The academic performance of children with asthma may differ from that of their non-asthmatic colleagues. Reports on the academic performance of children with asthma are limited and the findings are inconsistent. The academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with asthma aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age-, sex- and socio-economic- matched non- asthmatic classmates were recruited as controls. Academic performance was assessed overall using the average of the overall scores in the three term examinations of same session as well as specifically using the performance in four key subjects (English, mathematics, Social Studies and Sciences). Socio-economic status was determined using the occupational status and educational attainment of each parent. The median (range) overall academic scores for the children with asthma 79.04% (36.08% - 99.57%) was not significantly different from those of controls 80.01% (50.65% - 97.47%) (U = 6804, p = 0.461). We concluded that the academic performance of children with asthma compares favorably with that of children without asthma.
Some haematological alterations due to active cases of tuberculosis caused by Mycobacterium tuberculosis were investigated in Enugu Urban of South East, Nigeria. The results revealed thrombocythaemia, leucocytosis and elevated Erythrocyte sedimentation rates (p<0.05). There was oligocythaemia, as well as reduced haematocrit and haemoglobin concentrations (p<0.05). The significant oligocythaemia, anaemia, reduced packed cell volume found in active TB positive persons are all attributed to invasion of haematopoietic organs by any of the Mycobacteria tuberculosis complex (MTBC) namely: M tuberculosis, M. bovis, M africanum, M. canetti, M. microti, and M. leprae, which reduced substantially the rate of erythropoiesis. The invasion of lymphoid organs such as lymph nodes, thymus and tonsils by MTBC stimulated the synthesis of leucocytes leading to leucocytosis (p<0.05). This could be an inflammatory response which prepared the victim to defend itself against any of the MTBC that invaded the lungs and might even invade other extrapulmonary organs. Thrombocythaemia in active TB is attributed to haemoptysis, since the latter occurs whenever there is a wound or a threat to tissue injury or damage. When these changes in haematological parameters are used in combination with other tests, microscopic and clinical methods, TB diagnosis and treatment could be well improved.
Low birth weight (LBW) babies account for a large number of neonatal deaths globally, with over 90% of these occurring in developing countries with low resources. Identifying factors that determine survival in these sub-groups of babies in such a low-resource setting will help clinicians prioritize care and improve outcomes. This study aims to bridge some knowledge gaps in this regard. This was a 45-month prospective study carried out at the Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria. All eligible newborns weighing between 500g and <2500g that were seen in this period were enrolled and monitored. Data collected were analysed with SPSS Version 24, and significant associations identified using logistic regression models. A total of 166 LBW neonates were enrolled, and 68.2% of them survived. Asphyxia and episodes recurrent apnoea were recorded at least once in 78.8% and 68.4% of the babies respectively, with about two-thirds requiring respiratory support at one time or the other. Survival in these LBW newborns was negatively associated with gestational age at birth of less than 32 weeks (OR 0.17; CI 0.03-0.50; P<0.01) as well as with episodes of recurrent apnoea (OR 0.07; CI 0.02-0.34; P<0.01). However, intra-uterine exposure to malaria was associated with a 15 times higher likelihood of survival (OR 15.41; CI 2.22-106.91; P=0.01). No significant associations was found between survival and attendances to antenatal care, mode of delivery, birth weight and a number of neonatal morbidities like necrotizing enterocolitis, hypothermia, hypoglycaemia, septicaemia, anaemia and neonatal jaundice. Survival rate among low birth weight neonates in a low resource setting is decreased with delivery at less than 32 weeks completed gestation as well as recurrent episodes of apnoea, but is increased with in-utero exposure to malaria.
Malaria and typhoid are known major causes of febrile conditions in the South-Eastern Nigeria, hence healthcare providers usually co-administer antibiotics and anti-malaria on febrile patients without or before proper laboratory diagnosis. Despite this, fever and other symptoms of malaria sometimes persist after repeated treatment regimens. We investigated possible co-existence and prevalence of another fever-causing condition – brucellosis, with malaria and typhoid. The systematic study done between January 2015 and June 2016 involved 682 febrile patients referred to a private medical laboratory in Enugu metropolis in South-Eastern Nigeria for investigation for malaria and typhoid only. The number was made up of 295(43.3%) males and 387(56.7%) females, aged between 10 and 50 years. Identification of malaria parasites was done using thick films stained with Giemsa stain while typhoid and brucellosis were investigated serologically using Chromatest® febrile antigen kits. Our results showed prevalence of 39.1%, 66.0% and 28.6% for malaria, typhoid and brucellosis respectively in the studied population. Prevalence among male and female patients was 46.1% and 33.9% for malaria, 80.3% and 55.0% for typhoid, and 34.2% and 24.3% for brucellosis respectively. The results also showed that prevalence of malaria decreased with age while typhoid and brucellosis increased with age. We opine that 28.6% prevalence of brucellosis in a city with rare pastoral activities is high, and may be the cause of persistent fever after repeated combined treatment for malaria and typhoid. We advocate that these disease conditions should be simultaneously investigated for in all cases of febrile conditions to ensure wider investigation and treatment options, improvement on patients\' recovery time and reduction in man-hour loss.
Pregnancy has been shown to be a period of stress, during which the nutritional needs of the foetus is dependent on that of the mother. It is also a condition exhibiting increased susceptibility to oxidative stress, leading to potential damage. Ascorbic acid is a strong antioxidant as well as a reducing agent and is increasingly utilized to normalize the pro-oxidant - antioxidant balance during pregnancy. Since ascorbic acid cannot be synthesized by the body, leading to total dependence on exogenous supply in diets, there is need to evaluate the level of the vitamin in pregnant women and determine their predisposition or otherwise to avitaminosis C. Ascorbic acid levels of 60 apparently healthy pregnant women, aged between 20-40 years old and attending the antenatal clinic at the UNTH, Enugu, 60 age-matched women in their postpartum and 60 age-matched non-pregnant women (controls) were assayed using the 2,4-dinitrophenyl hydrazine method. The serum ascorbic acid levels were significantly lower (P<0.05) in pregnant women, showing a steady decline with gestational age increase. There were statistically significant decreases (P<0.05) in the second and third trimesters whereas a significant increase (P<0.05) was observed in the postpartum period, when compared to the controls. The serum levels of ascorbic acid were decreased significantly as pregnancy progresses; in spite of the supplements given Significant increases in the postpartum period may be attributed to the absence of oxidative stress and recovery from stress. Additional supplementation and increased dietary intake should be encouraged in pregnant women.
Interpersonal violence seems to be on the increase worldwide. This is known to cause significant morbidity and mortality. The aim of this study is to evaluate limb injuries that are related to assault seen in ESUT Teaching Hospital Park lane, Enugu, Nigeria. The limbs are very important in economic survival and its loss or dysfunction could create serious disability and jeopardize survival. This was a prospective study carried out between March 2012 and February 2013 in the Forensic Clinic of ESUT Teaching Hospital Park lane, Enugu. Interviewer administered structured questionnaire was used to collect data from the victims off assault visiting the Forensic Clinic of the Hospital. Data was analyzed using simple statistical methods. A total of 1928 individuals visited the Forensic Clinic during the study period. 233 of them sustained one form of injury or the other. Limb injuries occurred in 88 (37.7%) of injured victims. Upper limb and lower limb injuries occurred in 71.6% (n = 63) and 18.2% (n = 16) respectively and 10.2% (n = 9) had injuries involving both upper and lower limbs. Male to female ration is 1.6:1. The commonest weapon of assault was knife 22.7% followed by wood 18.1% and teeth 16.0%. Workman\'s tools and bottle accounted for 13.6% and 11.4% respectively. The youngest victim was 15 years and the oldest 65 years. The modal age range of victims was 21 – 30 years 43.1% (n – 38) and mean age is 34.1 years. Laceration 44.3% (n – 39) was the commonest soft tissue injury seen and bone fracture was seen in 3.4% (n – 3) of cases. Most of the injuries occurred in business or work place 37.5% (N – 33), closely followed by attacks in the living quarters 36.4% (n – 32). The upper limb is a common site of injury during assault probably because most individuals would attempt to protect themselves using their hands. Weapons used in assault are those commonly found at the point of assault and active young people are easily involved.
Ever since the history of infirmaries, nosocomial infections have been of grave threats to hospital set-ups, the deadliest being nosocomial respiratory tract infection (RTI). Nosocomial RTI was consequently investigated in two units of Obstetrics and Gynaecology department of a hospital in Nigeria using the “Settling Plate” technique and various culture media for bacteria isolation. Identification of the isolates was done on the basis of each isolate\'s cultural, morphological and biochemical characteristics. Six potentially pathogenic bacteria genera/species (Staphylococcus aureus, Streptococcus sp, Escherichia coli, Pseudomonas aeruginosa, Klebsiella sp and Bacillus sp) were isolated in the two units. Staphylococcus was isolated in all (100%) of the exposed plates; Streptococcus sp and Bacillus sp. in 75% (6/8), Pseudomonas aeruginosa and Escherichia coli in 50% (4/8), and Klebsiella sp in only 25% (2/8). This work therefore indicated high degree of poor atmospheric sanitation in those units as well as strong indication of imminent threat of nosocomial respiratory tract infections. Routine sanitary surveillance and fumigation of the wards are advocated
Each year an estimated 333 million new cases of curable sexually transmitted infections (STIs) occur worldwide with the highest rates among young people. Risk behavior and subsequent STIs, unwanted pregnancies and subsequent criminal abortions are fuelling the already excessive maternal mortality and morbidity rates in developing countries. Yet only a minority of young people have access to any acceptable and affordable adolescent health services. A total of 300 pre-tested semi structured questionnaires were administered to female JSS2 to SSS2 students selected by multistage sampling in August 2014. It contained questions on the socio demographic characteristics of respondents and their knowledge of sexually transmitted infections (STIs) and contraceptives and their patterns of sexual activity and contraceptive use. Majority (80.2%) of respondents had heard about contraception, their commonest source of information being radio (57.4%) and television (43.4%). The commonest contraceptive known was the condom (88.1%) and the contraceptive prevalence rate was 24.67%.Most respondents were sexually exposed (42.6%) with 84.3% of these previous 6 months. Mean age at first sexual debut was 12.0 ± 2.8 years. The prevalence of condom use at first and most recent sexual encounters were 31.3% and 57.8% respectively (p<0.005).The commonest reasons for not using contraceptives in both first and most recent encounters were ignorance (67.5%) and the partners dislike for it (17.5%). The inclusion of sex education into the school health programme for secondary school students as well as provision of guidance and counseling services by trained and retrained personnel and motivation of home based information and guidance for adolescents is recommended.
Discharge against medical advice (DAMA) can be defined as a situation in which a patient chooses to leave the hospital before the managing physician recommends discharge. It presents a peculiar challenge amongst the pediatric population because children are dependent on their parents or care givers for decisions regarding healthcare. Understanding the risks and reasons for DAMA is important for health system policy and the proactive management of those at risk of DAMA. This was a retrospective study that reviewed the medical records of children aged one day to 17 years discharged against medical advice in the Paediatrics Department of ESUTH, over a three-year period from 1st January, 2013 to 31st December, 2015.A total of 5464 patients were admitted into CHER, Newborn and the Children\'s wards during the study period. Out of these, 170 patients, representing 3.1%, were DAMA. Among the age groups, DAMA was more common amongst infants (45.6%). Malaria was the most common condition on discharge against medical advice (20.1%) followed by pneumonia (15.7%) and sepsis (12.3%).All the patients had evidence of signed documentation in the form of a signed entry in the case files. There was no alternative treatment plan offered to 111 (97.4%) cases and no option for follow up in 109 (95.6%). We recommend that the current documentation for DAMA as a signed entry in the case notes should be reviewed.
Pediatric emergency services are expected to form a key component of attaining universal coverage of quality healthcare as a target of the Sustainable Development Goals. In order to achieve this, accurate information about the causes of morbidity and mortality is essential. This retrospective study was conducted at the Children Emergency Room (CHER) of Enugu State University Teaching Hospital (ESUTH), Enugu. The admission records of all the children that were admitted into CHER of ESUTH over a three year period from July 2011 to June 2014 were reviewed. Frequency distributions of all relevant variables were reported as tables, charts and prose. Test of significance for discrete variables was done using the Chi-square test. A p-value <0.05 was regarded as significant. A total of 2869 children were seen during the three year period of study. Acute gastroenteritis, malaria, pneumonia and sepsis were the most frequent reasons for admission into the children emergency room. The major causes of death included sepsis, acute gastroenteritis, pneumonia and malaria. Mortality was highest among children under the age of 5years, with infants constituting over 50% of the mortalities. Anticipating peak periods during seasonal variations can improve patient outcomes. Most mortalities occur within 24 hours of arrival at hospital, thus more efforts should be made to improve health seeking behaviour and reduce late presentation.
The Editor in Chief, Journal of Experimental Research Department of Anatomy, Enugu State University of Science and Technology, College Of Medicine (ESUCOM), GRA Enugu, Nigeria.
Enugu State University of Science and Technology