Urinary Tract Infection in Adolescent/Young Adult Nigerians with Acquired Human Immuno Deficiency Disease in Benin City

In comparison with unaffected persons, individuals infected with HIV have undue predisposition to other infections including those of urinary tract. To assess this predilection to urinary tract infection (UTI) among this cohort, 158{59 (37%) males and 99 (63%) female} of them comprising mainly adolescents and young adults with confirmed HIV infection and attending Consultant Out patient Clinic of the University of Benin Teaching Hospital (UBTH) were evaluated for UTI through culture done on mid stream urine. The study carried out between September 2003 and May 2005 was prospective and cross sectional. Ten {(6.3%), one male and 9 females} patients had positive urine culture of uro-pathogenic organisms. Only 2 (20%) of these 10 patients had urinary symptoms of dysuria and loin pain. However fever was commoner among the patients with UTI as compared to those without it (54/148 or 36.5% vs 9/10 or 90.0%, \u3c72 =9.01, p<0.5). Urinary pathogens were Escherichia coli 5 (50%), Klebsiella species 3 (30%) and Staphylococcus aureus 1 (10%). In vitro sensitivity revealed that Escherichia coli and Klebsiella species were 100% sensitives to ofloxacin, 100% and 66.7% respectively to ciprofloxacin but completely resistant to cotrimoxazole, amoxicillin and clavulanic-acid potentiated amoxicillin. The adolescent/ young adult with HIV infection has enhanced risk of having UTI caused by similarly implicated organism in otherwise apparently health cohorts of comparable age bracket

An Assessment of Current Management of Childhood Urinary Tract Infections Amongst Private Medical Practitioners In Benin City, Nigeria

Private Medical Practitioners (PMPs) manage substantial number of children with urinary tract infection (UTI) in Benin City, Nigeria. Evaluating the management of this condition is considered worthwhile because of sequele of improper treatment. The study was conducted through use of questionnaire amongst PMPs in two Local Government Areas of Egor and Ikpoba– Okha. Subjects comprised 133 (80.1%) males and 33(19.9%) females. Twenty-three (13.6%) respondents had postgraduate qualifications, while majority (72.9%) graduated between 1991 – 2000. Majority of respondents preferred early morning and mid stream urine for patients' evaluation. Escherichia coli, Staphylococcus aureus and Proteus mirabilis were the commonest isolates listed. Their knowledge of predisposing factors and complications following UTI was appreciable. A third would give chemoprophylaxis for repeat infection(s) in females while only 6% would refer such patients to specialists. Reasons that warranted referral varied from inability to pay fees to appearance of complication(s) in the course of treatment. Half of the respondents preferred use of multiple antibiotics because of need to ensure adequate anti-microbial coverage, effective therapy, prevention of resistance and cost effectiveness. Ampicillin, cotrimoxazole and unexpectedly, quinolones plus tetracycline featured as first line drugs amongst 34% of respondents. In conclusion the knowledge and attitude of the average PMP to childhood UTI is at best fair. However, some practices are clearly at variance with current recommendations. Continuing Medical Education is recommended for bridging the gap between current practices and accepted norm amongst PMPs to enhance patients' care. Key Words : UTI, Children , Private Medical Practitioners, Benin. Nigerian Medical Practitioner Vol.45(5) 2004: 72-7

Niveaux de tocophérol-alpha dans le lait des mères qui nourrissent leurs bébés exclusivement au sein à Benin City

The influence of prolonged breastfeeding on breast-milk alpha tocopherol was assessed in 112 lactating mothers practicing exclusive breast-feeding on term infants. The cross sectional study was carried out between May 1st and 30th, 2005 at the University of Benin/University of Benin Teaching Hospital, Benin City among lactating mothers. Employing the Quaife’s method, mean alpha-tocopherol values were determined in spot samples of breast milk. Though not significant mean Breast-milk (BM) alphatocopherol tended to decline with maternal age (p > 0.05) parity (p > 0.05) and duration of breastfeeding. Similarly, family socio-economic status did not significantly influence mean BM alphatocopherol levels. Exclusive and or prolonged breast feeding do not predispose the infant to low vitamin E supplies through the breast milk. Further studies are advocated to evaluate the effects of other biosocial variables on the levels of BM anti-oxidant vitamins including alpha-tocopherol (Afr J Reprod Health 2009; 13[2]:55-60).Nous avons évalué l’influence de l’allaitement prolongé sur le tocophérol-alpha du lait maternel chez 112 mères allaitant qui pratiquent l’allaitement exclusive de leurs enfants nés à terme. L’étude transversale a été effectuée entre le 1e et le 30 mai 2005 à l’University of Benin Teaching Hospital auprès des mères allaitant. A l’aide de la méthode Quaife, les valeurs moyennes du tocophérolalpha ont été déterminés à travers des échantillons de taches du lait maternel. Quoique peu significatif, le lait maternel moyen (mm) du tocophérol-alpha avait la tendance à baisser avec l’âge maternel (p<0,05), la parité (0,05) et la durée de l’allaitement. De la même façon, la situation socio-économique familiale n’a pas influencé de manière significative les niveaux du tocophérol-alpha BM moyen. L’allaitement exclusif ou prolongé ne prédispose pas l’enfant à une provision baissée de la vitamine E à travers le lait maternel. Nous préconisons davantage d’études pour évaluer les effets d’autres variables biosociaux sur les niveaux des vitamines anti-oxidantes BM y compris le tocophérol-alpha (Afr J Reprod Health 2009; 13[2]:55-60)

Familial prune belly syndrome in a Nigerian family

A case of Prune Belly Syndrome in an infant, the second in a middle class family with both parents in their late thirties, is presented because of its rarity. Constraints in the manage-ment are discussed and relevant literature reviewed. This is intended to awaken interest and sharpen indices of suspicion that would facilitate early diagnosis, enhance management, and mitigate prejudices

Microalbuminuria in children with sickle cell anemia

Microalbuminuria (MA) is an early marker of various diseases affecting the renal system. Its relevance in children with sickle cell anemia (SCA), who are known to be prone to renal complications, has not been fully explored, particularly in the study locale. Besides, its occurrence in this group of patients remains under-reported in locations where the burden of SCA is enormous. To assess its prevalence in this cohort, 69 children with sickle cell anemia (in their steady state), aged 1-16 years, were consecutively enrolled and evaluated. The study, spanning from November 2006 to February 2007, was cross-sectional and descriptive. Employing a semiquantitative method, MA in an early morning spot urine sample was determined in each subject. Also evaluated were the anthropometry, blood pressure (BP) and packed cell volume. Prevalence of MA in the study subjects was 20.3%. Though not significant, prevalence of MA was more in females (25.9%) than in males (16.7%). Prevalence of MA increased with increasing age and was also significantly associated with weight (P = 0.033), but was independent of family history of hypertension. BP recordings, both systolic and diastolic, in the study subjects were within normal range. MA occurs significantly enough in children with SCA to warrant routine screening for it. Such a measure could assist in the early detection of ensuing renal complications and can pave way for improved management of a sickler who is particularly prone to such problems. In addition, interventional measures, known to retard rate of deterioration of kidney function due to prolonged proteinuria, could also be instituted early

CAREGIVERS’ VECTOR CONTROL METHODS AND ITS IMPACT ON MALARIA HEALTH INDICES IN UNDER-FIVES PRESENTING IN A TERTIARY HEALTH INSTITUTION IN NIGERIA

Background and aims: Integrated vector control especially use of insecticide-treated bed nets have been reported as effective malaria preventive strategies. This study aimed at documenting factors that influence regular use of insecticide-treated nets in under-fives and impact of vector control methods on malaria outcome (severe malaria prevalence and mortality) in under-fives presenting in tertiary health institution in Benin City, Nigeria.Methods: Cross-sectional study carried out from June 2012 and July 2013. Data was obtained by researcher-administered questionnaire and malaria was confirmed in each child by microscopy.Results: 329 caregiver (31.2 ± 6.0 years) /child (20.7 ± 14.0 months) pair were recruited. Netting of doors/windows (80.0%) was the most practiced vector control method. 177 (53.8%) caregivers possessed insecticide-treated bed nets, and only a quarter of their under-5s regularly sleep in these nets. Children from lower social class statistically significantly sleep in the nets (p = 0.03), however, presence of 2 or more nets in a household independently predicted its regular use for the under-5s (β = 1.09, OR = 3, p = 0.02). Prevalence of severe malaria was 36.2% and mortality was 52 per 1000. Combination of regular use of insecticide treated nets, environmental sanitation, indoor insecticide spray and netting of household doors/windows significantly predicted low prevalence of severe malaria compared to each of the malaria vector control methods used singly by the caregivers (β = 1.66, OR =5.0, p = 0.04).   Conclusions: Integrated vector control remains the most effective method of malaria vector control at the community