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Summary The preschool child is often confronted with adverse environmental influences that may affect his/her development and hence his readiness for schooling. The factors that affect school readiness were evaluated in 532 nursery school pupils using a proforma on perinatal problems and gross motor development of the pupils. Their nutritional status, neurodevelopment status, and their performance on the Draw A-Person Test were assessed. Sixty (11.3 per cent) of the 532 children were unready for schooling. Factors that are responsible for this included malnutrition, adverse perinatal period and a younger age at school entry.

Summary: A study was carded out with the aim of determining the prevalence of discharges against medical advice (DAMA) at the University of Nigeria Teaching Hospital, Enugu as well as identifying the reasons for such requests. Data in respect of 67 patients who fulfilled the criteria for DAMA were analysed. A prevalence rate of 1.8 per cent was obtained for DAMA out of 4443 admissions over the study period. Poor financial support was the commonest reason for discharge against medical advice. Septicaemia was the commonest cause of admission accounting for 17 (25.4 per cent) followed by HIV/pulmonary tuberculosis in 15 (22.4 per cent) cases. Fifty three (79.1 per cent) children were admitted without a formal referral letter and 51 (76.2 per cent) children were discharged within two weeks of admission while 45 (67.2 per cent) children belonged to the lower social classes. It is concluded that parental low social class, poor financial support and unpreparedness for hospital admission are ask factors for DAMA. A case is made for the implementation of the National Health Insurance Scheme as well as a review of the methods of counseling parents who ask for DAMA for their children or wards. This is important since the children are not directly involved in their parents/guardians' decision to seek their discharges.

Background: Human immunodeficiency virus (HIV) affects the kidney. Urine screening for abnormalities can detect early renal parenchymal diseases. Objectives: To determine the prevalence of abnormal urinary findings in HIV positive children in University of Nigeria Teaching Hospital, (UNTH), Enugu. Method: Urinary screening was carried out in 159 HIV positive children in UNTH over a period of4- months, to detect presence of abnormalities such as glycosuria, proteinuria, haematuria, as well as the presence of nitrite and leucocyte esterase, abnormal urine pH and specific gravity (SG). Results: Eighty males and 79 females were screened. Five (5), 4, and a child had proteinuria, SG of > 1.015 and alkaline urine, giving a prevalence rate of 3.1%, 2.5% and 0.6% respectively. Neither of the subjects had glycosuria, haematuria nor tested positive to nitrite and leucocyte esterase. Subjects with proteinuria were older (5-14 years), had longer duration of HIV diagnosis, longer duration of treatment with HAART, and a lower CD4 cell count (p=0.01). Sixty percent of those with proteinuria had severe immunosuppression, with 4 out of the 5 of them with urine SG more than 1.015. The children with urine SG more than 1.015 were among the older age group (5-14 years), on HAART, had non-advanced HIV disease as well as low CD4 cell count (p=

Background: Most health information from Nigeria and other developing countries are based on hospital records which although may not be a true representative of the whole population, they serve as pointers. Such information has shown that infections and malnutrition remain the leading causes of morbidity and mortality , although non - communicable diseases also pose substantial threat to child health. Objective: To review the pattern, trend and outcome of paediatric admissions at the University of Nigeria Teaching Hospital over a five year period. Methods: Patients admitted into the main pediatric wards of the hospital over a five year period were reviewed, through information obtained from their case notes. Neonates, surgical and trauma patients as well as patients admitted into the children’s emergency room were excluded. Results: Infections (44.5%) were the leading causes of hospital admissions while non-communicable diseases were the leading causes of death in this study with an overall mortality rate of 9%. Conclusion: Despite all efforts over the years, infections continue to pose serious challenges to child health in developing countries. At the same time, non-communicable diseases are taking over as leading causes of mortality. Therefore, as we make stronger efforts to tackle infections and malnutrition, we should make provisions for improved diagnosis and management of non-communicable diseases.

Background: Identifying impaired quality of life is a recognized component of asthma management with no published data in Nigerian children with asthma. The aim of this study was to describe the health-related quality of life of school-aged children with and without asthma seen at the Asthma Clinic of the University of Nigeria Teaching Hospital, Enugu. Methods: Cross-sectional hospital -based study of children aged 7- 17 years (with and without asthma) attending the Paediatric Asthma and General Children Outpatient Clinic of the University of Nigeria Teaching Hospital (UNTH) from parts of the south – east region of Nigeria were consecutively enrolled. Quality of life (QOL) scores were obtained using the Paediatric Quality of Life inventory (PedsQLTM) questionnaire which measures the core dimensions of health: physical functioning, emotional functioning, social functioning and school functioning. Results: There were a total of 180 study participants: (90 with asthma and 90 without asthma). Overall quality of life scores for children with asthma was worse than in those without asthma; 75.5, SD19.3 and 82.7, SD14.5 respectively (MD 7.1, CI = 2.3 to 2.3, p=0.01). Physical function domain was significantly more affected in asthmatics than nonasthmatics; 73.4, SD 23.2 vs. 84.4, SD17.3 respectively (MD 11.1, CI = 5.0 to 17.1, p=0.002). The psychosocial health summary scores in children with and without asthma were 77.6 SD 18.1 vs.81.1 SD15.1 (MD 3.5, CI= -1.4 to 8.4, p= 0.24), with the highest scores obtained in the social functioning domain for both asthma and nonasthma patients; 82.7, SD 20.3 and 87.6, SD 15.7(MD 4.9, p = 0.08) respectively. In both the overall and specific QOL domains, boys had higher scores than girls, irrespective of age or socioeconomic status with an inverse relationship between increasing age and QOL scores (r= -0.2, p=0.07). Conclusions: Children with asthma showed worse QOL and significant impairment in their physical functioning, more noticeable among the female study population. Information obtained from our QOL study forms a basis for a more informed management plan with regards to which age groups are more affected and the specific domains of health in children with asthma that need to be given closer attention to reduce asthma morbidity. The study emphasizes the need for QOL integration in asthma management for a more holistic approach to outcome evaluation of treatment rather than the physical outcomes.

Background: Urinary tract infection (UTI) is one of the serious bacterial infections in febrile young children, which may cause chronic morbidities. Studies from different parts of Nigeria have shown varying pattern in its bacteriology and antibiotic sensitivities. Antimicrobial resistance rate among uropathogens is an increasing problem limiting therapeutic options, and underscores the need to determine local bacteriological pattern that will guide empiric antibiotic choices. Objectives: To identify the bacterial pathogens responsible for UTI in febrile under-five children in Enugu as well as their antibiotic sensitivity patterns. Methods: A cross-sectional descriptive hospital based study of eligible febrile children aged one to 59 months. Urine samples were collected using mid-stream and suprapubic aspiration methods. Standard laboratory procedures were used to culture the urine specimens, identify the bacterial pathogens as well as their antibiotic sensitivity patterns. Descriptive statistics were used to analyse the outcome. Results: Significant bacteriuria occurred in 22 (11%) of the 200 samples. Escherichia coli isolates were the most common organisms in 7(31.8%) of the 22 positive samples. Others were Staphylococcus aureus, Klebsiella spp and Streptococcus faecalis isolated in 5 (22.7%), 3(13.6%), and 3(13.6%) of the positive samples respectively. Most of the isolates were sensitive to ofloxacin (90.9%), ciprofloxacin (81.8%), nitrofurantoin (77.3%) and ceftriaxone (72.7%). High levels of resistance to ampicillin, cotrimoxazole, amoxicillin, nalidixic acid and clavulanate-potentiated amoxicillin were observed. Conclusion: Escherichia coli is the most common cause of UTI in febrile under-five children studied. Ciprofloxacin and ceftriaxone showed better sensitivities are advocated for the empiric treatment of febrile UTI in Enugu.

Background: The review of childhood cancers has most times been done in retrospect by most authors and this has its inherent limitations. Most reviews in Africa show that lymphomas are the commonest malignancies of childhood while acute leukemia ranks much lower. Objective: To do a prospective audit of the pattern of childhood malignancies in Enugu, southeast, Nigeria. Methods: Demographic and medical information on patients aged 1 -17 years admitted over a 36 month period for malignancies was obtained and recorded in pretested interviewed administered questionnaire. Data was analyzed using spss, 15 (Chicago II, USA) software. Results: A total of 103 patients were admitted with diagnosis of cancer with a male: female ratio of 1.3: 1 and median age of 7 years. Majority (63.1%) of patients were from the rural area with low socioeconomic background. There was a decline in the incidence of childhood lymphoma from 40% about 25 years ago to 34% in the present study. Although lymphoma remains the leading childhood malignancy, sarcomas and acute leukemia rather than renal and eye tumors ranked second and third respectively among childhood cancers in the center. Conclusion: There is a reversing trend in the pattern of malignancies of childhood in Enugu as acute leukemia becomes one of the leading malignancies of children.

Background: Asthma prevalence is rising worldwide. Amongst the various factors influencing asthma control, the magnesium level of the affected individuals seems to make a major contribution to achieving asthma control through its antiinflammatory and bronchodilation effects. This study therefore was aimed at determining the magnesium level of stable asthmatic children and its relationship, if any, with their levels of asthma control. Methods: A cross-sectional study where the serum magnesium levels of 30 stable asthmatic children attending Asthma clinic and those of 30 children without asthma attending Children Out-patient clinic (CHOP) both at the University of Nigeria Teaching Hospital (UNTH), Enugu, were assessed using atomic absorption spectrophotometer. The levels of asthma control of children with asthma were assessed using asthma therapy assessment questionnaire (ATAQ). Mean serum magnesium levels of the different asthma control levels were compared using the analysis of variance (ANOVA). Results: The mean ages of children with asthma and those without asthma were 10.4 ± 2.98 years and 10.5 ±3.00 years respectively. The mean serum magnesium level of stable children with asthma (1.13 ±1.04 mmol/L) was found to be significantly lower than those of the non-asthmatic controls (1.46 ±1.01 mmol/L), p= 0.004.A significant association was also found between the serum magnesium levels and the levels of asthma control (p = 0.015). Conclusion: This study shows that the serum magnesium level of stable asthmatic children is significantly lower than that of children without asthma and there is a significant association between the mean serum magnesium levels and their levels of asthma control.

Background. Human immunodeficiency virus associated nephropathy (HIVAN) is a rapidly progressive chronic renal parenchymal disease that occurs in HIV-infected individuals and manifests commonly as proteinuria, which is preceded by microalbuminuria (MA). This clinical entity is defined as a spot urine albumin of 20–200 mg/L. Objectives. To determine the prevalence of microalbuminuria in HIV positive children in UNTH, Enugu and compare it with that of HIV-negative children. Methods. A total of 154 HIV positive children aged 18 months to 14 years and 154 HIV-negative children of corresponding attributes were screened for microalbuminuria, using Micral test II strip which has a sensitivity of 90–99%. Results. No child among the groups (HIV positive and negative) had microalbuminuria. Majority (96.0%) of HIV-positive children had nonadvanced HIV disease at the time of the study (𝑃=0.00). About 77.3% were using HAART (𝑃

Abstract 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 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 (≥105cfu/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.

Abstract Background Haemostatic derangements are thought to be due to an imbalance between hepatic synthesis of pro-coagulants and urinary losses of anticoagulants. Objectives This study evaluated the coagulation profile of Nigerian children with nephrotic syndrome and examined the relationship between coagulation variables, disease state and steroid responsiveness. Methods A cross- sectional hospital based study on evaluation of coagulation profile of children with nephrotic syndrome compared with their age- and gender- matched controls. Results The median fibrinogen level in subjects and controls was the same (2.9 g/L). Sixteen of 46 (35%) children with nephrotic syndrome had hyperfibrinogenaemia. The median fibrinogen level of children in remission was 2.3 g/L and differed significantly when compared with those of children in relapse (p = 0.001). The median APTT of children with nephrotic syndrome was 45.0 s and differed significantly compared with those of controls (42.0 s) (p value = 0.02). The median prothrombin time in children with and without nephrotic syndrome were 12.0 and 13.0 s respectively, (p = 0.004). About 90% of children with nephrotic syndrome had INR within reference range. Thrombocytosis was found in 15% of children with nephrotic syndrome. The median platelet count in children with new disease was 432 × 103cells/mm3 and differed significantly when compared with those of controls (p = 0.01). INR was significantly shorter in children with steroid resistant nephrotic syndrome (SRNS) (median 0.8 s; IQR 0.8 -0.9 s) compared with controls (median 1.0 s; IQR 1.0 -1.1 s) (p = 0.01). Steroid sensitivity was the strongest predictor of remission in children with nephrotic syndrome; steroid sensitive patients were 30 times more likely to be in remission than in relapse (OR 30.03; CI 2.01 – 448.04). Conclusion This study shows that the haemostatic derangements in childhood nephrotic involve mostly fibrinogen, APTT, PT, INR and platelet counts. Antithrombin levels are largely unaffected. Variations in fibrinogen, APTT, PT and INR values may be due to the heterogeneous nature of the disease.

Background: Although Bacillus Calmette Guerin (BCG) vaccine remains one of the most important public health preventive measures against tuberculosis (TB), the presence of a BCG scar may not imply an immune response. Tuberculin reactivity after BCG vaccination has been the most common measure of the effect of the BCG vaccine. Post-vaccination BCG-induced tuberculin reactivity ranges from no induration to an induration diameter of 15 mm. However, tuberculin conversion in infants is usually about 10 mm in more than 90% of infants tested at 12 weeks post-vaccination age. Objective: This study sought to assess the tuberculin conversion rate after BCG vaccination. Materials and Methods: It was a hospital-based cross-sectional study. Two hundred and eighty (280) infants aged 13 to 15 weeks who received BCG vaccination within one month of birth were enrolled. The BCG scar diameter was measured, and Mantoux test was done. Data were analyzed by using the Statistical Package for Social Sciences (SPSS), version 20 (Chicago Il). Results: Among the 280 BCG-vaccinated infants, tuberculin conversion rate was 64%, whereas scar failure rate was 28.9%. Overall, 75.9% of infants with a BCG scar had a positive Mantoux test. The BCG-vaccinated infants with a BCG scar were about six times more likely to have a tuberculin conversion than those without a BCG scar (OR =5.641, 95% C.I = 3.227 to 9.859). Conclusion: There was a 64% conversion rate among the BCG-vaccinated infants. The presence of the BCG scar correlated well with the tuberculin conversion rate.

Background: Adolescent obesity is a serious public health issue. Inconsistent findings on its association with mental health problems are reported. Objective: This study aimed to determine the prevalence, pattern, and sociodemographic correlates of psychosocial disorders among obese adolescents in Enugu metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted over a 5-month period in 16 secondary schools in Enugu, Nigeria. A multi-staged systematic sampling technique was used to select participating schools. A total of 4364 adolescents aged 10–19 years from these schools were screened for obesity by measuring their height and weight, and calculating their body mass indices (BMIs), which were plotted on the Centers for Disease Control and Prevention BMI percentile chart. Seventy-four obese students were identified, and from their respective class registers, systematic sampling scheme was applied in selection of equal number of apparently healthy normal BMI (5th–84th percentile) controls matched for age and sex. The youth version of the Pediatric Symptom Checklist was used to screen for psychosocial disorder in the study participants. Results: The prevalence of psychosocial disorder was 17.6% and 12.2% among the obese and control adolescents, respectively (P = 0.02). Attention and externalizing problems were the highest among the obese adolescents, whereas psychosocial disorders were more in females than males (28.1% vs 9.5%; χ2 = 4.34, P = 0.04). Conclusion: Obese adolescents have a higher prevalence of psychosocial disorder compared to controls, with attention and externalizing problems being most common, and this was influenced by gender. Periodic assessment of the mental health of obese adolescents is advocated.

Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P < 0.001), as well as a significant increase in high knowledge level (χ2 = 105.13, P < 0.001) after education. Conclusion: Health education improved the knowledge and awareness of sickle cell among adolescents in secondary schools, especially the chances of having children with SCA in carrier couples. Inculcating health education on sickle cell in secondary school curriculum will help in informed decision on marriage and birth, ultimately reducing the birth of children with SCA.

Background: Electrolyte abnormalities constitute the leading causes of morbidity and mortality in younger children with acute gastroenteritis. The aim of the study was to determine the clinical profile and pattern of electrolyte abnormalities in under-five children hospitalized for acute gastroenteritis from November 1, 2014, to January 31, 2015. Methodology: This was a cross-sectional descriptive study among hospitalized under-five children with acute diarrhea who were consecutively recruited from November 1, 2014, to January 31, 2015. Relevant clinical data were obtained, while the physical examination was done on all subjects. Serum electrolytes values were determined using the ion-selective electrode system and compared with standard reference ranges. The data were analyzed using SPSS version 21.0 with the level of statistical significance set at P < 0.05. Results: A total of 108 under-five children were studied. The majority (101; 93.5%) were

Background: HIV infection significantly increases depression risk in the caregivers of HIV-infected children. Our study is aimed at determining the depression prevalence and severity in caregivers of children who are infected with HIV. Materials and Methods: This was a hospital-based, cross-sectional, and comparative study. Study participants who met the inclusion criteria were enrolled consecutively to achieve the calculated sample size. Their sociodemographic variables were obtained, and the Zung Self-rating Depression Scale was used to assess the prevalence and severity of depression in the caregivers. Results: There were 352 study participants which comprised 176 caregivers of children infected with HIV, who served as cases and 176 caregivers of HIV-negative children, who served as controls. One hundred and fifty-five (88.1%) of the cases were the biologic caregivers, whereas the biologic caregivers comprised of 133 (75.6%) for the controls. Furthermore, 43 (24.4%) and 133 (75.6%) of the cases were males and females, respectively, whereas 47 (26.7%) and 129 (73.3%) of the controls were, respectively, males and females. The prevalence of depression among the cases and controls was 43.2% and 6.8%, respectively (P < 0.001; odds ratio [OR]: 10.39). Among the cases with depression, 73 (47.1%) were the biological caregivers, whereas 3 (14.3%) were the nonbiological caregivers. This was statistically significant (P = 0.009; OR = 5.341). The severity of depression among the cases was mild depression (52.6%), moderate depression (30.3%), and severe depression (17.1%). Conclusions: There is a high prevalence of depression among the caregivers of children infected with HIV and the biologic caregivers of these children tend to have a higher depression burden than their nonbiologic counterparts.

Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

Background: Factors such as race, poverty, nutrition and chronic diseases have been shown to influence the age of attaining menarche in girls. HIV is one of the most prevalent chronic diseases among young girls living in sub-Saharan Africa. This study compares the age at onset of menarche between HIV-infected girls and un-infected controls matched for age and socio-economic status. Materials and Methods: A cross sectional study involving 100 HIV-infected girls aged 8-17 years and 100 un-infected counterparts matched for age and social class. Questionnaire was administered to study participants after obtaining consent from their caregivers. Age at attainment of menarche was obtained using recall method. Data analysis was done with SPSS version 20 (Chicago IL). Significant levels were assumed at p-values less than 0.05. Results: Eighty-seven subjects and controls respectively (87%) were within the age range of achieving menarche. Among them, 19 subjects (22%) and 31 controls (36%) had attained menarche ((OR= 0.505, CI= 0.258-0.988, p =0.046). Menarche occurred at a mean age of 12.84 ± 1.30 years among the subjects and 12.32 ± 0.79 years among the controls (p=0.085).Conclusions: A significant proportion of subjects compared to controls had achieved menarche.

Children with sickle cell anemia (SCA) usually face psychological complications especially depression. Assessment of depression in resource-limited settings may help identify the extent to which the children with SCA in such settings may need its introduction as part of routine care. This study aimed to assess depression in children and adolescents with SCA in a low-resource setting. This cross-sectional observational study involved 84 children and adolescents with SCA aged 7–17 years who were selected using a systematic random sampling technique. Their controls were 84 age- and sex-matched individuals with AA hemoglobin genotype. A structured questionnaire was used to collect socio-demographic data while depression was assessed with the Children's Depression Inventory. The prevalence of depression was non-significantly higher in subjects compared to the controls (8.3% vs. 2.4%) (Fisher's χ2 = 1.88, p = 0.171). Though not statistically significant, the subjects had 3.7 times higher odds of having depression compared to the controls (OR = 3.7; 95% CI 0.75–18.50; p = 0.107). Of the 5 depression subscales, the subjects had a significantly higher difference in the negative mood (p = 0.042). Despite the comparable prevalence of depression with their normal controls, children and adolescents with SCA had a higher negative mood and higher odds of having depression than normal individuals. Thus, there is a need for the introduction of depression assessment as a complement to routine care of these children with SCA in resource-poor settings. [ABSTRACT FROM AUTHOR]