Assessing Oral Health Knowledge and Practices: A Study of Mothers and Children in Northwestern Nigeria

Purpose – To explore the knowledge, attitude, and practices regarding oral and dental health for mothers of children aged 6 months to 8 years and older children aged above 8 years to 15 years seeking healthcare in a tertiary health facility in the Sokoto metropolis. Design/methods/approach – A cross-sectional study was conducted between February and April 2022. Subjects included mothers of 6 months to < 8 years and children aged 8 to 15 years presenting with minor illnesses to the General outpatient clinic. A structured questionnaire and focus group discussion guide were used to collect the information. Data was analyzed using IBM SPSS version 25. Findings – Out of 238 participants, 128 children were 6 months to <8 years, while 110 were above 8 to 15 years old. Less than half of mothers, 46.9%, had inadequate knowledge, while 20.3% had adequate practices. Among the older children in this study, the proportion of those with good knowledge, attitude, and practice level of oral health was 60%, 61.8%, and 32.7%. There was a significant moderate positive correlation between knowledge and attitude scores but not practice for the 2 groups. Mothers’ education and fathers’ occupation were significantly related to good scores (p=<0.05). Mothers of children with primary teeth and older children with permanent teeth in this study all had poor oral and dental health practices. More awareness programs should be conducted in the community to target those with poor practices. Increasing female education and empowerment is also essential in this regard. Research implications/limitations – This research implies that from an early age, it is necessary to check oral and dental health to prevent infectious diseases. Originality/value – Oral and dental health is an essential aspect of primary health care and is a situation in which the mouth, teeth, and gums are healthy and free from any diseases. Parents, especially mothers, are responsible for maintaining good oral hygiene practices and inculcating good oral hygiene habits in children. Paper Type Research paper

Evaluation of Antibiotic Prescription and Utilization amongst Hospitalized Children in a Tertiary Facility in Sokoto, North-Western Nigeria

Background: Antibiotics are the most widely utilized therapeutic agents. Inappropriate use causes increase cost and antibiotic resistance. The World Health Organization recommends assessment of antibiotics use to guide prescribing practices. Objective: To describe the pattern of antibiotic usage among paediatric inpatients aged > 1 month to 15 years in a tertiary hospital in Sokoto, Nigeria. Methods: Febrile children were recruited prospectively by systematic random sampling from January to October 2018. Socio-demographics, diagnosis, antibiotics administered were obtained from case notes. The WHO indicators of use of antibiotics were employed for evaluation. Data was analysed with SPSS version 23. Results: Out of 352 children, 318 (90.3%) received antibiotics; commonest being Ceftriaxone in 155/318 (48.7%), Cefuroxime in 74 (23.2%), and Metronidazole in 29 (9.1%). Average number of antibiotics per patient was 2.3±1.1 with treatment duration of 4.3±1.4days. Antibiotic consumption was 937.2 days of antibiotic therapy/1000 patient days (DOT/PD). Generic name was used in 92.3% while 100% of the drugs were on the essential medicine list. Frequent diagnoses were severe malaria 98/352 (27.8%), respiratory infections 39 (11.1%) and severe malnutrition in 38 (10.8%). Only 6 (1.7%) patients had microbiologic evidence of infection. Conclusion: Utilization of antibiotics is higher than recommended. There is need for improved diagnostic facilities to avoid antibiotic overuse and its consequences. Keywords: antibiotics, prescription, utilization, children, inpatients, DO

Estimation of zinc levels among children with malnutrition at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Northwestern Nigeria

Objective: Zinc plays a critical role in many body functions and its deficiency is associated with impaired cognitive function, behavioral problems, memory impairment, growth retardation, increased incidence of diarrhoea and recurrent infections. Although severe zinc deficiency is not common, mild to moderate deficiency is quite common globally. It is estimated that some form of zinc deficiency affects about one third of the world population, with estimates ranging from 4% to 73% across sub Saharan Africa. To determine the prevalence of zinc deficiency among malnourished children at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.Methods: Study was descriptive cross-sectional, carried out at the Paediatric department of UDUTH, Sokoto from April 2013 to June 2014. It was conducted among children aged between 6 and 60 months who presented to the OPD and those that were admitted into paediatric wards of UDUTH with malnutrition. Children with similar characteristics that were well nourished served as controls. Cohorts were recruited consecutively until the required sample size was obtained. 5mls of venous blood was taken for serum zinc analysis from each child.Results: A total of 550 children were studied with 275 apiece for cohorts. The mean age of the malnourished children was 26.2±14.6 months compared to 28.2±17.0 months recorded for the controls (p=0.157).The mean serum zinc levels for the study subjects 13.5±3.3μmol/Lwas significantly lower than that of the controls (15.8±1.9μmol/L) (t=9.42, df=548, p=0.0001).Conclusion: The prevalence of zinc deficiency among both malnourished children and the controls was 0% using WHO reference value for children below the age of 5 years. Prophylactic doses of zinc should be given in all malnourish children in situation where mineral mix is not added to feed or f75 and f100 are not available. There is need to adhere to and use recommended cut off values recommended by WHO for defining zinc deficiency by researchers.Keywords: zinc, malnutrition, Sokot

Ecthyma gangrenosum on the face of a malnourished child with Pseudomonas sepsis: Simulating Cancrum oris

Introduction: Ecthyma gangrenosum (EG) is a cutaneous lesion commonly caused by Pseudomonas aeruginosa that involves mainly the lower limbs and gluteal region, seen more in immunosuppressed patients with neutropenia. Cancrum oris (Noma) is a gangrenous necrosis of the face that begins as a gingival ulcer and progresses rapidly to destroy contiguous tissues in malnourished children. Case Presentation: This article reports a case of facial EG which was similar to Noma in a malnourished child: a 16-month old girl with fever, cough, weight loss, watery stool and swelling on right cheek. She was febrile, pale, wasted with bilateral pitting pedal oedema. She had a solitary circumscribed round necrotic lesion, with surrounding hyperaemia on the right malar area which extended to destroy the right ala nasi. No intra-oral rashes but she had left ear discharge. She received blood transfusion, antibiotics, antiseptic wound care and nutritional rehabilitation. Management and Outcome: Swabs of the lesion and ear discharge both revealed Gram-negative bacilli and culture yielded P. aeruginosa. Retroviral, Mantoux and Gene Xpert tests were negative. She had moderate anaemia, normal white blood cell count, and neutropaenia. Parenteral ceftriazone was changed to ciprofloxacin based on sensitivity results and lack of clinical response. The wound healed with residual scarring and partial destruction of right ala nasi. Discussion: Although this patient had facial necrosis to suggest Noma, she did not have initial oral involvement, and clinical features such as Pseudomonas sepsis and neutropaenia suggested EG. Facial necrosis in malnourished children may be due to EG

A 5-year review of measles cases admitted into the emergency paediatric unit of a tertiary hospital in Sokoto, North-Western Nigeria

Background: Measles is a vaccine preventable viral infection which is still responsible for significantly high morbidity and mortality in Sub-Saharan Africa. Failure of routine immunization programs heralds a dismal outlook for this potentially eradicable viral infection. The objective of this study was to determine the hospital prevalence, vaccination status, pattern of complications, and outcome of children admitted with measles into the Department of Pediatrics of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Materials and Methods: This was a 5-year retrospective study from January 1, 2011 to December 31, 2015. Case folders of children below 15 years who were admitted with measles were retrieved, relevant information extracted, and entered into a pro forma. Data was analyzed using SPSS version 22. Results: Total admissions were 6104, out of which 204 were due to measles (prevalence, 3.3%). The mean age was 27.4 ± 18.9 months (range 6–96 months). Those aged 1–5 years were 144 (70.6%). The male-to-female ratio was 1.3:1. Only 28 patients (13.7%) had measles vaccination. Observed complications included bronchopneumonia in 168 (82.4%), acute laryngotracheobronchitis in 24 (11.8%), febrile convulsion in 20 (9.8%), encephalitis in 17 (8.3%), ocular complications in 12 (5.9%), and suppurative otitis media in 6 (2.9%) patients. The presence of complications was related to age <5 years (P = 0.0001) but not to vaccination status (P = 0.41). Forty-four patients died (21.6%), whereas 33 patients (16.2%) had residual problems at discharge. Outcome was related to vaccination status (P < 0.05). Conclusion: Measles is still a significant problem in the study area and it is associated with high morbidity and mortality. More efforts at prevention is necessary