BackgroundConvulsions with fever in children are a common neurologic emergency in the tropics, and determining the contribution of endemic viral infections can be challenging. In particular, there is a dearth of data on the prevalence and clinical differentiation of Lassa virus disease (LVD) in febrile children in endemic areas of Nigeria, which has multiple lineages of the virus. The aim of this study was to determine the prevalence and presentation of LVD in febrile children with and without convulsions.Methodology/Principal findingsThis was a prospective study of consecutive febrile children aged ≥1 month– 15 years admitted to the Children’s Emergency Room of Irrua Specialist Teaching Hospital over a period of 1 year. Febrile children with convulsions (Cases) were compared with those without convulsions (Controls). LVD was defined by the presence of a positive Lassa virus RT-PCR test. Rates were compared between groups using χ2 or Fisher’s exact tests and p <0.05 taken as significant. 373 (40.9%) of 913 admissions had fever. Of these, 108/373 (29%) presented with convulsions. The overall prevalence of LVD was 13/373 (3.5%; 95% CI = 1.9%, 5.7%) in febrile admissions, 3/108 (2.8%) in Cases and 10/265 (3.8%) in Controls [(Odds Ratio (95% Confidence Interval) (OR (95% CI)) of LVD in Cases versus Controls = 0.73 (0.2, 2.7)]. Only vomiting (OR (95% CI) = 0.09 (0.01, 0.70)) and bleeding (OR (95% CI) = 39.56 (8.52, 183.7)) were significantly associated with an increased prevalence of LVD.Conclusions/SignificanceLVD is an important cause of fever, including undifferentiated fever in children in endemic areas, but it is not significantly associated with convulsions associated with fever. Its prevalence, and lack of clinical differentiation on presentation, underscores the importance of a high index of suspicion in diagnosis. Screening of febrile children with undifferentiated fever in endemic areas for LVD could be an important medical and public health control measure.

Background Many developing countries are in a state of nutritional transition from prevalent under-nutrition to the emergent problem of over-nutrition (overweight and obesity), which is associated with increased morbidity and mortality, and whose complications can persist into adulthood with long-term consequences. However, data are limited on the risk factors for overweight and obesity (O&O) among primary school children, particularly those in rural and semi-urban areas in these countries. Aim and objectives To determine the socio-demographic factors associated with overweight and obesity among primary school children in semi-urban areas. Subjects and methods 1187 school pupils aged 6–11 years recruited from semi-urban areas using multistage sampling were interviewed for risk factors of overweight and obesity using a structured questionnaire. Nutritional status was assessed using body mass index and this was classified using a standard method. The proportions were compared using Pearson’s chi-squared. Multivariate logistic regression analysis was also carried out with overweight and obesity as the dependent variable and socio demographic factors as independent variables. The level of statistical significance was set at p <0.05 in all the statistical analyses. Results Fifty-eight pupils (4.9%) had overweight and obesity while 1129 (95.1%) were either of normal nutritional status (1088, 91.6%) or were thin/severely thin (41, 3.5%). Among those with overweight and obesity, 41 (3.5%) were overweight and 17 (1.4%) obese. A higher prevalence of overweight and obesity was significantly associated (in unadjusted analysis) with female gender [unadjusted Odds Ratio, OR (95% CI) = 2.42 (1.37, 4.28)], attendance at private schools [OR (95% CI) = 3.34 (1.86, 6.00)], higher socio-economic status families [OR (95% CI) = 2.32 (1.65, 5.80)] and presence of a television in the pupil’s bedrooms [OR (95% CI) = 2.22 (1.02, 4.82)] on bivariate analyses. However, only gender, school type and family socioeconomic status were independently associated with overweight and obesity on multivariate logistic regression analysis. Conclusion We conclude that overweight and obesity among primary school pupils in semi-urban areas is associated with female gender, attendance at private schools and higher socioeconomic status families. Preventive programmes should accordingly be more directed at children from affluent families; particularly those who are females and those attending private schools.

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Gastric duplications are uncommon developmental abnormality reported to present with different clinical scenarios. We present a 2-1/2-year-old Nigerian female who started having intermittent massive lower gastrointestinal haemorrhage at 5 months of age. She subsequently developed a lower chest wall mass and enterocutaneous fistula. She was found to have gastric duplication with fistulous communication with the descending colon, spleen, and lower chest wall. To the best of our knowledge, this is the first paper on gastric duplication resulting in intermittent massive lower gastrointestinal bleeding mainly from splenic capsular erosion and fistula and enterocutaneous fistula resulting from erosion of anterior abdominal wall. Gastric duplication is hence an important rare cause of intermittent massive lower gastrointestinal haemorrhage and spontaneous enterocutaneous fistula in the paediatric population.