The belief among mothers that teething is a cause of purulent ear discharge: fact or fiction?

Background: Various myths and health beliefs have been associated with teething. Some of these beliefs and myths have dire health consequences on children especially in Africa. This raises the need for further research into the subject with the aim of establishing the persistence of such beliefs and offering appropriate health education..Methodology: This was a cross-sectional, multi clinic study involving 265 mothers whose children had erupted at least a tooth and attending the children`s out-patients, dental and the ear, nose and throat clinics of a tertiary hospital in south-west Nigeria. An interviewer administered questionnaire was used to collect data from the mothers.Results: The age range of the mothers was 23 to 51years with a mean of 32.5 years. 15.1%, 20.7%, 25.7% and 38.5% had, no formal, primary, secondary and tertiary education respectively. About two-third (61.9%) believe that teething is a cause of purulent ear discharge while 12.1% and 26.0% did not believe in, and were unsure of, any association between teething and ear discharge respectively. Peers, parents, health care workers and personal experiences were the sources of beliefs associating teething with purulent ear discharge in 62.8%, 21.9%, 6.0% and 9.3% of the cohorts respectively. None (0%) of the respondents had prior knowledge of proven causes of ear discharge.Conclusion: Many of the mothers had erroneous beliefs regarding teething and ear discharge and peer inuence appears to be a key factor in the promotion of such beliefs. There is a need to educate mothers on correct information about teething and proven causes of ear discharge.Keywords: Teething, Myths, Ear discharge, Peer influenc

Red Eye: The Red Herring of Otolaryngologic Diseases

Background: Red eye of otolaryngologic origin could present a diagnostic conundrum. A clear understanding of the otolaryngologic differential diagnosis is required to clinch a diagnosis. In this paper, we describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin. Objective:To describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin with a view to facilitate early diagnosis and treatment. Methods: Records of patients with red eyes of otolaryngologic origin were reviewed. The otolaryngologic culprits and features that proved their culpability were highlighted. Results: In all, 32 patients with red eyes of otolaryngologic origin were seen. Majority had used eye drops as primary eye care. About 71.9% seen by the general practitioners were referred to ophthalmologists on account of persistent ocular symptoms. The otolaryngologic culprits were mostly nasal and paranasal diseases. Eight(25%) required conservative treatment, 24(75%) required surgical intervention and 3(9.4%) developed complete blindness. Conclusion: This study shows that red eyes of otolaryngologic origin are mostly caused by nasal and paranasal sinus diseases. However, both patients and general practioners could be misled to believe the eye is the primary source of the ocular symptoms. Such diagnostic conundrum are associated not only with increased morbidities but also cost of treatments. The need to have a clear understanding of the otolaryngologic differential diagnosis of red eyes is hereby stressed. Also, the public must desist from arbitrary use of eye drops and the slogan: “If symptoms persits after 2 days consult your doctor” should be a community watchword

Backpack use and associated problems among primary school children in Nigeria: a call to action by stakeholders

Background: Carrying backpacks is believed to contribute to the musculoskeletal problems in school children. Studies on the use of backpacks by Nigerian school children are scanty.Objectives: To evaluate the use of backpack and associated problems among primary school children.Methods: A cross-sectional descriptive study was carried out on 813 children in six primary schools in Ado-Ekiti. Information about backpack use and associated problems were obtained.Results: 788 (96.9%) children carried backpacks daily. The backpacks were all double strapped and 85% pupils wore them on both shoulders. The backpacks of 64.1% of the pupils contained educational materials. In 79.1% of cases, the backpacks exceeded 10% of their body weights. Pain and loss of sporting time were associated with carrying backpacks in 23.2% and 8.2% respectively, 15.3% took analgesic and 5.5% had medical consultations because of backpack injuries. No pupil missed school and none was hospitalised for backpack injury. Complaint of pain was significantly associated with older subjects, carrying heavier backpack and longer period of carrying packs (p<0.001).Conclusion: Backpack use and associated health problems are common among school children in the study area. Health workers should enquire about backpack use in children presenting with back and shoulder pain. We recommend more studies on backpack use. Also, Government and other stakeholders should draw up guidelines regarding the use of backpacks in Nigeria as practiced in other countries. Professional bodies including the Paediatric Association of Nigeria (PAN), and other stakeholders should be involved in formulating such guidelines.Keywords: Backpacks, School children, Pain, Dysfunction, Nigeri

Preterm births in a resource constrained setting: sociobiologic risk factors and perinatal outcomes

Background: To determine maternal risk factors and perinatal outcomes of preterm births in south-western Nigeria.Methods: A retrospective study of preterm and term deliveries in a tertiary hospital in Nigeria. The delivery records were reviewed and case files of preterm births were identified and retrieved. Perinatal outcomes were determined by review of the postnatal and special care baby unit records. Multivariate logistic regression was carried out to determine factors independently associated with preterm births. Adjusted odds ratios and confidence intervals were determined.Results: The preterm birth rate was 5.7%. Prelabour rupture of membranes was the leading cause of preterm birth, while a third of them were unexplainable. Age >35yrs (AOR 2.16(1.36-3.42)), the unbooked status (AOR 2.52(1.76-3.61)), Previous history of preterm delivery (AOR 6.41(2.48-16.60)), pre-labour rupture of membranes (AOR 11.08(6.01-18.56)), antepartum haemorrhage (AOR 10.91(4.94-24.09)), multiple gestations (AOR 32.23(13.07-79.50)) and hypertension in pregnancy(AOR6.42(3.79-10.88)) were independently associated with preterm delivery. Low birthweight, asphyxia, neonatal intensive care unit admission and perinatal mortality were common among preterm births. The perinatal mortality rate among the preterm neonates was 14.5%.Conclusion: Preterm birth remains a significant cause of perinatal deaths. Strategies addressing potentially modifiable risk factors will reduce the incidence and improve the perinatal outcomes associated with preterm births.Keywords: preterm delivery, prematurity, perinatal mortality, Nigeria

The financial burden of sickle cell disease on households in Ekiti, Southwest Nigeria

Oladele Simeon Olatunya,1,3 Ezra Olatunde Ogundare,1,3 Joseph Olusesan Fadare,2 Isaac Oludare Oluwayemi,1,3 Oyinkansola Tolulope Agaja,3 Babajide Samson Adeyefa,3 Odunayo Aderiye3 1Department of Paediatrics, Ekiti State University, Ado Ekiti, Nigeria; 2Department of Clinical Pharmacology, Ekiti State University, Ado Ekiti, Nigeria; 3Department of Paediatrics, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria Background: Studies on economic impact of sickle cell disease (SCD) are scanty despite its being common among children in developing countries who are mostly Africans.Objective: To determine the financial burden of SCD on households in Ado Ekiti, Southwest Nigeria.Methods: A longitudinal and descriptive study of household expenditures on care of 111 children with SCD managed at the pediatric hematology unit of the Ekiti State University Teaching Hospital was conducted between January and December 2014.Results: There were 64 male and 47 female children involved, aged between 15 and 180 months. They were from 111 households, out of which only eight (7.2%) were enrolled under the National Health Insurance Scheme. The number of admissions and outpatients' consultations ranged from 1 to 5 and 1 to 10 per child, respectively. Malaria, vaso-occlusive crisis, and severe anemia were the leading comorbidities. The monthly household income ranged between ₦12,500 and ₦330,000 (US$76 and US$2,000) with a median of ₦55,000 (US$333), and health expenditure ranged between ₦2,500 and ₦215,000 (US$15 and US1,303) with a mean of ₦39,554±35,479 (US240±215). Parents of 63 children lost between 1 and 48 working days due to their children's ill health. Parents of 23 children took loans ranging between ₦6,500 and ₦150,000 (US$39 and US$909) to offset hospital bills. The percentage of family income spent as health expenditure on each child ranged from 0.38 to 34.4. Catastrophic health expenditure (when the health expenditure >10% of family income) occurred in 23 (20.7%) households. Parents who took loan to offset hospital bills, low social class, and patients who took ill during the study period significantly had higher odds for catastrophic health expenditure (95% confidence interval [CI] 5.399–87.176, P=0.000; 95% CI 2.322–47.310, P=0.002; and 95% CI 1.128–29.694, P=0.035, respectively).Conclusion: SCD poses enormous financial burden on parents and households.Keywords: sickle cell disease, family income, health expenditure, financial catastrophe, Nigeri

Demographic survey and management outcome of Post-Neonatal Tetanus at the Ekiti state university teaching hospital, Ado Ekiti

Background: Tetanus continues to threaten the survival of children in spite of it being a vaccine preventable disease. The objective of this study was to determine the prevalence of post-neonatal tetanus, review the vaccination of affected children, complications encountered and the outcome among affected children in a tertiary health institution in southwestern Nigeria. Methods: The study was a retrospective study. Case notes of children outside neonatal life admitted to the Paediatric ward with clinical diagnosis of tetanus between January 2012 and October 2018 were retrieved and evaluated to identify socio-demographic and clinical characteristics. A review of the immunization history and cards was done where the immunization cards were available. Results: 21children with post-neonatal tetanus were admitted over a period of six years (November 2012 to October 2018) with a prevalence of 0.3%. The M:F was 3.2:1. The mean age in years was 10.14 ±3.44 while the age range of the subjects was 4 to 16years. None of the patients had booster doses of tetanus toxoid (TT) outside the infancy period. Nine (42.9%) subjects had no previous TT vaccination, 2 (9.5%) had 3 doses of TT vaccine in infancy but developed tetanus at age ≥9 years, 1(4.8%) subject had a dose of TT while the remaining 9subjects had no proof of previous TT vaccination. The percentage mortality was 19% (4 out of 21). All the patients that died had no prior record of TT vaccination. Complications identified included laryngeal spasm and autonomic dysfunction. Conclusion: Post-neonatal tetanus is still common in our locality because booster doses of Tetanus Toxoid are not part of the national immunization schedule. Complete dose of tetanus toxoid vaccination during infancy and booster doses at school entry is necessary and should be part of school health programme to forestall post-neonatal tetanu