Throughout the world, socio-economic status differentials of individuals have a lot of influence on privileges and opportunities enjoyed by society members. The different social and economic positions of individuals and income levels oftentimes hinder them from effective use of health care facilities. It is against this background, that the study was designed to investigate income differentials and its influence on utilization of healthcare services among the people of Calabar Metropolis in Cross River State, Nigeria. Relevant body of literature were reviewed and survey design method was adopted. The instruments used were the questionnaire, interview and Focus Group Discussions (FGD). A sample of 360 respondents was selected using a multi-stage sampling procedure for the study. Data was presented using simple percentage calculation while Chi-Square and ANOVA statistical tool was used to test and ascertain the relationship between income level and healthcare services usage at 0.05 level of significance. Findings of the study revealed that level of income and occupational status of individual influence health care service utilization among people in Calabar Metropolis. At the end of the study, several recommendations were made among which were a general improvement of socio-economic status of the people in areas of availability and compulsory education, employment opportunities as well as equitable distribution of income and minimizing cost of health care services for effective and equal utilization.

Data on pediatric endoscopy in Nigeria is almost non-existent. This may be due to lack of trained pediatric endoscopist or lack of facilities. Upper gastrointestinal(GI) endoscopy is thegold standard for evaluating upper GI symptoms/diseases. The majority of gastroscopies in Nigeria are done in adults but children also present with symptoms that require it,hence the need to develop pediatric endoscopy in Nigeria. This is a report of two cases done in the only private high definition video endoscopy facility in Calabar (JIL ENDOSCOPY), Nigeria. Two female children aged 10 years and 8 years had gastroscopy for swallowed foreign body (an office pin) and upper GI bleeding respectively. These patients were referred to JIL endoscopy by Pediatricians from the University of Calabar Teaching Hospital,Calabar. Conscious sedation was administered by the same anesthetist in the two cases. In the first patient, no foreign body was seen at gastroscopy while marked duodenitis was found to be responsible for the upper GI bleed in the second child. The choice of anesthesia for pediatric endoscopy has remained a topic of debate in many fora. A lot needs to be done to develop pediatric endoscopy in Nigeria.

Pertussis is a vaccine-preventable disease and antibodies formed are known to decline with time. The aim of this study was to measure Bordetella pertussis/toxin immunoglobulin G (IgG) antibodies in different age groups of Nigerian children and determine the age at which booster dose may be required. A total of 422 children, aged 6 to 60 months, were tested for the presence of B. pertussis/toxin IgG antibodies by ELISA (enzyme-linked immune sorbent assay). The highest positivity rate was in the 6 to 11 months of age group, while the highest negativity rate was in the age group of 24 to 35 months. We conclude that B. Pertussis/toxin IgG antibodies response is weak in Nigerian children after three doses of DPT (diphtheria, pertussis, and tetanus)/pentavalent vaccination, and there is a rapid decline of antibody levels between 12 and 35 months. We recommend that booster vaccination should be given at 12 to 15 months of age.

Tatumella ptyseos septicaemia in humans is yet to be reported in Nigeria with very few cases reported worldwide. This case report describes the clinical and distinctive biochemical characteristics of Tatumella ptyseos, its antibiotic sensitivity pattern and risk factors associated with Tatumella ptyseos septicaemia. Our case is a 2 months old ex-premature female from Calabar, admitted in the month of May, 2018 into the Children´s Emergency Room, of the University of Calabar Teaching Hospital, Nigeria. She presented with cough of one month and fever of three weeks, and was found to be acutely ill looking, febrile with temperature of 38.6°C, mildly pale, dyspnoeic and tachypnoeic with SPO 2 of 80% in room air, tender hepatomegaly of 6cm and a splenomegaly of 6cm. Blood culture yielded Gram negative rods identified as Tatumella ptyseos by OXOID MICROBACT™ GNB identification kit.

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Background: Tuberculosis (TB) is still causing deaths in children in TB endemic countries. Majority (80%) occur in the lungs, with 5% being miliary TB. It is an Interstitial Lung Disease (ILD) with similar clinical, physiological and radiological features to other ILD and affects mainly infants and children with a high mortality rate despite available treatment. Case Presentation: A three-month old male presented during the COVID-19 pandemic with fever of 2 weeks, cough of one week, fast and difficult breathing of 6 days’ duration. He received BCG vaccine 16 days after birth despite being unknowingly exposed to the TB contact from birth. He was acutely ill looking, with severe pneumonia and SPO2 of 76% in room air. Respiratory examination showed broncho vesicular breath sounds with no added sounds. A diagnosis of Severe pneumonia? Pneumocystis Jiroveci Pneumonia (PJP) and R/O COVID-19 was made. Subsequent reviews excluded PJP and COVID-19 and the final diagnosis was Disseminated (Miliary) TB. He was successfully treated with anti-TB medications for 12 months. Conclusion: Miliary TB presents with common and uncommon manifestations that may be confusing, and so a high index of suspicion with a careful history, focused systemic examination, imaging and bacteriological studies are strongly recommended for its early diagnosis.