IntroductionIn the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study.MethodsTwo hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey.ResultsThe prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure.ConclusionThe prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference.

SummaryBackgroundPaediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. Objective: To evaluate and document the currently available paediatric cardiac services in Nigeria.MethodsIn this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria.ResultsForty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%).ConclusionsAvailable paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

Background Congenital Heart Disease (CHD) places an enormous economic burden on families of affected children in Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its effects on the family’s income.Methods Using a semi-structured interviewer-administered questionnaire, family income, type of CHD, co-morbidity, healthcare payment mechanism and healthcare cost were investigated among 121 families with CHD children. Indicators of Catastrophic Health Expenditure (CHE); healthcare spending in excess of 10% family income were calculated. Factors associated with increased healthcare spending in CHD management were explored using the Kruskal Wallis test of significance.Results Of the 121 parents interviewed, about 80% paid for healthcare using out-of-pocket payment mechanism. Mean annual total cost of healthcare was ₦87,951± ₦120,213 ($244.31± $333.92) with direct medical care accounting for 81.0% of this total annual cost. Mean annual consultation, medication, investigation and admission cost were ₦5,515 ($15.32), ₦57,882 ($160.78), ₦30,462 ($84.62) and ₦87,789 ($243.86) respectively. Mean estimated annual indirect cost was ₦19,233 ± ₦31,722 ($53.42 ± $88.12). Incidence of CHE was 35.5% while catastrophic overshoot and mean positive overshoot attributable to CHD healthcare cost were 6.5% and 32.9% of family income respectively. Healthcare cost was significantly higher in families of children with co-morbidities (p = 0.016) and those who suffered financial catastrophe (p = 0.001). Health insurance did not significantly reduce healthcare spending among the insured.Conclusion The economic burden of pre-surgical management of children with CHD is high in Nigeria. There is the need to scale up the inclusion of CHD under the National health insurance scheme.

Congenital Ewing's sarcoma is a very rare occurrence indeed with only one case involving the humerus and none involving the ulna that has been noted in the literature to our knowledge. It is one of those tumours that not only do they rarely occur in the neonatal period, but is also very uncommon in black people. We present a case report of Congenital Ewing's Sarcoma in a black female infant involving the ulna bone and surrounding soft tissues which was diagnosed by histology and immnohistochemistry.

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