Stroke in children with sickle cell anaemia in Sokoto: a ten-year review

Objective: Stroke (cerebrovascular accident) generally occurs more often in children than once suspected, with its attendant potential consequences. It is an under recognized cause of neurologic disabilty in children, with varied causes. Stroke is a devastating and potentially life threatening complication of sickle cell anaemia (SCA). Children with sickle cell haemoglobinopathy have a life time increased risk of developing a stroke. This study aims to assess the pattern of stroke presentation among SCA children in Sokoto, North-Western Nigeria.Methodology: A review of all the clinical records of children with SCA who were diagnosed and managed for sickle cell related stroke at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria, over a ten-year period (May, 2004 – April, 2014) was undertaken. Data analysis was done using the statistical package for social sciences (SPSS) version 20.Results: Fifteen cases of Paediatrics stroke were identified, out of a total of 416 registered children with SCA, giving a stroke prevalence of 3.6%. Male: Female ratio was 1:1. All the stroke cases were of haemoglobin SS electrophoresis; with a mean age at diagnosis of SCA of 2.2 (±1.5) years and mean age at stroke onset of 6.3 (±2.8) years. Mean time of hospital presentation after the stroke onset was 10 (±2.5) days. Hemiparesis and expressive aphasia were the predominant presenting features. Based on the neuroimaging findings, majority of the stroke types were infarctive (71.4%). No mortality was recorded.Conclusion: The prevalence of sickle cell related childhood stroke of 3.6% in this series is relatively low. Majority of the patients presented to hospital very late, after the stroke onset. There is therefore the need for increased awareness on childhood stroke in our community, in order to facilitate early hospital presentation and prompt management to improve the outcome.Keywords: Paediatric stroke, Sickle cell anaemia, Late Presentation, Outcom

Prevalence and clinical forms of malaria among febrile HIV-infected children seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Background: Malaria and HIV infections are major health problems facing the world today. Sub-Saharan Africa with 10 percent of world’s population harbors more than half the burden of the scourge. The present study determined the prevalence and clinical forms of malaria among febrile HIV-infected children aged 3months to 15years, seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria.Materials and Methods: Cross-sectional study among febrile HIV-infected children and their control cohort were carried out between May and October 2016. The participants had the following investigations: malarial parasite, packed cell volume, random blood sugar, retroviral test.Results: A total of 140 febrile HIV-infected children aged 3 months to 15 years and 140 febrile HIV-negative age- and gender-matched children were recruited; 100 of the HIV-infected children were on ART and cotrimoxazole. The prevalence of malaria among the febrile HIV-infected children was 71.4% (100/140) which was significantly lower than the prevalence of 94.3% (132/140) among the control group (χ2 27.72, p=0.001). Among the febrile HIV-infected children that had malaria, 54(54.0%) had uncomplicated malaria while 46(46.0%) had severe malaria. Of the 132 controls that had malaria, 48(36.4%) had uncomplicated malaria and 84(63.6%) had severe malaria (χ2 =7.184, p=0.007).Conclusion: Malaria is a problem in HIV-infected children. Since nearly half of the febrile HIV-infected children had severe form of malaria, it is recommended that health promotion, intermittent malaria prophylaxis, early diagnosis and prompt effective treatment should be instituted for HIV-infected children. This may prevent severe form of malaria and its attendant mortality. Key words: Malaria; Prevalence and clinical forms of malaria; Febrile, HIV-infected, Sokoto state

Home management of childhood diarrhoea among mothers in Sokoto, Nigeria.

Diarrhoea diseases are major causes of childhood morbidity and mortality in developing countries. Treatment guidelines by the World Health Organization indicate that most cases of childhood diarrhoea can be treated at home by increased fluid intake and continued feeding during diarrhoea episodes. The aim of this study was to determine the knowledge, perception and practice of home management of childhood diarrhoea with ORS/SSS among mothers in Sokoto Metropolis. The study design was a cross-sectional descriptive study. Multistage sampling technique was used to select respondents. Pre-tested, structured, open and close-ended interviewer administered questionnaires and observer checklist were used for data collection. A total of 423 respondents were interviewed. The mean knowledge score (%) was 59.7±23.0. Majority (62.9%) knew correctly that diarrhoea is said to occur when a child passes loose stool more than three times within 24hours. Majority (81.1%) knew that diarrhoea can be caused by contaminated water; however, 32.4% were also of the view that evil eye is the cause of diarrhea. Majority (73.7%) of the mothers believed that ORS/SSS is the best method for home management of diarrhea while 11.1% believed it is harmful to the child.Agreat proportion (90.5%) of those who had attempted to manage diarrhoea at home reported that the child's condition improved. In conclusion this study has demonstrated high level of knowledge of home management of childhood diarrhoea using ORS/SSS among the study subjects. There is therefore need for more enlightenment campaigns to improve and sustain the knowledge. The use of ORS/SSS for home management of childhood diarrhoea should be included in the curriculum of females and perhaps males as well in secondary schools.Keywords: Laboratory results, clinical diagnosis, malari

Accuracy of dipstick urinalysis as a screening method in detecting hematuria in asymptomatic primary school children

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