A prospective study to determine the prevalence of bacteriuria and bacterial isolates in the urine of febrile children with sickle cell anaemia (SCA) was carried out at University College Hospital, Ibadan. Altogether, 171 febrile children (aged 1-15 years) with SCA and 171 age- and sex-matched controls were studied. After obtaining a history of the illness from the parents or guardians, each child was physically examined and a mid-stream urine specimen collected and subjected to microscopy and culture. The prevalence of bacteriuria in children with SCA was 21.6% compared with 15.8% in the controls. Escherichia coli and Klebsiella species were the predominant isolates from the urine, accounting for 64.9% and 18.9%, respectively, of the isolates from the SCA group and 63% and 22.2%, respectively, in the controls. In the SCA group, significant bacteriuria also occurred with other conditions such as pneumonia and osteomyelitis. Urinary tract infection (UTI) is common in children with SCA. Routine screening for it is therefore recommended during febrile illnesses. Children with fever from other overt causes, however, should not be exempted from the urine screening procedure in case there might be concomitant UTI.
Objectives: A retrospective study of all children with a diagnosis of sciatic nerve injury managed at the University College Hospital, Ibadan, Nigeria over a 12 year period was carried out in order to determine predisposing factors to the nerve injury and highlighting practical preventive measures. Design: The necessary data was collected from the case files of children seen at the hospital with a diagnosis of sciatic nerve injury, from 1988 to 1999. Results: There were 27 children aged five months to 12 years with a diagnosis of sciatic nerve injury. Twenty (74%) of the children were aged five years or less. While seven patients (26%) presented within two weeks of development of foot drop consequent on intramuscular (IM) injection given on the buttock, 20 patients (74%) presented much later. Fever was the most common complaint for which the injection had been given. The identity of the drugs given was not known in 10 patients. In the remaining 17 patients drugs administered were specified and included Chloroquine,Novalgin, Paraldehyde, Procaine penicillin, and Sulfadoxine-Pyrimethamine. Most of the patients had received the injections in privately owned medical facilities where staff with minimal training are often allowed to administer IM injections. Conclusion: It is suggested that the IM route for injection be strongly discouraged when a drug can be given by other routes. Only trained staff should be allowed to administer IM injections. Giving IM injections at sites other than the buttock maybe advantageous in children particularly those aged five years and below.
The concentration of haemoglobins F and A2 in 132 Hb SS children aged 6 months to 16 years and 50 age- and sex-matched controls has been determined. The mean HbF concentration in Hb SS patients and controls were 9.5 per cent (range 1.7-24.5 per cent) and 1.5 per cent (range 0.5-14.4 per cent) respectively while HbA2 concentrations were 2.7 per cent (range 1.6-3.7 per cent) and 2.4 per cent (range 1.3-3.9 per cent) respectively. For 18 Hb SS patients seen in the stable state and during vaso-occlusive crisis, there was no significant difference in HbF concentration between the two states.
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