Ikobah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Pneumocystis infection has proven difficult to study partly due to the lack of reliable culture system for the organism. 7 The mode of transmission is not firmly established but airborne human to human transmission is likely. Infections are almost always limited to the lungs and cannot be cultured reliably outside the lungs. 7,8 Clinical signs and symptoms are non-specific and confirmation is hampered by inability to reliably perform in vitro culture. 5 Definitive diagnosis in resource limited ABSTRACT Pneumocystis pneumonia (PJP), initially thought to be rare in this part of the world, has over the years, been diagnosed and treated in our center. PJP should be considered in a young child 3 to 6 months of age with very severe pneumonia, known or suspected to be HIV infected. It should be suspected when severity of illness is out of proportion with the chest findings and chest x-ray is normal or shows minimal or bilateral interstitial infiltrates. Treatment is oral or intravenous high dose cotrimoxazole given 6-8 hourly for 3 weeks and the addition of prednisolone. The objective of this report is to describe the presentation, challenges of diagnosing and management of PJP in children in a developing country. Report of 3 cases aged 3, 4 and 41/2 months, exposed to the HIV. All developed severe pneumonia characteristic of PJP and all responded to treatment with high dose cotrimoxazole and Prednisolone. A high index of suspicion is needed to diagnose PJP in a resource poor setting like ours. It is common in HIV positive children but can also occur in HIV negative individuals as shown by these case reports. A presumptive diagnosis can be made in a young child, usually below 6 months of age, very ill with severe pneumonia and minimal chest findings who responds to cotrimoxazole. Addition of prednisolone has been found to improve the outcome. Antibiotics should continue to cover for co-existing bacterial pneumonia.

Treatment methods used were m e d i c a t i o n (1. 6 %) , w a t e r restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. The frequency of enuresis was similar to most reports in literature. Help-seeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested. Nocturnal enuresis, Treatment, School children. Conclusion:

Background: Enuresis for most children is a source of shame and anxiety with a profound effect on self perception, relationship and school performance. Hence the study of nocturnal enuresis among primary school children in Calabar-Nigeria. Aims and objectives: This was to determine the frequency of enuresis among primary school children in Calabar and to study the treatment modalities. Study design: This was a prospective cross sectional study. A questionnaire was answered by parents of 3,230 pupils from six selected schools during the school term between January 2010 to March 2010. Results: The frequency of nocturnal enuresis was 6.7%. Enuresis frequency was higher among boys (7.3%) than girls (6.0%) though this was not statistically significant (P=0.216). Treatment methods used were medication (1.6%), water restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help-seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. Conclusion and recommendation: The frequency of enuresis was similar to most reports in literature. Helpseeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested.

Background: Asymptomatic Human Immunodeficiency Virus (HIV) infected children are prone to serious bacterial infection as a result of poor immunity.Objective: This was to determine the common pathogenic organisms responsible for bacteremia among asymptomatic HIV infected children attending the outpatient clinics at the University of Calabar Teaching Hospital, Nigeria. Subjects and Methods:This prospective non randomized cross-sectional study was conducted over 6months from January 1st to 30th June 2014 among cohorts of HIV infected Anti-retroviral (ARV) naive and experienced children attending the clinic. Ethical approval was obtained from the ethical committee of the institution. Blood culture specimens were collected from all HIV infected patients who met the criteria for enrollment. All specimens with isolated bacteria organisms were treated with antibiotics according to the sensitivity pattern, in addition to administered Anti-retroviral drugs.Results: Out of the total of 109 patients recruited, 38(34.9%) had bacteremia. There were more males (57.9%), and most of them (63.2%) had Highly Active Anti-Retroviral Therapy (HAART) for more than 24weeks. Bacteremia was inversely proportional to the CD4 count. The commonest organism isolated was unclassified Coliforms (47.3%) followed by Staphyloccocus aureus (39.5%). Conclusions:HIV infected children are prone to bacteremia especially among those with low CD4 count. Coliform was the commonest organism isolated. We recommend that HIV infected children be routinely investigated for bacteremia.