Comparison of actual (measured) weights and heights with the standard formula methods of estimation among children in Enugu

Background: In paediatric practice, weight and height are required for therapeutic and diagnostic interventions. In some circumstances actual anthropometric measurements are not possible and estimates are used. Several formulae are in use for weight and height estimations. The adequacy of these estimates has not been tested for our children. The aim of the current study was to compare the adequacy of formula methods ofweight and height estimation with measured values in children.Materials and Methods: This was a comparative observational study.Children who met the inclusion criteria were selected consecutively and studied over a two month period using a semi-structured questionnaire.Weight and height of each child were measured and recorded to the nearest 0.1kg and 0.1cm respectively using standard protocols. Weight and height for age were also estimated using the universally accepted formulae. Data were analyzed using SPSS 19.0. Paired t- test was used to compare the means of actual and estimated weights and heights according to age. The level of significance was set at p<0.05.Results: A total of 370 children were studied. They were aged one year two months to 12years. Among children .2 years the measured weights and estimated values showed no significant difference. However, in children3-5years, the estimated weights were significantly lower than the measured weights. There was no consistent relationship for children 7.12 years where a different formula was used to estimate weight. For heights, the estimated values were significantly lower than the measured except for two year oldswhere both where almost similar. Scatter diagrams comparing actual and estimated plots showed linear relationship.Conclusion: The current methods of estimation are underestimating weights and heights of children in our environment. There is need for a multi-centre cohort study to test the various formulae in our children.Key words: Measured, Estimated, Weight, Height, Children

Challenges of childhood obesity in a developing economy: A review

Background: Obesity once considered a high income country’s malady is now on the rise in most developing countries particularly in urban settings. Most of these emerging economies have been reported to have different shades of under – nutrition coexisting side by side with over-nutrition. It is pertinent therefore that we determine the factors driving the increase in obesity rates in developing countries as they generally lack the infrastructure to adequately handle the associated complications.Objectives: This communication is aimed at reviewing the burden and risk factors for obesity in children in developing countries, double burden of malnutrition, challenges including medical as well as economic costs and sustainable preventive programmes of obesity in our environment with the hope of sensitizing both the health community and policy makers of this emerging epidemic.Methods: We searched relevant literature on the subject published only in English language or translated into English language manually and electronically. The Index Medicus, AJOL, Medline, PUBMED, and HINARI were specifically searched for the period between 1980 and 2014 and reviewed. The following key words were applied in the search: Obesity in childhood, its burden and associated risk factors, complications of obesity in childhood, double burden of malnutrition in developing countries, assessment of obesity, childhood challenges of obesity including its direct and indirect costs in developing countries as well as practical preventive models in developing economies.Results: Several relevant studies were identified. The health as well as economic costs of obesity is diverse. Obesity is the major risk factor for a variety of non – communicable diseases including cardiovascular diseases, type 2 diabetes and malignancies in later life. Also obese children have higher risk of orthopaedic problems and psychological disturbances like low -self esteem and bullying. This can also lead to poor social adjustments among our teeming youths who are the bedrock of our future economy. Most of these diseases cause premature deaths in addition to long term morbidities. Many of these obesity associated complications impose substantial burden on the health care system in developing countries with weak health systems, and if allowed unmitigated the implications are that the cost of its care may overwhelm not only the health budget but also affect the provisions of basic social amenities.Conclusions: Preventive programmes have been shown to reduce the burden of obesity in developed countries. Dearth of data on burden of obesity and its associated complications in children and adolescents still a challenge in most developing economies. Efforts should be made to prevent childhood obesity using multi- pronged approach at population level through targeted education, sustainable interventions related to healthy nutritional practices as well as physical activity promotion.Key words: Challenges; Obesity; Children; Developing Economie

Mothers’ perception and management of abdominal colic in infants in Enugu, Nigeria

Background: Abdominal colic is common in infants but generally harmless. The exact aetiology is unknown but it has been associated with vicious cycle of crying and swallowing of air by the infant. The excessive crying associated with it can result in a lot of distress for family members creating unnecessary panics. We sought to find the perception and management of abdominal colic by mothers in Enugu.Objective: Objective of this study is to determine the perception and ‘home management’ of abdominal colic in infants by mothers in Enugu, south-east Nigeria and the factors associated with them.Materials and Methods: A cross-sectional survey involving 177 mothers that presented with their infants at the pediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu between June and November 2011. A pretested questionnaire was used after obtaining their consent.Results: A total of one hundred and seventy-seven mothers participated in this study. They were aged 20 to 60 years with mean age of 34 ± 7.3 years. Most of them (99.4%) believed that babies can have abdominal colic. While 41.3% attributed no problems to colic, the rest believed that it causes loose/greenish stools (12.4%), fever (16.4%) and vomiting (9.6%) etc. Most of the mothers (87.7%) do apply medications for colic which range from paracetamol (33.1%), Gbomoro (16.2%), teething powder (15.4%), salt water (13.2%), Buscopan (7.7%) and gripe water (4.6%).Conclusions: Mothers attribute symptoms of childhood illnesses to abdominal colic. This may have led to unnecessary and sometimes harmful management. There is need for health education of mothers and potential mothers.Key words: Abdominal colics, enugu, infant

Prevalence of hypoxemia among children with sickle cell anemia during steady state and crises: A cross.sectional study

Background: Patients with sickle cell anemia (SCA) are prone to recurrent pain crises related to red blood cell sickling and vaso.occlusion with subsequent tissue hypoxia. Alveolar hypoxia has been shown to be associated with entrapment of sickle cells in the pulmonary microcirculation which may propagate a cycle of further hypoxemia and sickling. Pulmonarycomplications are common in sickle cell disease (SCD) and may  exacerbate microvascular occlusive phenomena. Thus, detecting hypoxemia is of particular importance in SCD.Objectives: This study was designed to determine the prevalence of hypoxemia among children with SCA and compare the oxygen saturation of those in crises with those in steady state.Materials and Methods: This is a prospective observational study involving 46 children with SCA in steady state, 42 with crises, and 42 with HbAA genotype carried out between August and December 2010. The study compared the oxygen saturation of sickle cell anaemic children in steady state and in crises with normal hemoglobin genotype using Nellcon pulse oximeter while the hemoglobin concentration was analyzed using automated Sysmex KX.21N model.Results: A total of 130 participants aged 6 months to 18 years were recruited. The overall prevalence of hypoxemia in this study was 13.8%. Hypoxemia was highest among SCA patients in the crisis state (23.8%) compared to 13% and 0% for those in the steady state and in those with normal hemoglobin genotype, respectively (ƒÔ2 = 6.425, P = 0.04).Hypoxemia was higher among those with hemoglobin less than 5 g/dl (30%) and least among those whose hemoglobin levels were 10 g/dl and above.Conclusions: Hypoxemia was significantly higher among children with SCA during Vaso-occlusion crises. We recommend that one should have a high index of suspicion and take prompt action in managing these individualsespecially those with acute chest syndrome. Key words: Enugu, hypoxemia, oxygen saturation, sickle cell anemi

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

BACKGROUND: Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent. OBJECTIVE: To review the current and emerging challenges facing pediatric HIV care in sub-Saharan Africa; and proffer solutions that could help in tackling these challenges. METHOD: A Medline literature search of recent publications was performed to identify articles on “pediatric HIV”, “HIV and children”, “HIV and infants”, “HIV and adolescents” in sub-Saharan Africa. RESULT: There are a number of challenges and emerging complex issues facing children infected and affected by HIV in sub-Saharan Africa. These include late presentation, limited access to pediatric HIV services, delayed diagnosis, infant feeding choices, malnutrition, limited and complex drug regimen, disclosure, treatment failure and reproductive health concerns. A holistic cost effective preventive, diagnostic and treatment strategies are required in order to eliminate pediatric HIV in SSA. CONCLUSION: HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Background: Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent.Objective: To review the current and emerging challenges facing pediatric HIV care in sub-Saharan Africa; and proffer solutions that could help in tackling these challenges.Method: A Medline literature search of recent publications was performed to identify articles on “pediatric HIV”, “HIV and children”, “HIV and infants”, “HIV and adolescents” in sub-Saharan Africa.Result: There are a number of challenges and emerging complex issues facing children infected and affected by HIV in sub-Saharan Africa. These include late presentation, limited access to pediatric HIV services, delayed diagnosis, infant feeding choices, malnutrition, limited and complex drug regimen, disclosure, treatment failure and reproductive health concerns. A holistic cost effective preventive, diagnostic and treatment strategies are required in order to eliminate pediatric HIV in SSA.Conclusion: HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa.Keywords: Pediatric HIV, sub-Saharan Africa, Challenges

Relationship Between Nutritional Status and Intensity of Common Intestinal Helminths Among Children in Enugu, South‑East Nigeria

Background: Intestinal helminthiasis is associated with malnutrition in children.Aim: The objective of this study was to determine the intensity and effect of the common intestinal helminths on the nutritional status of children in Enugu, Nigeria.Subjects and Methods: A cross‑sectional study of 460 children conducted in Enugu metropolis, south‑east Nigeria between August and September 2003. Their stools were analyzed at the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Center, Enugu. The intensity of the common intestinal helminths was determined using the standard Kato‑Katz method of fresh stool samples. The classification intensity of helminthic infestation was according to the World Health Organization classification. Data were analyzed using Statistical Software for Social Sciences version 11.0 (Chicago IL, USA). P < 0.05 was regarded as statistically significant. Results: 452 of 460 children (98.3%) had normal height for age, weight for age and weight for height Z‑scores. Six of the 460 children (1.3% were wasted), 1/460 stunted (0.2%) and 1/460 wasted and stunted (0.2%). 150 out of 460 (32.6%) studied were infected with helminths. There was no significantrelationship between the intensity of helminth infection and the nutritional status of the children. Conclusion: Although the prevalence of helminthiasis in children in Enugu was high, intensity of helminthiasis in these children was mainly mild. Hence, majority of them had normal weight and height measurements for age and sex.Keywords: Anthropometry, Children, Helminthic infectio

A review of paediatric acquired immunodeficiency syndrome

No AbstractKeywords: Paediatric HIV/AIDS, HIV Virus, AR