Caregivers’ perceptions of childhood fever in Ilorin, North-Central Nigeria

Background: Fever remains a common clinical indicator of disease, accounting alone for over 25% of paediatric emergency rooms  consultations. Perception of this important sign is a crucial prelude and determinant of outcome in febrile children. The aim was to determine knowledge and attitudes of parents regarding fever in their children.Methods: The study is a crosssectional descriptive study carried out at the Emergency Paediatric Unit of the University of Ilorin Teaching Hospital (UITH). Fourhundred under-five children presenting with fever wererecruited along with their caregivers. A semi-structured questionnairewas administered to collect information on sociodemographics, and caregiver’s knowledge and attitudes regarding fever in their wards.Results: The mean age of the caregivers was 29.5 ± 4.46 years (Range 21 – 41 years). Only 30.3% of caregivers could correctly describe what fever was. The most frequently utilised fever detection method was tactile assessment. Only 3.2% of the caregivers used a thermometer to detectfever. Social class, maternal age and religion significantly influenced the decision to use thermometers. The most common remedies caregivers would use for fever in their children were to give paracetamol (96.3%), sponging (73.2%) and a warm bath (63.8%). About 61% of caregivers had a wrong perception of the possible complications of fever.Conclusions: Caregivers in this study had a poor knowledge of fever, and parental educational and socioeconomic status impacted on their responses to fever. There is a need for education of caregivers at all contacts with the healthcare system on fever, and its management. Keywords: Antipyretic, Attitude, Fever, Thermometr

Socio-demographic and clinical characteristics of asthmatic children seen at Aminu Kano Teaching Hospital, Kano, Nigeria

Introduction: Asthma is a chronic inflammatory disorder associated with variable air flow obstruction and bronchial hyperresponsiveness. It is characterised clinically by recurrent episodes of cough, difficulty in breathing and wheezing which resolves spontaneously or with treatment. Thesocio-demographic and clinical characteristics of asthmatic children in north western Nigeria have not been reported.Methods: This was a descriptive study in children with asthma aged 4-15 years carried out over a 3 month period Aminu Kano Teaching Hospital (AKTH), Kano. The aim was to determine the socio-demographic and clinical parameters of asthmatic children. Asthmatic children whoseparents or guardian consented to the study were recruited consecutively. Their bio-data, sociodemographic and physical examination were documented.Results: Seventy asthmatic children were recruited of which 50(71.4%) were males and 20(28.6%) were females, giving a male: female ratio of 2.5:1. Insecticide was the commonest asthma trigger (64.3%) and 26(37.1%)patients belonged to socio economic class III. Mild persistent asthma was the commonest form of asthma severity encountered. There was positive correlation between PEFR and height (r = 0.577, p< 0.0001).Conclusion: Most of the asthmatics children seen at AKTH, Kano were males with mild persistent asthma, had positive family history of atopy and belonged to the middle socio economic class.Key words: Asthma, Children, Socioeconomic class, Asthma severit

Childhood pneumonia at the University of Ilorin Teaching Hospital, Ilorin Nigeria

Background/Objectives: Pneumonia is a leading cause of morbidity and mortality in children and thus this study was designed to document the sociodemographic, clinical features as well as the bacterial agents  responsible for pneumonia in children seen at University of Ilorin Teaching Hospital.Methodology: A descriptive cross -sectional study of children aged one month to 14 years with features of pneumonia admitted between July 1st 2010 and June 31st, 2011 was carried out. Sociodemograpic data, clinical features, complications and outcome were obtained. Chest radiographs and blood samples for culture of bacterial organism and full bloodcounts were obtained in all children.Results: Pneumonia accounted for 13.3% (167 out of 1254) of the all admissions during this period. The male: female ratio was 1.5:1, and 101(60.5%) of the children were infants. Bronchopneumonia was identified in 147(88%) children, lobar pneumonia in 15 (9%) while 5(3%) had a combination of both. Cough, fever, difficulty in breathing, tachypnoea andchest wall recessions were recognised as clinical features in the study population. Bacteraemia was present in 46(27%)children and Staphylococcus aureus was the most common organism cultured from the blood of children with pneumonia present in 11 (23.9%) out of the 46 (100.0%) isolates. Heart failure was associated complication present in 52 of the 60 children with one or more complications accounting for over 30% of all patients. Eleven out of the 15 children with lobar pneumonia hadpneumonia-related complications which was significantly higher compared to 46 of 157 children with bronchopneumonia, p=0.003. The case fatality was 6.6%. Eight (72.7%) of the children that died were infants while the remaining three (27.3%) were aged between 12 and 60 months. The mean duration of hospitalization among those who survived of 6.5 ±5.0 days was significantly lower than the corresponding value of 10.2 ±12.3 days in those that died, p= 0.042. Conclusion: Pneumonia-related mortality and morbidity is high in under-five children, with the infant age group most affected. Bronchopneumonia is the most prevalent ALRI diagnosis but lobar pneumonia is associated with a higher mortality

Anhidrotic ectodermal dysplasia: a case report in a Nigerian child and literature review

This report of Hereditary anhidrotic ectodermal dysplasia (HAED), a genetic disorder characterized by abnormalities of structures of ectodermal origin, was informed by its rarity, and its import for survival in a tropical environment. The five-year old male was first seen on account of inability to cut the front teeth, and a persistent offensive nasal discharge. He had heat intolerance and inability to perspire from early infancy. Pedigree evaluation revealed that both parents are Nigerians and unrelated, but the maternal front dentition was visibly defective. A 19-year old female sibling needed dentures at 10 years of age, while the father was one of two survivors out of 12 children, eight of whom were males. Findings included hypotrichosis; “saddle-nose” deformity and an offensive nasal discharge; the skin was thin, warm and dry; he had no incisors and canines, but had a single erupted premolar on either side and radiographic evidence of unerupted premolars was found. Genetic counseling and parental anticipatory guidance were offered, as was antimicrobial treatment for the co-morbid atrophic rhinitis. Dentures were deferred on the dentist's advice. This case report of HAED in a Nigerian was aimed at raising the local index of clinical suspicion by highlighting the reality of rarities, even with inadequate diagnostic support. The diagnostic parameters, literature review and the management strategies are discussed.Key words: Anhidrotic ectodermal dysplasia; hypotrichosis; oligodontia;Nigeri

Serum zinc levels as a predictor of clinical features and outcome of paediatric acute lower respiratory infections in Nigeria

Background: Malnutrition, especially macronutrient deficiency, has been shown to be interrelated with ALRI-related morbidity and mortality. However the import of zinc deficiency has only recently become the focus of research attention.Objective: The current study was carried out in Ilorin, Kwara State, Nigeria to determine the relationship between serum zinc levels, clinical features and outcome in hospitalized children with acute lower respiratory infections(ALRI).Method: A descriptive crosssectional hospital-based study involving 120 children aged two months to five years with ALRI. Socio-demographic, clinical and laboratory data were obtained. The serum zinc was analyzed with a Jenway™ spectrophotometer after initial preparation with theQuantiChrom™ zinc assay kit.Results: Children with tachypnoea and crepitations had significantly lower mean serum zinc levels compared to the corresponding values in those without these features (each p<0.05). Significantly higher mean serum zinc level was recorded in children with grunting respiration compared with thosewithout grunting (p=0.028). Agerelated tachypnoea, grunting, and crepitations remained significant (each p<0.05) following a linear  regression analysis. The mean serum zinc level in children with multiple complications was significantly lower than the corresponding level recorded in children who had one complication, p=0.020. No significant differencewas found between the mean serum zinc level of the children who were discharged compared with the corresponding level recorded in those that died, p=0.589.Conclusion: The presence of crepitations had the strongest clinical association with a low serum zinc level. Children managed for ALRI would benefit from post-treatment zinc supplements and appropriate zinc-rich sources of food at discharge.Keywords: Children zinc respiratory infection

Acute Respiratory Infections in the Middle-Belt Region of Nigeria

Background: ARI continues to be a leeding cause of death among children globally beyond the year 2000. Close 12 million children under the age of 5years die each year in the developing countries, mainly from preventable causes and approximately 2.28 million (19%) were due to acute respiratory infections (ARI). It therefore became necessary to assess the present status of the disease in Nigeria to mastermind workable plans for reducing the mortality and morbidity burden.Methods: A designed pro-forma was used to collect and collate information from mothers or direct care givers of children at both hospital and community levels relating to family background, home setting, anthropometry, clinical presentation of ARI, previous medications, investigations, complications and outcomes of illness.Results: A total of 163 children were recruited for the study. One hundred and six had moderate and severe form of ARI while 57 had mild form. The in-patients accounted for 15.2% of all the admission within the study period.All children were under 12 years of age with male preponderance. Fast breathing, Tarchypnoea, Cough and Fever were the leading ways of presentations. The immunization coverage of study population by various antigens in the EPI were poor. Majority of the hospital children had pre-consultation antibiotics while none of the children from the rural community had pre-recruitment antibiotics. Streptococcus pneumoniae and Staphylococcus aureus were the leading organisms isolated with good sensitivity to Quinolones, Gentamycin and Cephalosporins. Heart failure was the leading complications. Mortality was 12.3% among the hospitalized patient and none among the community children.Conclusion: It was concluded that ARI is still a major cause of morbidity and mortality among children with opportunity for burden reduction.Keywords: Acute Respiratory Infection, present outlook, burde

Management of Community Acquired Pneumonia (CAP) in Children: Clinical Practice Guidelines by the Paediatrics Association of Nigeria (PAN)

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Bacterial Isolates of Blood in Children with Suspected Septicaemia in a Nigerian Tertiary Hospital

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