Ki Eyong

Malariometric Indices among Nigerian Children in a Rural Setting

Malaria contributes to high childhood morbidity and mortality in Nigeria. To determine its endemicity in a rural farming community in the south-south of Nigeria, the following malariometric indices, namely, malaria parasitaemia, spleen rates, and anaemia were evaluated in children aged 2–10 years. This was a descriptive cross-sectional survey among school-age children residing in a rubber plantation settlement. The children were selected from six primary schools using a multistaged stratified cluster sampling technique. They were all examined for pallor, enlarged spleen, or liver among other clinical parameters and had blood films for malaria parasites. Of the 461 children recruited, 329 (71.4%) had malaria parasites. The prevalence of malaria parasitaemia was slightly higher in the under fives than that of those ≥5 years, 76.2% and 70.3%, respectively. Splenic enlargement was present in 133 children (28.9%). The overall prevalence of anaemia was 35.7%. Anaemia was more common in the under-fives (48.8%) than in those ≥5 years (32.8%). The odds of anaemia in the under fives were significantly higher than the odds of those ≥5 years (OR = 1.95 [1.19–3.18]). Malaria is highly endemic in this farming community and calls for intensification of control interventions in the area with special attention to school-age children.

The Role of Radiotherapy and Chemotherapy in the Treatment of Primary Adult High Grade Gliomas: Assessment of Patients for These Treatment Approaches and the Common Immediate Side Effects

Gliomas are the commonest primary brain tumours in adults. They are usually classified and graded according to the criteria by the World Health Organisation. High-grade gliomas are the most malignant primary brain tumours. Conventional therapies include surgery, radiotherapy, and chemotherapy. The tumours often demonstrate high levels of resistance to these conventional therapies, and in spite of treatment advances the prognosis remains poor.

Stigma on Nigerian children living with epilepsy

The stigma on Nigerian children (aged 6–18 year) living with epilepsy attending the Pediatric Neurology Clinic in Calabar was studied. The survey was conducted between September 2010 and February 2011 on children having established epilepsy and was attending the Neurology Clinic of the University of Calabar Teaching Hospital, Calabar. A questionnaire with open-ended responses was drawn up and administered on the epileptic children. Information was collected from the children privately in the absence of the parents. The children were interviewed by the authors and the data recorded into the form by the latter. Forty percent of the children reported being regarded as demon-possessed, some were said to be mad and suffering under a family curse. Sixty percent of the children claimed being made objects of ridicule. Fifty percent of the children would wish to withdraw from school while 46% would change school because of embarrassment. Fifty-six percent knew that friends and schoolmates usually run away from them during attacks, 29.4% claim their teachers will not help but only watch them while fitting at school. Twenty-four percent of the victims, all in the age bracket 12–18 yrs, expressed suicide wish. Stigma associated with epilepsy is a problem of children in Calabar. Education of parents and the entire populace is advocated as this could change the societys misconception of epilepsy.

Nigerian secondary school teachers' knowledge and attitudes towards schoolchildren with epilepsy

A cross sectional study was undertaken to assess the knowledge and attitudes of secondary education teachers towards schoolchildren with epilepsy. Questionnaires were administered to three randomly selected schools and systematic random sampling method applied to select teachers in these schools. Their demographic characteristics and responses to the questions were analyzed. Out of the 105 teachers that returned completed forms, majority (97) were university graduates. Sixty-nine (65.7%) are aware that epilepsy may be caused by brain infection, 14 (13.3%) thought it is due to head trauma, while eight (7.6%) associates epilepsy with evil spirits; three (2.9%) thought that epilepsy follows a family curse and 11 (10.5%) were not sure of the cause. Concerning treatment, 89 (84.8%) believed the disease is curable but only 52.4% recommended orthodox treatment. Eighty-seven (82.9%) of the respondents will assist a convulsing child while 18 (17.1%) would either run away or not touch a convulsing child. Forty-nine (46.7%) of the teachers believed that epilepsy is contagious. There is a statistically significant relationship between the teachers who believed epilepsy is contagious and the action taken when a child is convulsing (χ 2 = 21.06, P = 0.00). Sixty (57.1%) of teachers thought that children with epilepsy are intellectually deficient, nevertheless, only 37.1% recommended special schools for children with epilepsy and another 11.4% suggested total exclusion of the children from school. There is relative lack of knowledge on epilepsy leading to misconceptions and stigmatization. These teachers can hand on same misconceptions to their pupils and by extension the entire community. We therefore, recommend an elaborate educational campaign on epilepsy by health professionals.

Antimicrobial susceptibility profile of community acquired and nosocomial isolates of Escherichia coli from clinical blood culture specimens at a Nigerian university teaching hospital

Objective: To ascertain the antibiotic susceptibility patterns of Escherichia coli recovered from blood culture specimens in Calabar, Nigeria. Methods: The study was retrospective in nature and was carried out at University of Calabar Teaching Hospital (UCTH) Calabar. Data generated from blood culture specimens over a five year period (Feb. 2004-Feb. 2009) was compiled, relevant information such as age, sex, organism recovered and antibiotic susceptibility patterns were obtained from patients records. Samples were collected, transported, stored and processed using standard laboratory procedures. Data obtained was analysed using Epi Info 6 statistical software. Results: Escherichia coli was responsible for 15.3% (31/203) of the blood infections being the third most common microorganism encountered. The community acquired (CA) isolates of the organism were significantly less resistant (P＜0.05), compared to the nosocomial (NC) isolates against ampicillin, cloxacillin, amoxicillin, tetracycline, co-trimoxazole, chloramphenicol and erythromycin. The sensitivity of both the NC and CA isolates of Escherichia coli to amikacin, augmentin, ofloxacin, ciprofloxacin, ceftazidime, cefuroxime, ceftriaxune and rifampicin was generally high (80-100%) with no significant difference (P＞0.05). Majority (＞95.0%) of the NC isolates of Escherichia coli were resistant to six of the antibiotics tested. Conclusions: Control mechanisms for hospital acquired infections should be stepped up so as to limit the spread of the highly resistant bacterial strains. Also the sale and consumption of antibiotics by the public need to be regulated.

Utilization of traditional healers for treatment of malaria among female residents in Makurdi city and its environs

Abstract Objective To ascertain the role of traditional healers in malaria treatment and its impact on control of the disease. Methods The study was cross-sectional in nature. Test-run structured and semi-structured questionnaires were either interviewer or self administered to adult women aged 18 years old and above. House holds were selected using systematic random sampling methods. Information such as age, educational level, marital status, occupation and methods of malaria treatment were obtained. Focused group discussions about beliefs and perceptions on utilization of traditional healers and in depth discussions on treatment and control of malaria were also carried out. Results Of the 2 075 respondents studied, 49.7% (n=1 031) utilized traditional healers for treatment of malaria, including 16.7% (n=172) utilizing traditional healers strictly while 83.3% (n=859) combining it with other treatment methods such as hospital/clinic, pharmacy/chemist shop, herbs or spiritual healing. The major contributors to utilization of traditional healers were: illiteracy and ignorance, poverty, unemployment/underemployment and slow pace of the comprehensive package implementation of the “roll back malaria” (RBM) programme initiate in the community. Conclusions Health education should be intensified while adequate facilities put in place to commence home management of malaria and probable free distribution of the artemisinin-based combination therapy (ACT).

Acute rubella infections mimicking measles in children in Calabar, Nigeria

The clinical diagnosis of rubella is unreliable as the symptoms are often confused with other viral and non-viral exanthematic illnesses. Acquired forms are self-limiting whereas the congenital type has devastating consequences on the foetus. The aim of this study is to highlight rubella infections in children and to draw to the attention of relevant authorities the need for routine rubella immunization for children and women of childbearing ages. This was a prospective cross-sectional study conducted from February to December 2012. Thirty five children aged 2 to 18 years, were referred to selected health facilities in Calabar following reports of symptoms of fever and skin rash, clinically resembling measles. The demographic data of the children were obtained. Blood was collected from each child and sent for measles and rubella IgM ELISA. Data were analysed using SPSS version 16. Of the 35 children with fever and skin rash, 22 were males while 13 were females (1.7:1). Fourteen (40%) of the children were found to be IgM seropositive for rubella. Five (35.7%) of rubella IgM seropositive children were less than five years of age while 7 (50%) were 5-10 years old. There was no significant difference in the seropositivity for rubella IgM antibody according to age and sex of the patients and (P = 12.5). Only one child (2.8%) was positive for measles IgM. Acute rubella infection is clinically indistinguishable from measles and is confirmed to be present in Calabar, Nigeria. We therefore advocate for routine immunisation of children and women of childbearing ages to prevent the damaging effects of rubella to the unborn baby.

Cranial nerve palsies in Nigerian children

Background : Cranial nerve palsies are common clinical problem routinely encountered in neurological practice; the dysfunction can occur at any point in the course of the nerve and may point to serious pathology. The aim of this study was to determine the pattern and underlying aetiology of cranial nerve palsies in Nigerian children. Method: Children in the Children’s Emergency Unit and the Children’s Ward of the University of Calabar Teaching Hospital, Calabar, Nigeria, with neurological problems over a 12-month period (January through December 2012), were recruited into the study. Each child was admitted and evaluated by the Paediatric Neurology Unit. Those with cranial nerve palsies were selected for detailed analysis. The biodata, clinical features and relevant laboratory results were documented. Results: Of the 285 with neurological problems 23 (8.1%) had cranial nerve palsies. Fifteen (65.2%) of the children had single cranial nerve palsies while eight (34.8%) had multiple cranial nerves involvement. Of the 43 nerves involved, the facial nerve was the commonest (38.3%) followed by the oculomotor (23.5%) and abducens (20.6%). Intracranial infections such as meningitis, viral encephalitis and brain abscess were incriminated in 60.8% of the patients and 70.6% of the nerves involved. Conclusion : Cranial nerve palsies cause handicap and cosmetic problems. It is recommended that every child with cranial neuropathy should be evaluated for intracranial infections among other differentials. Prompt diagnosis, treatment and immunisation against related infections is paramount.