Prevalence and risk factors of hepatitis B virus transmission among children in Enugu, Nigeria

Background: Hepatitis B Virus (HBV) infection has reached pandemic proportions all over the world with areas of highest prevalence being the sub- Saharan Africa and Southeast Asia. Most deaths related to HBV are due to complications from chronic infection. Acquisition of infection at a younger age is the most important predictor of chronicity. Eradication of HBV is an important but difficult tasks facing public health. HB immunization is the single most important factor in hepatitis B control and was commenced in 2004 in Nigeria.Objectives: To determine the prevalence of Hepatitis B surface antigen (HBsAg) among children in the era of HB immunization, the risk factors of transmission and knowledge of mothers about their HB status.Methods: A cross sectional study carried out on one hundred and forty children aged 18 months to 15 years at the children outpatient clinic (CHOP) of the University of Nigeria Teaching Hospital, Ituku. Hepatitis B surface antigen (HBsAg) was determined using Determine Test Kits and a structured interviewer administered questionnaire administered.Results: Six were positive for HBsAg, giving a prevalence rate of 4.3%. HBsAg was least prevalent among children 1-5 years (2%). None of the children ≤ 5 years who received HB vaccination was positive for HBsAg though one child > 5 years who received the vaccine was positive. Sharing of toothbrushes among siblings was found to be a significantly associated risk factor. Only 6.4% of mothers knew their hepatitis B status.Conclusion: There is a gradual fall in the prevalence of HBsAg in our environment due to HB immunization. Sharing of toothbrushes may be a potent means of transmission of HBV infection.Keywords: HBV, Prevalence, Children, Transmission, HB immunizatio

Mothers’ knowledge, perception and practice of childhood immunization in Enugu

Introduction: Immunization has been shown to be the most successful and cost-effective public health intervention in the 20th century. In the developing world, it does not only prevent about three million child deaths annually, but also has the potential to prevent additional two million deaths if coverage improves. However, immunization coverage has remained low in Nigeria although vaccines are provided relatively free by the government. Efforts have focused on the health worker, health system and logistics with little attention being paid to maternal factors like knowledge, perception, beliefs and practice.Objectives: To assess mothers’ knowledge, perception and practice of routine and campaign immunization in Enugu.Methods: A structured questionnaire was administered to 207 mothers who have at least one child less than 5 years of age, attending children outpatient and immunization clinics at the University of Nigeria Teaching Hospital, Enugu.Results: Forty-eight per cent of the mothers had tertiary education, 42% had secondary education, and 9% had primary education while 1% had no formal education. Eighty-two per cent knew that children are immunized to prevent major killer diseases, 14% and 3.4% believed it was to prevent all diseases, and to treat diseases respectively. Most mothers took their children to health facilities for routine immunization (95.2%) and also accepted immunization on immunization campaign days (75.4%). However, 23.6% had never immunized their children during campaigns. On the other hand, 13% (27) of mothers had out-rightly rejected immunization during campaign while 85% (177) had never rejected immunization. The remaining 2% were not immunized due to reasons other than rejection. More mothers significantly rejected campaign immunization than the number that did not go for routine immunization (p=0.000). Maternal highest educational level was significantly associated with knowledge of reason for immunization and acceptance of immunization (p=0.000). Religious denomination was not significantly associated with rejection of campaign immunization (p=0.056).Conclusion: Most mothers studied had good knowledge and positive perception and practice of immunization. However, the Campaign immunization rejection rate was relatively high for the south eastern Nigeria where it is often assumed that non-compliance is not a problem. Similarly, the proportions of mothers with wrong knowledge and poor perception of immunization require policy attention. Maternal education was significantly associated with knowledge and acceptance of immunization. These findings are important in the design and implementation of childhood immunization programmes

Blood pressure values in healthy term newborns at a tertiary health facility in Enugu, Nigeria

Background: Blood pressure (BP) is a reflection of hemodynamic variables. It is an important vital sign and indicator of clinical stability. Accurate measurement of this physiological signal is essential for the optimal management of the ill infant. An increase in the awareness of hypertension among neonates has resulted to increased ability to diagnose neonates with the disease.Objectives: This study aimed to determine BP values in apparently healthy term newborns in the first 48 h of life and evaluate the factors affecting BP at birth.Methods: Three hundred and ten healthy appropriate for gestational age term newborns were consecutively recruited. BP measurements were determined using the oscillometric technique with the neonate supine after an appropriate size cuff was applied on the right arm. The monitor (Dinamap 8100) is switched on while the cuff inflation and deflation is automatically done by the instrument with subsequent display of the BP values on the screen. BP measurements were taken at age 0–24 h and 25–48 h. Their weight was measured with infant’s weighing scale, and data analyzed with SPSS version 15.Results: The mean systolic BP (SBP), diastolic and mean arterial BP at 0–24 h were 63.3 ± 5.5 mmHg, 36.8 ± 5.3 mmHg and 46.4 ± 5.2 mmHg respectively. There was a positive correlation between birth weight and SBP at birth. No significant correlation was found between BP and gender, mode of delivery or maternal age.Conclusion: This study provides current normative BP values that can be used in neonatal Intensive Care Unit.Key words: Blood pressure, healthy, newborns, ter