Normal Foetal Middle Cerebral Arteries Doppler Velocimetry; Study from Benin-city

Doppler assessment of the middle cerebral artery (MCA) is one method of evaluating foetus before delivery and can determine foetuses at risk in high risk pregnancies. This study was done to determine the normal reference values of foetal middle cerebral artery Doppler indices in our population. One hundred and forty eight women with uncomplicated pregnancies were voluntarily recruited and had MCA Doppler study. Pulsatility index (PI), Resistivity index (RI), Systolic/Diastolic ratio (S/D ratio), Peak systolic velocity (PSV), End diastolic velocity (EDV) and Mean velocity (MeanV) values were documented for all subjects. Statistical analysis was done using SPSS version 16. The mean value of foetal middle cerebral artery PSV was 40.1cm/s, EDV 11.97cm/s, MeanV 25.0cm/s, RI 0.70, PI 1.14, and S/D ratio 4.05. PSV, EDV and MeanV increased with gestational age such that they were higher in 3rd trimester than 2nd trimester. RI, PI and S/D ratio showed an initial increase but decreased in the 3rd trimester. A normogram of foetal middle cerebral artery Doppler parameters has been documented for our population by this study.Keywords: Foetal middle cerebral artery, Doppler velocimetry, normal Doppler indices, middle cerebral artery Doppler, foetal Doppler

Urinary Tract Infection In Children With Acute Nephritic Syndrome.

Fifty-four of the 63 cases of acute nephrotic syndrome (ANS) paediatric wards of the University of Benin Teaching Hospital, Benin City, over a 5 year period were prospectively evaluated for prevalence of Urinary Tract Infection (UTI). Of the 54,26 (48.1%) were males while 28 (51.9%) were females. The mean age (+SEM) of the children was 6.9+0.50 years (Range 0.90-15 years). Forty-nine (90.1%) of these children with ANS were drawn from families of low socio-economic status. Prevalence of UTI was 24.1%. Although UTI prevalence in families (32.1%) was higher than in males (15.4%), The difference was not statistically significant ( xy2=2.14: p>0.05). The prevalence of UTI amongst these patients was remarkably higher than what is observed both in healthy childhood population and those with other association morbidities. Escherichia coli (61.5%) Klebsiella pneumoniae (15.4%) and Staphylococcus aureus (23.1%) were the bacterial isolates that demonstrated appreciable in-vitro sensitivity to ofloxacin, gentamycin, ceftriazone, ceftazidime and azithromycin only. Some interaction may exist between UTI and ANS but further studies are advocated in other centers to evaluate the observation. And access possible association between degree of proeinmia and prevalence of UTI. Annals of Biomedical Science Vol. 1 (1) 2002: pp. 22-2

Anti-typhoid agglutinins in School aged African children

Objectives: To determine baseline antibody responses to H and O antigens of Salmonella typhi and Salmonella paratyphi (A, B and C) in school aged Nigerian children. Design: Cross-sectional study involving 175 children. Using both rapid slide and tube agglutination techniques in dilutions of sera (1:20 to 1:320), agglutination reactions with various antigens were determined. Setting: Community based study involving primary school pupils in Benin City. Subjects: Apparently healthy school children (5-16 years) selected systematically, using multistage sampling technique. Results: No subject demonstrated agglutination to any of antigens at 1: 320 dilution. Two (1.1%), 26 (14.9%), 85 (33.1%) and 51 (29.1%) pupils respectively had reactions to either antigens of Salmonella typhi at dilutions of 1:160, 1:80, 1:40 and 1:20. At 1:40 dilution 1 (0.6%) and 3 (2.3%) each had reactions to HB, OB and HC respectively. Sixteen per cent had reactions at higher dilutions of _ 1:80 and this occurred more significantly in older children ( ~y2 = 15.50; p < 0.001), those with low maternal socio-economic status ( ~y2 = 22.06, p< 0.001), those from poor apartments (~2 = 4.49; p < 0.05) and those who used predominantly none pipe-borne water ( ~2 = 5.40; p < 0.02). Against OD and HD, about 50.0% seroconverted at 1:40 dilution with antibodies against H being more prevalent. Conclusion: Interpretation of single widal reaction in endemic areas must take into cognisance age, clinical and socio-cultural characteristics of the child. (East African Medical Journal: 2002 79(2): 92-95

Sodium concentration in home made salt – sugar – solution (sss): influence and implications of changing solvent measures.

In a cohort of 210 young mothers, selected through cluster sampling technique from Ogida health district of Egor Local Government Area of Edo State, the electrolyte concentration of prepared salt-sugar-solutions (SSS) were evaluated. This was predicated on the need to determine the effects of introduction of various solvent measures on electrolyte concentration. About 85% of mothers used appropriate sized bottles. Of the 32 that used inappropriate sized bottles, 21 (65.5%), 9 (28.1%) and 2 (6.3%) respectively used two of the 350ml coke bottle, one of 350ml coke bottle and 2 of 250ml coke bottle. The choice of appropriate sized bottle was not significantly influenced by previous use of SSS, recent use of SSS, age, maternal education and social class. Mean sodium concentration of the 600ml beer bottle or two 300ml coke bottles varied significantly from those obtained with the use of multiples of 250ml (t = 6.76; p 120.0 and < 91.0. The preparation of solution with appropriate sodium concentration was uninfluenced by recent use of SSS, prior use of SSS, maternal age and maternal education. The multiplicity of various sizes of soft drink bottles in the Nigerian market has the potential of worsening the problem of inappropriate sodium concentration of homemade SSS. It is recommended that a standard measure of 600ml capacity, devoid of any relationship with sale and consumption of any commercial drink be introduced into the Nigerian market to enhance SSS promotion and standardization. Keywords: Sodium concentration, SSS, Solvent – measures. Annals of Biomedical Science Vol. 1 (2) 2002: pp. 124-13

Socio-demographic determinants and impact on academic performance of attention deficit/hyperactivity disorder in school children in Benin City, Nigeria

Background: Attention-deficit/hyperactivity disorder (ADHD) affects children worldwide. In Nigeria, there is paucity of information on the socio-demographic associates of this important childhood condition. Methods: Across-sectional study was conducted between February and August 2006 among 1473 public primary school pupils aged 6 to 12 years, selected randomly among pupils drawn from Egor Local Government Area of Edo State. The subjects were screened using Disruptive Behaviour Disorder (DBD) Rating Scale to identify children with ADHD symptoms. Identified subjects were further evaluated with questionnaires to ensure that they met the other explicit non-symptom criteria contained in the DSM-IV manual, such as functional impairments. Children who were confirmed to have ADHD were compared with randomly selected controls to determine the association, if any, between the prevalence of the condition and some socio-demographic characteristics. Results: The prevalence of ADHD was 7.6%. There was no statistically significant difference in the prevalence of ADHD amongst the different age cohorts. No significant association was found between the prevalence of ADHD and socioeconomic background, size of family, age of parents and characteristics of the child′s primary caregiver. The children with ADHD had significantly lower school aggregate than that of selected control (Mean aggregate score of 51.7+16.1% versus 63.7+ 16.5%, p<0.001). Conclusion: The prevalence of ADHD in this study is relatively high. Community screening under the umbrella of the School Health Programme is required. Appropriate medications, educational support and psychotherapy when incorporated in the national health system will go a long way in redirecting affected children′s developmental lives

Community survey of attention-deficit / hyperactivity disorder among primary school pupils in Benin City, Nigeria

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neuro-developmental condition with early onset. ADHD affects children worldwide. However, there is a variation in the prevalence across different countries. In Nigeria, there is paucity of information on the prevalence. To provide the relevant information, a cross-sectional study was conducted between February and August 2006 among 1473 public primary school pupils aged 6-12 years selected systematically among pupils in Egor Local Government Area of Edo State. Materials and Methods: All the 1473 pupils were screened with the Disruptive Behavior Disorder (DBD) Rating Scale to identify children who had ADHD symptoms as contained in the DSM -IV. Such children were compared with randomly selected controls. The academic records of both the groups were also compared. Results: The prevalence of ADHD was 7.6%. The prevalence was higher in boys (9.4%) when compared to girls (5.5%) (P = 0.003). Of the three different subtypes of ADHD, the predominantly inattentive subtype (ADHD-I) was the most prevalent (47.3% of the ADHD population) followed by the combined type (ADHD-C; 31.3%), while the least prevalent was the hyperactive/impulsive subtype (ADHD-HI; 21.4%). There was no statistically significant difference in the prevalence of ADHD amongst the different age cohorts. Conclusion: The prevalence of ADHD was relatively high when compared to the figures available for other countries. For this reason, there is a need to pay increased attention to this condition in Nigeria. Community screening under the umbrella of the School Health Program could be of assistance

Community survey of attention-deficit / hyperactivity disorder among primary school pupils in Benin City, Nigeria

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neuro-developmental condition with early onset. ADHD affects children worldwide. However, there is a variation in the prevalence across different countries. In Nigeria, there is paucity of information on the prevalence. To provide the relevant information, a cross-sectional study was conducted between February and August 2006 among 1473 public primary school pupils aged 6-12 years selected systematically among pupils in Egor Local Government Area of Edo State. Materials and Methods: All the 1473 pupils were screened with the Disruptive Behavior Disorder (DBD) Rating Scale to identify children who had ADHD symptoms as contained in the DSM -IV. Such children were compared with randomly selected controls. The academic records of both the groups were also compared. Results: The prevalence of ADHD was 7.6%. The prevalence was higher in boys (9.4%) when compared to girls (5.5%) (P = 0.003). Of the three different subtypes of ADHD, the predominantly inattentive subtype (ADHD-I) was the most prevalent (47.3% of the ADHD population) followed by the combined type (ADHD-C; 31.3%), while the least prevalent was the hyperactive/impulsive subtype (ADHD-HI; 21.4%). There was no statistically significant difference in the prevalence of ADHD amongst the different age cohorts. Conclusion: The prevalence of ADHD was relatively high when compared to the figures available for other countries. For this reason, there is a need to pay increased attention to this condition in Nigeria. Community screening under the umbrella of the School Health Program could be of assistance

Co-existence of urinary tract infection and malaria among children under five years old: A report from Benin City, Nigeria

Children with fever are a majority in the various emergency rooms all over the world, and especially in the tropics. Most in sub-Saharan Africa will be treated for malaria, whether confirmed or not. It therefore follows that some of the morbidities other than malaria may go undiagnosed. The comorbidities with malaria that may have similar presentation among under-fives therefore are difficult to detect, and diseases like respiratory tract infections and urinary tract infections (UTI) are left to debilitate affected children. The exact burden of UTI co-existing with malaria in Nigeria remains ill defined. This study looks at the co-existence of UTI in under- fives with a primary diagnosis of malaria. Well-nourished children aged less than five years with confirmed malaria seen at the Children Emergency Room of the University of Benin Teaching Hospital were recruited into a prospective cross-sectional study between June and August 2006. The prevalence of UTI was 9% (27 of 300 children), with those aged less than 24 months comprising the majority. The uropathogens isolated included Staphylococcus aureus (55.6%), Escherichia coli (29.6%) and Kleibsiella pneumonia (14.8%). The isolates demonstrated high in vitro sensitivity to clavulanic acid-potentiated amoxicillin, ciprofloxacin and gentamicin, but were resistant to other commonly used antibiotics like amoxicillin and co-trimoxazole. The study indicates that UTI is a silent comorbidity in children aged less than 5 years with malaria and there is a need to evaluate these children in order to prevent the long-term morbidity of chronic renal diseases