Factors influencing the incidence of pre-term birth in Calabar, Nigeria

Women who had pre-term birth in the University of Calabar Teaching Hospital, Calabar, over a 2 ½ year period were studied. The aim was to establish the factors influencing the incidence of pre-term birth in Calabar. Factors which significantly increase the incidence of pre-term delivery included: previous induced abortion (

Asymptomatic proteinuria in children in Calabar

The urine samples of pupils from 4 Primary schools in Calabar were studied for asymptomatic proteinuria. The aim was to determine the prevalence of asymptomatic proteinuria in children in calabar. For each pupil, two urine samples were tested for proteinuria using the dipstick. The first urine sample was collected at school and the second was an early morning urine sample brought from home. A total of one thousand two hundred and seventy five children (1,275) were screened. Two hundred and thirty eight (18.6%) children had varying degrees of proteinuria ranging from trace to 500gm/dl in the daytime. Of these, only twenty (1.6%) had significant proteinuria of 30mg/dl to 500mg/dl. A repeat testing with early morning urine still showed significant proteinuria in 1.6% of these children. The prevalence of asymptomatic proteinuria was more in girls (65%) than in boys (35%), giving a male to female ratio of 1:1.9. The study identifies the need to always screen all children for proteinuria before admission into schools, as this will facilitate early detection of nephropathies in them and permit early investigation, treatment and follow-up

Nocturnal Enuresis And Its Treatment Among Primary School Children In Calabar Nigeria.

Background: Enuresis for most children is a source of shame and anxiety with a profound ef fect on sel f percept ion, relationship and school performance. Hence the study of nocturnal enuresis among primary school children in Calabar-Nigeria. Objectives: This was to determine the frequency of enuresis among primary school children in Calabar and to study the treatment modalities. Patients and Methods: This was a prospective cross sectional study. A questionnaire was answered by parents of 3,230 pupils from six selected schools during the school term between January to March, 2010. Results: The frequency of nocturnal enuresis was 6.7%. Enuresis frequency was higher among boys (7.3%) than girls (6.0%) though this was not statistically significant (P=0.216). Treatment methods used were medication ( 1.6%) , water restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. Conclusion: The frequency of enuresis was similar to most reports in literature. Help-seeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested.Key words: Nocturnal enuresis, Treatment, School children

Neonatal seizures in Calabar: A revisit

Newborns admitted with convulsion in the University of Calabar Teaching Hospital, Calabar during the period 1st May 2004 to 30 April 2006 were studied prospectively. The aim was to determine the place of birth in relation to the cause of seizures, the current situation in terms of the aetiology, clinical spectrum and outcome. There were 55 neonates with convulsion representing 5% of admissions into the newborn unit during the period. Birth asphyxia, sepsis, and hypoglycaemia were important identifiable aetiological factors which operated either singly (45.5%) of cases) or in concert (54.5% of cases) in causing seizures. Hypocalcaemia and hyponatraemia contributed less. These results are similar to that of a previous study carried out in this centre ten years earlier . There was no statistical significant difference between home and hospital deliveries in relation to causes of seizures. Septicaemia was caused mainly by staphylococcus aureus, enterobactericae and unclassified coliforms. No neonatal meningitis was diagnosed. Surprisingly, there was a high prevalence of generalized seizures (76.4%). The mortality of 34.0% was related to onset of the seizures within 4 days of life but not the place of birth.The causes of neonatal seizures in our environment are mostly preventable. There is need to provide modern facilities for investigating newborn seizures, training and retraining of Traditional Birth Attendants, health education of expectant mothers

Worm Infestation And Anaemia Among Pre-school Children Of Peasant Farmers In Calabar, Nigeria.

Background: Worm infection and anaemia are common childhood conditions in Nigeria. We assessed the status of helminthiasis and associated anaemia among pre school children of peasant farmers aged 1-5 years living in a rubber plantation near Calabar, Nigeria. Design: Cross sectional. Method: Three hundred and fifty children were selected by multi-stage cluster sampling technique. Freshly passed stool was examined using Kato-Katz method while anaemia was estimated using haematocrit technique. Result: Of the 350 children, 174 (49.7%) had intestinal helminths: Ascaris lumbricoides 64.4%, hookworms 10.9% and Trichuris trichuria 1.1%. There were 41(23.6%) children with polyparasitism, 33 of them were due to Ascaris lumbricoides and hookworms. The worm load was generally light in intensity with egg per gram of stool ranging from 24-60,960. Males (28.9%) were infected more than females (20.8%). The frequency of infection increases with age. The prevalence of anaemia among the entire study population and in those infected with worms was 56.6% and 56.9% respectively. With polyparasitism there was a relative increase in the frequency of anaemia females > males. Conclusion: Worm infections and anaemia are common in our children. A comprehensive control strategy involving good sanitation, sinking of bore hole for clean water supply and regular deworming exercises are recommended. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 220-22

Enema abuse by mothers of children presenting to the emergency room at the University of Calabar Teaching Hospital

Enema is largely used and widely abused in our community for various ailments including fever, constipation; abdominal pains vomiting and even diarrhoea.Objectives: To describe the abuse of enema at home in the Calabar area, and the associated findings among children who received enema.Method: Children admitted to the Children Emergency Unit of the University of Calabar Teaching Hospital with history of enema use at home were recruited into the study. The presenting symptoms, type of enema used and associated findings were documented. Relevant investigations were carried out where necessary. Tables and simple proportions were used to analyze the data.Results: Twenty two children were seen with enema abuse over a six months period. Diarrhoea diseases and fever were the predominant reasons why enema was given. Types of enema given were herbal concoctions in 13(59.1%) plain water enema in 8(36.4%) and salt water enema in one (4.5%) child. Electrolytes derangements were the commonest associated findings. Others were convulsions/coma, intestinal perforation, acute renal failure and severe dehydration from diarrhoea.Conclusion: Enema abuse is a continuing cultural phenomenon in the Calabar area. It is associated with severe consequences including intestinal perforation. Enema abuse should form part of history taking in this environment and child care practitioners should actively search for possible complications. Most importantly, health education to stem this widespread practice

Prevalence of Persistent Proteinuria using Urine Protein/Creatinine Ratio in Asymptomatic Primary School Children in Calabar, Nigeria

Background: Quantitative urinary protein estimation is the cornerstone in the diagnosis, treatment and prognostication of renal diseases. This could either be carried out by 24-hour urine protein estimation or spot urine protein: creatinine (UPC) ratio. The latter is simple, convenient, quick and reliable. It can be used in the follow-up of asymptomatic proteinuric children at risk of developing chronic renal disease.Aim: To determine the prevalence of persistent proteinuria in asymptomatic primary school children in Calabar, Nigeria using the UPC ratio.Methodology: This was a descriptive cross-sectional study of 1,600 apparently healthy primary school children aged 5 to 12 years recruited by multi-stage sampling. Urinalysis using dipstick was performed and those with significant proteinuria (proteinuria ≥ 1+) had urinalysis repeated after two weeks. Those with persistent proteinuria were quantitated using the modified Biuret method while urine creatinine was measured with the modified Jaffe Kinetic method (done with the Biolabo creatinine kit). Urine protein:creatinine ratios > 0.20 were confirmed as persistent proteinuria.Results: Out of the 1,600 pupil, 761(47.6%) were males and 839(52.4%) females, giving a male to female ratio of 1:1.1. The mean age was 8.7 ± 1.9 ranging from 5-12 years.The modal age group was 9-10 years. The prevalence of persistent proteinuria using the dipstick urinalysis was 1.8% while with the UPC ratio was 1.6%. There was a high female preponderance 19 (1.2%) of persistent proteinuria, which was statistical significant. Age and social class did not contribute significantly to having persistent proteinuria.Conclusion: The prevalence of persistent proteinuria in these asymptomatic children using UPC ratio was almost similar to the repeat urinalysis done after two weeks. It is hereby recommended that where UPC ratio is not available a positive repeat urinalysis using first void early morning urine after two weeks can be used as persistent proteinuria. This information will enable proper treatment and follow-up which will forestall rapid progression to kidney damage.Keywords: Urinalysis,Protein: Creatinine Ratio,Asymptomatic Children

The Profile Of Congenital Malformation Among Newborn Infants In Calabar, Nigeria

Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria.Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were reviewed. The diagnosis was made clinically in 91.1% of cases; 95.5% was made postnatally and 4.5 % by prenatal ultrasonography.Results: The prevalence of CM in the institution was 10.8 per 1000 live births during the period. There was a male preponderance. The prevalence of CM was highest in mothers aged 30-34 years and in those of parity 1-2. Malformations of the alimentary canal formed the majority (44.6%) followed by musculoskeletal (19.8%), then the central nervous system (17.8%). Imperforate anus was the dominant malformation in the alimentary tract, myelomeningocoele in the central nervous system, and talipes in the musculoskeletal. Seven babies presented with multiple malformations (7.7%). A case fatality rate of 9.8% was recorded and constituted 1.4% of the total mortality within the period.Conclusion: The present study can be utilized as a database for further surveys. An indepth analytic research is necessary to determine the possible factors underlying the various types of CM encountered in Calabar and therefore to consider possible preventive measures. Facilities for prenatal and postnatal diagnosis need to be provided.Keywords: Profile of congenital malformatio

Post Neonatal Tetanus in Calabar, Nigeria: A 10 Year Review

A 10 year retrospective study of post neonatal tetanus in University of Calabar Teaching Hospital was carried out. The study period spanned from January 1, 1997 to December 31, 2006. The aim was to determine the incidence of post neonatal tetanus and associated bio-characteristics. Information was extracted from case records of children admitted with the diagnosis of post neonatal tetanus. During the period of study, sixty-seven patients were admitted with tetanus out of a total 6,026 admissions giving an incidence of 1.1%. Male to female ratio was 1.9:1. The age range was 2 - 14 years, all from low socio-economic class. About 10% of the patients were partially immunized. Portal of entry to Clostridium tetani was mostly wounds sustained during play and while executing house-hold chores. Incubation period ranged from 4 – 27 days while onset period was 1 – 6 days. Case fatality rate was 18% accounting for 3.7% of the 300 deaths recorded during the period. In conclusion, tetanus remains a problem in this sub-region. Injuries predispose to majority of the cases. Booster dose of tetanus toxoid at school entry to all children has been recommended. Keywords: Paediatric ward, Post Neonatal, Tetanus. Nigerian Medical Practitioner Vol. 54 (2) 2008: pp. 45-4