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Introduction: Rational use of drugs against most common and life‑threatening tropical diseases such as malaria remains a huge challenge, particularly in sub-Saharan African region. The correct use of antimalarial drugs is the key not only to therapeutic success but also to deterring the spread of drug resistance malaria. Aims: To assess the physicians’ compliance with the national anti’-malaria treatment guidelines among Under five (U-5) years children in secondary health facilities in Sokoto metropolis. Methods: This was a cross-sectional study conducted as an exit interview among 292 mothers/caregivers of febrile U-5 children with antimalarial prescription, that presented to the out-patient clinics of the selected secondary health facilities in Sokoto metropolis. Simple random sampling technique using balloting option was used to select 2 secondary Health facilities in the metropolis, Proportionate allocation was done to allocate study subjects to the selected Health facilities based on average weekly outpatient attendance. The data was collected using an interviewer-administered questionnaire. Descriptive statistics was used to analysed data using IBM SPSS version 22. Results: Of the 292 children, only 115(39.4%) had malaria parasite test requested by the physician, out of which 63(54.8) had microscopy, while 52(45.2) of the children had malaria Rapid Diagnostic Test (mRDT). One hundred and eighty-five (65.1%) of the children were treated presumptively with anti-malarial drugs. Artemisinin based Combination Therapy (ACT) was prescribed in 221(77.8%) of the under-fives. The commonest prescribed ACT was Artemether-Lumefantrine in 113(77.4%) of the children. Majority 263(92.6%) of the prescriptions were in brand names. Recommendation: The physicians’ compliance with national malaria treatment guidelines using the proportion of U-5 children was suboptimal. There was over prescription of anti-malarial drugs, as majority of the patients treated for malaria had no laboratory evidence for the treatment. However, compliance with the use of ACT was good. This study shows also suboptimal compliance with WHO prescribing indicators with respect to prescription in generic names. Regular training of the health care providers by the government is recommended to improve adherence to antimalarial treatment guideline.

Introduction: Mortality pattern is reflective of both the severity of illness and the quality of treatment given. Objective: To identify the age, time and cause of death in the paediatric wards of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methods: This was a retrospective review of mortalities in children 5weeks to 15 years at the paediatric wards of UDUTH from 1st January 2016 to 31st December 2017. The bio-data, duration of illness, diagnoses, complications and duration of hospital stay were extracted from the mortality case files and analysed. Results: There were 121 mortalities, representing 2.3% of 5,355 total admissions during the study period. Sixty-seven (55.4%) were males (M: F ratio 1.2:1). Seventy-five (62.0%) were under-fives and mean age ± standard deviation was 54 months ± 46.3. Most deaths 76 (62.0%) occurred between July and December and majority 96 (79.3%) occurred ≥ 24 hours after admission. Severe acute malnutrition [SAM] 31 (41.3%), severe malaria 12(16.0%), and septicaemia 9 (12.0%), were the leading causes of death in the under-fives, whereas severe malaria 8 (17.4%), meningitis 7(15.2%) and malignancy 5 (10.9%) predominate in those > 5 years [P

Introduction: Counselling of caregivers about common childhood diseases is an important component of health care services. Objective: To assess the quality of counselling offered to caregivers on their children’s condition by health care providers at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methods: A prospective cross-sectional study carried out from 1st August 2015 to 30th April 2016. Caregivers with children less than 15 years of age seen in the units of Paediatric Department of UDUTH, Sokoto, were consecutively interviewed. The corresponding case notes of their children were reviewed to obtain data on the child’s diagnosis and to check whether the attending physicians have documented the content of the counselling offered to caregivers. Data were analysed using SPSS version 20. Results: A total of 420 caregivers were interviewed. Their mean age was 28.9±8.6 years (range of 15-64 years). Only 218 (51.9%) caregivers were counselled, but there was no documentation of the content of counselling in the case notes of their children. 81 (37.2%) of the diagnosis mentioned by caregivers did not tally with the one documented in the case notes of their children (p=0.0001). Majority of the caregivers 156 (71.6%) were counselled in an open ward and only 6 (2.7%) were counselled in a private consulting room. Conclusion: This study revealed inadequate counselling of caregivers on their children condition and poor counselling practices among healthcare providers in UDUTH, Sokoto. Hence, there is the need for training and retraining of healthcare providers on counselling of caregivers on their children condition in the hospital.

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed. Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria. Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly. Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52). Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%). Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB.

Background: Antibiotics are the most widely utilized therapeutic agents. Inappropriate use causes increase cost and antibiotic resistance. The World Health Organization recommends assessment of antibiotics use to guide prescribing practices. Objective: To describe the pattern of antibiotic usage among paediatric inpatients aged > 1 month to 15 years in a tertiary hospital in Sokoto, Nigeria. Methods: Febrile children were recruited prospectively by systematic random sampling from January to October 2018. Socio-demographics, diagnosis, antibiotics administered were obtained from case notes. The WHO indicators of use of antibiotics were employed for evaluation. Data was analysed with SPSS version 23. Results: Out of 352 children, 318 (90.3%) received antibiotics; commonest being Ceftriaxone in 155/318 (48.7%), Cefuroxime in 74 (23.2%), and Metronidazole in 29 (9.1%). Average number of antibiotics per patient was 2.3±1.1 with treatment duration of 4.3±1.4days. Antibiotic consumption was 937.2 days of antibiotic therapy/1000 patient days (DOT/PD). Generic name was used in 92.3% while 100% of the drugs were on the essential medicine list. Frequent diagnoses were severe malaria 98/352 (27.8%), respiratory infections 39 (11.1%) and severe malnutrition in 38 (10.8%). Only 6 (1.7%) patients had microbiologic evidence of infection. Conclusion: Utilization of antibiotics is higher than recommended. There is need for improved diagnostic facilities to avoid antibiotic overuse and its consequences. Keywords: antibiotics, prescription, utilization, children, inpatients, DOT

BackgroundRoutine vaccination, a cost-effective means of preventing deadly childhood disease, has a low coverage in Nigeria. The study assessed the willingness of mothers to receive reminder messages for routine vaccination appointments in Northern Nigeria.MethodsA multi-centre cross-sectional study involving at least 363 mother–infant pairs per centre from five states in Northern Nigeria. Data collected include the socio-demographic details, responses on parental phone ownership, mothers’ willingness to receive reminders for immunization appointments and the reminder type characteristics. Data analysis was done with SPSS.ResultsOf the 1952 mother–infant pairs, ownership of at least one household phone was 97.7%. In total, 1613 (82.6%) mothers were willing to receive reminders. A majority (62.2%) of mothers preferred phone calls. A day before the vaccination appointment was the preferred timing (78.1%), and the predominant communication language was the local language for each region.The odds of being willing to receive reminders were 3.1 times, 2.6 times and 1.8 times higher in those with no formal education, primary education and secondary education, respectively, compared with mothers with tertiary education, each p < 0.05. Mothers who delivered at home were significantly less likely to want reminder messages (p = 0.03).ConclusionEight of 10 women in Northern Nigeria are willing to receive a reminder for their child. The predominant mode of reminder preferred is phone calls using the local language. Deployment of mobile phone reminders strategy in Northern Nigeria as a means to improve vaccination uptake is feasible. The institution of this strategy can be in collaboration with service providers.