Assessment of Physical Growth in Male Children Infected with Human Immunodeficiency Virus on Highly Active Antiretroviral Therapy in Abakaliki

Background: Human immunodeficiency virus (HIV) infection causes a derangement in growth. Antiretrovirals promote immune function restoration and improvement in the quality of life. Variables such as poor adherence to drugs and unsuppressed viral load may negatively influence growth in HIV-infected children. The study aimed at determining the growth in HIV-infected males aged 8–17 years in Abakaliki who were on antiretrovirals. Methods: Acase–control hospital-based study, involving 80 HIV-infected males aged 8–17 years who were matched for age and socioeconomic class with 80 HIV‑uninfected controls. Growth parameters including the heights, weights, and body mass index (BMI) of subjects and controls were measured, and Z scores for age derived for height, weight, and BMI. Results: The mean height of subjects (1.420 ± 0.18 m) was significantly lower than that of controls (1.515 ± 0.17 m). The mean weight of subjects (35.09 ± 12.48 kg) was significantly low compared to controls (42.21 ± 12.95 kg). A significant difference was documented in the mean BMI for age among subjects (16.78 ± 2.12 kg/m2 ) and controls (17.93 ± 2.27 kg/m2 ). There was a significant relationship between CD4 count and growth (BMI) (P = 0.006) and between duration on highly active antiretroviral therapy and growth (P = 0.024). Conclusion: HIV‑infected males had significantly impaired growth despite the use of antiretroviral drugs. Keywords: Children, human immunodeficiency virus antiretroviral drugs, males, physical growt

Maternal Diet during Exclusive Breastfeeding can Predict Food Preference in Preschoolers: A Cross-Sectional Study of Mother- Child Dyads in Enugu, South-East Nigeria

Background: The relationship between food preference in early childhood and prenatal exposure to flavor in the amniotic fluid is well documented. Although its association with flavor transmission in the breast milk has also been noted, it is poorly reported in this country. Objective: The present study aims to determine the relationship between mothers’ dietary exposure during exclusive breastfeeding and food preference in their preschool-aged children. Methods: Two hundred and twenty (220) mother-child dyads who met the study criteria were enrolled. A pre-tested, structured questionnaire was administered to the mothers. The relationship between maternal consumption of flour-based snacks and staple foods during exclusive breastfeeding and the child’s preference for these foods was determined using risk estimates. After controlling for potential confounders, logistic regression was used for multivariate analysis. Statistical significance was determined at p < 0.05 and all the risk estimates were presented as odds ratios (OR) at 95% confidence intervals (CI). Results: The relationship between daily maternal exposure to staple foods during exclusive breastfeeding and the children’s preference for this variety of food was not statistically significant (p = 0.847, OR= 1.083, 95% CI = 0.481-2.437). However, the children’s preference for flour-based snacks was significantly related to weekly or fourth-nightly maternal exposure to similar diet during exclusive breast feeding (p = 0.035, OR = 2.405, 95% C.I = 1.064 - 5.435). Conclusion: Transmission of flavor in the breast milk may contribute in shaping children’s feeding behavior early in life

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

Communiqué issued at the end of a 3-day stakeholders’ meeting on the second edition of Nigeria research days for maternal newborn and child health with the theme “Integration of mental health into reproductive and community health : community mobilisation and engagement” - Wuse II Abuja, Nigeria, 24th to 26th September, 2019

This second workshop promoted by the West African Health Organization (WAHO) shared research findings from three IMCHA projects in Maternal, Newborn, Child and Adolescent Health plus Nutrition (MNCAH+N) in Nigeria, and discussed the use of research in decision making in MNCH. It also enhanced the capacity of stakeholders to use the regional evidence-based policy making guidance tool. The report briefly outlines workshop activities along with concluding recommendations.Canadian Institutes of Health Research (CIHR)Global Affairs Canada (GAC

Validation of Pediatric Height Estimation Formulae in Suburban Communities in South-east Nigeria: A Cross-sectional Study.: Validation of Pediatric Height Estimation Formulae

Background: Height measurement is one of the common essential anthropometric measurements in clinical pediatrics. The most accurate method of determining a child  height is to  measure the height. However, in emergency situations and some resource limited settings, obtaining the actual height of a child may not be feasible hence the need to estimate. The most common age-based formulae for height estimation in children is 6n + 77 where n = age in years. The accuracy of this height estimation formulae has not been assessed in developing setting like ours with high prevalence of malnutrition. This study therefore sought to evaluate the accuracy of the height estimation formula in children in communities across Enugu southeast Nigeria. Method: Children 2-12 years old who met the inclusion criteria were enrolled over 12 months from three of the 17 Local Government Area of Enugu State. Height was measured using a standard stadiometer and estimated height was calculated 6n + 77. Data collected was analyzed using SPSS. Result: Of the 4046 children enrolled, majority (86.1%) were of normal height for age while 2.6% were stunted. The formula underestimated height of children in younger age bracket and overestimated height in older children. Overall, the estimated height using the formula was within ±10% agreement of the actual height of surveyed children in 77.0% of children surveyed. Conclusion: The 6n + 77 formula is a reasonable but not entirely accurate for height estimation for children in our setting. Keywords: Children, Height, Estimation, Accurac

Socio-demographic determinants of malnutrition among primary school aged children in Enugu, Nigeria

Introduction: Several factors including the parental literacy, illness, socioeconomic status, poor sanitation and hygienic practices affect the physical growth of children. The aim of this study was to determine the socio-demographic determinants of malnutrition among primary school aged children in Enugu, Nigeria.Methods: A cross-sectional descriptive study involving primary school children in Enugu was carried out over a 3 month period. Subjects were selected using multistage sampling technique. Weight and height were measured using a digital scale and a wooden stadiometer, respectively. Body Mass Index (BMI), weight-for-age (WAZ), Height-for-age (HAZ) and BMI-for-age z scores were then derived using the new WHO reference standards.Results: 348 children (40.4%) were recruited from 5 public schools while 512 (59.6%) were recruited from 9 private schools. The mean age of the study participants was 9.2 ± 1.8 years. 7 (0.8%) children were stunted, 26 (3.3%) wasted and 28 (3.3%) underweight. Of all the study participants, overweight and obesity were observed in 73 (8.5%) and 35 (4.1%) children, respectively. Children of lower socioeconomic class were more stunted, underweight and wasted, while overweight and obesity were more prevalent among children from the upper socioeconomic class.Conclusion: Factors such as age and sex, parental education and socioeconomic class had a significant impact on nutritional status. Overweight and obesity were more prevalent among the children from the upper socioeconomic class, attending private schools, while stunting and wasting were more in children of the lower class attending public schools.Keywords: Socio-demographic, malnutrition, school-age, children, Enug

Academic performance and intelligence quotient of primary school children in Enugu

Introduction: intellectual capacity measured as intelligence quotient (IQ) is one of the determinants of school performance of children. It influences academic achievement, future personal health, social well-being and therefore, is of public health significance. The objectives of the study was to determine the intelligence quotient (IQ) and academic performance of primary school children in Enugu-East LGA. Methods: children who met the inclusion criteria were recruited from both public and private primary schools in the Local Government Area (LGA) using a proportionate multistage sampling technique. Academic performance was classified into high, average and low academic using past records of class assessment. Intelligence Quotient was assessed using the Raven´s Standard Progressive Matrices (RSPM) and was grouped into optimal and suboptimal. A semi-structured questionnaire was used to obtain data such as-age, gender, socio-economic indices and family size of the study participants. Analysis was done with Statistical Package for Social Sciences (IBM-SPSS). Results: a total of 1,122 pupils aged 6 to 12 years were recruited. Optimal IQ and high academic performance was found in 54.0% and 58.8% of the study participants. Being from upper social class, in private school, and family size less than 4 were the significant determinants of high IQ and good academic performance (p<0.001). Conclusion: low socio-economic status, large family size and public school attendance impact negatively on IQ and academic performance. Hence, measures to curb large family sizes (i.e.>4 children) and improve the socio-economic status of families are needed environmental measures to improve intelligence and academic performance

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

Perception of donor breast milk and determinants of its acceptability among mothers in a developing community: a cross-sectional multi-center study in south-east Nigeria

Abstract Background Due to the health and economic benefits of breast milk, the World Health Organization (WHO) recommends that for infants who cannot receive breast milk from their own mothers, the next preferred option is donated breast milk. This recommendation is however rarely practiced in most developing countries where donor milk is not widely accepted. Methods This cross-sectional multi-center study enrolled mothers attending antenatal or pediatric clinics in six tertiary institution in south-east Nigeria using purposive and convenient sampling method. Data collection was done using pretested questionnaires. The study aimed to assess the knowledge, acceptability and willingness to donate breast milk and/or use donated breast milk for their infants It also explored factors that determine this behavior. Results A total of 1235 mothers participated; 39% (480/1225) have heard about the concept of donor milk, while only 10% (79/759) and 7% (81/1179), respectively, had adequate knowledge of the concept and policy on donor milk. Sixty percent indicated willingness to use donor milk or donate breast milk if need arises. Respondents with lower age (p = 0.049) and with higher occupational status (p = 0.001) were more likely to have adequate knowledge of donor breast milk, while respondents with lower educational attainment (p = 0.002) and those who are non-Christians (p = 0.004) were more likely to request financial inducement for donating their breast milk. Adequate knowledge of the concept of donor milk (p = 0.001), preference of donor milk to infant formula (p = 0.001) and requirement of financial remuneration (p = 0.001) were the only significant predictors of willingness to donate and/or receive donated breast milk. Conclusion The knowledge of the concept of donor breast milk and awareness of policies regulating its practice in Nigeria is low, but the prospect of its acceptability is high among mothers surveyed in south-east Nigeria. Targeted public education by relevant government agencies in collaboration with clinicians, community and religious leaders about the concept of donor breast milk to families may help increase the acceptance and practice of donating breast milk and/or use of donated breast milk among mothers in the region

Factors associated with common mental disorders among breastfeeding mothers in tertiary hospital nurseries in Nigeria.

BackgroundSeveral studies have shown that the impact of maternal mental health disorders on newborns' well-being in low and middle-income countries (LMIC) are underreported, multi-dimensional and varies over time and differs from what is reported in high-income countries. We present the prevalence and risk factors associated with common mental disorders (CMDs) among breastfeeding mothers whose infants were admitted to Nigerian tertiary care facilities.MethodsThis was a national cross-sectional study involving mothers of hospitalised babies from eleven Nigerian tertiary hospitals. We used the WHO self-reporting Questionnaire 20 and an adapted WHO/UNICEF ten-step breastfeeding support package to assess mothers' mental health and breastfeeding support.ResultsOnly 895 of the 1,120 mothers recruited from eleven tertiary healthcare nurseries in six geopolitical zones of Nigeria had complete datasets for analysis. The participants' mean age was 29.9 ± 6.2 years. One in four had CMDs; 24.0% (95% CI: 21.235, 26.937%). The ages of mothers, parity, gestational age at delivery, and length of hospital stay were comparable between mothers with and those without CMDs. Antenatal care at primary healthcare facilities (adjusted odds ratio [aOR:13], primary education [aOR:3.255] living in the south-southern region of the country [aOR 2.207], poor breastfeeding support [aOR:1.467], polygamous family settings [aOR:2.182], and a previous history of mental health disorders [aOR:4.684] were significantly associated with CMDs. In contrast, those from the middle and lower socioeconomic classes were less likely to develop CMDs, with [aOR:0.532] and [aOR:0.493], respectively.ConclusionIn Nigeria, the prevalence of CMDs is relatively high among breastfeeding mothers with infants admitted to a tertiary care facility. Prior history of mental illness, polygamous households, mothers living in the southern region and low or no educational attainment have a greater risk of developing CMDs. This study provides evidence for assessing and tailoring interventions to CMDs among breastfeeding mothers in neonatal nurseries in LMIC