patients: 2 Case Reports

The Jehovah’s Witnesses are a rapidly growing religious group in the Western world and in Nigeria with an  estimated 7 million members worldwide. Procedures generally regarded as unacceptable by Jehovah’s  witnesses include transfusion of whole blood, packed red cells, white cells, plasma, platelets and preoperative autologous blood collection with storage for later reinfusion. In the event of a refusal when seriously indicated, it creates an ethical dilemma for the health care professional, as well as being a frustrating experience. Central to modern medical ethics is a respect for the patient’s autonomy, while the Physician respects this, he also must abide with the principles of beneficence, non-maleficence and Justice. In the case of minors of Jehovah’s Witnesses requiring blood transfusion, a standard of care procedure should be designed for use in emergency care and elective procedures. Standard steps of procedures must be agreed upon by management as well as the ethics committee of every hospital. This report examines two cases of Jehovah’s Witnessesminors whose parents refused a much needed blood transfusion for emergency procedures due to religious reasons.Key words:  Jehovah’s Witnesses; Blood Transfusion; Anaemia

Patterns of Voluntary Counselling and Testing among Undergraduate University Students in Lagos, Nigeria

It is critically important for individuals to learn about their HIV status and make informed decisions about their future. The study aimed at determining the patterns of voluntary counselling and testing among undergraduate university students in Lagos, Nigeria. The study was conducted in May 2010 among students recruited from seven faculties within two of the campuses of Lagos State University, Ojo and Ikeja campuses. A total of 200 respondents were recruited using systematic random sampling method and surveyed with the aid of structured questionnaire. A high percentage of respondents (54.0%) had not performed HIV counselling and testing before the survey interview. 54.1% and 53.8% of male and female respondents, respectively, had not performed HIV counselling and testing before the survey. The commonest reasons given for not doing HIV counselling and testing is that respondents are too busy which accounted for 35.1% of total respondents. Ahigh percentage of respondents (65.5%) are aware of location of HIV counselling and testing centre within their institution. Students are not particularly interested in HIV counselling despite the high awareness of availability of HIV counselling and testing centre located within their educational institution; they invest their time and interest more in academics

Caregivers’ perception of oral health‑related quality of life in a group of Nigerian children living with human immunodeficiency virus

Aim: This study examined the caregivers’ perception of the effect of dental conditions on general well‑being and family life of a group of human immunodeficiency virus (HIV)‑infected Nigerian children. A secondary aim was to investigate correlations between the children’s sociodemographic and health‑related variables and caregivers’ global ratings of oral health and well‑being.Study Design: A cross‑sectional questionnaire‑based survey was conducted among parents/caregivers of 95 HIV‑positive children receiving care at the Lagos State University Teaching Hospital, Nigeria.Materials and Methods: The “Parental‑Caregivers Perception Questionnaire” which included measures of global ratings of oral health and well‑being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well‑being, and family well‑being/parental distress was used. Assessment was based on the child’s oral health within the preceding 3 months of the study.Results: The most affected subscale of the oral health‑related quality of life was functional limitation followed by parental distress and then oral symptoms. Caregivers of older children were 2½ times more likely to view oral health as impacting their child’s overall health (P = 0.034). Furthermore, caregivers of children who had not yet commenced antiretroviral therapy were 15% more likely to report oral symptoms (P = 0.024) and 11% were more likely to be distressed. Statistics: Data entry, validation, and analysis were done using SPSS version 17.0. Findings were considered to be statistically significant when 95% confidence intervals were not overlapping.Conclusions: According to caregivers’ perceptions, oral symptoms, functional limitations, and parental distress outweighed emotional well‑being in impacting a child’s oral health quality of life. Oral health programs to improve the knowledge of caregivers on the importance of oral health in HIV‑positive children are necessary for improvement in overall quality of life.Keywords: Caregivers, human immunodeficiency virus infection, Nigerian children, oral health‑related quality of lif

AGE AT DIAGNOSIS OF SICKLE CELL ANAEMIA IN LAGOS, NIGERIA

Background: Sickle cell anaemia is the most common genetic disorder worldwide as well as in Nigeria. Delay in the diagnosis of the condition constitutes an important cause of concern for caretakers of affected children. Objective: To determine the age at diagnosis in a population of children with sickle cell anaemia in Lagos, Nigeria. Methodology: The study was conducted between October and December 2009 at the sickle cell clinic of the Department of Paediatrics of Lagos State University Teaching Hospital, Ikeja, Lagos in South west Nigeria. By convenience sampling, a total of 192 children with sickle cell anaemia aged six months to 15 years were interviewed with the aid of a structured questionnaire. Results: Overall, the mean age at confirmation of haemoglobin genotype was 27.33 months (± 26. 36 months). The mean age at diagnosis was significantly lower among males than females (25.59 ± 27.74 Vs 29.14 ± 24.85, p = 0.04). A quarter of the children were diagnosed before infancy and three-quarters before three years of age. Upper social stratum and small family size were significantly associated with earlier diagnosis of sickle cell anaemia. Conclusion: Too few subjects are diagnosed in infancy. Routine screening should ideally be done at birth and neonatal period or at the latest, between six and nine m Background: Sickle cell anaemia is the most common genetic disorder worldwide as well as in Nigeria. Delay in the diagnosis of the condition constitutes an important cause of concern for caretakers of affected children. Objective: To determine the age at diagnosis in a population of children with sickle cell anaemia in Lagos, Nigeria. Methodology: The study was conducted between October and December 2009 at the sickle cell clinic of the Department of Paediatrics of Lagos State University Teaching Hospital, Ikeja, Lagos in South west Nigeria. By convenience sampling, a total of 192 children with sickle cell anaemia aged six months to 15 years were interviewed with the aid of a structured questionnaire. Results: Overall, the mean age at confirmation of haemoglobin genotype was 27.33 months (± 26. 36 months). The mean age at diagnosis was significantly lower among males than females (25.59 ± 27.74 Vs 29.14 ± 24.85, p = 0.04). A quarter of the children were diagnosed before infancy and three-quarters before three years of age. Upper social stratum and small family size were significantly associated with earlier diagnosis of sickle cell anaemia. Conclusion: Too few subjects are diagnosed in infancy. Routine screening should ideally be done at birth and neonatal period or at the latest, between six and nine m Key words: diagnosis, genetic disorders, population, sickle cell anaemi

Osteosarcoma with Orbital Metastasis in a Nigerian Child: A Case Report and Review of the Literature

Osteosarcoma is the most common primary bone tumour with a peak occurrence in adolescence. The occurrence of osteosarcoma in preadolescents is rare with a paucity of data in the developing world. Metastasis of osteosarcoma to the orbit is even a rarer presentation with few cases reported in the literature but to the best of the researchers’ knowledge, none of the previous cases had contralateral orbital metastasis to osteosarcoma. This is the first case report of orbital metastasis of osteosarcoma in Nigeria. The present case is presented for its rarity, to increase awareness and add to knowledge on the possibility of metastasis to contralateral orbit in osteosarcoma

Head circumference of children with sickle cell disease in Lagos, Nigeria

Introduction: growth retardation and under-nutrition are common in children with sickle cell disease (SCD). The aim of this study was to compare the head circumference (HC) of SCD children and non-SCD children and to determine the effect of malnutrition on head circumference of children with SCD. Methods: this was a prospective case-control study conducted at the Lagos State University Teaching Hospital, Nigeria, involving SCD children (subject, n = 118) and non- SCD children (control, n = 118) matched for age, sex, and socioeconomic status. Weight, height and HC were measured using standard techniques. Results: the mean ages of children with and without SCD were 7.46 ± 3.69 years and 7.01 ± 3.58 years, respectively. The HC increased significantly with age in both males and females (r = 0.75, p = &lt; 0.001; r = 0.70, p &lt; 0.001 respectively). There was no significant difference in HC between males and females (p &gt; 0.05). At all ages, the mean head circumference of SCD children was not significantly (p &gt; 0.05) different from non-SCD children. The In the age group 11-15 years, the prevalence of stunting was significantly higher among SCD children than non-SCD children. The mean HC of SCD children with stunting was significantly lower than those not stunted (51.7 vs. 53.5; P= 0.006) in age group 11.15 years. Conclusion: the head circumference of children with SCD is not significantly different from that of non-SCD children. Therefore, the HC chart for the general population is also applicable for monitoring head growth in children with SCD. The effect of malnutrition on head circumference of SCD children is most marked in age group 11-15 years.The Pan African Medical Journal 2016;2