Challenges of Managing Childhood Malaria in a Developing Country: The Case of Nigeria

Malaria still remains one of the highest childhood killer diseases, especially in the developing countries of Africa, Southeast Asia, and Eastern Mediterranean regions. With an estimated 100 million cases and 300,000 deaths from malaria annually, Nigeria has one of the highest burdens of malaria in the world, with children mostly affected. It accounts for 60% of outpatient visits, 30% hospitalization among children under 5 years of age. Great efforts and huge funding have been committed globally towards the fight for malaria, but malaria continues to be a major challenge in these developing countries, especially countries in Sub-Saharan Africa. The World Health Organisation adopted a cost-effective intervention strategy, which comprises a three-pronged approach: vector control, chemoprophylaxis, and case management. Case management involves early diagnosis and treatment. This chapter looks at the challenges militating against the achievement of this important aspect of malaria control in children as well as efforts that have been made or not made to overcome these challenges using Nigeria as a case study

A National Survey of Resources to Address Sepsis in Children in Tertiary Care Centers in Nigeria.

Background: Infections leading to sepsis are major contributors to mortality and morbidity in children world-wide. Determining the capacity of pediatric hospitals in Nigeria to manage sepsis establishes an important baseline for quality-improvement interventions and resource allocations. Objectives: To assess the availability and functionality of resources and manpower for early detection and prompt management of sepsis in children at tertiary pediatric centers in Nigeria. Methods: This was an online survey of tertiary pediatric hospitals in Nigeria using a modified survey tool designed by the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS). The survey addressed all aspects of pediatric sepsis identification, management, barriers and readiness. Results: While majority of the hospitals 97% (28/29) reported having adequate triage systems, only 60% (16/27) follow some form of guideline for sepsis management. There was no consensus national guideline for management of pediatric sepsis. Over 50% of the respondents identified deficit in parental education, poor access to healthcare services, failure to diagnose sepsis at referring institutions, lack of medical equipment and lack of a definitive protocol for managing pediatric sepsis, as significant barriers. Conclusions: Certain sepsis-related interventions were reportedly widespread, however, there is no standardized sepsis protocol, and majority of the hospitals do not have pediatric intensive care units (PICU). These findings could guide quality improvement measures at institutional level, and healthcare policy/spending at the national level

Oxygen Saturation Reference Value by Percutaneous Pulse Oximetry in Asymptomatic Newborn Babies in Nigeria: A Cross-Sectional Study

About 1/4 of all neonatal deaths in Nigeria are caused by birth asphyxia. Normal values of oxygen saturation vary according to regional altitudes. They are important for the screening of cyanotic congenital heart diseases and during newborn resuscitation. There is a dearth of such information in Nigeria. We determined reference values for oxygen saturation by pulse oximetry (SpO2) in asymptomatic newborns aged ≤7 days in Enugu at an altitude of 180 m. The study was cross-sectional. Neonates weighing ≥1500 g at birth were enrolled consecutively. Pre-and post-ductal oxygen saturation was measured using a Datex-Ohmeda Tuffsat® pulse oximeter with neonatal probes. Five hundred and fourteen babies comprising of 24 (4.4%) preterm and 490 (95.3%) term neonates were studied. The mean pre-ductal SpO2 of all babies was 96.1% ± 1.4% and higher than mean post-ductal SpO2 of 95.9% ± 1.4% (p = 0.022). The mean pre-ductal SpO2 were 96.1% ± 1.5% and 96.1% ± 1.3%, (p = 1.000) for males and females, respectively. The mean pre-ductal SpO2 values were higher than the mean post-ductal SpO2 for the corresponding post-natal ages

Socio-demographic characteristics of children and young adults with varied asthma control- does it make a difference?

Background The socioeconomic status and caregiver perception of asthma as a disease, the availability of specialty care and medication adherence have major influence on outcome of asthma control in children with asthma. The control of asthma therefore depends on the optimizing the interplay of these factors taking into consideration the regional and racial variations.ObjectiveThe objective of this study was to evaluate the association between socio-demographic factors and asthma control outcome in children with asthma.Materials and MethodsThis was a cross-sectional study involving 66 consecutively enrolled participants with asthma whose economic burden for asthma was assessed in a previous study. Based on the number of registered children attending the clinic, a minimum sample size of 66 calculated for this study was obtained.The participants were consenting children and young adults between the ages of 1 and 20 years. Using standard methods, data on socio-economic status, personal and family demographics, including household number, mothers’ educational attainments and employment status; and asthma control were collected and analyzed. Asthma control was assessed using Asthma control test (ACT) and guided by the original developers scoring, participants were grouped into well controlled, partly controlled and uncontrolled. The Chi-square test was used to test for association between participants’ socio-demographic characteristics (age, socioeconomic status, mothers’ education and employment, and number of children in the household) and asthma control status at 5% level of significance. ResultsOf all study participants, 34 (51.55%) were male, with mean age (SD) of 11.6 (4.8) years. The mean (SD) age at initial asthma diagnosis was 6.2 (4.6) years. The majority 49(76.5%) of the mothers had tertiary education. Study participants belonging to the poorest; very poor; poor; and least poor socio-economic cadres were, 16 (24.2%); 17 (25.8%); 17 (25.8%); and 16 (24.2%) respectively. Asthma control classification showed that, 26 (39.4%); 31 (47%) and 9 (13.6%) participants had well controlled asthma, partially controlled asthma and uncontrolled asthma respectively. The factors like age, socioeconomic status, mothers ‘educational level, employment status and number of children in the household did not show any statistically significant association with the asthma control status of participants.Conclusions Asthma control outcome remains multifactorial as participants’ socio-demographic characteristics did not impact on the level of control of asthma, among participants in the south eastern parts of Nigeria, despite being in a LMIC. A larger study is recommended to further explore this

Childhood diabetes: a myth or reality?- perception of the public from a low-income country: a cross-sectional study

Abstract Background The diagnosis of Type 1 diabetes is commonly missed in most health facilities in Nigeria. Adequate knowledge of childhood diabetes is necessary for the recognition and possible intervention for the control of the disease. However, research to assess knowledge deficiencies and their relationship to attitude is lacking in most developing countries including Nigeria. This study intends to survey the beliefs and perceptions of caregivers of children towards diabetes in childhood. It also aims at determining the caregivers’ depth of knowledge of diabetes in children, the relationship between knowledge and practices as well as the association between level of education and gender with practices and knowledge. The study outcome will help in the formulation of policy and education of the communities with regards to the preconceived myths and realities of childhood diabetes. Methods A descriptive study involving 500 respondents, population groups were selected by multi-staged sampling from different areas in Enugu metropolis, south-East of Nigeria. A validated structured interviewer-administered questionnaire was used. Ethical approval was obtained, and only consenting subjects were interviewed. Data was analyzed with Statistical Package for the Social Sciences (SPSS) version 20. Result Almost all the respondents (99.8%) had heard of diabetes in adults. However, a lower proportion of respondents 43.2% knew about diabetes in childhood. Only 24.8% had good knowledge of the different aspects of diabetes. Although females were more knowledgeable about the effects of healthy life style modifications on diabetes, there was no gender predisposition in knowledge about diabetes in childhood. A positive association existed between knowledge and education [p < 0.001] concerning childhood diabetes. Irrespective of this association 82.6% of the respondents with good knowledge of the disease still had a poor attitude towards healthy life style practices. Conclusion This study has shown that beliefs and perceptions of childhood diabetes among the adult caregivers in Enugu, south – East Nigeria is mostly erroneous and their knowledge deficient. Literacy did not improve both knowledge and attitude to healthy lifestyle practices

Additional file 1: of Childhood diabetes: a myth or reality?- perception of the public from a low-income country: a cross-sectional study

Blank questionnaire on childhood diabetes: a myth or reality?- Perception of the public from a low-income country. (DOCX 17 kb

К истории журнала "New Worlds" - первого общенационального журнала фантастики Великобритании

Гопман Владимир Львович. К истории журнала "New Worlds" - первого общенационального журнала фантастики Великобритании [Электронный ресурс] / В. Л. Гопман// Вестник РГГУ. - 2014. - № 12. - С. 111-120. - (Серия "Филологические науки. Журналистика. Литературная критика")