Child sexual abuse in Zaria, Northwestern Nigeria

Background: Child sexual abuse has been reported from all corners of the globe, and all age groups and both sexes are affected. Although the trauma of abuse heals with time, it leaves long term psychological and medical problems. This study was aimed at documenting the pattern of child sexual abuse in Zaria, Northern Nigeria.Methods: Retrospective study of case notes of all patients seen with a history of sexual abuse, from August 2008 to October 2009, at a primary health centre in Northwestern Nigeria.Results: A total of twenty cases were seen out of a total of 33, 313, which gave a prevalence rate of 0.06%. There were three boys and 17 girls, with a male: female ratio of 1: 5.7. The age range was 3-13 years, with a mode of 7years. Majority (19, 95%) were aged 12 years and below. Eleven cases (55%) attended school, while three (15%) were hawkers. Twelve (60%) of the children presented more than 72 hours after the assault. Twelve (60%) cases were abused more than once, and there was evidence of genital trauma in 60% of cases. The assailants were all males, and identified in 70% of the cases. Of those identified, 55% of them had previously been suspected of committing sexual abuse. In 55% of cases the assailants were either household members or neighbours. Only 12 (60%) of incidents were reported to the police. Legal outcome was not known in any of the cases. All the cases defaulted to follow-up.Conclusion: Child sexual abuse is not an uncommon problem in Zaria. There is a need to ensure follow-up after treating immediate medical problems, in order to manage and prevent the long-term psychological problems of sexual abuse. The high default rate to follow-up needs to be further investigated. The legal outcome in all the cases was unknown

Bacterial aetiology of septicaemia in children of post-neonatal age at the Institute of Child Health, Banzazzau, Zaria, Nigeria

Introduction: Septicaemia is a clinical syndrome characterized by systemic inflammatory response. It is has been reported to be one of the major causes of morbidity and mortality among children in developing countries of the world.Objectives: the aims of the study were to determine the prevalence of septicaemia in children brought to the Institute of Child Health Banzazzau, Ahmadu Bello University Teaching Hospital, (ABUTH) Zaria and to isolate the aetiologic agents responsible for septicaemia in these children.Methods: Blood samples of children (aged one month – 12 years) with clinical symptoms of suspected septicaemia was taken under strict aseptic condition and inoculated into thioglycolate broth then incubated for 24hrs Subcultures were made after the first 24 hrs onto blood, chocolate and MacConkey agar plates and also when there were signs of bacterial growth shown by turbidity of the samples. Identification of isolates was based on their morphology on agar plates, Gram stain reaction and biochemical properties.Results: The mean age was three years with a peak in the first year of life. The male: female ratio was 1:1.3. Staphylococcus aureus and Salmonella species were the commonest isolates accounting for 24 (43.64%) and 13 (23.64%) respectively. Other bacterial isolates included Coagulase negative staphyloc occi(CoNS) (7.27%), Citrobacter specie (10.94%), Pseudomonas specie (7.24%), Proteus species (3.64%) and Klebsiella species (3.64%).Conclusion: Results show both Gram positive and Gram negative bacteria to be implicated with septicaemia with Staph aureus and Salmonella being the most frequent aetiologic agents, children less than or equal to five years were mostly affected, there is a need for routine monitoring of bacterial isolates and the age group at risk.Keywords: Bacterial isolates, children, septicaemia

Pyuria as a diagnostic test for urinary tract infection in children with sickle cell anaemia in Zaria, Nigeria

Objective: This study aimed at determining the significance of pyuria as a screening test for UTI in children with sickle cell anaemia (SCA).Methods: Two hundred and seventy-two children with SCA, aged 6 months to 15 years, were studied out of which 185 (68.0%) were in stable state and 87 (32.0%) were in crises. Their urine was assessed for microscopy culture and sensitivity. Significant pyuria and bacteriuria was determined using standard methods. Results: Significant bacteriuria was detected in 22 (8.1%) of the 272 subjects with SCA. The prevalence of significant bacteriuria was higher among those in crisis (18/87; 20.7%) than in those in steady state (4/185; 2.2%) and the difference was statistically significant (χ2 = 27.323, p = 0.001). Of the 22 SCA subjects with confirmed UTI, 19 (86.4%) had significant pyuria with a sensitivity of 86.4%, specificity of 68.8%, and positive predictive value of 19.6%. The most common bacterial isolates were Escherichia coli 11 (50.0%) while the least isolated were Salmonella typhi 1 (4.6%).Conclusion: This study indicates that pyuria as a screening test for UTI is not very specific but very sensitive necessitating a more test to be done for diagnosis of UTI.Keywords: Sickle cell anaemia, bacteriuria, pyuria, childre

Significant bacteriuria in children with sickle cell anaemia in a Nigerian tertiary hospital

Background: Urinary tract infections (UTI) in children with sickle cell anemia (SCA) may result in long term morbidity and mortality due to chronic renaldysfunction.Objectives: To evaluate the prevalence of significant bacteriuria among children with SCA and to determine their antimicrobial sensitivity patterns of isolates.Methods: Two hundred and seventy two children with SCA in steady state (n = 185) and in crises (n = 87) aged 6 months to 15 years had their urine samples screened for significant bacteriuria. The urine samples were collected aseptically and incubated aerobically at 37‹C for 24 hours.Children whose urine samples yielded .105cfu/ ml of bacteria on two consecutive cultures were regarded as having significant bacteriuria. The antimicrobial sensitivity pattern of isolates was determined.Results: Significant bacteriuria was detected in 22 (8.1%) of the 272 subjects, 156 boys (57.4%) and 116 (42.6%) girls. The prevalence of significant bacteriuria was higher among those in crisis, 18 (20.7%) than among those in steady than, 4 (2.2%) state: ƒÔ2 = 27.323, p = 0.001. The most common organism isolated was Escherichia coli, 11 (50.0%). Theantibiotic with the best sensitivity was ceftriaxone. Most organisms were resistant to the commonly used ant ibiot ic s l ike cotrimoxazole, amoxicillin and ampicillin.Conclusion: The prevalence of significant bacteriuria was found to be higher in SCA subjects in crisis (20.7%) than among those in steady state (2.2%). The most prevalent urinary pathogens were sensitive to ceftriaxone but resistant to commonly used antibiotics.Keywords: Sickle Cell Anaemia, Children, Prevalence, Significant Bacteriuria 

Seroprevalence of Varicella Zoster Virus Infection among Primary school Children In Northern Nigeria

Background: Varicella Zoster infection occurs exclusively in man and commonly affects children with predilection for school age children. Following infection the course of the disease in immunocompetent children is often mild and self limited but in older age groups infection may be severe with poor outcomes ranging from complicating bacterial morbidities to death. In Kaduna State, Northern Nigeria the seroprevalence ofVaricella - zoster virus (VZV) infection is unknown The current cross - sectional study was conducted to assess the seroprevalence of VZV infection among nursery and primary school pupils in Kaduna State. Mathods: Nursery and primary school pupils between the ages 4 and 15 years were randomly selected from the three geopolitical zones of Kaduna State . Demographic data on each subject  were obtained by administration of a questionnaire and blood samples were collected for serum analysis of Varicella - zoster virus immunoglobulin G (IgG) using the Automat ion ELISA IgG Kit manufactured by Automation INC. USA. Data obtained were summarized using percentages and frequency tables. Results were analyzed using Epi- info version 3.0. Results: Three hundred and fifty three pupils were recruited for the study. The overall prevalence rate for VZV infection was 66.3% with the value in males being 68.5% and in females 63.9%. The prevalence of VZV infection increased with age in both sexes. A high percentage of children (60%) were seropositive at 4-6 years. Conclusion: The study shows a 66.3% prevalence of VZV infection among children in Kaduna State. Thi s high pr eva l enc e r a t e necessitates further studies to establish the burden of the problem in Nigeria and rationalize the institution of preventive measures against the infection, particularly immunocompromi sed young children

Seroprevalence of IgG Antibodies to Herpes Simplex Virus Type-1 in Nigerian Children

Background: Herpes simplex virus type-1 (HSV-1) can cause chronic ulcerative infection in immunosuppressed children leading to latency with subsequent reactivate in the conjunctiva resulting in scarring, thickening of the cornea and blindness. They are also common cause of fatal sporadicencephalitis in 70% of paediatric patients. This cross sectional study  determined the prevalence of HSV-1 in children in Kaduna State, Nigeria.Method: A total of 377 blood samples were collected from children less than five years old attending some selected hospitals in Kaduna State and analyzed for HSV-1 IgG antibodies employing Enzyme immune assay technique by using commercially available ELISA Kits.Results: Sero-prevalence rate of 57.8 % (218 /377) was obtained. The highest prevalence of HSV-1 infection was obtained in children in age group 49-60 months (85.2%) and lowest in children in age group 13-24 months (44.8%). Further analysis of the result of children less than one year old showed that children 9-16 weeks old were more susceptible to HSV-1 infection. HSV-1 infection was significantly 2 associated with age (÷ =37.92, df = 4, p = 0.001). Though a higher prevalence was obtained in femalechildren (61.5%) than male children (54.5%), the difference observed in the prevalence was not 2 statistically significant (÷ =1.84, df =1, P =0.105).HSV-1 infection was significantly associated with 2 children who were in school (÷ = 15.28, df = 1, P= 0.001) with a higher prevalence of 74.3%.Conclusion: Over half of the children sampled were protected from HSV-1 infection while 42.2% were susceptible to the infection and were at risk of developing severe HSV-1 manifestation which includes keratitis, encephalitis and Keratoconjunctivitis.Keywords: Seroprevalence, Herpes Simplex Virus Type-1, Children, ELIZA, Kaduna State, Nigeri

Paediatric HIV/AIDS seen at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Background/Objective: Paediatric HIV/AIDS is an escalating problem of frightening proportion in Nigeria, although not much has been reported from our center. Method: A retrospective study of 35 children with the diagnosis of HIV/AIDS admitted into the Emergency Paediatric Unit (EPU) of Ahmadu Bello University Teaching Hospital (ABUTH) over a 3.4 year period between March 1998 and June 2001 was undertaken in order to determine the most common mode of presentation and also the most prevalent complicating infection among these patients. Results: The mean age of the patients was 2±1.8 years (range 2-144 months), with the majority 30 (85.7%) aged three years and below, and a male to female ratio of 2.1:1. The probable mode of infection was vertical in 88.6% patients, through blood transfusion in 8.6%, while the source of infection could not be established in one (2.8%) due to inadequate data. Multiple symptoms at presentation were common with fever and cough being the most frequent, occurring in 82.8% of patients, followed by diarrhea in 71.4% and weight loss in 60.0% of cases. The most common signs were wasting which was found in 74.3%, generalized lymphadenopathy in 68.6% and pyrexia in 54.3%. Commonly diagnosed infections were oral candidiasis, pneumonia and tuberculosis, seen in 60.0%, 45.7% and 31.4% respectively. Nine (25.7%) out of the 35 children died, 7(20.0%) were discharged against medical advice, 19 (54.3%) improved and were discharged to follow up, but all except four have been lost to follow up. Conclusion: Paediatric HIV/AIDS is becoming a major cause of childhood morbidity and mortality in our environment. The prevention of HIV infection in women particularly in the reproductive age group would go a long way in controlling the disease in Nigeria. Keywords: HIV/AIDS, paediatric, morbidity, mortality Annals of African Medicine Vol. 5(2) 2006: 73-7

Correlates of childhood enuresis in north western Nigeria

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Serum vitamin A levels among malnourished children aged 6 - 59 months in Zaria

Background: Vitamin A deficiency (VAD) affects an estimated 6 million pre-school children in Nigeria and 20 million in Africa. When associated with severe malnutrition, it significantly increases morbidity and mortality.Objectives: To determine serum vitamin A levels in children with Protein Energy Malnutrition and age and sex prevalence of vitamin A deficiency among children with Protein Energy Malnutrition and controls at the institute of Child Health ABUTH Zaria.Method: This was a case-control hospital-based descriptive study carried out at the Institute of Child Health (ICH) Banzazzau, Zaria. Systematic sampling method was adopted to select undernourished children aged 6-59 months for the study. Serum vitamin A level was analysed by High Performance Liquid Chromatography. The frequency of values below a cut off, usually taken as 0.70 μmol/L (20 μg/ dl ) for low and 0.35 μmol/L (10 μg/dl) for deficiency. Data was analysed using the Statistical Programme for Social Sciences version 15.4.Results: In this study, 132 children (66 cases and 66 controls) aged 6-59 months were studied. Among the cases, all were wasted, out of which 13 (19.7%), 9 (13.6%) and 44 (66.7%) had mild, moderate and severe wasting. Similarly, all the cases were stunted with the severity ranging from mild, 11 (16.7%), moderate, 19 (28.8%) and severe, 36 (54.5%). All the controls were nutritionally normal. Twenty six (39.4%) and 30 (45.5%) were males while 40 (60.6%), 36(54.2%) were females (M:F= 1:1.5 and 1:1.2) among cases and controls respectively. Low serum vitamin A levels among the cases was 16.7%. VAD was seen only in those with severe wasting (5%). Malnourished females aged 13-24 months and males aged 49-59 months for the controls were more at risk of low vitamin A levels. Children who had measles, persistent diarrhoea, low maternal educational levels and low social class were at a higher risk of having low serum vitamin A levelsConclusion: This study has been able to establish low vitamin A levels among both undernourished and controls in Zaria. This is of public health significance

A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol. A three year old preschooler was attacked by a swarm of bees, receiving over 150stings. Initial clinical features were allergic response involving the head, face and tongue for which he had first aid in a primary healthcare facility and thereafter sent home. Few hours later he developed clinical features of intravascular haemolysis, rhabdomyolysis, hypertension and acute renal failure. Laboratory findings were in keeping with clinical presentation. Despite supportive management, serum biochemistry worsened necessitating haemodialysis. Massive bee sting envenomation can cause systemic reactions and organ dysfunctions. To improve the overall clinical outcome, sting treatment protocol is advocated.Key Words: Bee sting envenomation, acute kidney injury, sting treatment protocol, rhabdomyolysis, myoglobinuria, haemodialysis