The serum concentrations of zinc, copper and selenium in children with inflammatory bowel disease

A CAJM article on IBD.Inflammatory bowel diseases (IBD) are a group of chronic inflammatory process of the bowel whose aetiology is unknown and are seen commonly in Caucasians and Jews, but rarely in blacks.1,2 These conditions are characterised by recurrent bloody diarrhoea, abdominal pain, tenesmus, malaise, perianal abscess and anaemia resulting in malabsorption and increased loss of nutrients.3 Zinc and selenium have been reported to be low in adults with IBD4,S and children with allergic colitis.6 Zinc deficiency leads to a decreased natural killer cell activity.7,8 There are conflicting reports of the copper status of adults with IBD.9,10 Oxygen free radicals mediate tissue injuries and a high level of free radicals has been observed in IBD.9 Antioxidant agents of which selenium and zinc are important mop up these free radicals. The available literature on the trace element status of children with inflammatory bowel disease is limited. Since trace elements are scavengers of free radicals, and since free radicals are high in IBD, this study aims at estimating the levels of the trace elements in children with IBD

Acute diarrhoea in hospitalized under-five children in Ilorin, Nigeria: Relationship between isolated enteropathogens and clinical outcome

Background: Acute diarrhoea due to different enteropathogens contributes significantly to childhood morbidity and mortality globally, despite the advances made in diarrhoea management via use of fluid therapy and zinc supplementation. Aim: To determine the prevalence of bacterial and viral etiology among children hospitalized with acute diarrhoea and the relationship with clinical outcome. Methods: A total of 135 children aged one to 59 months with acute diarrhoea were recruited in Ilorin, Nigeria. Stool specimens were investigated for three viruses (rotavirus, adenovirus and norovirus) and bacterial pathogens using immunochromatographic and conventional culture techniques respectively. Results: One hundred and twenty-two (90.4%) study participants had stools that yielded enteropathogens, while 13 (9.6%) had no isolates. Sixty-one (45.2%) children had a single pathogen isolated, while 61 (45.2%) had co-infections. The prevalence of viruses was 17.0% with rotavirus, adenovirus and norovirus detected in 10.3%, 3.7% and 3.0% respectively. Bacterial pathogens were isolated in 28.2% with Escherichia coli (14.1%), Klebsiella spp. (8.2%), Proteus spp. (3.7%) and Pseudomonas aeruginosa (2.2%) detected as isolates. The duration of hospital stay, likewise the duration of diarrhoea were prolonged by the presence of an infectious aetiology and co-infections (p <0.001 and p =0.04 respectively). However, these clinical outcomes were not influenced by the type of bacteria/virus isolated nor the enteropathogens constituting co-infection (p >0.05). Conclusions: There was a high burden of infectious aetiology of childhood diarrhoea, with bacteria being the predominant enteropathogens isolated. The clinical outcomes of the children studied were influenced by the isolation of enteropathogens and the presence of multiple infections

Hepatic function tests in children with sickle cell anaemia during vaso occlusive crisis.

A CAJM article on Hepatic function tests done on children suffering from sickle cell anaemia.There is evidence in the literature suggesting that biochemical and morphological hepatic changes occur in sickle cell anaemia patients.1'7 It is however, uncertain whether or not these changes which occur during crisis are reversible. Earlier studies have demonstrated an impairment of liver functional integrity with a rise in serum transaminases, but the extent of the hepatic injury has not been documented.4,5 This study was conducted to assess the hepatic functional derangement that occurs during vaso-occlusive crisis using biochemical techniques, to document the extent of derangement, and whether or not there was recovery

Glucose 6 phosphate dehydrogenase levels in babies delivered at the University of Ilorin teaching hospital.

Background: Glucose-6-phosphate dehydrogenase deficiency, an X-linked recessive disorder, is the most common enzymopathy producing disease in humans.It is known to cause severe neonatal hyperbilirubinaemia. Aims and Objectives: To determine G6PD levels in babies delivered at the University of Ilorin Teaching Hospital with a view to determining the prevalence of G6PDdeficiency. Methods: Samples of cord blood were collected at delivery, from 933 babies who met set criteria. Blood was assayed for G6PD levels using a quantitative in vitro test (RANDOX©). Results: A total of 348 (37.3%) of the 933 tested subjects had G6PD deficiency with enzyme activity of ≤ 2.8U/gHb. Glucose 6 Phosphate Dehydrogenase levels in female babies with normal enzyme levels were significantly higher than in male babies with normal enzyme levels (5.72 ± 2.45 U/gHb versus 4.99 ± 2.3 U/gHb, p = 0.002). Enzyme levels in babies with G6PD deficiency was comparable in both males and females (2.05 ± 0.60 u/gHb in females and 2.1 ± 0.66 U/gHb in males, p = 0.66). The prevalence of G6PD deficiency was comparable among males and females (p = 0.81 Χ²= 0.06, RR = 1.02 , CI = 0.9 0 < R R < 1.15 , OR=1.04). Conclusion: There is a high prevalence of G6PD deficiency in babies delivered at the University of Ilorin Teaching Hospital, and the enzyme deficiency appears to occur equally among the sexes.Key words: Glucose-6-phosphate, neonates, cord bloo

Risk factors for Hepatitis C virus antibody seropositivity among children with sickle cell anaemia in Ilorin, Nigeria

Background: Hepatitis C is an infectious disease of the liver caused by the hepatitis C virus (HCV) resulting to a chronic hepatitis. Chronic HCV infection constitutes a serious public health challenge in Nigeria where donor blood is not routinely screened for HCV. Patients with sickle cell anaemia (SCA) are considered a subset of the population at higherrisk of acquiring the virus, due to their frequent needs for transfusion of blood and its products. Other risk factors like scarification markings, tattooing, and circumcision also predispose children to acquiring this infection. However, the magnitude of HCV infection has not been adequately measured in our general population and specific data on HCV in SCA patients are scanty, hence a prospective case controlled study to determine the risk factors that predispose to the acquisition of hepatitis C Virus infection.Objective: To determine the risk factors for Hepatitis C Virus Antibody Seropositivity among transfused children with SCA in Ilorin.Subjects and Method: Eighty two transfused SCA children aged 6 months to 14 years were recruited consecutively from February 2008 to January 2009 while eighty four non transfused SCA children of the same age range recruited over the same period served as controls. Hepatitis C virus Antibody screening was done using a second generation ELISA method. Information on the study population were collected by use of a pretested questionnaire by the investigator.Results: There was a positive correlation between numbers of units of blood transfused and seropositivity. Those who had three or more units of blood had a prevalence rate of more than 50%. There was a strong correlation between seropositivity and scarification marks in both subjects and controls (p=0.001 and 0.02 respectively). Other plausible risk factors for hepatitis C infection tested in this study included circumcision and sharing of clippers which showed no statistically significant difference. No cases of tattooing, drug abuse, needle sharing or sexual activities were seen in this study.Conclusion: Transfused SCA patients belong to a high risk group for hepatitis C virus infection compared to the nontransfused population. The risk of acquisition increases with higher number of transfusions and scarifications marks.Key words: Hepatitis C virus, Sickle cell anaemia, Risk factors, Blood transfusion

Risk factors and seroprevalence of hepatitis C antibody in mothers and their pre-school age children in Ilrorin

No Abstract. African Journal of Clinical and Experimental Microbiology Vol. 7(3) 2006: 155-15

The burden of under-nutrition among school aged children in Ilorin north central Nigeria

Background: Nutrition is a major determinant of a child’s overall  development and learning. The new trend of malnutrition, described as  double burden of malnutrition, is one in which under-nutrition is coexisting with over-nutrition and is a major problem facing the world today. Under-nutrition is the most common health disorder among children, linked with  various diseases causing death in developing countries. There is paucity of data on the burden of under-nutrition among school aged children in Ilorin and Nigeria as this is presently not routinely done hence this study.Objective: To determine the prevalence of under-nutrition among school age children in Ilorin.Methods: A cross sectional descriptive studies of school aged children in Ilorin Kwara State using a multi – staged sampling techniques. Sixteen primary schools, eight public and equal number of private school pupils were recruited for the study. The anthropometric measurements were taken to determine the anthropometric indices using the World Health  Organization (WHO) reference 2007.Results: A total number of 480 primary school pupils from Ilorin were recruited. Males were 221 (46.0%) with a M:F of 1:1.2 and a mean age of 9.2 ± 1.8 years. The prevalence of underweight and stunting were 15.4% and 11.5% respectively. There are more underweight and or stunted children among the public school pupils compared with the private school pupilsConclusion: The study brings to the fore the magnitude of under-nutrition among school children in Ilorin Nigeria. Routine nutritional assessment of primary school children is advocated as against the present practice where such an important survey is limited to once and at the point of school entry only. The ongoing pilot school meal programme should also be extended to all states of the federation

Febrile Convulsion among Hospitalized Children Aged Six Months to Five Years and Its Association With Haemoglobin Electrophoretic Pattern

BACKGROUND: Febrile convulsion and sickle cell disease are common in tropical countries and both are associated with significant morbidity and mortality. Worldwide, Nigeria has the highest prevalence of sickle cell disease. However, there is a dearth of knowledge on the haemoglobin electrophoresis in patients with febrile convulsions.METHODS: This was a hospital based, descriptive, cross-sectional study of the relationship between haemoglobin genotype and febrile convulsion at the University of Ilorin Teaching Hospital over a period of 12 months. A self-designed pretested questionnaire was administered on the subjects, and necessary examinations and investigations were conducted.RESULTS: Of a total of 1675 children admitted into the emergency paediatric unit during the study period, children aged 6 months–5 years that presented with febrile convulsions were 167(10%) . Of this, 1,212 were aged 6 months-5 years. Thus, the age specific, hospital-based prevalence was 13.8%. The M:F was 1.1:1. Their Haemoglobin genotype distribution was AA 131(78.4%), AS 23(13.8%), AC 6(3.6%), SS 6(3.6%), and 1(0.6%) SC. The mean age of the sickle cell disease patients was higher at 46.0±13.5 months compared to 29.2±15.4 months in the non-sickle cell disease patients (p=0.005). The mean packed cell volume in subjects with sickle cell anaemia was 8.8±1.5%; the only case of haemoglobin SC had packed cell volume of 20%, while the non-sickle cell disease patients had a normal PCV. Malaria was present in 80.4% of them.CONCLUSION: Febrile convulsion remains a common cause of hospitalisation. It is uncommon in haemoglobin SS where severe anaemia is always an accompanying derangement. The packed cell volume is nearly normal in children with normal haemoglobin genotype.KEYWORDS: Febrile Convulsion, haemoglobin genotype, children, Malari

OCULAR FINDINGS IN CHILDREN WITH CEREBRAL PALSY ATTENDING A TERTIARY HOSPITAL IN NORTH CENTRAL NIGERIA

Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria.   We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of Ilorin Teaching Hospital, Nigeria (UITH). A cross sectional survey of children with cerebral palsy presenting at Pediatric neurology clinic of UITH between January and December 2012 was done. Age appropriate visual acuities were checked, ocular examination was done with hand held Slit Lamp and Cycloplegic refraction and fundoscopy done with indirect Ophthalmoscope. Thirty - seven (42.5%) of 87 subjects seen within that period presented for ocular assessment. There were 24 males (64.9%) and 13 females (35.1%) with a male female ratio of 1.8:1. The age ranged between 6-168months with a mean of 50.11+ 46.51months. Thirty- three (89.2%) were delivered full term while 4(10.8%) were preterm. Spastic cerebral palsy accounted for 45.9% of all the cases seen.  Strabismus was found in thirteen subjects (35.1%). This was esotropia in 7(54%) and exotropia in 6 (46%) subjects. Refractive error was found in 32(86.5%) subjects and Cortical Visual Impairment (CVI) in 28(75.7%) subjects    CVI, refractive errors and strabismus are the most common ocular findings in children with Cerebral Palsy in Nigeria. Early detection and early intervention is important to achieve best developmental and educational attainment. Multidisciplinary approach involving Neurologists, Ophthalmologists, and Physiotherapist is paramount in managing these children from the time of diagnosis.

Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria