Search

Background: Breastfeeding is the ideal form of nutrition for the healthy growth of infants, and it reduces the risk of malnutrition and several childhood morbidities. Objectives: To assess the breastfeeding practices of mothers and the relationship between these practices and the nutritional status of their children. Methods: It was a descriptive, hospital-based, cross-sectional study that involved children aged six to 24 months in Ilesa, Osun State, Nigeria. Socio-demographic characteristics and breastfeeding practices were documented, anthropometric measurements were obtained, and nutritional status was determined for the children. Underweight, stunting and wasting were defined as z-score < -2 for the weight-for-age, length-for-age and weight-for-length, respectively. A child was taken to be undernourished if any of underweight, stunting or wasting was present. Results: Fifteen (3.6%) of the 420 children studied had mixed feeding from birth, while 273 (65.0%) were exclusively breastfed for six months. Two hundred and sixty-eight (63.8%) of them were still breastfeeding at the time of the study, while 152 (36.2%) had stopped breastfeeding. Nearly one-quarter (103/420; 24.5%) of the children were undernourished. A significantly lower proportion of children who had exclusive breastfeeding were undernourished, compared to those who were not exclusively breastfed (p = 0.033). Exclusive breastfeeding was independently associated with reduced odds of undernutrition (OR = 1.62, 95% CI = 1.02-2.57, p = 0.039). Conclusion: Exclusive breastfeeding for six months significantly reduces the risk of undernutrition among young children.

The management of neonatal hyperinsulinaemic hypoglycaemia remains a major challenge in hospitalized newborns globally. Diazoxide is one of the recommended therapeutic options. We report a late preterm, male infant of a diabetic mother who suffered severe perinatal asphyxia and had persistent hypoglycaemia requiring progressively increasing intravenous glucose concentrations to as high as 12.5 mg/kg/minute along with intravenous hydrocortisone administration. A critical sample revealed inappropriately high serum insulin, inappropriately low serum cortisol and growth hormone responses. Urinalysis was negative for ketones. With the persistence of hypoglycaemia, oral diazoxide at 5 mg/kg/day with oral hydrochlorothiazide was administered. The infant was diazoxide-responsive with complete resolution of hypoglycaemia. Diazoxide therapy was discontinued after 14 days and he was discharged after one month of admission. This report emphasizes the importance of diazoxide in the management of neonatal transient hyperinsulinaemic hypoglycaemia. The availability and cost of diazoxide, as well as the endocrine and metabolic tests, are major concerns in resource-poor settings.

Aim: Implementing the Baby-Friendly Hospital Initiative (BFHI) programme has been fraught with challenges globally. The study aimed to assess the implementation of the BFHI and breastfeeding practices in healthcare facilities in Ogun State, Nigeria., Methods: It was a questionnaire-based cross-sectional study carried out between August and October 2019 among 100 healthcare workers and 110 mothers from health facilities in Ijebu-Ode Local Government Area of Ogun State, Nigeria., Results: Nearly two-thirds (61.0%) of the healthcare workers were community health workers while the others were nurses. Less than a quarter (23.8%) of the healthcare workers had ever attended breastfeeding educational programmes since they started working. About half of the healthcare workers had good knowledge, attitude and practice of BFHI. Nurses had a significantly better practice of BFHI than community health workers. Understaffing was a major limitation to the implementation of BFHI. The mothers had an exclusive breastfeeding rate of 47%., Conclusion: The knowledge, attitude, and practice of BFHI were suboptimal and the exclusive breastfeeding rate among the mothers was low. There is a need to improve staff strength, training and re-training of staff, as well as regular monitoring and evaluation of healthcare facilities on the implementation of BFHI., (© 2023 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background: Globally, electronic learning (e-learning) is being embraced in all spheres, including the field of Medicine, where it has an engrained role in both medical education and practice., Objectives: The study aimed to assess the knowledge, perception and factors influencing the utilisation of e-learning amongst medical students in Nigeria., Methods: It was a descriptive, cross-sectional survey. The study involved public and private medical schools across the six geopolitical zones of Nigeria. Five hundred and thirty (530) medical students responded to the online questionnaire (Google forms). Data were analyzed using SPSS version 23.0., Results: The mean age of the participants was 21.5 ± 3.1 years, with 60.8% being females. About three-fifths (59.5%) of the respondents were in public universities, while the remaining were in private universities. Nearly all the respondents (98.1%) were aware of e-learning. The majority believed that e-learning would be useful for lectures and seminars, but not for laboratory demonstrations, clinical demonstrations, and bedside teaching. Class of study (p = 0.002), school ownership (p = 0.034), institutions having e-learning platform (p <0.001); having received e-learning training (p <0.001)) and institution encouraging e-learning for students (p <0.001) were significant predictors of utilization of e-learning. High cost and poor internet connectivity were the most cited disadvantages of e-learning., Conclusion: This study showed that e-learning is well known among Nigerian medical students, although some had never utilized it. The high financial costs, poor internet connectivity, and irregular electricity were among the major constraints to the utilization of e-learning., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)

Aim: Paediatric gastroenterology remains an under-recognised sub-speciality in Africa. We determined the preferred sub-specialities among paediatric residents in Southwest Nigeria and what influenced whether they chose paediatric gastroenterology., Methods: This was a cross-sectional survey of paediatric residents in seven teaching hospitals in Southwest Nigeria. A self-administered questionnaire was used to obtain information on their socio-demographics, educational attainment, choice of sub-speciality and the factors influencing that choice., Results: Of 144 eligible paediatric residents, 124 (86.1%) completed the survey. Their mean age was 35.0 ± 1.7 years, and 83 (66.9%) were females. The majority (94.4%) had already chosen their sub-speciality, and nearly two-thirds (65.0%) made the decision during training. The most popular sub-speciality was neonatology (30.6%), and only three (2.4%) residents chose gastroenterology. Factors influencing the choice of sub-speciality were perceived ability (85.3%) and academic experience (83.8%). Financial reasons were less frequent (32.5%). Lack of diagnostic equipment (30.6%) and role models (21.0%) were the most frequent reasons for residents being disinterested in paediatric gastroenterology., Conclusion: Few residents were interested in paediatric gastroenterology and there is a need to encourage interest in this subject at an early stage in their training and provide more diagnostic equipment and greater mentorship., (© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objectives: The prevalence of type 1 diabetes mellitus (T1DM) is increasing in most developed and developing countries. This study described the clinical characteristics and compliance with care among Nigerian children and adolescents with T1DM., Methods: This was a cross-sectional descriptive multi-center study of children seen at the paediatric endocrinology clinic of seven selected tertiary health facilities in Nigeria. Information was collected on socio-demographics, clinical characteristics and compliance of the children with dietary recommendations and insulin therapy. Compliance with dietary recommendations and insulin therapy was graded as either good or poor based on defined criteria., Results: The mean age of children was 13.1 ± 4.7 years. The mean age of children at the diagnosis of T1DM was 9.9 ± 4.2 years. Sixty-nine (60%) children were female while about half (47.8%) of the children were from the lower socioeconomic class. Compliance with insulin administration was good in 39.1% of the children and was significantly associated with the father's (p=0.001) and mother's educational status (p=0.024) while compliance with dietary recommendations was good in 20.0% of the children and was significantly associated with mother's educational status (p=0.034) and family socioeconomic class (p=0.010). Only the mother's level of education was independently and significantly associated with compliance to recommendations on insulin therapy (OR 4.2, 95% CI=1.5-11.6, p=0.007)., Conclusions: The compliance of children with dietary recommendations and insulin therapy was poor. Efforts should be strengthened at all healthcare facilities to educate parents on the need for compliance with management guidelines., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Parents play a significant role in the sexual orientation and behaviours of their children. Lack of communication between parents and their children about sexual matters may contribute to engagement of young people in risky sexual behaviours., Objectives: To assess the pattern of parent-youth sexual discussions and its association with sexual activity among unmarried undergraduates in a Nigerian university., Methods: A descriptive cross-sectional study was conducted among 400 undergraduates aged 15-24 years in a tertiary institution in Ogun state, Nigeria. A structured selfadministered questionnaire was used for data collection. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.0. The level of significance was set at p <0.05., Results: Parent-youth discussions on sexual issues had occurred in 225 (56.2%) of the respondents, with mothers being more involved than fathers; onset was at secondary school level in nearly three-fifths. There was no statistically significant relationship between parent-youth sexual discussions and engagement in sexual intercourse (p = 0.666); however, parental visit(s) on campus was associated with a significant reduction in sexual intercourse (p = 0.006)., Conclusion: Engagement of youths in sexual discussions by their parents is still low and such discussions are often not impactful in preventing pre-marital sex. Parental supervisory visits for undergraduates on campus may be helpful in consolidating the desired effect of such sexual discussions, and should be encouraged., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Ackground/objectives: Vaccine-preventable diseases (VPDs) have been shown to account for one-fifth of deaths among under-fives. Father's knowledge and attitude greatly influence the approval and uptake of childhood vaccination in patriarchal communities. This study aimed to assess and compare fathers' knowledge and attitude to childhood vaccination in urban and rural communities of Ogun State, Nigeria., Methods: Four hundred and forty men each were interviewed in rural and urban areas. An interviewer-administered questionnaire was used to elicit data which were analyzed with IBM SPSS version 20. Mean ages of respondents were compared using T-test while chisquare was used in testing association between categorical variables. Results were presented in tables and P < 0.05 was considered statistically significant., Results: There was no statistically significant difference in the mean ages of residents in the urban and rural areas (t = -1.82, p= 0.07). A greater proportion of rural participants (51.4%) had an overall good knowledge of childhood vaccination as against 45.2% of urban men but this difference was not statistically significant with p = 0.069. A greater percentage of participants in the urban area (58.0%) had an overall positive attitude to male participation in childhood vaccination compared to 54.1% of rural men. However, this difference was not statistically significant (p= 0.204)., Conclusion/recommendation: There was better knowledge of childhood vaccination among rural participants. In contrast, attitude towards childhood vaccination was better among urban residents. There is a need for educational interventions that may positively influence the attitude of men towards childhood vaccinations, particularly in rural areas to be conducted by the government, health workers, and other stakeholders through various communication media and adopting diverse health education methods., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Introduction: exchange blood transfusion (EBT) is a form of massive transfusion useful in rapidly reducing serum bilirubin levels, but serum bilirubin levels frequently rebound within hours of completing the procedure, due to equilibration of extravascular bilirubin as well as on-going hemolysis. The study was carried out to determine the pattern of reduction in serum bilirubin levels following EBT among neonates with severe hyperbilirubinemia, as well as the factors contributing to this pattern, so as to establish evidence-based expectations following EBT., Methods: a retrospective descriptive study covering a two-year period in a Nigerian tertiary hospital. Details of the EBT procedures, including serial serum bilirubin levels, were obtained from the hospital records of all newborn babies who had double volume EBT done for severe hyperbilirubinaemia during the study period. Data was analyzed using the statistical software SPSS version 21.0., Results: the mean total serum bilirubin (TSB) before EBT in the 36 babies was 17.9 ± 6.3 mg/dl. The mean percentage decrease in TSB immediately following EBT was 44.3 ± 10.2%. Six hours after EBT, TSB levels had increased from the immediate post-EBT values by an average of 57.5 ± 32.2%. Twenty-four hours after the procedure, TSB values in most (87.1%) cases were still higher than the immediate post-EBT values, but lower than the pre-EBT values. Post-EBT anemia was recorded among 33.3% of the babies., Conclusion: EBT is effective in rapidly reducing serum bilirubin levels and preventing acute bilirubin encephalopathy in neonates with severe hyperbilirubinemia, despite the rebound increase that occurs in TSB values after the procedure., Competing Interests: The authors declare no competing interests., (Copyright: Olufunmilola Olubisi Abolurin et al.)

Background: Oral rehydration solution (ORS) is an evidence-based intervention to reduce diarrhoea-related morbidity and mortality, but consistently low rates of ORS use have been documented in Nigeria., Aim: To identify barriers to the optimal use of ORS for childhood diarrhoea in Nigeria and recommend appropriate interventions to improve uptake of ORS at community and facility levels., Methods: A quantitative cross-sectional survey of 400 mothers with children under 5 years of age was conducted in Nigeria to explore reasons for suboptimal utilization of ORS for childhood diarrhoea. An interviewer-administered questionnaire was used for data collection. Data were analysed using the statistical software SPSS version 21.0®., Results: Sixty-one (15.3%) of the respondents were unaware of ORS. Of the 339 that were aware, their source of information was mainly hospital/health workers (81.1%). Among mothers that affirmed they could prepare ORS, only 64 (22.1%) prepared it correctly. Level of education significantly influenced awareness of ORS as well as its correct preparation. Nineteen mothers (5.6%) had difficulty getting ORS when needed, whereas 13 (3.8%) reported that it was difficult for them to remember how to prepare ORS. Four in ten children took ORS reluctantly or refused it outrightly. No cultural taboo concerning the use of ORS was reported., Conclusion: There is still a wide gap in the awareness of ORS and many caregivers prepared the solution incorrectly. We recommend that the method of preparation of ORS be clearly indicated on the sachets, and production of commercial 1-L water packages for ORS preparation be encouraged. Lay summaryOral rehydration solution (ORS) is an evidence-based intervention to reduce diarrhoea-related morbidity and mortality, but consistently low rates of ORS use have been documented in Nigeria. A quantitative cross-sectional study was carried out among 400 mothers to identify barriers to the optimal use of ORS for childhood diarrhoea and recommend appropriate interventions. Sixty-one (15.3%) of the respondents were unaware of ORS. Among mothers that affirmed they could prepare ORS, only 64 (22.1%) prepared it correctly. Level of education significantly influenced awareness of ORS as well as its correct preparation. Some mothers had difficulty getting ORS when needed, while some found it difficult to remember how to prepare it. Four in ten children took ORS reluctantly or refused it outrightly. No cultural taboo concerning the use of ORS was reported. The study showed that there is still a wide gap in the awareness of ORS and many caregivers prepared the solution incorrectly. Hence, we recommend that the method of preparation of ORS be clearly indicated on the sachets, and production of commercial 1-L water packages for ORS preparation be encouraged., (© The Author(s) [2020]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Zinc deficiency has been associated with increased incidence, severity and duration of childhood diarrhoea., Objective: The objective of the study was to determine the prevalence of zinc deficiency among under-five children with acute diarrhoea., Methods: The study was a comparative cross-sectional study in which serum zinc levels were determined using atomic absorption spectrometry in under-five children with acute diarrhoea and in apparently healthy contols. Two hundred and fifty children with acute diarrhoea and 250 controls were studied at the Wesley Guild Hospital, Ilesa, Nigeria., Results: The diarrhoea patients had a mean ± SD serum zinc level of 78.8 ± 35.6 µg/dl, while the controls had a mean of 107.3 ± 46.8 µg/dl. The mean serum zinc level was significantly lower in the patients than the controls (t = -7.66; p < 0.001). Furthermore, the prevalence of zinc deficiency was significantly higher among the patients (30.4% versus 12.4% in the controls; OR = 3.09; 95% CI = 1.94 - 4.90; χ2 = 24.08; p < 0.001). Low social class was associated with a significantly higher prevalence of zinc deficiency among the patients (p = 0.013)., Conclusion: Zinc deficiency is significantly associated with diarrhoea among under-five children in the study community. Hence, routine zinc supplementation should be encouraged for the treatment of diarrhoea, and availability should be ensured., (© 2020 Abolurin OO et al.)

Background: Vitamin A deficiency (VAD) and diarrhoea are still important contributors to childhood deaths in Africa, and vitamin A deficient children are at increased risk as well as severity of diarrhoea., Objectives: To determine the prevalence of VAD and identify the associated factors among children with diarrhoea., Methods: The study was a hospital-based cross-sectional descriptive study. Consecutive children with diarrhoea were recruited, provided they met the inclusion criteria. Serum retinol levels were determined by high performance liquid chromatography (HPLC) in one hundred and seventy under-five children who presented with diarrhoea at the Wesley Guild Hospital, Ilesa, Nigeria., Results: The serum retinol levels of the children ranged from 0.29 - 2.35 µmol/L with a mean ± SD of 1.07 ± 0.42 µmol/L. Twenty seven (15.9%) were vitamin A deficient with three (1.8%) of these having severe VAD. Wasting was significantly associated with a higher prevalence of VAD [p = 0.023, OR (95% CI) = 3.08 (1.21 - 7.79)]. A significantly greater proportion of the subjects who had VAD were hospitalized, compared with the non-deficient ones [p = 0.001, OR (95% CI) = 4.40 (1.82 - 10.66)]. The only subject who died was vitamin A deficient., Conclusion: Wasting and hospitalization are factors that may indicate the presence of VAD in a child with diarrhoea. Vitamin A supplements should therefore be given, as part of the treatment for diarrhoea, to children who have wasting, especially when they require hospitalization.

Background and Aim: Vitamin A deficiency (VAD) constitutes a major nutritional concern in developing countries. It contributes significantly to the morbidity and mortality of under-five children and can result in impaired resistance to infection as well as increased risk of death. The aim of this study was to determine the prevalence of VAD among Southwestern Nigerian children., Methods: Apparently healthy children aged between 6 months and 5 years were recruited for the study. Their serum retinol levels were determined by high-performance liquid chromatography., Results: Of the 170 children studied, nine (5.3%) had VAD, although none had severe VAD. The prevalence of VAD did not show statistically significant variation with age (P = 0.159), sex (P = 1.000), social class (P = 0.740), immunisation status (P = 0.197) or nutritional status (P = 0.090)., Conclusion: The prevalence of VAD among Nigerian children appears to have reduced, compared with previous reports; however, further studies are required to assess the current national prevalence, so as to design programmes that can achieve further reduction in the proportion of children affected., Competing Interests: There are no conflicts of interest