An evaluation of school health services in Sagamu, Nigeria

Context: School health services (SHS) have been shown to be suboptimal in Nigeria. The paucity of data on the status of SHS in Sagamu makes it even more challenging for instituting corrective action.Aim: To evaluate SHS in public and private schools in Sagamu.Settings and Design: This was a cross.sectional study carried out on private and public nursery/primary and secondary schools in Sagamu, Ogun State.Materials and Methods: A total of 91 schools, randomly selected from 182 available, comprising 53 private nursery/primary schools, 22 public nursery/primary schools, 11 private secondary schools and 5 public  secondary schools,were inspected for availability of the components of the SHS and evaluated using the SHS Evaluation Scale (SHSES). Statistical Analysis Used: Data were analyzed using SPSS version 15.0. Categorical variables were analyzed using Chi-square test. Level of significance was taken to be P < 0.05.Results: Only one (1.1%) school benefited from the services of a school doctor. Essential drugs and materials for first aid services were available in 85 (93.4%) of the schools, while only 26 (28.6%) had a sick bay. Screening tests for disabilities were performed in only 10 (11%) of the schools visited. Although school midday meals were available in all the schools, they were not free. Private secondary schools had the highest percentage of good school health evaluation scores (63.6%), while 96.2% of the private primary schools had poor health service evaluation scores. Conclusions: SHS are unsatisfactory in Sagamu. It is therefore necessary for all stakeholders in Sagamu schools (private and public) to provide the materials and manpower needed to achieve effective SHS in the area.Key words: School Health Services, School Health Services Evaluation scale, Health knowledge, Nigeri

Relationship between anthropometric parameters and the location of apex beat in children

Background: Childhood growth is characterized by changes in anthropometric parameters. The location of the apex beat may besimilarly influenced by growth.Objectives: The objective of this study was to determine any relationshipbetween the location of the apex beat and anthropometric parameters.Subjects and Methods: This crosssectional survey was carried out inSagamu, Nigeria. Apparently healthy children were randomly selected for the study. Apex beat location in the intercostal space was determined and distance from the midline was recorded. Weight and length/height were also recorded while Body Mass Index (BMI) and Body Surface Area (BSA) were calculated.Results: A total of 237 children aged 12 hours to 10 years were surveyed.The mean distance of the apex beat from the midline from birth to 10 years ranged from 2.3cm to 6.4cm. The mean distance of apex beat from the midline increased progressively with weight, height, chest circumference and BSA but not with BMI. Strong correlations were observed betweendistance of apex beat from the midline and weight (r = 0.850, p .0.001); height (r = 0.867, p .0.001); chest circumference (r = 0.833, p . 0.001); BSA (r = 0.862, p . 0.001) but not with Body Mass Index (r = 0.019, p = 0.774).Conclusion: The location of the apex beat in children was stronglyinfluenced by growth as suggested by anthropometric parameters.Key words: Anthropometry, apex beat, children, mid-clavicular line,nipple lin

Relationship between age and location of the apex beat among apparently healthy Nigerian children

Background: Normal location of apex beat varies with age in children. Location of apex beat is an integral part of routine cardiovascular system examination in clinical practice. However, there is paucity of literature on apex beat location in Nigerian children. Objective: The aim of this study was to locate apex beat position in apparently healthy Nigerian children from birth to ten years, and to relate the location with age. Subjects and Methods: This was a cross sectional study carried out in Sagamu, Nigeria. A sample size of two hundred and thirty-seven was calculated from a previous study. Hence two hundred and thirty-seven apparently healthy Nigerian children who satisfied the inclusion criteria were enrolled for the study. Apex beat location in the intercostal space was determined and distance of apex beat from the midline, midclavicular line and nipple lines were measured. The measured distances were related to age using linear regression and Pearson correlation. Results: The mean distance of apex beat from the midline from birth to 10 years ranged from 2.3cm to 6.4cm. The distance of apex beat from the midline increased progressively with age. In children up to the age of three years, the apex beat was in the 4th left intercostals space. In 91.7%, 51.3% and 14.3% of children aged four, five and six years respectively, the apex beat was present in the 4th left intercostal space. Above six years, it was located in the 5th left intercostals space. Conclusion: The location of the apex beat from the midline was strongly related with age Thus, the distance of apex beat from the midline can be predicted from age in months.Keywords:  Apex beat, Children, Mid-clavicular line, Nigeria, Nipple lin

Subacute combined degeneration of the spinal cord in a Nigerian child: a need for a high index of suspicion

Background: Vitamin B12 deficiency has been reported to be associated with a spectrum of neurological disorders among which is subacute combined degeneration of the spinal cord.Method: We report a case of subacute combined degeneration of the spinal cord secondary to vitamin B12 deficiency and discussed the clinical presentation and management challenge.Result: The diagnosis was made through a high index of suspicion when the clinical presentation ranked highly with the mode of presentation of Vitamin B12 deficiency. Patient responded well to parentheral vitamin B12 preparation but subsequently defaulted from follow up for 8 years after which he represented with paraparesis and urinary incontinence. He was managed again with parentheral vitamin B12 preparations with good outcome and total resolution of symptoms at discharge.Conclusion: A high index of suspicion is needed in identifying vitamin B12 deficiency related paraparesis in paediatric practice while the need for indefinite treatment and follow up is hereby emphasized.Keywords: Vitamin B12 deficiency; myelinopathy; paraparesis; subacute combined degeneratio