Parental socioeconomic status and birth weight distribution of Nigerian term newborn babies

Background: Birth weight is one of the most important determinants of perinatal well -being and survival. It may be influenced by socioeconomicstatus among other factors.Objective: To evaluate the influence of parental socioeconomic status on birth weight distribution of term infantsPatients and Methods: Consecutive singleton, term newborns and their parents were recruited. Socioeconomic status was determined from parental education and occupation. Neonatal anthropometry was recorded soon after birth. The relationship between neonatal anthropometry and parental socioeconomic status was evaluated.Results: The mean birth weight of the 280 newborns was 3180g + 501 with a range of 1800g to 5000g. Most babies (181; 64.7%) weighed between 2500g and 3490g while 5.7% weighed less than 2500g and 20 (7.1%) weresmall for gestational age. Most parents (196; 70%) were in the upper classes I and II, 69 (24.6%) were in class III while 15 (5.4%) were in classes IV and V. Babies in the socioeconomic classes IV and V had significantly lower mean birth weight than babies in each of classes I, II and III (p = 0.005, 0.006 and 0.04 respectively). High maternal educationand paternal occupation were associated with significantly higher mean birth weights (p = 0.007, 0.018 respectively). The low birth weight rate was significantly higher in the lower social classes III to V compared to the two upper classes (10.7% vs. 3.57%;, p = 0.022.Conclusion: Disadvantaged socioeconomic status was associated with lower mean birth weights with maternal education and paternal occupation exerting the higher influences.Key words: Socioeconomic Status, Birth weight, maternal education, paternal occupatio

Upper body segment to lower body segment and arm span to height ratios among children with sickle cell anaemia in Lagos

Objective: To determine ratios of upper body segment to lower body segment and arm span to height in the sickle cell anaemia patientsBackground: Sickle cell anaemia may adversely affect linear growth and body proportions.Methods: Height, upper segment and arm span were measured in100 sickle cell anaemia patients aged eight months to 15 years and100 age/sex matched controls. Lower body segment length, upper body segment to lower body segment ratio, and arm-span to height ratio were derived.Results: Sickle cell anaemia subjects older than 10 years had significantly shorter upper body segment than controls (p = 0.035 and p = 0.004 for males and females respectively). The mean upper segment/lower segment ratio decreased with age among primary subjects (SS) and AAcontrols. In comparison with AA controls, female sickle cell anaemia subjects older than 10years had significantly lower mean upper bodysegment to lower body segment ratio (p = 0.005). Mean arm span was significantly shorter in male sickle cell anaemia patients older than 5 years (p = 0.034 at 5 to 10 years and p = 0.029 at . 10 years) and in females older than 10 years than in controls (p = 0.025). The mean arm  span/height ratio was lower in sickle cell anaemia subjects than controls, except in males younger than five years.Conclusions: Sickle cell anaemia patients older than 10 years haveshorter mean upper segment. In this age group, females also hadsignificantly lower upper segment to lower segment ratio.Keywords: sickle cell anaemia, upper body segment, lower body segment, rati

Age and gender-related fat mass index and fat- free mass index patterns among adolescents in Surulere LGA, Lagos

Background: Percent body fat, fat mass and fat mass index are measures of body fat while fat free mass and fat free mass index measure lean mass. These measures of body composition vary with age and sex.Aim: To show the age-related patterns of measures of fat and lean mass in adolescent Nigerians in Lagos.Methods: Percent body fat was measured in school pupils aged 10years to 18years (377 boys and 376 girls) using Tanita ® body fat monitor (BF 666). Fat mass (FM) was derived from percentage body fat and body mass and fat free mass (FFM) was obtained by subtracting fat mass from body mass. Fat mass index (FMI) and fat free mass index (FFMI) were derived by dividing FM and FFM, respectively by the square of the height.Results: Overall percent body fat and FM were significantly higher in girls (18.9±7.5% Vs 9.5±4.5%: p < 0.001 and 9.7±6.1kg Vs 4.5±3.2kg: p < 0.001 respectively). FMI for girls ranged from 3.2 to 4.5kg/m² peaking at 16 years. At all ages, girls had higher mean FMI than boys. The mean FMI for males fell from 2.6 kg/m² at 10 years to a trough of 1.5 kg/m² at 16 years before a slight rise to 1.9 kg/ m² at 18 years. FFM in boys increased consistently with age, overtaking that of girls at 12 years with the gap widening up to 18 years. Measures of body fat were much lower in study subjects than reported from western countries even where lean mass was comparable.Conclusion: Adolescent females have higher body fat indices while males have higher lean mass indices. Indices of body fat in the current study are much lower than reported for western counterparts.Keywords: Adolescents, Fat mass, Fat mass index, Fat free mass and Fat free mass inde

Haematological profile of apparently healthy term babies aged one day, three days and six weeks delivered in Sagamu, Nigeria

Background: Normal values of haematological parameters are often required to assist with diagnosis and monitoring. Objective: To determine the haematological indices of apparently healthy term babies on the first day, third day and sixth week of life. Method: A longitudinal survey of the haematological parameters of apparently healthy Nigerian term infants was carried out between  October 2007 and March 2008 using electronic devices. Results: On the first day of life, the mean values were 46.3% for packed cell volume (PCV), 10.8 × 109/L for total white blood cell (TWBC) and 261.3 × 109/L for platelets. The mean values obtained on the third day of life includedPCVof 43.3%,TWBC of 10.7 × 109/L and platelets count of 242.5 × 109/L. In the sixth week of life, the mean values of PCV, TWBC and platelets count were as follows: 32.0%, 8.8 × 109/L and 277.7 × 109/L respectively. The mean percentage neutrophil counts and lymphocyte counts were 56.8% and 38.7% respectively on the first day but were reversed to 34.6% and 63.4% respectively on the sixth week of life. Conclusion: The mean values of the PCV and TWBC were highest on the first day of life and lowest in the sixth week of life whereas the mean values of platelets count showed a less consistent pattern over the same period.Key words: Erythrocytes, Haematological indices, Leucocytes, Newborn, Platelet

Maternal factors in the aetiology of small-for-gestational age among term Nigerian babies

Background: Babies are classified according to the relationship between birth weight and gestational age, the latter being the strongest determinant of birth weight. Small-for-gestational age (SGA) babies have birth weights less than the 10th percentile for age and sex or more than two standard deviations below the mean for age and sex.Objective: The study was carried out to investigate the maternal factorsassociated with the delivery of term small-for-gestational age babiesin a Nigerian Hospital.Methods: In the cross-sectional survey, the anthropometric parametersof term singleton infants were related to maternal age, parity, socio-economic class, anthropometry and medical disorders in pregnancy.Results: A total of 825 babies were surveyed within the first 24 hoursof life. The mean birth weight of babies was 3233 ± 539g. The males had significantly longer mean crown-heel length and mean occipitofrontal circumference compared to females p = 0.048 and p < 0.000 respectively). The prevalence of infants with small-for-gestational age was 7.2% (5.7% and 8.8% among males and females respectively). The proportion of mothers who did not encounter significant illness in pregnancy was lowestamong those who had SGA babies, followed by mothers of LGA babiesand those of AGA babies in that order. With respect to maternal age,weight, height and body mass index (except inter-pregnancy interval),mothers of SGA babies had significantly lower values compared tomothers of the AGA and LGA babies (p < 0.03).Conclusion: This study identified age, parity, anthropometry and  hypertension-related disorders as major maternal factors associated withthe birth of SGA babies in Nigeria.Keywords: Anthropometry, Intrauterine growth restriction, maternal illness, Nigeria

Relationship of age, anthropometry and haemoglobin concentration with echocardiographic findings in Nigerian children with sickle cell anaemia

Background: Assessment of the structural and functional effects of sickle cell anaemia (SCA) on the heart can be done using echocardiography.There has been no agreement on which indicator of body size (weight, height, and body surface area (BSA)) or age in children should be used to relate to and correct echocardiographic measurements.Aim: To correlate the echocardiographic findings of children with SCA aged one to fifteen years in steady state with their age, anthropometryand haemoglobin concentration.Methods: A prospective study carried out at the Lagos University Teaching Hospital (LUTH), between May and October 2005. The subjects were 60 paediatric patients attending the LUTH SCA outpatient clinic and 60 age, sex and socioeconomic matched controls. Their height, weight, and echocardiographic parameters were measured and their BSA and haemoglobin level were determined.Results: The direct echocardiographic measurement (AO, LA, LVPW, EDD, ESD, IVS) and LVM each increased progressively with body weight, height, body surface area and age in both subjects and controls (r > 0.3, p < 0.001 in each case). Multivariate analysis showed that height correlated significantly with AO, ESD, EDD and LVPW in the subjects. All the parameters except age were significantly correlated with LVM both in univariate and multivariate analysis.Conclusion: Echocardiographic parameters in SCA patients are significantlycorrelated with anthropometric indices and age. Our data suggest best correlation with height in these subjects

Reliability of bedside blood glucose estimating methods in detecting hypoglycaemia in the children’s emergency room

Background: Hypoglycaemia occurs in many disease states common in the tropics. Facilities and skilled manpower required for laboratory blood glucose measurement are not always available in health facilities in developing countries. Objective: The study was carried out to determine the validity of bedside methods of blood glucose measurement in detecting hypoglycaemia.Methods: Blood glucose was determined by two bedside methods (Accuchek Active® and Betachek Visual®) in 430 patients aged between one month and 10years and simultaneously sent for laboratory spectrophotometric analysis at a wavelength of 500nm using the hexose kinase method. Hypoglycaemia was defined as plasma glucose < 2.5mmol/L.Results: The prevalence of hypoglycaemia was 5.6%.There was a higher correlation (r =0.84, p< 0.05) between Accuchek Active® results and laboratory values than was obtained with Betachek Visual ® (r = 0.48, p=0.000).In detection of hypoglycaemia, both bedside glucose monitors were found to have a high specificity and high predictive values of a negative test (99.8% and 98.5% for Accuchek Active® and 89.4% and 97.8% for Betachek Visual® respectively) with moderate sensitivity (75.0% and 66.7% respectively). However, the Accuchek Active® monitor has a much higher predictive value of a positive test (94.1%) compared to the Betachek Visual® (27.1%).Conclusion: The bedside glucose monitors are valid bedside tools for detecting or ruling out hypoglycemia.Keywords: hypoglycaemia, children, bedside investigation, glucose estimation, blood glucose

Exclusive breastfeeding practices among women attending a private health facility in Lagos, Nigeria

Background: Exclusive breast feeding (EBF) is an effective tool of child survival. While many mothers understand the importance of breast feeding, some circumstances may hinder the practice.Objective: To determine the pattern and factors influencing EBF among women attending a private health facility in Lagos, Nigeria.Methodology: One hundred and twelve mothers with children aged twelve months or less were interviewed through a questionnaire on their breastfeeding practices.Results: At the end of second month, two-fifths of the babies were still exclusively breastfed. This dropped to one-fifth by the end of the fourth month. At the end of six months, less than onetenth of subjects were still exclusively breastfed (3.6%). No association was found between breastfeeding pattern and variables such as gender of infants, place ofdelivery, maternal age, type of delivery and number of antenatal visits. On the contrary there was an association with following variables: birth order among mother siblings, prenatal and postnatal feeding advice.Conclusion: The rate of exclusive breast feeding among mothers forthe recommended six months was very low (3.6%). Antenatal and postnatal programmes that will encourage mothers to practice exclusivebreastfeeding should be strengthened.Key words: Exclusive breast feeding, survival analysis, practice, private hospital, mothe

Antibody response to routine measles vaccination among a population of Nigerian children and evaluation of vaccine potency

Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria.Objective: To determine antibody response to routine measles vaccinationin Nigerian children and evaluate vaccine potency.Methods: A prospective study of 234 children selected from 3 health centres in an urban area of Lagos, Nigeria. Blood was obtained before and 8-12 weeks after routine vaccination with Edmonston-Zagreb strain of measles vaccine. Antibodies were detected using the measles antibody neutralization test. Reconstituted vaccines samples were analysed forpotency on monolayers of Vero slam cells in 96-well tissue culture plates.Results: Twenty seven(11.5%) had pre-vaccination antibodies. Seroconversion rate among the 195 who returned for postvaccinationsampling was 69.2%: It was however 74.2% in children with no pre-vaccination antibodies compared to 17.6% in those with antibodies. (p<0.05). Only six (50%) of the measles vaccine vials were potent. Seroconversion rate among subjects vaccinated from potent vials was 74.3% compared with 42.9% in those vaccinated from non-potent vials (p = 0.006).Conclusion: Seroconversion to measles vaccination in our environmentis sub-optimal, partly attributable to low vaccine potency. Improvement of vaccine handling processes and booster doses of the vaccine are recommended

The influence of socioeconomic status on the hemoglobin level and anthropometry of sickle cell anemia patients in steady state at the Lagos University Teaching Hospital

Background: Sickle cell anemia (SCA) has multisystemic manifestations and is associated with severe morbidity and high mortality. It commonly affects growth leading to wasting and stunting.Aims and Objectives: This study aimed to determine the influence of socioeconomic status on the nutritional status using anthropometric measurements and steady-state hemoglobin, of children with homozygous SCA, aged 1 year to 10 years in steady state at the Lagos University Teaching Hospital.Materials and Methods: This is a cross-sectional study involving 100 children with SCA and 100 age-, sex-, and social class-matched controls that fulfilled the inclusion criteria. Social class was assessed using educational attainment and occupation of parents. Hemoglobin concentration was determined using the oxy-hemoglobin method.Results: This study demonstrated a significantly lower mean weight and weight-for-height in the SCA patients than those of controls (P < 0.001). By contrast, this study did not demonstrate any statistical significant difference in the mean height and mean body mass index of SCA patients and controls (P = 0.06) and (P = 0.12), respectively. The mean weight, height, and body mass indices of the subjects and controls were consistently below those of the NCHS standards. The magnitude of the difference from the NCHS standard was also more pronounced in the subjects, increased with advancing age and affected male subjects more than females. Progressive declines in the anthropometric attainment and hemoglobin concentration were observed from social class 1 to 4; this was statistically significant in controls (P = 0.00) but not in subjects (P > 0.1). However, SCA patients had significantly lower values than controls in each of the social classes.Conclusion: Poor socioeconomic status has an adverse effect on the nutritional status and hemoglobin of SCA patients