Teenage organophosphate insecticide poisoning: An ugly trend in Enugu, Nigeria

Background: Organophosphate poisoning is still a major problem in developing countries owing to indiscriminate use of these compounds in many households. The risk of poisoning is worsened by uncontrolled sale of organophosphorus insecticides on the streets and in open markets. We report three cases of organophosphate compound poisoning among adolescents with suicidal intent.Methods: We reviewed the hospital admission case records of three cases of organophosphate poisoning among adolescents managed at the children emergency room of University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, South-east Nigeria. Relevant information on the clinical characteristics of the patients, investigations and treatment, and outcome of treatment were obtained.Results: The events of poisoning were preceded by strained family relationship in two of the cases while failure in a promotional examination preceded the incident in one of them. Atropine monotherapy in addition to airway management and oxygen support successfully reversed the symptoms and signs in 2 of the 3 cases. One died within 18 hours of admission from cardio-respiratory depression. Mean duration of admission in patients that survived was 48 hours.Conclusion: This report highlights the ugly trend of suicidal ideation among adolescents and the challenges of management of organophosphate poisoning in our setting. It serves as a wake-up call to Nigerian parents and healthcare providers on the increased risk of indiscriminate use of organophosphorus compounds as insecticides in the homes.Keywords: Organophosphate poisoning, Atropine, Adolescents, Suicide ideation, Enug

Malaria chemoprophylaxis: The use and abuse by caregivers of children in South east Nigeria

Introduction: Malaria still remains a major cause of morbidity and mortality in children despite concerted efforts to reverse this. Chemoprophylaxis involves the use of anti malarial drugs to prevent malaria infection in humans. However the increasing resistance of plasmodium to medications has limited the effectiveness of chemoprophylactic regimens used in the past. This study will explore the perception of caregivers about these practices and determine the proportion of caregivers who treat their children for malaria without meeting standard criteria. Methodology: This cross-sectional descriptive study, was carried out over a 3-month period, from March 2017 to June 2017. Structured questionnaires accompanied by informed consent forms were sent to parents of selected pupils through their children. The first section of the questionnaire was about socio-demographic features of participants while the second section, collected information on outcome variables which assessed respondents’ level of practice of chemoprophylaxis. Results: A total of 318 (77.2%) caregivers give antimalarial prophylaxis to their children. Mothers without tertiary education (χ = 12.90, P = 0.00) and those from middle and lower socioeconomic classes (χ =15.76, P = 0.00) were significantly more likely to administer malaria chemoprophylaxis to their children. Conclusion: The misconception on malarial chemotherapy could portend treatment failure if not controlled. Extensive public enlightenment programs on the guidelines for use of anti-malarial will go a long way in ensuring rational use of anti-malarial drugs in the fight against malaria particularly in high burden areas such as Nigeria

Severe falciparum malaria in children in Enugu, South East Nigeria

Introduction: Severe malaria remains one of the leading causes of morbidity and mortality in sub-Saharan Africa and parts of Asia despite several efforts in prevention and management. The prevalence and pattern of presentation may vary from one location to another and from one age group to another.Objectives: This study was undertaken to review the prevalence and pattern of severe malaria among children presenting in the two tertiary hospitals in Enugu, south-east Nigeria. Methods: The case records of children presenting with malaria in the two tertiary hospitals in the state were retrieved and the necessary information were obtained using a structured questionnaire.Results: The children aged from 1 month to 184 months (15 years), with a median age of 36 months and mean age of 49.2 ± 42.7 months. About two-thirds (68/102, 66.7%) of the children were under the age of 5 years, with only 6 of them (8.8%) being 6 months and below. There were significantly more males than females (χ2 = 6.48, P = 0.01); with a M:F ratio of 1.55:1. The peak of presentation was from August and November. Prostration, respiratory distress and severe anaemia were the commonest features of severe malaria, while shock, acute renal failure and abnormal bleeding were the least presenting features Of all the features, only severe anaemia was significantly related to age, (χ2 = 5.027, P = 0.02). Sixty-one (59.8%) of the children had one or more co-morbidities. There were 2 deaths, giving a case fatality rate of 1.96%.Conclusion: Early presentation will significantly reduce blood transfusions, prolonged admission and death in children with severe malaria.Keywords: Children, Enugu, falciparum, malaria, Nigeri