Pattern and Trends of Respiratory Disease Admissions at the Emergency Paediatrics Unit of Jos University Teaching Hospital – A Four Year Review

Aims: Respiratory diseases contributes substantially to the number of Paediatric admissions and deaths especially in low income countries. Understanding the trends will help in health planning and resource distribution. This study is to describe the pattern and trend of respiratory diseases in children in a tertiary healthcare facility in north-central Nigeria. Study Design: This study was a retrospective study including all patients admitted and managed with respiratory diseases. The relevant clinical information was extracted from the hospital records. Place and Duration of Study: The Emergency Paediatric Unit (EPU) of the Jos University Teaching Hospital (JUTH), Jos Nigeria, between January 2012 and December 2015. Methodology: A total of 2277 children aged 6 weeks-18 years were admitted into the unit within the study period. Out of these, 498 (21.9%) were diagnosed with respiratory disease. Clinical records were retrieved and reviewed. Those with inconclusive diagnosis as well as those with associated co-morbidities such as cardiac anomalies were excluded. The data collected were entered and analyzed using Epi Info version 7.2. Student t-test and chi-square test were used to analyze categorical and continuous variables respectively. Results: Pneumonia accounted for 54.4% of total respiratory diseases. Cases of Pneumonia were mostly seen at the peak of the rainy and the harmattan seasons. (March, June/July and October/November). The highest number of cases of respiratory diseases were in the under-fives. The commonest complication was congestive cardiac failure and it was commoner in the younger age group. Conclusion: The prevalence of respiratory diseases remains high and contributes significantly to hospital admissions especially in the under five children. There is need to introduce new vaccines and re-enforce existing immunization against common organisms that cause pneumonia in children. There is also need to introduce policies that would ensure appropriate treatment for children to reduce the burden of these diseases

Pattern of utilization of antiepileptic drugs in the first 12 months of epilepsy treatment in children

Background: Drug utilization studies are important methods of assessing how drugs are used in the society. Without the knowledge of how drugs are being prescribed and used, it is difficult to initiate discussion on rationale drug use and to suggest measures to change prescribing habits for better management of patients. This study therefore aimed to evaluate the pattern of utilization of antiepileptic drugs (AEDs) in the first 12 months of epilepsy treatment in children in Jos, Nigeria.Methods: A case record form was used to document all relevant information of children with epilepsy that were commenced on AED from January 2011 to December 2015. Information collected in the first 12 months of commencement of AED was used to evaluate the pattern of utilization of AEDs among the study subjects. Information obtained was analyzed with statistical package for social sciences software version 20.Results: Three hundred and eighty one subjects with a median age of 5.4 years were studied. The most frequently prescribed drug at commencement of epilepsy treatment was Carbamazepine (CBZ) (75.9%) followed by Sodium Valproate (VPA) (17.1%) while the most frequent AED combination was CBZ+VPA. Despite the fact that all the patients were commenced on monotherapy, the rate of polytherapy at 12 months was 35.2%. Deviation from standard treatment guidelines was observed in 127 (33.3%) of the subjects with the most common deviation being the use of CBZ for generalized tonic-clonic seizures.Conclusion: Significant deviations were observed in the utilization of AEDs in children with epilepsy. Using standard guidelines in the treatment of childhood epilepsy will reduce the rate of uncontrolled seizures and improve their long term outcome. Keywords: Epilepsy, Children, Antiepileptic drugs, Pattern, Utilizatio

Intestinal parasites and human immunodeficiency virus (HIV) status of children in Jos, Nigeria

Intestinal parasitic infestations (IPI) are not uncommon in immunocompetent individuals. However, human immunodeficiency virus (HIV)-infected individuals with depleted immunity have an abnormally high susceptibility to infections. This study therefore, examines children with intestinal parasites according to HIV status and degree of immunosuppression. Consecutively consenting patients aged 1 to 15 years attending the Paediatric Clinic of acquired immune deficiency syndrome (AIDS) Prevention Initiative, Nigeria, were recruited as cases, while age and sex matched HIV negative controls were recruited from Out Patient Department of Jos University Teaching Hospital. Stool samples were examined for parasites by direct wet mount, formol-ether and modified Ziehl-Neelsen technique. Levels of immunosuppression were assessed amongst HIV-positive subjects. Five hundred and ten children aged 1 to 15 years equally divided between the two cohorts were enrolled for the study. Seventy-nine had IPI, giving a prevalence rate of 15.5%; 44 (8.6%) HIV positive and 35 (6.9%) HIV-negative children. The most prevalent extracellular parasite was Giardia lamblia, however HIV positives had significantly higher rate of G. lamblia infestation. Among the intracellular parasites, the infection rate in HIV-positive subjects (5.9%) was three times that in HIV-negative subjects (2.0%). HIV positive children with advanced and severe immunosuppression had significantly higher intracellular parasites. HIV status did not significantly predict the overall risk of having extracellular intestinal parasites however, it was noted that G. lamblia infection was significantly higher in HIV positive children. HIV positive children had higher risk of having intracellular parasites especially if they have advanced or severe immunosuppression. Therefore, the policy of screening children for intestinal parasites should continue irrespective of their HIV status. Those that are HIV positive children should specifically be screened for intracellular parasites