Background and Objectives:Children with congenital heart disease (CHD) are prone to malnutrition. This can have a significant effect on the outcome of surgery. Our objective was to determine the burden and determinant of malnutrition in children with several types of congenital heart disease (CHD).Methods:This is a descriptive cross sectional study of children attending the outpatient clinic of UNTH, Ituku – Ozalla, Enugu State, over a six year period from March 2007 to April 2014. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 19 (Chicago IL).Results:Forty thousand one hundred and twenty three (40,123) children attended the outpatient clinic during the study period. Of these, 50 had congenital heart disease, from which 46 were found to have various degree of malnutrition, giving a prevalence of 92% among children with congenital disease and 0.11% in the general population. Malnutrition showed significant correlation between age in years, age appropriate dietary adequacy and pulmonary hypertension. (r= 0.22, p = 0.01; r = 0.20, p = 0.02; r = 0.15, p = 0.01).Conclusion:Children with CHD develop severe malnutrition and growth failure. The significant contributing factors are mean age at presentation and age appropriate dietary adequacy.
Introduction:When a child reaches a certain age, he or she moves over to the adult physician. For this to maximally benefit the child, there has to be a process of equipping the child with skills required for taking on more responsibilities. Transitioning involves a process in which the adolescent with chronic illness is prepared ahead of time to enable them to eventually transfer to adult care with good outcomes. In high-income countries with wellorganized health financing, the transitioning process begins as early as 12 years. In Africa, this process is not as organized and most hospitals would write a referral letter once the child turns 18 and transfer to adult clinic. In four of our chronic disease clinics (asthma, HIV, sickle cell anaemia and chronic kidney diseases) patients up to 24 years old are still attending the paediatric clinics. Understanding transition readiness among African adolescents remains a gap. Our findings will form a basis for informed practices for adolescent clinics in African countries. Methods: This was a descriptive cross-sectional study of pre-transition readiness in adolescents and young adults with chronic illnesses attending four outpatient specialist clinics in a tertiary hospital in Enugu Nigeria. This was done using the validated STARx Questionnaire. Total scores were computed and scores nearer the upper limit of 90 were acceptable, while mean subdomain scores of 4 and above were considered as optimal level of transition readiness. Demographic and clinical data were also collected. Acceptability to move on to adult-oriented care was documented using binary response (yes/no). Cross tabulations were done, and likelihood ratios obtained for predictors of acceptability of transition. Significant value was set at p-value of ≤0.05. Results: A total of 142 adolescents and young adults aged 12 to 24 years were studied. There were 38.0% (54), 24.6% (35), 22.5% (32) and 14.8% (21) from HIV, sickle cell anaemia, asthma and nephrology clinics, respectively. Their mean age was 15.6 years ± 2.4, and 48.6% (69) were male. The mean total transition readiness score was 56±14 and this was not nearer the higher spectrum of total scores obtainable. Highest mean scores (3.7) occurred in the knowledge subdomain while least mean score (2) was noted in the use of medication reminders. The males had highest scores in the knowledge subdomain while the females were better informed about medication adherence and were more inquisitive about their chronic illness. Only about 37% (53) of the adolescents and young adults welcomed the idea of moving on to adult-care clinics. Children who had less frequent emergency hospital visits and better treatment outcome accepted the idea of transfer to adult care. Irrespective of the age all participants had suboptimal subdomain scores. High scores did not influence the participants' choice to embrace transfer to adult care.
Adolescence is an important developmental period of childhood. Good health and adequate nutrition consisting major food constituents and trace elements like zinc are fundamental for optimal sexual maturation. To determine the relationship between zinc levels and pattern of breast and pubic hair development, as well as menarcheal age of female SCA children aged 6-18 years and their matched controls with hemoglobin genotype AA. Cross sectional, case-control study. Information on biodata, age at menarche, medical and drug history as well as 24-hour dietary recall was documented using interviewer administered questionnaire. Sexual maturation was assessed using Tanner staging and zinc levels determined using Atomic absorption spectrophotometer. Eighty-one subjects were compared with 81 controls. There was significant delay in the mean age of attainment of various Tanner stages of breast and pubic hair in the subjects. Mean age of 14.81 ± 1.07 years at menarche in subjects was significantly higher than 12.62 ± 1.18 years in controls (p = 0.001). Serum zinc of 58.01 ± 10.58 µg/dl in subjects was significantly lower than 68.37 ± 8.67 µg/dl in controls (p = 0.001). Serum zinc levels were found to have a significant positive relationship with stages of sexual maturation and mean age at menarche. Reduced serum zinc in children with SCA was associated with delayed sexual maturation.
Objectives: This study aimed to determine the prevalence and associated factors of internet addiction amongst adolescents in Southeast Nigeria during the coronavirus disease 2019 (COVID-19) era. Methods: A cross-sectional study was carried out in 10 randomly selected secondary schools, 2 (one urban and one rural) each from Abia, Anambra, Ebonyi Enugu and Imo states of southeastern Nigeria between July and August 2021. Data on demographic variables were collected using a structured self-administered questionnaire. Young’s Internet Addiction Test was used to assess the extent of internet use. Analysis was done using the IBM SPSS Statistics version 23. The level of significance was set at a p-value of <0.05. Results: The mean age of the respondents was 16.2 ± 1.8 years and the male: female ratio was 1:1.6. Most of the adolescents (61.1%) used the internet for academic purposes, while 32.8% used it for social interactions and the majority (51.5%) used their phones. The prevalence of internet addiction was 88.1% (24.9% had mild, 59.6% had moderate, while 3.6% had severe addiction) and a good proportion of the respondents (81.1%) perceived addiction as bad. Internet addiction was significantly associated with the respondent’s age ( p = 0.043), mother’s level of education ( p = 0.023), family size ( p = 0.021), place of residence ( p = 0.035), alcohol intake ( p = 0.017), smoking ( p = 0.015), substance use ( p = 0.001) as well as the duration of internet use ( p < 0.001). Internet addiction was predicted by the male gender (adjusted odds ratio (AOR): 2.054; confidence interval (CI): 1.200–3.518), early adolescent age group (10–13 years) (AOR: 0.115; C1: 0.015–0.895) as well as the duration of internet use (AOR: 0.301; CI: 0.189–0.479). Conclusions: The prevalence of internet addiction among adolescents during the COVID-19 pandemic era was high. The predictors of addiction were the male gender, early adolescent age group and duration of internet use.
Background Corona virus pandemic (COVID 19) has emerged as the single most important topical issue and poses a challenge to medicine. Adolescent school children are exposed to a varying degree. Objectives The study is aimed to determine the knowledge of the mode of spread and preventive practices among college adolescents attending six secondary schools in Enugu metropolis. Methodology This was a cross-sectional study carried out in 6 secondary schools among 500 college adolescents. A pretested, interviewer-administered questionnaire was used for data collection. Results Majority of the respondents, 98.4% were aware of COVID-19. Although, a higher proportion of the respondents, 52.0% were aware COVID-19 could be transmitted through contact with infected persons, only a minor proportion of them, 42.4% had a good knowledge of the mode of spread of COVID-19. However, a high proportion of the respondents, 69.2% practiced good preventive measures against COVID-19. Also, respondents whose parents were self-employed were 1.4 times more likely to have good knowledge of the mode of spread of COVID-19 when compared with those whose parents were on paid employment [adjusted odd ratio (AOR) = 1.4, 95% confidence interval (CI): 0.9–2.0]. The respondents whose fathers have attained tertiary education were 1.6 times more likely to have good preventive practices against COVID-19 when compared with those who had secondary school and below (AOR = 1.6, 95% CI: 1.04–2.5). Conclusion Though college adolescents were aware of COVID-19, not a significant proportion practiced good preventive measures against COVID-19. Knowledge of mode of spread and preventive practices were significantly enhanced by fathers’ educational status and being a female adolescent child.
IntroductionFolic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis. AimTo determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype. MethodThis study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment. ResultsThe median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001). Conclusion Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state.
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