Ic Anochie

Prevalence of Sexual Activity and Outcome among Female Secondary School Students in Port Harcourt, Nigeria

Sexual activity among 534 Nigerian female secondary school students was studied using self-administered questionnaire. Prevalence of sexual intercourse was 25.7%. There was no significant difference between the junior (48.2%) and senior (51.8%) students (p > 0.05). Seventeen (12.4%) students had initiated sexual intercourse before 11 years. The frequency of sexual exposure was high, with 34.3% of the students having intercourse more than once in a week. Pregnancy rate among sexually active females was 27.0%, with 24.8% rate of induced abortion. Early sexual health education starting from primary school would be helpful in influencing the reproductive decisions and sexual behaviour of the students, including contraceptive acceptance and usage, to avoid teenage pregnancy. Education of parents is also recommended in order to overcome the cultural barriers that discourage parents from providing sex education to their children at home.

Weight status of adolescents in secondary schools in port Harcourt using Body Mass Index (BMI)

BackgroundAdolescent weight status is a cumulative effect of health and nutritional problems. Adolescent weight problems often go unnoticed as weight assessment is not considered a priority in adolescents.ObjectivesTo determine the weight status of adolescents using BMI and to identify the contributing factors to adolescent weight problems.MethodsIn April 2010, 960 adolescents aged 10–19 years in secondary schools in Port Harcourt were selected for the study using a stratified multi-staged sampling method. Structured questionnaires were filled by the investigators while weight and height were measured. BMI was calculated using the formula weight/height2 (kg/m2).ResultsThe prevalence of underweight, overweight, obesity and stunting were 6.4%, 6.3%, 1.8% and 5.4% respectively. Factors which were commoner in overweight adolescents were high socioeconomic class, higher maternal education, spending > 3 hours a day watching television and frequent ingestion of snacks.ConclusionThere is a need for periodic weight assessment of adolescents and health education to promote healthy eating habits and regular physical exercise as part of the School Health Programme.

Paediatric acute peritoneal dialysis in southern Nigeria

Background: Acute peritoneal dialysis (APD) is the preferred treatment for isolated failure of the kidney. The authors reviewed children with acute renal failure (ARF) who had APD in Port Harcourt, Nigeria. Results: 221 patients, 147 boys and 74 girls (M: F, 1.99:1), mean (SD) age 5.4 (4.9) years had ARF. Dialysis was indicated in 112 cases. The main clinical indication being convulsion/uraemia 30 (26.8%) Only 27 patients (21 boys and 6 girls) had APD, giving an access rate of 24.1%. The commonest dialysis related complication was catheter malfunction 12 (44.4%). The mortality rate among the dialysed patients was 22.2%. Lack of dialysis and intractable hypertension significantly increased mortality (χ2 = 7.13, p<0.01) and (χ2 = 14.9, p<0.001) respectively. Conclusion: APD is effective in reducing mortality of children with ARF. However, there were low dialysis access rate and few complications.

Ambiguous External Genitalia in Childhood in Port Harcourt, Nigeria

Ambiguous external genitalia are a major cause of parental anxiety and a challenge to paediatricians in developing countries. Aims and objectives: This study aims to highlight the pattern of presentation and challenges in the management of ambiguous external genitalia in a developing country. Patients and methods: A prospective study of all patients with ambiguous external genitalia managed in the paediatric endocrine unit of the University of Port Harcourt Teaching Hospital between January 2008 and Dec 2010 was done. Biodata, clinical presentation, management and outcome were documented. Results: Six patients were seen with ambiguous external genitalia during the study period. Age ranged from birth to 16 years at presentation. The commonest presentation was clitoral hypertrophy in all patients. The commonest initial diagnosis was CAH. Definitive confirmation of cause of ambiguous external genitalia with a reconstructive surgery was done in only one patient due to non-availability and high cost of investigation. Three (50%) patients were lost to follow up of which 2(66.7%) have resorted to spiritual treatment. One patient who presented at 16 years of age died from an associated obstructive uropathy with chronic renal failure. Conclusion: The challenges in managing children with ambiguous external genitalia in developing countries include late presentation, high cost andnon-availability of investigations for making definitive diagnosis.

The effect of some social factors on adolescents nutritional status in an oil-rich Niger-Delta region of Nigeria

Background: Adolescence is the period of transition from childhood to adulthood and the second most critical period of physical growth after the first year of life. Nutritional problems may arise from poor eating habits, snacking and consumption of nutrition deficient processed foods. Some social factors have been shown to influence their nutritional status, the result of which may have detrimental health implications as they advance into adulthood. Aim: To determine the effect of some social factors on the nutritional status of adolescents in Port Harcourt. Methods: A multi-staged sampling technique was used to select 960 adolescents from eight secondary schools in Port Harcourt. Using an investigator-administered questionnaire, information on their socio-economic status, eating habits, food content and level of activity was obtained. Anthropometric measurements were taken and BMI calculated using the formula weight/height 2 (kg/m 2 ). This was then used to categorize their nutritional status. The results were analyzed using SPSS 14 and EPI Info 6.04. Results: Eight hundred and nineteen adolescents (85.3%) had normal weight, 61(6.4%) were underweight while 17 (1.8%) were obese. Significantly more males (8.9%) were underweight compared to females (3.8%); while females were significantly more overweight and obese than males. Consumption of snacks (17.4%), soft drinks (10%), higher social economic class (11.5%) and watching television for >3hrs a day (18.6%) were associated with overweight and obesity. Conclusion: Social economic status, snacking and hours spent watching television have a detrimental effect on the nutritional status of adolescents in Port Harcourt.

Steroid Induced Diabetic Ketoacidosis (DKA) in a 13 year Old Female with Renal Disorder

Background: Diabetic ketoacidosis (DKA) is a common complication of poorly controlled diabetes mellitus in children and a rare complication of steroid therapy. Patients on steroid therapy may develop hyperglycemia as a complication, but presentation with DKA is rather unusual. Aim: To highlight a rare clinical entity of DKA induced by prednisolone in a 13 year old female on treatment for nephrotic syndrome. Case report: NC was a 13 year old female who presented with first episode of generalized body swelling, oliguria, massive proteinuria and hypercholesterolenaemia with normal renal function. She was not a known diabetic and had no family history of diabetes mellitus. She was started on prednisolone at 20 mg three times daily for nephrotic syndrome. Two weeks after commencement of prednisolone, she developed DKA with blood glucose of 31.1 mmol/l, glycosuria and ketonuria. She received intravenous insulin, fluids and was discharged on mixtard insulin with withdrawal of prednisolone. Her fasting blood sugar gradually normalized to between 3.1-4.5 mmo/L and insulin stopped after 4 months of treatment. She has remained normoglycaemic on follow up. Conclusion: The possibility of hyperglycaemia and DKA should be anticipated on every adolescent on steroid therapy for nephrotic syndrome. We therefore recommend routine blood glucose monitoring for early identification of DM in order to avoid DKA in such patients.