Prevalence of neonatal septicaemia in the University of Port Harcourt Teaching Hospital, Nigeria

Background : Septicaemia is a major cause of morbidity and mortality in the neonatal period. Early detection of neonatal septicaemia is often hampered by its subtle and nonspecific symptoms and signs thus a high index of suspicion is needed.Objectives: To determine the prevalence of neonatal sept ic a emia , ident i fy the predisposing factors, clinical features and causative organisms inthe University of Port Harcourt Teaching Hospital.Methods: Four hundred and six neonates with clinical suspicion of sepsis were recruited into the study over a six months period. Blood culture was used as gold standard for the diagnosis of neonatal septicaemia.Results: One hundred and sixtynine (41.6%) neonates had positive blood culture giving a prevalence rate of neonatal septicaemia as 33.1%. Thepredominant predisposing factors were out-born delivery (68.0%), birth asphyxia (30.2%) and prematurity (21.4%) while the major clinical features of septicaemia were respiratory distress (30.2%), fever (26.6%)and poor suck (22.5%). Klebsiella pneumoniae ( 6 5 . 4 % ), Staphylococcus aureus (15.4%) and Escherichia coli (7.7%) were the commonest organisms isolated in neonates with septicaemia.Conclusion: Prevalence of blood culture-proven septicemia is high, being 33.1%. Klebsiella pneumoniae is the predominant cause of neonatal septicaemia in Port Harcourt.Key Words: Neonatal septicaemia; Prevalence; Port Harcourt

Perception of Rape Amongst Secondary School Students In Port Harcourt

Background: Rape in children is a significant public health problem and represents the least reported but most devastating major form of child abuse all over the world. It occurs when one person does not fully and freely consent to sexual intercourse. This study seeks to evaluate the perception of rape among secondary school students in Port Harcourt.Methods: This study was conducted among secondary school students during a series of debates organised by the Medical Women Association of Nigeria in Port Harcourt. Using a structured, anonymous and self-administered questionnaire, data collected included bio data, awareness information, response and practices.Results: One thousand and fifty students, 486 (46.3 %) males and 564 (53.7 %) females participated in the study. Their ages varied between 10 and 20 years with a median age of 15. 872 (83%) knew the general definition of rape but only 4% knew that intercourse between an adult and a minor is also rape. 412 (39.3%) believed that only persons between 16 and 19 years could be raped. 442 (42.1%) believed that anyone, both relatives and strangers could be the perpetrator. Only 138 (13.2%) knew that rape should be reported to the police. 48(4.6%) of them had been raped, of which 62.5% were by close acquaintances.Conclusion: The study shows that respondents had a fair general knowledge about rape but the perception of age at risk and actions to take in case of rape is poor. There is therefore need for  awareness/enlightenment campaigns about rape targeted at secondary  school students.Key words: rape, secondary schools, student

Pattern of congenital heart defects in children with Down syndrome at the University of Port Harcourt Teaching Hospital, Port Harcourt

Down syndrome (DS) is the most common chromosomal abnormality in man and congenital heart defects (CHD) the most life threatening of its manifestations. The cardiac anomalies and early pulmonary hypertension are associated with high morbidity and mortality. It is thus important to diagnose and intervene early to improve the quality of life. Few studies have been done on Down syndrome patients in Nigeria. Objective: The objective was to find out the incidence and types of congenital heart defects in Down syndrome patients seen in the Paediatric cardiology unit of this tertiary institution. Method: A prospective study of Down Syndrome patients seen at the Paediatric Cardiology clinic of the University of Port Harcourt Teaching Hospital over a three year period was carried out. Data of age, sex, birth order, mother’s age, indication for surgery, clinical and echocardiographic findings and outcome was analysed. Result: Of the 31 patients who had echocardiography done, all had cardiac defects (100%). Patent ductus arteriosus, occurring solitarily or in combinations was the commonest cardiac defect seen followed by ventricular septal defects. Interestingly, over 60 % of the patients had multiple cardiac defects with VSD/PDA, VSD/ASD accounting for 50%. Conclusion: The incidence of multiple cardiac defects in more than 60% of DS patients seen underscores the need for early diagnosis and intervention. Routine extensive cardiac evaluation in  the first few weeks of life is advocated.Key word: Down syndrome, congenital heart defects, Port Harcourt, Nigeria

Evaluation of Teachers’ Performance of Vision Screening in Primary School Children in Port Harcourt

Objective: To evaluate the ability of primary school teachers toperform simple vision screening on their school pupils, so asto determine if they can provide the first level of school visionscreening services, and refer to the ophthalmologist for furtherevaluation when necessary.Methods: Using a multi-stage sampling technique, 130 teacherswere randomly selected from 13 schools in Port HarcourtLocal Government Area of Rivers State. They were trained forsix hours at a skills acquisition workshop on vision disordersin children and vision screening using Snellen visual acuitycharts. Subsequently, they screened 1,300 of their pupils, whowere all re-screened by the research team.Results: One hundred and ten female (84.6%) and 20 maleteachers (15.4%) participated in the study. Seventy (53.8%)were from public schools while 60 (46.2%) were from privateschools. The sensitivity of the teachers’ visual acuity test,compared to that of the research team, was 53.3%, with a highspecificity of 94.6%. The positive and negative predictivevalues of the teachers’ test were also high. The teachers’ visualacuity measurements showed moderate agreement with thatof the research team with a Kappa score of 0.604.Conclusion: The study concluded that trained primary schoolteachers can effectively perform vision screening in schoolchildren using Snellen visual acuity charts for early detectionand treatment of vision disorders in school pupils

Epidemiology of childhood heart failure in Port Harcourt, Nigeria

Background: Heart failure (HF) is a clinical syndrome that complicates a variety of childhood illnesses. Recent studies in various parts of Nigeria show a prevalence rate of 5.8-15.5%. There is relatively scant data on heart failure in children in the south-south geo-political region of the country, necessitating this study.Aim: To determine the epidemiology of HF in the University of Port Harcourt Teaching HospitalMethods: A prospective study of consecutive children presenting with three of the four cardinal signs of HF (tachycardia, tachypnoea, tender hepatomegaly and cardiomegaly), over one year. Data sought included age, sex, underlying cause of HF and outcome.Results: There were 1152 children admitted into the Children Emergency Ward (CHEW) during the period; 75 met the criteria for HF giving a prevalence rate of 6.5%. There were 39(52.0%) males and 36(48.0%) females. Their ages ranged from 1month to 11years. Common acute causes of HF were pneumonias 32(42.7%) and severe anaemia secondary to severe malaria 27(36.0%). Thirteen patients had underlying chronic diseases such as congenital heart diseases in 11(14.7%), sickle cell anaemia in 1(1.3%), and renal disease in 1(1.3%). Hospital stay ranged from 1 to 15 days. Six mortalities were recorded.Conclusion: HF is a common complication of the emerging double burden of communicable and non-communicable childhood diseases in Nigeria and a potential contributor to mortality in these diseases. An up-scaling and sustenance of effective infectious disease control measures and screening and early detection of chronic diseases is necessary to avoid complications and preventable death in Nigerian children. Keywords: Heart failure, Childhood, Epidemiology, Port Harcour

The effect of some social factors on adolescents nutritional status in an oil-rich Niger-Delta region of Nigeria

Background: Adolescence is the period of transition from childhood to adulthood and the second most critical period of physical growth after the first year of life. Nutritional problems may arise from poor eating habits, snacking and consumption of nutrition deficient processed foods. Some social factors have been shown to influence their nutritional status, the result of which may have detrimental health implications as they advance into adulthood.Aim: To determine the effect of some social factors on the nutritional status of adolescents in Port Harcourt.Methods: A multi-staged sampling technique was used to select 960 adolescents from eightsecondary schools in Port Harcourt. Using an investigator-administered questionnaire, information on their socio-economic status, eating habits, food content and level of activity was obtained. Anthropometric measurements were taken and BMI calculated using the formula weight/height2 (kg/m2). This was then used to categorize their nutritional status. The results wereanalyzed using SPSS 14 and EPI Info 6.04. Results: Eight hundred and nineteen adolescents (85.3%) had normal weight, 61(6.4%) were underweight while 17 (1.8%) were obese. Significantly more males (8.9%) were underweight compared to females (3.8%); while females were significantly more overweight and obese than males. Consumption of snacks (17.4%), soft drinks (10%), higher social economic class (11.5%) and watching television for >3hrs a day (18.6%) were associatedwith overweight and obesity.Conclusion: Social economic status, snacking and hours spent watching television have a detrimental effect on the nutritional status of adolescents in Port Harcourt.Keywords: Adolescents, Nutritional status, Social factor

Simple vision screening in lower primary school children in Port Harcourt city

Background: Vision disorders are significant causes of morbidity worldwide and in children, can lead to life long visual impairment or blindness. Thus, the impact on a child's education and life if not detected and ameliorated on time, can constitute a huge socio-economic burden to the child, family and community. Aim: To determine the prevalence of reduced vision in lower primary school children in Port Harcourt city. Methods: A multi-staged sampling technique was used to select 1,234 lower primary school pupils from 12 schools in Port Harcourt for visual screening. Visual acuity (VA) measurements using Snelling's charts, and a basic eye examination using a pen torch was carried out in all the pupils. Vision was regarded as reduced if VA is < 6/18, in which case a pinhole was presented to the affected eye and VA repeated, to check for presence of refractive error.  Results: A total of 1,234 school children were screened, 73 pupils had reduced vision in one or both eyes giving a prevalence of 5.9%. Refractive errors accounted for 72.6% of cases of reduced vision. Gross external eye abnormalities accounted for 9.6% of cases of reduced vision, with corneal opacity and nystagmus being the most commonly seen.   Conclusion: Reduced vision is an important cause of visual disability in primary school pupils in Port Harcourt city, mostly due to correctable refractive errors. There is therefore a need for routine vision screening of all pupils, especially on commencement of school for early detection and treatment, to prevent life long visual disability.   Key words: Reduced vision, Primary school children, Port Harcourt cit

Screening for Congenital Color Vision Deficiency in Primary Children in Port Harcourt City; Teachers\' knowledge and performance

Background: One hundred and thirty teachers were studied to evaluate their knowledge of congenital Color Vision Deficiency (CVD), and their ability to perform the Ishihara color vision test, so as to determine if they can provide color vision screening services for their pupils. Methods: The teachers were randomly selected from 13 schools in Port Harcourt City (PHC) and given a six hours training workshop on vision disorders in children and congenital color vision screening. They were given a self administered pre and post test questionnaires before and after training respectively. Subsequently, they screened 1,300 of their school pupils for congenital vision deficiency using the Ishihara color vision chart; and their results compared to that of the research team. Results: Female teachers constituted 84.6% and males 15.4% of the study population. Seventy three teachers (53.8%) were from public schools while 46. 2% were from private schools. Prior to the training workshop, only 6.2% of teachers had heard of the Ishihara color vision chart and none of the teachers could identify or knew how to use the chart. However with training there was significant improvement in knowledge of CVD. Comparison of the teachers\' performance of color vision screening using the Ishihara chart to that of the research team showed a sensitivity of 67.6% with a specificity of 99.1%. The prevalence of congenital color vision deficiency in the 1,300 primary school screened was 2.6%, with males having a significantly higher prevalence than females. Conclusion: The study thus concludes that congenital color vision deficiency is prevalent amongst primary school children in Port Harcourt City, and with training, teachers can effectively perform color vision screening, and as such modify their teaching methods to accommodate the child with color vision deficiency. Keywords: congenital color vision deficiency, school teachers, primary school children. Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 428-43