Socio-demographic correlates of childhood malnutrition in a rural community in Southwest Nigeria - A call for targeted interventions for vulnerable children

BACKGROUND: Nigeria has the second-highest burden of stunted children globally. Yet, only two out of ten malnourished Nigerian children benefit from intervention programs to address malnutrition. This study describes some socio-demographic factors associated with malnutrition among children living in a rural community in Southwest Nigeria. METHODS: This study was a community-based cross-sectional study involving 364 children randomly selected from their homes aged 1–15 years. Factors such as socioeconomic status, birth order, and whether the mother was alive were obtained. Weights, heights, and body mass index (BMI) were measured and interpreted using the WHO z-scores. Chi-squared test of associations was used for categorical variables and an independent t-test was used to compare the mean BMI between both genders. The level of significance was set at a p-value <0.050. RESULTS: There were 185 (51%) females: 173(48%) belonged to the age group 1–5 years and 168 (46%) belonged to the lower socio-economic class. Over 80% of the participants had normal nutritional status: 19 (6%) were underweight, 36 (10%) were stunted, and 29 (8%) were thin (low BMI, <-2SD). Maternal demise was associated with thinness. Males from lower socio-economic classes and first-born males had a higher mean BMI than the females (p<0.050). CONCLUSION: Although malnutrition prevalence was low, there is a need to use targeted interventions to further reduce malnutrition among vulnerable children. There is also a necessity for more studies to identify and address the risk factors for stunting in the study area

Paediatric brought-in-dead at a tertiary health facility in South western Nigeria: Patterns and drivers

Background: ‘Brought- in-dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross-sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety-eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under-fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19 (19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre-hospital treatment was received (p < 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p < 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors drivingits menace

Influence of composting and thermal processing on the survival of microbial pathogens and nutritional status of Nigeria sewage sludge

Abstract Purpose Sewage sludge samples from a water treatment plant in Nigeria were subjected to an in-vessel composting (using sawdust as a bulking agent) and thermal sludge processing to improve its quality for agricultural applications. Methods Treated samples were analyzed for physicochemical and microbiological properties using standard analytical and aerobic culture protocols. Results Microbiological analysis of the initial fresh mixture (sewage sludge/sawdust) showed that the total heterotrophic bacteria was 1.17 × 106 CFU/g of fresh compost, coliforms 4.7 × 104 CFU/g, Salmonella sp., and Shigella sp. 7.3 × 104 CFU/g, yeasts and moulds 9.0 × 104 CFU/g. These values were significantly (p = 0.05) reduced after 40 days of in-vessel composting to 4.3 × 104 CFU/g for total heterotrophic bacteria, 7.4 × 102 CFU/g for coliforms, while yeasts and moulds, Salmonella and Shigella sp. were not detected in the final compost. The results of the physicochemistry revealed variation in pH, temperature, and nutrients status of treated sludge. Conclusion Salmonella sp., Staphylococcus aureus, and Shigella sp. were eliminated, while a 2-log reduction in coliform counts occurred after 40 days of composting. Composting had a better processing impact by increasing the ash as well as reducing the carbon/nitrogen ratio of treated sludge, while thermal processing improved the sulfate and phosphate components of treated sludge. The treated sludge (biosolids) met the permissible limits of microbiological and nutritional standards recommended by US EPA for land application of sludge and could, therefore, be used as a biofertilizer, soil conditioner and also for land reclamation