Changing Pattern of Bacteriuria among Asymptomatic Secondary School Adolescents within Enugu South East Nigeria

Background: Urinary tract infection is one of the infections that could lead to chronic kidney disease. Most of the offending isolates are usually Gram-negative bacteria such as Escherichia coli. Adolescent age groups are a special group of individuals who indulge in some risk behavior that could predispose them to urinary tract infections with possible mixed flora.Aim: The aim was to determine the burden of Gram.positive significant bacteriuria among adolescents in Enugu.Subjects and Methods: A survey of 628 adolescents attending secondaryschools in Enugu was studied. Information on sociodemographic profile was obtained using a self-administered questionnaire. Clean-catch urine sample was collected using a sterile boric acid bottle, and this was cultured in both anaerobic and aerobic media. Significant isolates were Gram-stained in order to determine their characteristics. Data were analyzed using SPSS version 15.0.(Chicago Illinois USA). Results: There were 324 females and 304 males. Significant bacteria growth was identified in 61 samples giving a prevalence rate of 9.7% (61/628). Gram-positive bacteria were isolated in 77.1% (47/61) of samples, while Gram-negativebacteria were isolated in 22.9% (14/61) of samples. Staphylococcus saprophyticus was the most common Gram-positive organism isolated this consists 38.3% (18/47) while E. coli was the most common Gram.negative bacteria isolated comprising 64.2% (9/14). Other Gram-positive bacteria isolated were Staphylococcus auerus, Staphylococcus epididimis. All isolated bacteria were more common in females 44/61 (72.1%) than males 17/61 (27.9%).Conclusion: Gram-positive bacteriuria is prevalent among secondary school adolescents, and S. saprophyticus is the most common Gram-positive organism implicated. Further studies should be undertaken to determine the risk factors and possible sensitivity pattern among the age group.Keywords: Adolescents, Bacteriuria, Urinary tract infectio

Violence and mental health among adolescents in South East Nigeria

Background: There is a rise in the prevalence of mental illness among adolescents and the impact of violence on this rising trend requires to be evaluated. Aim: The aim of the study is to better understand the impact of violence on adolescent's mental health. Materials and Methods: The study was a cross-sectional school-based study. Adolescents in the selected schools were interviewed using a structured questionnaire. Information on previous experience of violence, the action is taken, and the effect on them was collected. Data were entered and analyzed using SPSS. The level of significance was at P < 0.05. Results: A total of 716 adolescents were studied over a one month period. The prevalence of violence was 87%. About 57.2% of the violence occurred at home, 44.2% was carried out by relatives and 49.2% happened within the past six months. Sexual abuse was 10.2%. Among the adolescents that experienced violence, 58.7% suffered some form of mental illness. There was a significant difference between the action the adolescents took after the violent incident and the action that was considered appropriate for it (P = 0.00001). Female gender (P = 0.042), not living with parents (P = 0.015) and poverty (P = 0.00001) significantly correlate with adolescent violence. Conclusion: Violence is high among adolescents and associated with a high prevalence of mental illness. Interventional measures targeted at reducing violence by improving poverty alleviation programs that empower families to carter for their children should be implemented

Disseminated Histoplasmosis in a 13-year-old girl: A case report

BACKGROUND: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune-compromised individuals such as those with acquired immuno-deficiency syndrome. OBJECTIVE: To describe a case of disseminated histoplasmosis in an adolescent girl. METHOD: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. RESULT: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. CONCLUSION: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-year-old girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria

Timing of cardiac surgery and other intervention among children with congenital heart disease: A review article

Background: Early diagnosis and improved facilities are necessary for determining the optimal timing of surgery and other interventions in children with congenital heart diseases in Nigeria. This is because late presentation, late diagnosis and delayed surgery can lead to mortality and affect the quality of life among these children. Objectives: This review article is aimed at enumerating the timing of cardiac surgeries and other interventions and to seek if there is any factor associated with the timing of cardiac surgery. Methods: A search on PubMed database, World Health Organization libraries, Google scholar, TRIP database, and reference lists of selected articles on timing of cardiac surgery in children was done. The Cochrane Database of Systematic Reviews was also searched. We noted few data from African setting. Key words such as timing of cardiac surgery; children, congenital heart defect were used. Conclusion: Appropriate timing for cardiac surgery in children with congenital heart disease is very important as late surgical intervention could result in several morbidities and mortality