Nutritional status and sociodemographic characteristics of ‘urban poor’ school children in Onitsha, Southeast Nigeria

Background: The neglect of the health and nutritional status of school aged children has adverse consequences on their long term cognition and survival. Sequel to emerging issues on urbanization and the health ofschool children, this study focused on the nutritional status and sociodemographic characteristics of ‘urban poor’ school children inOnitsha, a major city in South East Nigeria.Objectives: The study was aimed at determining the nutritional status and evaluating the effect of certain sociodemographic factors on the nutritional status of ‘urban poor’ public primary school children in Onitsha, South East NigeriaMethod: This was a cross sectional study of 788 children aged 6 to 12 years, randomly selected from 12 public primary schools in Onitsha metropolis. Their anthropometric measures were used to determine their nutritional status. Data on their sociodemographic characteristics was  obtained from their parents or caregivers using interviewer administered standardized questionnaires. Analysis was done using Microsoft Office Excel2007, SPSS version 17 and Epiinfo version 3.5.1 software packagesResults: Stunting was the predominant form of under nutrition with ahigher prevalence in the slum resident children. Greater than 60% ofall the children studied were from large families with more than 4 children. Family size, however, age and gender were not significantly associated with the nutritional status of the children. Relatively though, a greater  percentage of the stunted children were from large families.Conclusion: The nutritional status of ‘urban poor’ school children especially in slums in Onitsha is suboptimal compared with their counterparts in developed countries of the world. There is need for regional studies of children with similar characteristics who should be considered when  favourable health policies are being made for children

Pattern of childhood and adolescent malignancies at a tertiary health institution in South-east Nigeria : A ten year study

Background: Cancer remains a major cause of death in children and adolescents, and differs in adults in nature, distribution and prognosis1. A culture of case documentation is lacking in our environment and many cases go unreported.Study objectives: To document the pattern of childhood and adolescent malignancies at a tertiary health institution in south-east Nigeria over a ten year period (January 2004 to December 2013)Methodology: Details of all children and adolescents aged 18 years and below treated for malignancy were extracted from the cancer registry and the records unit of the histopathology department for the period beginning at January 2004 to December 2013 at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Information retrieved was verified against the hospital admission register, as well as the medical and histopathology records for all cancer patients over the period of interest.Results: Eighty-five cases of childhood and adolescent malignancy were treated at NAUTH, Nnewi between January 2004 and December 2013. Median age of the study population was 9years, with a range of 0.1– 18years, more males (56.50%) than females (43.50%). Commonest tumours were the Lymphomas (11.76%) comprising Non- Hodgkin’s lymphoma (80%), Hodgkin’s lymphoma (10%) and Large-cell lymphoma (10%), the Leukaemias (11.76%) comprising Acute myeloblastic leukaemia (80%) and Acute lymphoblastic leukaemia (20%). Others were Rhabdomyosarcoma (11.76%), Nephroblastoma (11.76%), Retinoblastoma (5.88%), Ovarian tumours (4.71%), the Soft tissue sarcomas-excluding rhabdomyosarcoma (3.53%) and Osteogenic sarcoma (3.35%)’.Conclusion: Study findings suggest that lymphoma, leukaemia, rhabdomyosarcoma and nephroblastoma are the commonest childhood and adolescent malignancies in south-east Nigeria.Keywords: Childhood, Adolescent, Malignanc

Estimating the burden of selected non-communicable diseases in Africa: a systematic review of the evidence

Background The burden of non-communicable diseases (NCDs) is rapidly increasing globally, and particularly in Africa, where the health focus, until recently, has been on infectious diseases. The response to this growing burden of NCDs in Africa has been affected owing to a poor understanding of the burden of NCDs, and the relative lack of data and low level of research on NCDs in the continent. Recent estimates on the burden of NCDs in Africa have been mostly derived from modelling based on data from other countries imputed into African countries, and not usually based on data originating from Africa itself. In instances where few data were available, estimates have been characterized by extrapolation and over-modelling of the scarce data. It is therefore believed that underestimation of NCDs burden in many parts of Africa cannot be unexpected. With a gradual increase in average life expectancy across Africa, the region now experiencing the fastest rate of urbanization globally, and an increase adoption of unhealthy lifestyles, the burden of NCDs is expected to rise. This thesis will, therefore, be focussing on understanding the prevalence, and/or where there are available data, the incidence, of four major NCDs in Africa, which have contributed highly to the burden of NCDs, not only in Africa, but also globally. Methods I conducted a systematic search of the literature on three main databases (Medline, EMBASE and Global Health) for epidemiological studies on NCDs conducted in Africa. I retained and extracted data from original population-based (cohort or cross sectional), and/or health service records (hospital or registry-based studies) on prevalence and/or incidence rates of four major NCDs in Africa. These include: cardiovascular diseases (hypertension and stroke), diabetes, major cancer types (cervical, breast, prostate, ovary, oesophagus, bladder, Kaposi, liver, stomach, colorectal, lung and non-Hodgkin lymphoma), and chronic respiratory diseases (chronic obstructive pulmonary disease (COPD) and asthma). From extracted crude prevalence and incidence rates, a random effect meta-analysis was conducted and reported for each NCD. An epidemiological model was applied on all extracted data points. The fitted curve explaining the largest proportion of variance (best fit) from the model was further applied. The equation generated from the fitted curve was used to determine the prevalence and cases of the specific NCD in Africa at midpoints of the United Nations (UN) population 5-year age-group population estimates for Africa. Results From the literature search, studies on hypertension had the highest publication output at 7680, 92 of which were selected, spreading across 31 African countries. Cancer had 9762 publications and 39 were selected across 20 countries; diabetes had 3701 publications and 48 were selected across 28 countries; stroke had 1227 publications and 19 were selected across 10 countries; asthma had 790 publications and 45 were selected across 24 countries; and COPD had the lowest output with 243 publications and 13 were selected across 8 countries. From studies reporting prevalence rates, hypertension, with a total sample size of 197734, accounted for 130.2 million cases and a prevalence of 25.9% (23.5, 34.0) in Africa in 2010. This is followed by asthma, with a sample size of 187904, accounting for 58.2 million cases and a prevalence of 6.6% (2.4, 7.9); COPD, with a sample size of 24747, accounting for 26.3 million cases and a prevalence of 13.4% (9.4, 22.1); diabetes, with a sample size of 102517, accounting for 24.5 million cases and a prevalence of 4.0% (2.7, 6.4); and stroke, with a sample size of about 6.3 million, accounting for 1.94 million cases and a prevalence of 317.3 per 100000 population (314.0, 748.2). From studies reporting incidence rates, stroke accounted for 496 thousand new cases in Africa in 2010, with a prevalence of 81.3 per 100000 person years (13.2, 94.9). For the 12 cancer types reviewed, a total of 775 thousand new cases were estimated in Africa in 2010 from registry-based data covering a total population of about 33 million. Among women, cervical cancer and breast cancer had 129 thousand and 81 thousand new cases, with incidence rates of 28.2 (22.1, 34.3) and 17.7 (13.0, 22.4) per 100000 person years, respectively. Among men, prostate cancer and Kaposi sarcoma closely follows with 75 thousand and 74 thousand new cases, with incidence rates of 14.5 (10.9, 18.0) and 14.3 (11.9, 16.7) per 100000 person years, respectively. Conclusion This study suggests the prevalence rates of the four major NCDs reviewed (cardiovascular diseases (hypertension and stroke), diabetes, major cancer types, and chronic respiratory diseases (COPD and asthma) in Africa are high relative to global estimates. Due to the lack of data on many NCDs across the continent, there are still doubts on the true prevalence of these diseases relative to the current African population. There is need for improvement in health information system and overall data management, especially at country level in Africa. Governments of African nations, international organizations, experts and other stakeholders need to invest more on NCDs research, particularly mortality, risk factors, and health determinants to have evidenced-based facts on the drivers of this epidemic in the continent, and prompt better, effective and overall public health response to NCDs in Africa

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city

Background: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth.Objective: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum.Materials and Methods: A cross.sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non.slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmentalvariables of interest were analyzed to determine their relationship with undernutrition in the children.Results: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non.slum areas (ƒÔ2 = 66.69, P = 0.000).Conclusion: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.Key words: Determinants, school.aged children, undernutritio

Infantile fibrosarcoma of the parotid gland in a 6-year old female: case report and management challenges

Infantile fibrosarcoma is a rare soft tissue sarcoma that may present at any time from birth to early childhood. The parotid gland is not a common site for malignancies especially in children, and there has been no report of this disease in our environment.The aim of this publication is to report a case of this rare tumour, managed recently in our Centre, and to highlight some of the attendant challenges during the management.We present the case of a 6-year old female child with infantile fibrosarcoma of the left parotid gland and subtle left facial palsy – probably the first in Nigeria; emphasizing the rarity of this tumour, and the need for a high index of suspicion in making the diagnosis.Keywords: Chemotherapy, facial palsy, infantile fibrosarcoma, parotidectom

Parental practice of child car safety in Enugu, Southeast Nigeria

KI Ndu,1,* U Ekwochi,1,* DC Osuorah,2,* OC Ifediora,3 FO Amadi,1 IN Asinobi,1 OW Okenwa,1 JC Orjioke,1 FN Ogbuka,1 TO Ulasi4 1Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria; 2Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia; 3Griffiths University Medical School, Gold Coast, QLD, Australia; 4Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria *These authors contributed equally to this work Abstract: Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs) among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=–0.121, P=0.310). Only respondent’s use of seat belt during driving (P=0.001) and having being cautioned for non-use of CCRs (P=0.005) maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%); restraints not being important, 53 (26%), and restraints being too expensive, 32 (15%). Similarly, for irregular users, exceptions for non-use included the child being asleep (29%), inadequate number of CCRs (22%), and the child being sick (18%). There is a need for a strategy change to enforce the use of CCRs in Nigeria. Keywords: car restraints, children, safety, Enug