Determinants of Outcome in Febrile Children Admitted into the Emergency Rooms of Two Tertiary Hospitals in Enugu Southeast Nigeria

Introduction: Febrile illnesses have continued to be the highest causes of mortalities in children admitted to the children emergency roomsin Nigeria. This study was carried out to review the determinants of outcome in children admitted for febrile illness into the emergency roomsof two tertiary institutions in Enugu, Nigeria. Materials and Methods: This was a retrospective study of 335 children who presented with fever to the emergency rooms over one year (January–December 2018). Their case records were retrieved, and the necessary information was obtained using a structured questionnaire. Statistical analysis included odds ratio and Chi‑square test. Results: The mean age of the children was 43.20 ± 50.30 months. The mean temperature at presentation was 38.2°C ± 0.9°C. Fever of 39.0°C or above at presentation and fever duration of >2 days were significantly associated with fatal outcome. Children residing in rural areas or referred from other health facilities were more likely to die. The risk of dying from fever was highest when it was associated with diarrhea, weakness, pallor, convulsions, unconsciousness, and difficult/fast breathing. Conclusion: Most of the factors responsible for mortality in febrile children are largely preventable and treatablewhen the presentation is early. Keywords: Determinants, emergency room, febrile children, Nigeria, outcom

Proteinuria and haematuria in apparently healthy primary school children in Enugu, Nigeria

Background: Mass screening for proteinuria and haematuria is advocated, especially in resource-poor countries with non-existent health insurance policy, to enhance awareness of renal diseases. This screening increases the chance for early detection and treatment, which in turn reduces incidences of resultant kidney failures. Objective: To determine the prevalence of asymptomatic proteinuria and haematuria in apparently healthy primary school children in Enugu. Methodology: This was a cross-sectional descriptive survey involving apparently healthy primary school children in Enugu, aged 6 to 12 years, conducted from January 2018 and March 2018 through a pre-tested, caregiver administered questionnaire. Subjects were clinically examined, and samples of on-the-spot mid-stream urine collected from each participant for dipstick urinalysis. The data obtained were analyzed using the Software Package for Social Science (SPSS) version 22 for Windows Results: One thousandchildren comprising, 437 (44%) males and 563 (56%) females were selected with an age range of 6 to 12 years and a mean of 10.13 ± 1.81 years. A total of 190(19%) urinary abnormalities were noted existing as isolated proteinuria, isolated haematuria or as a combination of both. These urinary abnormalities were more in the females, higher among the early adolescents (9-12 years) with proteinuria predominating.Conclusion: Asymptomatic urinary abnormalities can easily be detected early in the course of renal disease development. A urine dipstick is an important tool in the screening program for everybody, including children of school age. It is important that screening programs be organized for these children at regular intervals and those with positive findings referred immediately for appropriate management. Keywords: Proteinuria, Haematuria, Primary school children, Prevalence. Running title: Proteinuria and haematuria in school-aged children in Enugu

A Comparison of the Performance of the Midarm Circumference and the Nelson Weight Estimation Formulas in Nigerian Children

Background: In emergencies, two commonly used weight estimation methods are Nelson and mid‑arm circumference (MAC)‑based formulae. Nelson’s method requires the child’s age while the MAC formula offers weight estimation without any prior details of the child, which is useful in our environment due to the lack of proper vital statistics documentation. Methodology: We measured the weight, height, and MAC of 1390 children aged 1–12 years. Values got from the measurements were substituted in MAC and Nelson formulae for weight estimation. The estimated weights were compared to the actual weights of the children. Results: Atotal of 1390 children were enrolled. The mean of enrolled children’s actual weight was significantly higher than the mean weight estimated using MAC and Nelson formula. MAC method overestimated weight in children 1–7 years and underestimated weight in those 8–12 years old. On the other hand, the Nelson formula underestimated weights in children 2–11 years and overestimated weight in 1 and 12-year olds. Conclusions: Both the MAC and Nelson method have their deficiencies in weight estimation. Though the Nelson formula  appears slightly more accurate than the MAC, weight estimates from both methods were mostly within the actual weight agreement limits. Keywords: Actual weight, children, comparison, formulae, mid‑arm circumference, nelso

Nutritional status of primary school children in Enugu, Nigeria using anthropometric measurements

Background: The survival and wellbeing of children is largely dependent on nutrition. Malnutrition in children can co-exist as under- and over-nutrition in the same population with varying attendant medical risks.Objective: The aim of this study was to determine the nutritional status of primary school children in Enugu North LGA, using anthropometry.Methodology: This was a cross sectional descriptive study involving primary school children aged 6-12years in Enugu. Subjects were selected using multistage sampling technique over a 3 month period. Weight and height were measured using a digital scale and a wooden stadiometer, respectively. Weight-for-age, Height- for -age and Body Mass Index-for-age z scores were then derived using the new WHO reference standards.Results: Three hundred and forty eight (40.4%) children were recruited from public schools while 512 (59.6%) were recruited from private schools. The mean age of the study subjects was 9.18 ± 1.79 years. Seven (0.8%) children were stunted, 26 (3.3%) wasted and 28 (3.3%) underweight. Overweight and obesity were observed in 73 (8.5%) and 35 (4.1%) children, respectively. Under-nutrition was more prevalent in children aged 12 years (P= 0.001) whereas males were found to be more obese than females (P= 0.02).Conclusion: There was a low prevalence of under nutrition. However, overweight and obesity appear to be emerging as nutritional problems.Keywords: Nutrition, Obesity, Stunting, Underweight, Wasting, Anthropometr