The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Abstract:Background: Child sexual abuse has been reported from all corners of the globe, and all age groups and both sexes are affected. Although the trauma of abuse heals with time, it leaves long term psychological and medical problems. This study was aimed at documenting the pattern of child sexual abuse in Zaria, Northern Nigeria. Methods: Retrospective study of case notes of all patients seen with a history of sexual abuse, from August 2008 to October 2009, at a primary health centre in Northwestern Nigeria. Results: A total of twenty cases were seen out of a total of 33, 313, which gave a prevalence rate of 0.06%. There were three boys and 17 girls, with a male: female ratio of 1: 5.7. The age range was 3-13 years, with a mode of 7years. Majority (19, 95%) were aged 12 years and below. Eleven cases (55%) attended school, while three (15%) were hawkers. Twelve (60%) of the children presented more than 72 hours after the assault. Twelve (60%) cases were abused more than once, and there was evidence of genital trauma in 60% of cases. The assailants were all males, and identified in 70% of the cases. Of those identified, 55% of them had previously been suspected of committing sexual abuse. In 55% of cases the assailants were either household members or neighbours. Only 12 (60%) of incidents were reported to the police. Legal outcome was not known in any of the cases. All the cases defaulted to follow-up. Conclusion: Child sexual abuse is not an uncommon problem in Zaria. There is a need to ensure follow-up after treating immediate medical problems, in order to manage and prevent the long-term psychological problems of sexual abuse. The high default rate to follow-up needs to be further investigated. The legal outcome in all the cases was unknown.

The efficacy of 3-day regimens of artemether-lumefantrine and artesunate-amodiaquine were evaluated in 747 children < 5 years of age with uncomplicated malaria from six geographical areas of Nigeria. Fever clearance was significantly faster (P = 0.006) and the proportion of children with parasitemia 1 day after treatment began was significantly lower (P = 0.016) in artesunate-amodiaquine—compared with artemether-lumefantrine-treated children. Parasite clearance times were similar with both treatments. Overall efficacy was 96.3% (95% confidence interval [CI] 94.5–97.6%), and was similar for both regimens. Polymerase chain reaction-corrected parasitologic cure rates on Day 28 were 96.9% (95% CI 93.9–98.2%) and 98.3% (95% CI 96.1–99.3%) for artemether-lumefantrine and artesunate-amodiaquine, respectively. Gametocyte carriage post treatment was significantly lower than pretreatment (P < 0.0001). In anemic children, mean time to recovery from anemia was 10 days (95% CI 9.04–10.9) and was similar for both regimens. Both treatments were well tolerated and are safe and efficacious treatments of uncomplicated falciparum malaria in young Nigerian children.

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Cerebral malaria is a significant cause of childhood morbidity in our region. The challenges of effective management include time and quality of treatment. The study appraised the health care seeking behavior of caregivers of sick children who developed cerebral malaria, in Zaria, northwestern Nigeria. Caregivers indentified were parents 29 (87.9%) and grandparents 4 (12.1%). Most of them were in the upper social classes. Health care options utilized before presentation at our facility were formal health facility 24 (72.7%), patent medicine seller 12 (36.4%), home treatment 10 (30.3%), and herbal concoction 6 (18.2%) with majority 24 (72.7%) using more than one option. Antimalarial therapy was instituted in 25 (75.6%) of the cases. Mortality was significantly associated with the use of herbal concoction, treatment at a formal health facility and patent medicine seller, multiple convulsions, age less than 5 years, and noninstitution of antimalarial therapy before presentation. The study showed use of inappropriate health care options by caregivers and highlighted the need to pursue an awareness drive among caregivers on the use of health care options.