Background: Infections are a common cause of childhood morbidity and mortality in developing countries. Proper management of these conditions in appropriate health facilities provides the best opportunity for survival and reducing disability. Aims: To evaluate the care-seeking behavior by parents of under-five children with fever in Nigeria and determine household characteristics associated with appropriate care-seeking. Material and methods: The study is a secondary analysis of 2013 Demographic and Health Survey data for Nigeria, which was a cross-sectional survey conducted nationwide to obtain demographic and health characteristics of the population among 40,680 households selected using a multistage cluster sampling method. Under-five children with fever in the preceding two weeks were selected alongside their mothers. Selected sociodemographic parameters were related to parents seeking care from appropriate health facilities or otherwise. Logistic regression analysis was employed to evaluate the association of these parameters with appropriate care-seeking. Results: There were 3632 (12.6%) under-five children with fever in the preceding two weeks. Of these, 1142 (31.4%) had been taken to an appropriate health facility for care. Factors associated with appropriate care-seeking were paternal secondary (OR, 95% CI; 1.49, 1.16-1.90), paternal tertiary education (OR, 95% CI; 2.03, 1.49-2.76) and belonging to the Muslim faith (OR, 95% CI; 2.31, 1.86-2.87). Others were age of child <36 months, being married and working mother. Conclusion: There is poor care-seeking for fever in under-five children by parents in Nigeria. Improved literacy, women empowerment and health education are strategies that may improve care-seeking behavior. Highlighted regional differences are additional considerations for such interventions.
Background: Congenital heart diseases cause significant childhood morbidity and mortality. Several restricted studies have been conducted on the epidemiology in Nigeria. No truly nationwide data on patterns of congenital heart disease exists. Objectives: To determine the patterns of congenital heart disease in children in Nigeria and examine trends in the occurrence of individual defects across 5 decades. Method: We searched PubMed database, Google scholar, TRIP database, World Health Organisation libraries and reference lists of selected articles for studies on patterns of congenital heart disease among children in Nigeria between 1964 and 2015. Two researchers reviewed the papers independently and extracted the data. Seventeen studies were selected that included 2,953 children with congenital heart disease.
Results:The commonest congenital heart diseases in Nigeria are ventricular septal defect (40.6%), patent ductus arteriosus (18.4%), atrial septal defect (11.3%) and tetralogy of Fallot (11.8%). There has been a 6% increase in the burden of VSD in every decade for the 5 decades studied and a decline in the occurrence of pulmonary stenosis. Studies conducted in Northern Nigeria demonstrated higher proportions of atrial septal defects than patent ductus arteriosus. Conclusions: Ventricular septal defects are the commonest congenital heart diseases in Nigeria with a rising burden.
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