Nutritional status and sociodemographic characteristics of ‘urban poor’ school children in Onitsha, Southeast Nigeria

Background: The neglect of the health and nutritional status of school aged children has adverse consequences on their long term cognition and survival. Sequel to emerging issues on urbanization and the health ofschool children, this study focused on the nutritional status and sociodemographic characteristics of ‘urban poor’ school children inOnitsha, a major city in South East Nigeria.Objectives: The study was aimed at determining the nutritional status and evaluating the effect of certain sociodemographic factors on the nutritional status of ‘urban poor’ public primary school children in Onitsha, South East NigeriaMethod: This was a cross sectional study of 788 children aged 6 to 12 years, randomly selected from 12 public primary schools in Onitsha metropolis. Their anthropometric measures were used to determine their nutritional status. Data on their sociodemographic characteristics was  obtained from their parents or caregivers using interviewer administered standardized questionnaires. Analysis was done using Microsoft Office Excel2007, SPSS version 17 and Epiinfo version 3.5.1 software packagesResults: Stunting was the predominant form of under nutrition with ahigher prevalence in the slum resident children. Greater than 60% ofall the children studied were from large families with more than 4 children. Family size, however, age and gender were not significantly associated with the nutritional status of the children. Relatively though, a greater  percentage of the stunted children were from large families.Conclusion: The nutritional status of ‘urban poor’ school children especially in slums in Onitsha is suboptimal compared with their counterparts in developed countries of the world. There is need for regional studies of children with similar characteristics who should be considered when  favourable health policies are being made for children

Adherence to infant-feeding choices by HIV-infected mothers at a Nigerian tertiary hospital: the pre-“rapid advice” experience

Objectives: The study examined adherence to infant-feeding choices made by human immunodeficiency virus (HIV)-infected mothers at a Nigerian tertiary hospital prior to implementation of the “rapid advice” guideline, i.e. the revised World Health Organisation principles and recommendations on infant feeding in the context of HIV.Design: This was a longitudinal descriptive study.Subjects and settings: The study was conducted on mother-infant pairs recruited from the prevention of mother-to-child transmission (PMTCT) of HIV programme of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Final analyses included 142 mother-infant pairs.Outcome measures: Adherence to a prenatal infant-feeding choice and the infant’s HIV status at six months of age were determined.Results: On enrolment, 73% (n = 103) of the mothers chose exclusive formula feeding (EFF), and 28% (n = 39) exclusive breastfeeding (EBF) for the first six months of life. Of the mothers who chose EBF, the actual practice of EBF declined from 88% at two weeks to 21% at six months, while EFF with correctly reconstituted infant formula decreased from 55% to 8% over the same period. The proportion of mothers who switched over to early complementary feeding increased from 8% at six weeks to 80% at six months in the EBF group, and 2% at two weeks to 92% at six months in the EFF group. Major reasons for nonadherence to their initial choice were fear of the mother-to-child transmission (MTCT) of HIV (65%) and non-affordability of the formula (97%) in the EBF and EFF groups, respectively. Factors significantly associated with adherence to their initial choice included having individual prenatal infant-feeding counselling sessions, being married, having a small number of children, being of higher socio-economic status and the mother’s educational status. However, only socio-economic status remained significant after logistic regression analysis was applied. The total MTCT of HIV rate was 1% at six months.Conclusion: Adherence to either EFF or EBF in this study was low, owing to early breastfeeding cessation and the inability to sustain EFF.Keywords: HIV-infected mothers, infant-feeding choice, infant-feeding practices, PMTCT, adherenc

Prevalence of asymptomatic bacteriuria among pre-school children in Nnewi, South-East Nigeria

Background: Early diagnosis and management of urinary tract infection (UTI) in young children reduces the risk of renal scarring and chronic renalinsufficiency. We determined the prevalence of asymptomatic bacteriuria(ASB) among pre-school children in Nnewi, South-East Nigeria.Methodology: This was a crosssectional survey involving apparently healthy nursery school children aged 3-5 years. A pre-tested, care-giver administered questionnaire was used to obtain information about the participants including age, sex, history of fever and antibiotic administration in the two weeks preceding the study. Following a clinical examination, a sample of mid-stream urine was collected from each participant for dipstick urinalysis, and urine microscopy and culture. ASB was defined as the presence of .105CFU/ml of urine in a participantwho had no symptoms of UTI.Results: Out of 792 children, 417 (52.3%) were females and 375 (47.4%) were males. The mean age of the children was 4.0 } 0.7 years. ASB was found in 31 children (4%). The prevalence of ASB in females (7.2%) was significantly higher than in males (0.5%), p<0.001. The highest prevalenceof ASB of 5.6% occurred in the 4-year-olds and the lowest of 2.0 %occurred in 5 year olds, p=0.09. The commonest bacterial isolates among the ASB cases were Staphlococcus aureus, 13 (40.6%); Streptococcus faecalis, 9 (28.1%) and Escherichia coli, 5 (15.6%). Conclusion: Asymptomatic bacteriuria is commoner in female preschoolchildren and S. aureus is the commonest bacterial isolate. Routine evaluation of female preschool children for bacteriuria is recommended.Key words: Asymptomatic bacteriuria, Pre-school children, Prevalenc

Social Support and Health: A Theoretical Formulation Derived from King's Conceptual Framework

This article describes the development and initial empirical testing of a theoretical formulation of social support, family, health, and child health derived from Imogene King's conceptual framework for nursing. A correlational design was used to test the formulation with 103 families who have children with diabetes mellitus. Three hypotheses were sup ported : parents' social support had a direct and positive effect on family health, parents' social support and child's social support were positively related, and illness factors had a direct and negative effect on child health. Both the supported and unsupported hypotheses are discussed in terms of the present substantive knowledge base and evidence of validity for King's framework. Direction for further theory development and research are identified.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68995/2/10.1177_089431848900200309.pd

Women's sexual health and contraceptive needs after a severe obstetric complication ("near-miss"): a cohort study in Burkina Faso

BACKGROUND: Little is known about the reproductive health of women who survive obstetric complications in poor countries. Our aim was to determine how severe obstetric complications in Burkina Faso affect reproductive events in the first year postpartum. METHODS: Data were collected from a prospective cohort of women who either experienced life threatening (near-miss) pregnancy-related complications or an uncomplicated childbirth, followed from the end of pregnancy to one year postpartum or post-abortum. Documented outcomes include menses resumption, sexual activity resumption, dyspareunia, uptake of contraceptives, unmet needs for contraception and women's reproductive intentions.Participants were recruited in seven hospitals between December 2004 and March 2005 in six towns in Burkina Faso. RESULTS: Reproductive events were associated with pregnancy outcome. The frequency of contraceptive use was low in all groups and the method used varied according to the presence or not of a live baby. The proportion with unmet need for contraception was high and varied according to the time since end of pregnancy. Desire for another pregnancy was highest among near-miss women with perinatal death or natural abortion. Women in the near-miss group with induced abortion, perinatal death and natural abortion had significantly higher odds of subsequent pregnancy. Unintended pregnancies were observed mainly in women in the near-miss group with live birth and the uncomplicated delivery group. CONCLUSIONS: Considering the potential deleterious impact (on health and socio-economic life) of new pregnancies in near-miss women, it is important to ensure family planning coverage includes those who survive a severe complication

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city

Background: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth.Objective: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum.Materials and Methods: A cross.sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non.slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmentalvariables of interest were analyzed to determine their relationship with undernutrition in the children.Results: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non.slum areas (ƒÔ2 = 66.69, P = 0.000).Conclusion: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.Key words: Determinants, school.aged children, undernutritio

Comparative use of anthropometric indices in the detection of malnutrition among nursery school children in Nnewi, Nigeria

Background: Nutritional status in children can reliably be assed using various anthropometric parameters.Objective: This study was carried out to assess the nutritional status of preschool children by comparing it with internationally recognizedgrowth standards, using the anthropometric indices of nutritional status.Methods: A cross-sectional study was carried out upon a random sample of children (N=300) aged 25 to 83 months who attended nurseryschools in Nnewi, southeast Nigeria. Individual measurements of weight, height and mid-upper arm circumference were taken for each child.Anthropometric indices of weight and height were calculated. These indices were related to the US National Center of Health Statistics (NCHS)reference population by standard deviation scores (Z-scores).Results: One hundred and sixty-two (54.0%) of the 300 subjects were boys, and 138 (46.0%) girls. Of all children, 8 (2.7%) suffered from malnutrition (weight for age less than 2 SD of the reference median), 6 (2.0%) were stunted (height for age less than 2 SD of the reference median), and 63 (21.0%) were wasted (weight for height less than 2 SD of the reference median). Using the mid-upper arm circumference 3 (1.0%) were malnourished, while 149 (49.7%) children were undernourished using the body mass index classification.Conclusion: Weight for height detected more malnourished children than weight for age. The mid upper arm circumference seems to be a lesssensitive anthropometric index, while body mass index is less specific

The influence of maternal anthropometric characteristics on the birth size of term singleton South-East Nigerian newborn infants

Objective: This study examined the usefulness of maternal anthropometry in predicting the birth size of term singleton newborn infants at NAUTH, Nnewi, Nigeria.Materials and Methods: A cross-sectional study was conducted among 301 mother/newborn infant pairs.Results: The mean birth weight was 3.27 ± 0.60kg whereas the incidence of low birth weight and fetal macrosomia were 8.0% and 11.3%, respectively. The anthropometric indices varied in their ability to detect newborn babies who experienced abnormal intrauterine growth. The rate of subnormal intrauterine growth was 9.0%, 11.6%m and 18.6% using weight-forgestational age (GA), ponderal index (PI), and mid-arm circumference (MAC)/ occipito-frontal circumference (OFC) criteria, respectively. On the other hand, the rate of excessive intrauterine growth was 16.6% and 12.0% using weight-for-GA and PI criteria, respectively. Apart from maternal height, all the assessed maternal anthropometric parameters had a significant relationship with size at birth. Mothers of newborn infants who experienced subnormal intrauterine growth were more likely to have MAC < 25 cm, intrapartum weight < 65 kg, intrapartum BMI < 25 kg/m2, and rate of third trimester weight gain < 250 g/week. On the other hand, mothers of newborn infants who experienced excessive intrauterine growth were more likely to have MAC > 30 cm, intrapartum BMI ≥ 30 kg/m2, and rate of third trimester weight gain ≥ 500 g/week.Conclusion/Recommendation: Maternal anthropometry is a very useful tool in identifying mothers at risk of having newborn infants who experienced abnormal intrauterine growth. Therefore, its routine application is recommended to enable such mothers benefit from interventions targeted at ensuring optimal intrauterine growth and improved pregnancy outcomes.Keywords: Anthropometry, intrauterine growth, newborn infant

Cultural Influences on Hepatitis B Surface Antigen Seropositivity in Primary School

Objective: To determine the role of cultural influences, namely: circumcision, ear piercing and traditional scarification, on HbsAg seropositivity among primary school children in Nnewi. Subjects and Method: Two hundred and thirty seven randomly selected primary school children aged 5-12 years, were screened for HbsAg. Information on the subjects were collected by use of a pretested questionnaire and physical examination. Results: An HbsAg prevalence of 7.6 percent was observed. There was no significant difference in the prevalence of HbsAg between exposed children and those unexposed to the various traditional practices [P >05]. Conclusion: Culturally related exposure did not seem to be a significant mode of HBV spread in Nnewi childhood population. Key Words: Cultural influences, Hepatitis B surface antigen Nigerian Journal of Paediatrics Vol.30(4) 2003: 140-14