Boma Alali Ngozi Okoh

Prevalence of hypertension in primary school-children in Port Harcourt, Nigeria

Abstract Background: Hypertension is defined as average systolic and/or diastolic blood pressure (BP) ⩾95th per centile for gender, age and height, and pre-hypertension as ⩾90th and <95th per centile, measured on three occasions. Although the prevalence of hypertension during childhood is lower than that in adulthood, it is not rare in children. Aims and Objectives: To evaluate the prevalence of hypertension and its severity in primary school-children in Port Harcourt. Methods: A stratified, multi-staged sampling technique was used to recruit pupils between 6 and 12 years of age in 13 primary schools. Data were collected using a pre-tested questionnaire completed by parents/guardians. The average of three blood pressure measurements was taken for each pupil using standardized techniques. Results: A total of 1302 pupils of whom 585 (44·9%) males and 717 (55·1%) females were studied, giving a male to female ratio of 1:1·2. The prevalence of hypertension was 61 (4·7%), 55 (4·2%) with stage 1 and six (0·5%) with stage 2 hypertension. Sixty (4·6%) of the pupils had pre-hypertension. Twenty-three (3·9%) of the 585 males and 38 (5·3%) of the 717 females were hypertensive (P = 0·25). The mean (SD) age of 8·83 (1·90) years for the normotensive children was higher than the mean (SD) age of 8·56 (2·05) years for the hypertensive children (P = 0·27). Of the study subjects, 152 (11·7%) were underweight, 998 (76·7%) were of normal weight, 75 (5·7%) were overweight and 77 (5·9%) were obese. The prevalence of hypertension among the different weight groups fell steadily from 13 (16·9%) in the obese children to 4 (5·3%) in the overweight children, to 43 (4·3%) in the normal weight children and one (0·7%) in the underweight children (P<0·001). Conclusion: The prevalence of hypertension in school-children in Port Harcourt is 4·7% which is similar to that in other studies in Nigeria and elsewhere. A higher BMI was significantly associated with a higher prevalence of hypertension.

Theoretical knowledge of cardiopulmonary resuscitation among clinical medical students in the University of Port Harcourt, Nigeria

Aim: To assess the knowledge of cardiopulmonary resuscitation (CPR) among clinical medical students of the University of Port-Harcourt. Materials and Methods: A cross-sectional study on the knowledge of CPR among clinical medical students (4 th -6 th year classes) of the University of Port Harcourt. The data collected were analyzed using the Epi info version 7 statistical packages and Chi-square test was used to compare proportions with P < 0.05 considered significant. Results: Two hundred and forty-five questionnaires were distributed with 177 (72.2%) duly filled. The male to female ratio was 1.5:1, the age range was 19-40 years with a mean of 24.50 ΁ 2.79 years. The 6 th year class had 109 (61.6%) respondents, 5 th year had 49 (27.7%) and 4 th year had 19 (10.7%). Forty-six (26.0%) of students had some form of CPR training and 11 (6.2%) admitted having performed CPR. Of the 46 students that had CPR training, 39 (84.8%) did so because it was given to them at some point in their medical training, while 7 (15.5%) acquired the training due to personal interest. One hundred and two (74.6%) students scored <50%, while 45 (25.4%) scored >50%. The number of students scoring >50% increased with increasing class level (P < 0.001). Students with some prior training in CPR (50.0%) scored above average compared to the students without CPR training (16.8%) (P < 0.001). Conclusion: There is a need to periodically and constantly organize CPR for the medical students and incorporating the training in their medical curriculum to enhance better understanding of the procedure.

Basic cardiopulmonary resuscitation knowledge of house-officers in a tertiary institution: factors determining accuracy.

Background To assess the level of knowledge of CPR among House-Officers (HO) and some factors determining accuracy of knowledge. Methods A total of 50 structured questionnaires were administered to HO with 35 (70%) questionnaires duly filled and returned. Data on the participants’ brief biodata and the understanding of basic skills of BLS were collected and analyzed using International Business Machine SPSS Statistics version 21 for Windows. The t-test for independent samples was applied for the grouped data with P < 0.05 taken as level of significance. Results The age of the respondents ranged from 20-37 years with the mean age of 25.4 + SD2.7 years and the male/female ratio was 1:1.3. Eleven (31.4%) out of the 35 HO had no prior CPR training while 68.6% had prior training; Eighteen (51.4%) had training within the last 2 years. Twenty (57.1%) had performed CPR in a real situation, while 42.9% had not. Six (17.1%) HO scored above 50% while 82.9% scored below 50%. The female HO got more correct answers than the males (25% versus 6.7%, p = 0.167). The number of respondents who had prior CPR training had more correct answers than those who did not (25% versus 0%, p = 0.083) while those who had previously performed CPR had more correct answers than those who had not (33.3% versus 5%, P <0.05). Conclusion There was a general poor knowledge of the performance of basic CPR amongst HOs. However, previous experience of having performed CPR in real setting, or the use of mannequins, improved their theoretical knowledge of CPR.

Home management of diarrhoea by caregivers presenting at the diarrhoea training unit of a tertiary hospital in southern Nigeria.

Background: Diarrhoea is a leading cause of under – five morbidity and mortality. Diarrhoea deaths can be prevented by adequate case management of diarrhoeal episodes in children. With majority of cases being treated initially or completely in the home and community, the level of awareness of diarrhoea and simple home management practices among caregivers are key determining factors to reducing diarrhoea morbidity and mortality in children. Aim: To determine caregivers’ perception, knowledge and practice of home management of diarrhoea of children under five years of age presenting to the Diarrhoea Training Unit of a tertiary hospital in Southern Nigeria. Study Design: A clinic – based descriptive cross sectional study. Place and Duration of Study: The study was carried out in the Diarrhoea Training Unit of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria from July to December 2013. Methodology: A structured pre–tested questionnaire was used to collect data from caregivers on demographic characteristics, knowledge and practice of diarrhoea home treatment. There were 8 knowledge and 10 practice questions; each was scored a point Original Research Article British Journal of Medicine & Medical Research, 4(35): 5524-5540, 2014 5525 if correctly answered. The caregivers were grouped into those having good, moderate and poor knowledge or practice according to scores obtained. Results: Of the 157 caregivers, 29.3% had a good level of knowledge, while 33.8% had good level of practice of the home management of diarrhoea. A higher knowledge score was significantly associated with the Social class (P=.002) and mother’s educational level (P=.002). A higher practice score was also significantly associated with the Social class (P<.001) and mother’s educational level (P<.001). After adjusting for other factors, mother’s educational level was significantly associated with both level of knowledge (P=0.022) and practice (P=0.012) of the home management of diarrhea. Conclusion: The study has shown a low level of knowledge and practice among the caregivers as regarding the home management of diarrhoea. A higher level of education in mothers was significantly associated with a higher level of knowledge and practice.

Clinical Pattern of Autism in Nigeria

Autism, a global disorder has been widely studied in the Western world. However, there are limited studies on its occurrence, risk factors, and presentation in developing countries such as Nigeria. This retrospective study highlights the pattern of presentation of autism and presence of some risk factors in 75 Nigerian cases referred to a private autism center. The diagnosis of autism was made using Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV), International Classification of Diseases Fourth edition, the Modified Checklist for Autism in Toddlers, Autism Treatment Evaluation Checklist, and Childhood Autism Rating Scale. There were 60 males and 15 females with a male to female ratio of 4:1. The mean age at presentation to the center was 6.87 ± 4.20 years and majority (91.9%) belonged to a high socioeconomic class. Already established risk factors, clinical features, and comorbidities of autism present among the study group were similar to findings in individuals with autism in other parts of the world. Autism Res 2016, 9: 376–381.

HIV Encephalopathy (HIVE) in Children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria

Background: HIV encephalopathy (HIVE) is associated with cognitive impairment in children with HIV infection, early diagnosis and initiation of HAART may reduce the morbidity associated with HIVE. Objective: To determine the prevalence of HIVE and associated comorbiditiesin children at the UPTH. Methodology: This was a retrospective study carried out from January to June 2017. The case notes of all HIV positive children presenting to the Paediatric Department of the University of Port Harcourt Teaching Hospital (UPTH) were studied. Children who met the diagnostic criteria for HIVE according to the Centre for Disease Control (CDC) definition were selected. The socio-demographic characteristics of the patients, mode of HIV transmission, CD4 count and associated comorbidities in these children were retrieved from the case notes. Obtained data was analyzed using Epi Info version 7.2. Comparisms of subgroups was carried out using the chi square test while statistical significance at 95% confidence interval was p value p = 0.187). Thirty (85.7%) of the patients with HIVE were on HAART at diagnosis. The mean age at diagnosis of HIV was 3.2 ± 3.1 years and the mean age at diagnosis of HIV encephalopathy was 3.4 ± 3.2 years. The documented route of transmission for all the subjects was mother-to-child-transmission (MTCT). Seventy five percent of the children were breastfed from birth and at 6 months all the mothers had discontinued breastfeeding. The mean CD4 count was 1053 ± 630 cells/ml. Tuberculosis was the most prevalent co-morbidity occurring among the patients. Conclusion: The prevalence of HIVE in children at the UPTH is high and Tuberculosis is the commonest comorbidity. Early infant diagnosis, use of modern diagnostic tool and early initiation of HAART are advocated to reduce its associated morbidity.

Awareness and Status of Tetanus Toxoid Vaccination among Female Undergraduate Students in a Nigerian University

Aims: The study aimed to determine the level of awareness and status of tetanus toxoid (TT) vaccination among female undergraduates in Port Harcourt. Study Design: This was a cross sectional descriptive study carried out among female undergraduate students. Place and Duration of Study: The study was carried out in University of Port Harcourt from 1 to 31 st of May 2014. Methodology: A pre-tested questionnaire was administered to 512 female students selected through a Multi-Staged sampling technique. Information sought included socio-demographics, Original Research Article Alex-Hart and Okoh; IJTDH, 7(1): 6-15, 2015; Article no.IJTDH.2015.052 7 awareness of TT vaccine, knowledge of the vaccination campaign for women of childbearing age and TT vaccination status. Data was analyzed using epi info version 7.1.3.3. Results: A total of 512 students participated in the study; mean age was 22±2.79 years. Four hundred and eighty five (94.7%) and 409 (79.9%) students had heard of tetanus and TT vaccine respectively. Commonest sources of information were health workers. 33.8% knew the target population for the TT vaccination campaign and 18.2% knew that the correct number of doses of TT is 5 doses. Two hundred and ninety eight (58.2%) and 10 (2%) students had received at least 1 dose and 5 doses of TT respectively. Students who had knowledge of the target population for TT vaccination campaign (OR=2.14, p=0.003) and those who were confident in the effectiveness of TT (OR=2.41, p<0.001) were twice more likely to receive at least a dose of TT vaccine. Conclusion: There was poor knowledge of TT vaccination campaign for women of childbearing age and very poor coverage of TT5 among the female undergraduate students in Port Harcourt. Female undergraduate students should be reached during TT vaccination campaigns.