4 research outputs found
Assessment of extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, federal capital territory, Nigeria
BACKGROUNDPhysical inactivity, a phenomenon that cuts across age groups, is increasingly becoming a menace among children globally. With a rise in the obesity rates among children in the last three decades, lack of physical activity is a cause for major concern among school-aged children.
AIMThis study aimed to assess extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, of the Nigerian capital
METHODOLOGYA cross-sectional study was conducted among 146 primary schools. Respondents’ interviews and direct observations were used. The findings were entered into a questionnaire adapted from School Health Program Evaluation questionnaire.
RESULTWhile 5 (3.4%) of the schools surveyed allotted three periods a week for physical activities/ health education, 106 (72.6%) assigned two periods per week for this. All the schools surveyed observed break periods/ recess. A total of 39(36.8%) private schools, compared with 33(82.5%) public schools, had sports fields (p<0.001). Within the preceding year of the study, one hundred and seventeen (80.1%) of the schools staged drama as a form of periodic extracurricular activity. Inter-house sports was organized by 22(55.0%) public and 19(17.9%) private schools (p<0.001).
CONCLUSIONMost of the schools carried out varying forms of extracurricular activities on a daily, weekly or annual basis. Physical activities were more commonly undertaken in public schools. Private schools should be compelled by the appropriate authorities to provide adequate space for sporting and other physical activities. The schools should be made to adopt the recommendations of the World Health Organizatio
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Perception of Substance Use among In-School Adolescents and Key Informants in Gombe State, Nigeria
Background: Substance use has gradually become a global problem resulting in negative effect on the physical, mental and social wellbeing of individuals. This study aimed to determine the perception of adolescents and key informants on substance and illicit drug use in order to control this menace.Methods: A cross-sectional study design employing qualitative method of data collection. Focused Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted. All data generated were collated and analysed using content analysis. Results: The key informants reported that peer influence, male sex and having broken homes were factors that were responsible for substance use. Adolescents also reported that easy access to these substances, the zeal to perform better in school, ability to have more fruitful relationships and ability to confront their parents were some of the reasons they engaged in substance use. Conclusion: This study has therefore implied that adolescents in school have easy access to and engage in substances despite being aware of the complications as it is mostly done to address their social needs.Recommendation: It is therefore recommended that periodic mental health screening should be conducted for adolescents with the support of their parents and guardians in line with school health services in order to identify and manage those with mental problems that could predispose them to use of substances
Burden and outcome of respiratory morbidities among children and adolescents with sickle cell disease-A retrospective review of emergency presentations in some Nigerian tertiary institutions.
BackgroundDespite the huge burden of sickle cell disease (SCD) among Nigerian children, the burden and outcome of respiratory illnesses remain undocumented. Thus, we aimed to describe the spectrum and outcome of respiratory illnesses among SCD childrenand adolescentadmissions in ten Nigerian tertiary hospitals.MethodA retrospective review of the SCD admission records of children and adolescents with a confirmed diagnosis of respiratory illnesses from 2012 to 2021 in ten tertiary health facilities across five geopolitical zones in Nigeria was conducted. The data, collectedbetween March and June 2023, included the age, sex, diagnosis, complications, duration and outcome of hospitalization.ResultsOf the 72,333 paediatric admissions, 7,256 (10.0%) had SCD; the proportion of SCD from the total admission ranged from 2.1 to 16.3% in the facilities. Of the 7,256 children and adolescents with SCD, 1,213 (16.7%) had respiratory morbidities. Lower respiratory disease was the most common (70.0%) respiratory entity and the majority were pneumonia (40.1.0%), followed by acute chest syndrome (26.7%). Seventeen (1.4%) patients died; all had lower respiratory diseases [(acute chest syndrome ACS (11, 64.7%), pneumonia; 5, 29.4%, and asthma (1, 5.9%). Based on the proportion of deaths among overall SCD, the 17 death cases contributed 9.4% (95% CI 5.9 to 14.5). Factors associated with deaths included duration of hospitalization less than 72 hours and lower respiratory tract diseases.ConclusionSickle cell disease is a major contributor to hospitalization among Nigerian children and adolescents, with high respiratory morbidity and mortality. Pneumonia and acute chest syndrome were associated with mortality, andthe highest risk of death within the first 72 hours