Clinical presentation of congenital malaria at the Lagos University Teaching Hospital

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Awareness and use of Gross Motor Function Classification System (GMFCS) by health professionals in a developing country

Introduction The degree of disability in children with Cerebral Palsy (CP) can be evaluated with the Gross Motor Function Classification System (GMFCS), a valid tool which was designed for such purposes. However, there appears to be paucity of data on the awareness and use of the GMFCS particularly in the Sub-Saharan continent where the condition is still prevalent. Thus, this study aims to describe awareness, use, merits and demerits of the GMFCS system as perceived by health professionals who take care of children with CP.Methods: This was a cross sectional study of health professionals from three Nigerian teaching hospitals. Information obtained via structured questionnaire were demographic data, years of qualification, years of experience of working with children with CP, awareness, use, merits and demerits of the GMFCS. Factors associated with use of the GMFCS were also evaluated with the Chi-square analysis.Results: 78 health professionals participated in the study and majority (58.9%) were doctors. 55 (70.5%) of the study participants were aware of the GMFCS but only 33(42.3%) were using it. The nurses were neither aware of the system nor using it. A higher proportion of therapists (65.4%) were familiar with the system compared to the doctors (54.3%) . The location of practice was significantly associated with the use of the GMFCS (p=0.013). More doctors noted the merits and demerits of the system compared to the therapists.Conclusion: Though health professionals were aware of the GMFCS only a small proportion was using this vital tool in the clinical setting. Thus, there is the need to create more awareness on GMFCS and its clinical utility, and the training of nurses should be of paramount importance in the developing country.Key words: Awareness, cerebral palsy, gross motor function classification system, developing countr

Herpes simplex encephalitis

No Abstract

Diagnosis of Plasmodium falciparum malaria in children using the immuno-chromatographic diagnostic technique

Background: Children under five years of age constitute the “at risk” population for fatal complications of P. falciparum malaria infection. Early diagnosis and prompt treatment are key features in the current Roll Back Malaria Programme.Objective: To assess the diagnostic performance of the Immunochromatographic test (ICT) in the rapid diagnosis of falciparum malaria infection in children aged less than five years with a presumptive clinical diagnosis of malaria.Method: This prospective study was conducted at the Children Emergency Room of the Lagos University Teaching Hospital between January and October 2001. Febrile children aged less than five years and were suspected to have malaria, were enrolled. Blood samples from all patients were tested using the ICT-Malaria P f Ò test kit as well as the conventional blood film microscopy after Giemsa staining. Results: The results showed that the diagnosis of falciparum malaria was achieved within eight minutes using the ICT-Malaria P f Ò test kit. The sensitivity of the test kit was 69.6 percent while the specificity was 98.4 percent. However, among patients with severe malaria, the ICT had a sensitivity of 90.3 percent. The test kit was unable to detect antigenaemia at parasite density below 400/ml. An increase in body temperature was associated with higher rate of ICT test positivity.Conclusion: The low sensitivity of the ICT technique obtained in this study makes it a poor screening tool for the routine diagnosis of falciparum malaria in children aged 0-5yrs. It may be useful in the rapid diagnosis of suspected severe malaria in febrile children. The high cost of the test kit is likely to prove a major limitation to its widespread use. Nigerian Journal of Paediatrics Vol. 31(3) 2004: 71-7

Oxidative Stress Markers and Genetic Polymorphisms of Glutathione S-Transferase T1, M1, and P1 in a Subset of Children with Autism Spectrum Disorder in Lagos, Nigeria

Background: The role of oxidative stress has been identified in the development of autism spectrum disorder (ASD), and polymorphisms of glutathione S-transferase have been associated with some diseases linked to oxidative stress. Hence, we evaluated the serum levels of oxidative stress markers and investigated genetic polymorphisms of glutathione S-transferase associated with autism. Materials and Methods: Forty-two children clinically diagnosed with ASD using the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria and a clinical interview were included in the study. Twenty-three age-matched controls without any known genetic/developmental disorder were also recruited. Oxidative stress markers along with the genetic polymorphisms of glutathione S-transferase were determined. Results: Reduced glutathione in ASD patients was significantly lower than the control (P = 0.008), whereas other oxidative stress markers measured were not significantly different in both the control and case populations. The frequencies of GSTT1 and GSTM1 null genotypes were lower among the controls compared with the cases, however, no association risk was observed. The observed risk of carrying Val/Val genotype among the cases was approximately six times that of the controls. Conclusion: Individuals with ASD showed a significant diminished level of reduced glutathione, however, the distribution of GSTT1, GSTM1, and GSTP1 polymorphisms was not found to be associated with autism in this study population.Keywords: Autism, genetic polymorphisms, glutathione S-transferase, Nigeria, oxidative stres