Background and aim: Poor immunization coverage especially in rural areas has led to a high burden of vaccine preventable diseases in children. The study assessed routine immunization coverage and its determinants in a rural community in South Western Nigeria. Methods: A descriptive cross-sectional survey using the WHO cluster survey design was conducted among children aged 12 to 23 months. Coverage was assessed by immunization cards. Results: A total of 440 mothers were interviewed with a mean age of 27.9 ± 5.7 years. The mean age of the children was 17.3 ± 3.7 months. Full immunization was recorded among 130(29.5%) children and of these only 53.8% completed their immunization by 12 months. The highest and lowest vaccine coverage was observed for DPT1 (90.2%) and Yellow fever (55%) respectively. The commonest reasons for failure to immunize were; non availability of vaccines (40%) and the mother being too busy (24.2%). Predictors of immunization status included maternal education (p=0.002), place of delivery (p<0.001), family type (p=0.04) and child's birth order (p=0.03). Conclusion: The immunization coverage rate among children in this rural community was sub-optimal and lower dropout rates may be achieved by making vaccines readily available. High female literacy levels and delivery in health facilities need to be promoted.
Introduction displacement predisposes to deprivation and hunger and consequently malnutrition. In Nigeria, information on anthropometric characteristics and associated factors among displaced under-five children is important to strengthen strategies to ameliorate malnutrition and promote child health. This study was conducted to identify the determinants on anthropometric indices among under-five children in internally displaced persons’ camps in Abuja, Nigeria. Methods this cross-sectional study involved 317 mother-child (0-59 months) pairs selected using two-stage simple random sampling technique. Information on socio-demographic, care practices (infant feeding, immunization, deworming) and anthropometric characteristics of index children was obtained using semi-structured, interviewer-administered questionnaire. Weight and length/height were assessed using standard procedure and analysed using World Health Organization (WHO) Anthro software. Data were analysed using descriptive statistics and logistic regression at p<0.05. Results median age was 24 months, 50.8% were male and 42.3% were delivered at health facility. Only 45.4% were exclusively breastfed, 28.8% were fed complementary foods too early, 45.4% were dewormed in the preceding six months and 43.9% had complete/up-to-date immunisation. Prevalence of underweight, stunting and wasting was 42%, 41% and 29.3%, respectively. Poor anthropometric indices were higher among male than female children, except wasting. Having good anthropometric index was 2.5 times higher among children <12 months than children ≥37 months (CI: 1.08-5.8), 2.4 times higher among 1 st birth order than 5 th orders (CI: 0.19-0.93), 1.7 times higher among female than male children (CI: 1.08-2.82). Conclusion malnutrition is a major health problem among under-five children in internally displaced camps and major determinants include age, birth order, gender and deworming status.
Ventricular septal defect (VSD) is the most common congenital cardiac lesion encountered worldwide. Only very rarely is it acquired, and causation through blunt injury in a child is extremely rare. A previously healthy 7-year-old boy suffered blunt chest trauma while at play. He presented 11 days later with features of acute congestive cardiac failure. Two-dimensional echocardiographic examination revealed a mid-muscular VSD. The connection between the defect and the trauma was not initially appreciated. Facilities for required urgent open-heart surgery were not available. Cardiac failure was refractory to anti-failure therapy. His clinical condition steadily worsened, and he succumbed after 20 days on admission. We conclude that a diagnosis of traumatic VSD, though rare, should be considered in any previously well child presenting in acute congestive cardiac failure following blunt trauma to the chest. Any such patient should undergo careful echocardiographic evaluation. There is an urgent need for facilities for open-heart surgery to be more readily available and accessible in Nigeria.
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