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Background: Sickle cell anaemia (SCA) is the commonest monogenic haematologic disorder resulting from the inheritance of homozygous mutant haemoglobin genes from both parents. Some factors have been identified as important in explaining the variability in depression in sickle cell anaemia (SCA). Information on this is limited in a resource-limited setting like Nigeria. This study aims to determine factors which influence depression in children and adolescents with sickle cell anaemia in a resource-limited setting.Methods: Systematic random sampling technique was used in this cross-sectional study to select children and adolescents aged 7-17 years at the weekly sickle cell clinic of the University of Nigeria Teaching hospital (UNTH) Enugu, Nigeria. Pretested, structured questionnaire was used to collect sociodemographic and disease severity data while depression was assessed using the Children's Depression Inventory.Results: Age and educational level had significant positive linear relationships with depression (r = 0.253, p = 0.02; r = 0.225, p = 0.04 respectively) while gender (χ2 = 0.531, p = 0.466), socioeconomic status (χ2 = 0.451, p = 0.798) and disease severity (χ2 = 0.422, p = 0.810) had no relationship with depression in children and adolescents with SCA.Conclusion: Depression in children and adolescents with SCA increased with increasing age and educational level. Psychological evaluation should be integrated into routine assessment of children with SCA during their follow up visits as they get older and progress in class. [ABSTRACT FROM AUTHOR]

Background: Majority of the oral diseases in children are preventable. The paediatricians owing to the unique position they occupy in child care are invaluable in achieving standard oral and dental healthcare in children. This study was aimed at assessing the paediatricians' views on basic oral healthcare in children in Nigeria. Methods: This was a cross sectional descriptive study. Respondents were paediatricians attending the 2015 Annual General Meeting and Scientific Conference of the Paediatric Association of Nigeria. Relevant information sought from the respondents included: socio- demographic characteristics, duration and location of practice; specific questions on knowledge of basic oral health care in children and recommendations for improvement in knowledge of oral and dental health among paediatricians based on standard clinical guidelines. Data was analyzed using the SPSS version 20.0 and presented in simple frequencies and percentages. Test of associations was done using chi- square while logistic regression analysis was used to determine significantly associated variables (p < 0.05). Results: A total of 121 paediatricians were recruited. 108 (89.3 %) reported that children should be referred to dental health care when caregivers/older patients report dental problems (χ² = 9.377; p = 0.02). 53.7 % felt that examination of the oral cavity should be routine while 61 (50.4 %) of them reported that health education should be given to caregivers/mothers about nursing caries starting early in life. Majority of the respondents 66 (54.5 %) disapproved gum pad cleaning of young infants. 32 (26.4 %) suggested starting tooth brushing in infants as soon as a tooth appear in a child while 112 (92.6 %) recommended the disapproval of pacifiers in infants/younger children. 93 (76.9 %) were of the opinion that the paediatrician is competent in identifying and handling of basic oral health care in children. However, 108 (89.3 %) recommended that the current postgraduate curriculum in paediatrics should incorporate knowledge of basic oral health care in children. Conclusion: Majority of the paediatricians were found to have limited knowledge about some basic oral health care in children. It is recommended that the current postgraduate training curriculum in paediatrics in our setting should incorporate knowledge of basic oral healthcare in children. [ABSTRACT FROM AUTHOR]

Background: Sickle-cell anaemia (SCA) is the most common inherited haemoglobinopathy affecting the Negroid race. Renal complications such as enuresis can occur during childhood. Reports show that children and adolescents with SCA may be at a higher risk of nocturnal enuresis than their counterparts with normal haemoglobin genotype. Aims: The study aims to determine the prevalence of nocturnal enuresis and possible risk factors among school-aged children with SCA in a South-east Nigerian city. Methods: A hospital-based and cross-sectional descriptive study of 70 school-aged children with SCA who met the study criteria, and 70 age- and sex-matched controls with normal haemoglobin genotype was conducted in the Paediatric Sickle-cell Anaemia Clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu. Data was subjected to multivariate analysis using logistic regression model with nocturnal enuresis as the dependent variable and the possible risk factors as the independent variables. Results: The prevalence of nocturnal enuresis among the Subjects and the Controls was 31.4 and 21.4 % respectively (p = 0.180). It was significantly higher among male Subjects (48.7 %) than among male Controls (23.1 %) [OR (95 % CI) =8.14 (2.12-31.24), p < 0.001]; and among Subjects whose parents had a childhood history of enuresis [OR (95 %) =10.39 (2.45-44.05), p = 0.002]. The difference in the prevalence of enuresis in the female cohort was however not significant. Conclusions: Children with SCA have a tendency to develop nocturnal enuresis when compared to their non-affected counterparts. Male gender and parental childhood history of nocturnal enuresis are potential socio-demographic risk factors. [ABSTRACT FROM AUTHOR]

Some factors are known to influence the academic performance of children with Sickle Cell Anaemia (SCA). Information on their effects in these children is limited in Nigeria. The factors which influence academic performance of children with SCA in Enugu, Nigeria are determined in this study. Methods Consecutive children with SCA aged 5-11 years were recruited at the weekly sickle cell clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- and sex- matched normal classmates were recruited as controls. The total number of days of school absence for 2009/2010 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. Intelligence ability was determined with Draw-A-Person Quotient (DAPQ) using the Draw-A-Person Test while socio-economic status was determined using the occupational status and educational attainment of each parent Results Academic performance of children with SCA showed statistically significant association with their socio-economic status (χ² = 9.626, p = 0.047), and significant correlation with DAPQ (r = 0.394, p = 0.000) and age (r = -0.412, p = 0.000). However, no significant relationship existed between academic performance and school absence in children with SCA (r = -0.080, p = 0.453). Conclusions Academic performance of children with SCA is influenced by their intelligence ability, age and socio-economic status but not negatively affected by their increased school absenteeism. [ABSTRACT FROM AUTHOR]

Background Hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood. Objective To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu South East Nigeria. Methodology A study of 2694 adolescents aged 10-18 years in Enugu metropolis was carried out . Sociodemographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as Prehypertension, hypertension and BMI were obtained. Results The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25 + 7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23 + 8.26 mmHg respectively ( p < 0.01). Blood pressure was found to increase with age. Prevalence of hypertension and prehypertension was 5.4% and 17.3% respectively with a higher rate in females (6.9%) than males (3.8%). Prevalence of prehypertension among males and females were 14.3% and 20.1% respectively. The prevalence of obesity was 1.9%. Conclusion Modifiable risk factors exist among adolescents. Early lifestyle modification and a strengthened school health are recommended. [ABSTRACT FROM AUTHOR]

Background: Mother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. A number of risk factors contribute to the rate of this transmission. Such risk factors include advance maternal HIV disease, lack of anti-viral prophylaxis in the mother and child, mixing of maternal and infant blood during delivery and breastfeeding. This study aims to determine the cumulative HIV infection rate by 18 months and the associated risk factors at the University of Nigeria Teaching Hospital, Enugu. Results: A retrospective study, involving HIV exposed infants seen at the pediatric HIV clinic of UNTH between March 2006 and September 2008. Relevant data were retrieved from their medical records. The overall rate of mother to child transmission of HIV in this study was 3.9% (95% CI 1.1%- 6.7%). However, in children breastfed for 3 months or less, the rate of transmission was 10% (95% CI ?2.5%-22.5%), compared to 3.5% (95% CI 0.5%-6.5%) in children that had exclusive replacement feeding. Conclusions: This retrospective observational study shows a 3.9% cumulative rate of mother-to-child transmission of HIV by 18 months of age in Enugu. Holistic but cost effective preventive interventions help in reducing the rate of mother-to-child transmission of HIV even in economically-developing settings like Nigeria [ABSTRACT FROM AUTHOR]

Background: Urinary tract infection (UTI) is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA) may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI., Objectives: This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin., Methods: One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥ 10⁵ cfu/ml) on two consecutive cultures were regarded as having asymptomatic bacteriuria., Results: Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1) when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%). All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones., Conclusion: The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.

Background: Monitoring of body temperature is an important clinical procedure in the care of sick children, especially the under-5 children, as many disease conditions present with fever. The oral mercury-in-glass thermometer which has relatively good accuracy cannot be used in children less than 5 years because it requires their cooperation., Objective: This study was aimed at using the infrared tympanic thermometer (IRTT) in oral mode to measure temperature in febrile and afebrile children less than 5 years., Methods: Rectal and tympanic temperatures were measured consecutively in 400 febrile and 400 afebrile under-5 children matched for age, using the mercury-in-glass thermometer and the IRTT in oral mode respectively., Results: In the febrile children, the mean tympanic temperature was 38.6 ± 0.9°C, while the mean rectal temperature was 39.0 ± 0.8°C. In the afebrile group, the mean tympanic temperature was 37.0 ± 0.4°C, while the mean rectal temperature was 37.4 ± 0.3°C. The mean difference between rectal and tympanic temperatures in both groups was statistically significant. There was good correlation between the two temperatures. The tympanic thermometer used in the oral mode had a sensitivity of 87.3% and a specificity of 96.5%., Conclusion: The IRTT (oral mode) may not be reliable in estimating 'core' body temperature in children under the age of five years, but with a fairly good sensitivity and specificity, as well as its other advantages such as short duration of measurement, convenience and safety, it is a useful instrument for screening children with fever in a busy setup.