489 results on '"Ikefuna AN"'
Search Results
2. An Assessment of Factors influencing Hospital Discharges Against Medical Advice of Paediatric Patients in Enugu: A Review of 67 Cases
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Ikefuna AN and Emodi IJ
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Medicine - Abstract
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.
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- 2024
3. Urinary findings in HIV positive children by dipstick screening test in Enugu
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Ezeonwu BU BU, Oguonu T, Ikefuna AN, and Okafor HU
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Medicine - Abstract
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=
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- 2024
4. Pattern and outcome of paediatric medical admissions at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu: a five year retrospective review (2007 – 2011)
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Chukwu BF, Chinawa JM, Ikefuna AN, and Emodi IJ
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outcome ,paediatric ,medical admissions ,enugu ,Medicine - Abstract
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.
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- 2024
5. Health-related quality of life in school-aged children with and without asthma in Enugu, South East Nigeria
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Ayuk AC, Oguonu T, Ikefuna AN, and Ibe BC
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Medicine - Abstract
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.
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- 2024
6. Bacteriology of urinary tract infection and antimicrobial sensitivities in under-five children in Enugu
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Ibeneme CA, Oguonu T, Ikefuna AN, Okafor HU, and Ozumba UC
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uti ,under-fives ,bacterial pathogens ,antibiotic sensitivities ,Medicine - Abstract
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.
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- 2024
7. A prospective study of childhood malignancy in Enugu, Eastern Nigeria (2011-2013)
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Chukwu BF, Ezenwosu OU, Ikefuna AN, and Emodi IJ
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childhood ,malignancy ,lymphomas ,leukaemia ,Medicine - Abstract
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.
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- 2024
8. Magnesium levels in stable children with asthma: It’s relationship with asthma control
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Ogbuka FN, Ndu IK, Oguonu T, Ikefuna AN, and Ibe BC
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serum magnesium ,asthma control ,stable asthma ,Medicine - Abstract
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.
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- 2024
9. Screening for Microalbuminuria in HIV-Positive Children in Enugu
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Ezeonwu Bertilla Uzoma, Okafor Henrietta Uchenna, Ikefuna Anthony Nnaemeka, and Oguonu Tagbo
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
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
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- 2012
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10. Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria
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Ibeziako Ngozi S, Ubesie Agozie C, Emodi Ifeoma J, Ayuk Adaeze C, Iloh Kene K, and Ikefuna Anthony N
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HIV ,Mother-to-child transmission ,Risk factors ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
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.
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- 2012
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11. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria
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Ikefuna Anthony N, Okafor Henrietta U, and Chukwu Bartholomew F
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Asymptomatic bacteriuria ,Children ,Sickle cell anemia ,Pediatrics ,RJ1-570 - Abstract
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.
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- 2011
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12. Fever detection in under 5 children in a tertiary health facility using the infrared tympanic thermometer in the oral mode
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Ikefuna Anthony N, Ojinnaka Ngozi C, and Edelu Benedict O
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Pediatrics ,RJ1-570 - Published
- 2011
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13. Anthropometric Indices and Nutritional Status of Infants in Nigeria – A Preliminary Study
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Ekechukwu, Echezona Nelson Dominic, Anyaene, Chiamaka Chinyere, Ikefuna, Ogechukwu, Aguwa, Emmanuel Nwabueze, Iroezindu, Israel Chijioke, Okeke, Theodora A., Arinze-Onyia, Susan U., Kacprzyk, Janusz, Series Editor, Gomide, Fernando, Advisory Editor, Kaynak, Okyay, Advisory Editor, Liu, Derong, Advisory Editor, Pedrycz, Witold, Advisory Editor, Polycarpou, Marios M., Advisory Editor, Rudas, Imre J., Advisory Editor, Wang, Jun, Advisory Editor, Black, Nancy L., editor, Neumann, W. Patrick, editor, and Noy, Ian, editor
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- 2022
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14. Haemostatic profile of children with nephrotic syndrome attending University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria
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Chioma L. Odimegwu, Anthony N. Ikefuna, Henrietta U. Okafor, Theresa Nwagha, Agozie Ubesie, and Josephat M. Chinawa
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Coagulation ,Haemostasis ,Nephrotic syndrome ,Children ,Nigeria ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
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.
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- 2022
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15. Haemostatic profile of children with nephrotic syndrome attending University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria
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Odimegwu, Chioma L., Ikefuna, Anthony N., Okafor, Henrietta U., Nwagha, Theresa, Ubesie, Agozie, and Chinawa, Josephat M.
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- 2022
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16. Tuberculin conversion rate after BCG vaccination of apparently healthy infants in a resource-poor setting
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Eziamaka J Enemuo, Kenechukwu Kosisochukwu Iloh, Agozie C Ubesie, Henrietta U Okafor, and Anthony Nnaemeka Ikefuna
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bcg ,mantoux ,scar failure ,tuberculin conversion ,Medicine - Abstract
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.
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- 2022
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17. Prevalence, Pattern and Sociodemographic Correlates of Psychosocial Disorders in Obese Adolescents in Enugu, Nigeria
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Okechukwu N Ozoalor, Anthony N Ikefuna, Ann E Aronu, and Ngozi C Ojinnaka
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adolescent ,enugu ,mental health problems ,obesity ,psychosocial disorder ,Medicine - Abstract
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.
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- 2022
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18. Nutritional status of primary school children: Association with intelligence quotient and academic performance
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Akubuilo, U.C., Iloh, K.K., Onu, J.U., Iloh, O.N., Ubesie, A.C., and Ikefuna, A.N.
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- 2020
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19. Effect of health education on knowledge and awareness of sickle cell disease among adolescents
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Osita U Ezenwosu, Barth F Chukwu, Ikenna K Ndu, Ndubuisi A Uwaezuoke, Ifeyinwa L Ezenwosu, Ifechukwu M Udorah, Anthony N Ikefuna, and Ifeoma J Emodi
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awareness ,health education ,knowledge ,sickle cell ,Medicine - Abstract
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.
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- 2021
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20. Pattern and Prevalence of Intestinal Helminthiasis among Human Immunodeficiency Virus-Infected Children at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State
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Onyia, JT, primary, Onyia, OA, additional, Ikefuna, A, additional, Oguonu, T, additional, Ubesie, A, additional, Eke, CB, additional, and Chinawa, JM, additional
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- 2024
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21. Normalization of Cardiac Structural dimension and Function to Body Surface Area in South East Nigeria Children
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Chinawa, JM, primary, Chinawa, AT, additional, Ujunwa, FA, additional, Odimegwu, CL, additional, Onyia, JT, additional, Chukwu, K, additional, Chukwu, BF, additional, Aronu, AE, additional, and Ikefuna, A, additional
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- 2024
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22. Anthropometric Indices and Nutritional Status of Infants in Nigeria – A Preliminary Study
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Ekechukwu, Echezona Nelson Dominic, primary, Anyaene, Chiamaka Chinyere, additional, Ikefuna, Ogechukwu, additional, Aguwa, Emmanuel Nwabueze, additional, Iroezindu, Israel Chijioke, additional, Okeke, Theodora A., additional, and Arinze-Onyia, Susan U., additional
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- 2021
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23. Clinical profile and electrolyte abnormalities in hospitalized under-five children with acute gastroenteritis in a tertiary health facility
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Christopher B Eke, Ikenna K Ndu, Benedict O Edelu, Nwachinemere D Uleanya, Uchenna Ekwochi, Josephat M Chinawa, Ikenna C Nwokoye, and Anthony N Ikefuna
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acute gastroenteritis ,electrolyte abnormalities ,under-five children ,Medicine - Abstract
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
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- 2020
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24. Prevalence and severity of depression among caregivers of HIV-infected children in Enugu, South-East Nigeria
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Anthony Nnaemeka Ikefuna, Ikechukwu Frank Ogbonna, Marcellinus Nkpozi, Nneka Chioma Okoronkwo, Adaobi Bisi-Onyemaechi, and Ugo Chikani
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caregivers ,children ,depression ,hiv ,nigeria ,Medicine - Abstract
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.
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- 2020
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25. Determinants of psychosocial disorders among caregivers of HIV-infected children in Enugu, Southeast Nigeria
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Ikechukwu F Ogbonna, Ngozi C Ojinnaka, Ifeoma J Emodi, and Nnaemaka A Ikefuna
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caregivers ,children ,human immunodeficiency virus ,nigeria ,psychosocial disorders ,Medicine - Abstract
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.
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- 2019
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26. A Descriptive Analysis of Paediatricians’ Involvement in Community Child Health in Nigeria: So Far How Far?
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Arodiwe, I. O., primary, Ubesie, A. C., additional, and Ikefuna, A. N., additional
- Published
- 2023
- Full Text
- View/download PDF
27. Right ventricular function among South East Nigeria children with sickle cell anaemia
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Chinawa, Josephat M., Chukwu, Bartholomew F., Chinawa, Awoere T., Ossai, Edmund N., Ikefuna, Anthony N., Aronu, Ann E., and Obidike, Egbuna O.
- Published
- 2020
- Full Text
- View/download PDF
28. Menarche among Peri-Natally HIV-Infected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Author
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O A Iloh, A C Ubesie, K K Iloh, I J Emodi, A N Ikefuna, and A C Ayuk
- Subjects
menarche ,peri-natal ,hiv ,girls ,nigeria ,Medicine - Abstract
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.
- Published
- 2017
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- View/download PDF
29. Effect of Birth Weight and Gender on the Umbilical Cord Serum Zinc in Neonates Delivered at the University of Nigeria Teaching Hospital, Enugu.
- Author
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Olisaka, Chinwe Lilian, Asinobi, Isaac Nwabueze, Iloh, Kenechukwu Kosisochukwu, Osuorah Osuorah, Chidiebere Donatus Ignatus, Iloh, Ogochukwu Nneka, Ubesie, Agozie, Ikefuna, Anthony Nnaemeka, and Ibe, Bede Chiedozie
- Published
- 2023
- Full Text
- View/download PDF
30. Zinc Levels in HIV-positive Children at the University of Nigeria Teaching Hospital
- Author
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Chukwu, Uchenna Kennedy, primary, Emodi, Ifeoma I., additional, Ibeziako, Ngozi, additional, Ikefuna, Anthony N., additional, Asinobi, Isaac N., additional, Iloh, Kenechukwu K., additional, Udeogu, Kosisochukwu E., additional, and Chukwu, Chibuebem J., additional
- Published
- 2023
- Full Text
- View/download PDF
31. Sociodemographic influences on immunization of children with chronic neurological disorders in Enugu, Nigeria
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Okoro, J.C., Ojinnaka, N.C., Ikefuna, A.N., and Onyenwe, N.E.
- Published
- 2015
- Full Text
- View/download PDF
32. Relationship between disease severity and folate status of children with sickle cell anaemia in Enugu, South East Nigeria
- Author
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Anthony N Ikefuna, Uchenna C. Nnajekwu, Osita U Ezenwosu, Ifeoma J Emodi, Chukwubike O. Nnajekwu, Ndubuisi A Uwaezuoke, and Vivian O Onukwuli
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Nigeria ,Anemia, Sickle Cell ,Folic Acid Deficiency ,Severity of Illness Index ,Teaching hospital ,Folic Acid ,children ,Disease severity ,Internal medicine ,Genotype ,South east ,Humans ,Medicine ,Child ,business.industry ,Sickle cell anaemia ,Infant ,Folate supplementation ,Articles ,General Medicine ,Hospital based ,folate status ,Child, Preschool ,Population study ,Female ,disease severity ,business ,Relevant information ,Enugu - Abstract
Background: Repeated crises in children with sickle cell anaemia (SCA), which is a manifestation of disease severity, results in depletion of their minimal tissue folate stores, with higher likelihood of folate deficiency. The study aimed to determine the relationship between disease severity and the folate status of children with SCA attending University of Nigeria Teaching Hospital (UNTH), Enugu. Methods: This was a hospital based, cross-sectional study conducted between September 2018 and March 2019. One hundred participants were recruited, consisting of 50 children having sickle cell crisis and 50 age and gender matched hae- moglobin AA genotype controls. Relevant information was documented using a pretested questionnaire. Sickle cell severity score was determined using frequency of crisis, admissions and transfusions in the preceding one year, degree of liver and splenic enlargement, life-time cummulative frequency of specific complications of SCA, leucocyte count and haematocrit. Results: Folate deficiency was observed in eight percent of the subjects and none of the controls. The difference was not significant (Fisher’s exact = 4.167, p=0.117). The odds of being folate deficient was 8.5 times more likely during anaemic crisis than in vaso-occlusive crisis, though not significant (95% C.I 0.05 – 89.750, p = 0.075). The mean SCA severity score was 8.06 ± 3.64, signifying a moderate SCA severity in the study population. There was a no relationship between folate status and severity of SCA (Fisher’s exact = 0.054, p = 0.949) Conclusion: Folate status in children with SCA is not affected by their disease severity. Therefore, there may be no need for additional folate supplementation with increasing severity of sickle cell anaemia. Keywords: Sickle cell anaemia; disease severity; folate status; children; Enugu.
- Published
- 2021
33. Menarche among Peri-Natally HIV-Infected Girls at the University Of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Author
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Iloh , O.A., Ubesie , A.C., Iloh , K.K., Emodi, I.J., Ikefuna, A.N., and Ayuk, A.C.
- Abstract
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.
- Published
- 2022
34. Folate levels in children with sickle cell anaemia on folic acid supplementation in steady state and crises at a tertiary hospital in Enugu, Nigeria: a prospective, comparative study
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Uchenna C, Nnajekwu, Chukwubike O, Nnajekwu, Vivian O, Onukwuli, Bartholomew F, Chukwu, Anthony N, Ikefuna, and Ifeoma J, Emodi
- Subjects
Tertiary Care Centers ,Folic Acid ,Dietary Supplements ,Humans ,Nigeria ,Anemia, Sickle Cell ,Prospective Studies ,Child - Abstract
Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis.To determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype.This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment.The median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p0.001).Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state.
- Published
- 2022
35. Neurocognitive Function of School-aged HIV-infected Children in Enugu, Nigeria
- Author
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Iloh, Kenechukwu K, Emodi, Ifeoma J, Ibeziako, Ngozi S, Ikefuna, Anthony N, Ubesie, Agozie C, Iloh, Ogochukwu N, Ilechukwu, Gideon C, and Ayuk, Adaeze C
- Published
- 2017
- Full Text
- View/download PDF
36. Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study
- Author
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Osita U. Ezenwosu, Barth F. Chukwu, Ndubuisi A. Uwaezuoke, Ifeyinwa L. Ezenwosu, Kelechi O. Urom, Maria I. Udorah, Anthony N. Ikefuna, and Ifeoma J. Emodi
- Subjects
Oncology ,Pediatrics, Perinatology and Child Health ,Hematology - Abstract
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 χ
- Published
- 2022
37. Folate levels in children with sickle cell anaemia on folic acid supplementation in steady state and crises at a tertiary hospital in Enugu, Nigeria: a prospective, comparative study
- Author
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C Nnajekwu, Uchenna, O Nnajekwu, Chukwubike, O Onukwuli, Vivian, F Chukwu, Bartholomew, N Ikefuna, Anthony, and J Emodi, Ifeoma
- Subjects
Red cell folate, sickle cell anaemia, steady state, crises - Abstract
IntroductionFolic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis. AimTo determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype. MethodThis study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment. ResultsThe median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p
- Published
- 2022
38. Clinical Summary and Reasoning Format: Cognition Levels and Proposal of a Grading System
- Author
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E A, Disu, A N, Ikefuna, F O, Njokanma, and K E, Nkanginieme
- Subjects
Cognition ,Humans ,Nigeria ,Child - Abstract
The Clinical Summary and Reasoning Format (CSRF) was designed by the Faculties of Paediatrics of the National Postgraduate Medical College of Nigeria and the West African College of Physicians. The form is recommended for routine use in clinical practice as well as for training and examination purposes. The form has sections for documenting information derived from interacting with an index patient and sections for documenting sequential deductions on the way to various levels of diagnosis. The levels of cognition required to complete different sections of the Clinical Summary and Reasoning Format (CSRF) vary in complexity. The CSRF is potentially useful for assessing the quality of a clinician's clinical reasoning process. Such assessment will be enhanced by having a grading system for completed CSRF forms. In turn, grading contents of the form should reflect complexity of the levels of cognition required for the various sections. The present paper evaluated the sections of the CSRF with reference to the modified Bloom's Taxonomy of cognition and also proposed a grading scheme for assessing CSRF forms completed by trainees.Le format de résumé clinique et de raisonnement (CSRF) était conçu par les Facultés de Pédiatrie du National Collège médical de troisième cycle du Nigeria et de l’Afrique de l’Ouest Collège des médecins. Le formulaire est recommandé pour la routine utilisation dans la pratique clinique ainsi que pour la formationet l’examen Fins. Le formulaire comporte des sections pour documenter les informations dérivé de l’interaction avec un patient index et des sections pour documenter les déductionsséquentiel les sur le chemin de diverses niveaux de diagnostic. Les niveaux de cognition requis pour compléter différentes sections du résumé clinique et du raisonnement Le format (CSRF) varie en complexité. Le CSRF est potentiellement utile pour évaluer la qualité d’un processus de raisonnement clinique du clinicien. Cette évaluation sera amélioré par la mise en placed’un système de classement pour le CSRF complété Formes. À son tour, le contenu de classement du formulaire doit refléter complexité des niveaux de cognition requis pour les différents sections.Le présent document a évalué les sections du CSRF avec référence à la taxonomie modifiée de bloom de la cognition et a également proposé un système de notation pour l’évaluation des formulaires CSRF complété par des stagiaires. Mots-clés: Cognition, Raisonnement clinique, Évaluation, Notation.
- Published
- 2022
39. Association between HIV infection, sociodemographic characteristics and depression in caregivers of HIV infected children in Enugu, South-East, Nigeria
- Author
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Ogbonna, Ikechukwu F., Ojinnaka, Ngozi C., Ikefuna, Anthony N., and Emodi, Ifeoma J.
- Subjects
HIV infection, Sociodemographic, Depression, Children, Caregivers, Nigeria - Abstract
Background: In the presence of certain factors, HIV infection in children increases the burden of depression in their caregivers. This necessitated the need for this study which aimed to determine the factors that are associated with depression in the caregivers of HIVinfected children.Methods: A comparative hospital-based study of 352 study participants comprising two groups. The first group was the subjects consisting of 176 caregivers of HIV-infected children and the second was the control consisting of 176 caregivers of HIV negative children. Having met the inclusion criteria, these study participants were screened for HIV infection, their sociodemographic characteristics were obtained and depression in them was assessed using Zung self-rating depression scale (SDS). The essence was to determine the factors that were significantly associated with depression in the subjects.Results: Forty-three (24.4%) and 133 (75.6%) of the subjects were males and females respectively while 47 (26.7%) and 129 (73.3%) of the control were males and females respectively. Seventy-six (43.2%) of the subjects and 12 (6.8%) of the control group had SDS scores in the depression range and this difference was significant (2 = 62.06, df = 1, p < 0.001). The factors that were significantly associated with depression in the subjects were the age of the HIV-infected children (p = 0.023, OR = 2.28), caregiver’s sex (p = 0.003, OR = 3.25), socioeconomic status (p < 0.001, OR = 4.00), marital status (p < 0.001, OR = 2.18), type of caregivers (p = 0.028, OR = 2.78), spouse support (p = 0.019, OR = 2.08).Conclusion: There is a high burden of depression among caregivers of HIV-infected children and depression in them is significantly associated with caring for a preadolescent HIVinfected child, female caregivers, lower socioeconomic status, death of a spouse, being a biologic caregiver and lack of spouse support.
- Published
- 2022
40. Clinical Summary and Reasoning Format: A Tool for Clinical Practice and Medical Training
- Author
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A N, Ikefuna, F O, Njokanma, K E, Nkanginieme, and E A, Disu
- Subjects
Clinical Decision-Making ,Humans ,Nigeria - Abstract
Patients' records are often bulky and unwieldy, necessitating the creation of summaries. A structured summary format adds the advantage of improved organization and easier retrieval of information. However, typical clinical summary formats do not document intermediate deductions linking symptomatology to diagnosis and to that extent fall short of tracking the cognition process of the clinician. The Clinical Summary and Reasoning Format of the Faculties of Paediatrics of the National Postgraduate Medical College of Nigeria and the West African College of Physicians was designed to track the clinical thought and reasoning processes of clinicians. It consists of two major sections. The first section is for documenting data from history, physical examination and early laboratory reports while the second section is for recording hierarchical deductions on the way to reaching various levels of diagnosis. Definitions and descriptions of the various components of the format are herein presented. The usefulness of the format for clinical practice, clinical training and assessment of trainees is discussed.Les dossiers des patients sont souvent volumineux et peu maniables, ce qui nécessite la création de résumés. Un format de résumé structuré offre l’avantage d’une meilleure organisation et d’une récupération plus facile de l’information. Cependant, les formats de résumé clinique typiques ne documentent pas les déductions intermédiaires reliant la symptomatologie au diagnostic et, dans cette mesure, ne permettent pas de suivre le processus cognitif du clinicien. Le format de résumé clinique et de raisonnement des facultés de pédiatrie du National Postgraduate Medical College of Nigeria et du West African College of Physicians a été conçu pour suivre la pensée clinique et les processus de raisonnement des cliniciens. Il se compose de deux sections principales. La première section sert à documenter les données provenant de l’histoire, de l’examen physique et des premiers rapports de laboratoire, tandis que la seconde section sert à enregistrer les déductions hiérarchiques permettant d’atteindre les différents niveaux de diagnostic. Les définitions et les descriptions des différents composants du format sont présentées ici. L’utilité du format pour la pratique clinique, la formation clinique et l’évaluation des stagiaires est discutée. Mots clés: Cognition, Résumé clinique, Raisonnement clinique, Format, Diagnostic. Mots clés: Cognition, Résumé clinique, Raisonnement clinique, Format, Diagnostic.
- Published
- 2022
41. Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study
- Author
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Ezenwosu, Osita U., primary, Chukwu, Barth F., additional, Uwaezuoke, Ndubuisi A., additional, Ezenwosu, Ifeyinwa L., additional, Urom, Kelechi O., additional, Udorah, Maria I., additional, Ikefuna, Anthony N., additional, and Emodi, Ifeoma J., additional
- Published
- 2022
- Full Text
- View/download PDF
42. Risk Factors of Skin Diseases among School Children in South Eastern Communities in Nigeria
- Author
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O, Ewurum, C A, Ibeneme, T O, Nnaji, and A N, Ikefuna
- Subjects
Male ,Cross-Sectional Studies ,Schools ,Risk Factors ,Prevalence ,Humans ,Nigeria ,Child ,Skin Diseases - Abstract
Skin disorders frequently seen among primary school children are common causes of morbidity. Determining the risk factors of skin diseases, will enhance a better understanding of skin health and prevent skin diseases in school children.To determine the common risk factors of skin diseases among primary school children in Umuahia South Local Government Area of Abia State.A descriptive cross-sectional study carried out over a 4-month period among pupils of public and private primary schools. Diagnosis of skin diseases was based on clinical findings as well as laboratory investigations where indicated. A pre-tested, self-administered, close ended questionnaire was used to ascertain the risk factors of skin diseases.Eight hundred and forty-seven (847) and seven hundred and thirteen (713) subjects were recruited from public and private schools respectively. Fifty-six percent of the subjects were males. The mean age of the study participants was 8.74 ± 2.08 years. The overall prevalence of skin diseases was 40.2%. Using a multivariate logistic regression, gender, number of people per room, frequency of bathing per week and source of water were found to be significant risk factors for skin diseases.Socio-demographic factors and living conditions are significant risk factors of skin diseases. Standard hygienic practices by school children and their parents/ caregivers will help to reduce the high prevalence of skin diseases in our environment.Les troubles cutanés fréquemment observés chez les enfants des écoles primaires sont des causes courantes de morbidité. Déterminer les facteurs de risque des maladies de la peau, permettra de mieux meilleure compréhension de la santé de la peau et de prévenir les maladies les enfants scolarisés.Déterminer les facteurs de risque communs des maladies cutanées chez les élèves de l’école primaire de la zone de Umuahia South Local Government Area of Abia State.Étude descriptive transversale menée pendant une période de 4 mois auprès d’élèves d’écoles primaires publiques et privées. Le diagnostic des maladies de la peau était fondé sur les cliniques ainsi que sur des examens de laboratoire, le cas échéant. Un questionnaire pré-testé, auto-administré et fermé a été utilisé pour déterminer les facteurs de risque des maladies de la peau a été utilisé pour déterminer les facteurs de risque des maladies de la peau.Huit cent quarante-sept (847) et sept cent treize (713) personnes ont été recrutés respectivement dans des écoles publiques et privées respectivement. Cinquante-six pour cent des sujets étaient de sexe masculin. L’âge moyen des participants à l’étude était de 8,74 ± 2,08 ans. La prévalence globale des maladies de la peau était de 40,2 %. En utilisant une régression logistique multivariée, le sexe, le nombre de personnes par pièce, la fréquence des bains par semaine et la source d’eau se sont avérés être des facteurs de risque significatifs de maladies de la peau.Les facteurs sociodémographiques et les conditions de vie sont des facteurs de risque significatifs de maladies de la peau. Les pratiques hygiéniques normalisées des écoliers et de leurs parents ou parents/soignants contribueront à réduire la prévalence élevée des maladies de la peau dans notre environnement.Facteurs de risque, maladies de la peau, écoles, enfant.
- Published
- 2022
43. Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study.
- Author
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Ezenwosu, Osita U., Chukwu, Barth F., Uwaezuoke, Ndubuisi A., Ezenwosu, Ifeyinwa L., Urom, Kelechi O., Udorah, Maria I., Ikefuna, Anthony N., and Emodi, Ifeoma J.
- Subjects
SICKLE cell anemia ,DEPRESSION in adolescence ,RESOURCE-limited settings ,STATISTICAL sampling - Abstract
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 χ
2 = 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]- Published
- 2023
- Full Text
- View/download PDF
44. Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria
- Author
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Ezenwosu, O. U., Chukwu, B. F., Ikefuna, A. N., Hunt, A. T., Keane, J., Emodi, I. J., and Ezeanolue, E. E.
- Published
- 2015
- Full Text
- View/download PDF
45. Mental Health of Adolescents With Epilepsy in Enugu, Nigeria: A Cross-Sectional Study
- Author
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Uchenna C. Nnajekwu, Nnaemeka Anthony Ikefuna, Chukwubike O. Nnajekwu, and Chinyelu Ngozi Ojinnaka
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Social stigma ,Cross-sectional study ,Population ,Nigeria ,Severity of Illness Index ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,education ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Depressive Disorder ,education.field_of_study ,business.industry ,medicine.disease ,Mental health ,Cross-Sectional Studies ,Pediatrics, Perinatology and Child Health ,Female ,Neurology (clinical) ,business ,Attitude to Health ,Psychosocial ,030217 neurology & neurosurgery ,Management of depression - Abstract
Adolescence is an important period, marked by significant changes in biological and psychosocial domains. Epilepsy is a chronic neurologic disorder associated with social stigma and prejudice. The etiology of depression in epilepsy appears to be a complex interplay between psychosocial and neurobiologic factors. This period may be too taxing for the adolescent with epilepsy to steer, as epilepsy can affect the development of independence by its social, educational, and mental health effects. The study aimed to compare the burden of depression in adolescents with epilepsy with the general population. One hundred forty-five adolescents with epilepsy and their classmates matched for age and gender were studied over a 9-month period. Zung Self-rating Depression Scale was used to determine the burden of depression in the study population. Among the subjects, 70 (48.3%) had scores in the depressive range to varying degrees compared to 38 (26.2%) controls. The difference in scores was significant (OR=2.628, P < .001). Among the population with positive scores, mild depression category was the commonest for both groups (40% and 22.8%, respectively). There was a statistically significant relationship between gender, seizure type, and depression, whereas there was no significant relationship between age, social class, number of antiepileptic drugs, seizure frequency in the last 12 months, and depression. Adolescents with epilepsy had higher rates of depression than the general population. Hence, there might be need for routine screening of adolescents with epilepsy for early detection and management of depression to improve their overall well-being and quality of life.
- Published
- 2020
46. Magnesium levels in stable children with asthma: It’s relationship with asthma control
- Author
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T Oguonu, Ikenna K Ndu, Anthony N Ikefuna, F.N. Ogbuka, and Bede C. Ibe
- Subjects
medicine.medical_specialty ,business.industry ,Magnesium ,chemistry.chemical_element ,Asthma clinic ,Magnesium level ,medicine.disease ,respiratory tract diseases ,Teaching hospital ,Asthmatic children ,chemistry ,immune system diseases ,Internal medicine ,Asthma control ,Medicine ,Analysis of variance ,business ,Asthma - Abstract
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 i ts anti - inflammatory 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 therapyassessment 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. Keywords: Serum magnesium, asthma control, stable asthma
- Published
- 2020
47. Knowledge and awareness of individual sickle cell genotype among adolescents in a unity school in Southeast, Nigeria: a cross-sectional study
- Author
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Anthony N Ikefuna, Echezona E. Ezeanolue, B F Chukwu, Osita U Ezenwosu, Ifeyinwa L Ezenwosu, and Ifeoma J Emodi
- Subjects
Sickle cell trait ,Cross-sectional study ,business.industry ,Nigerians ,030231 tropical medicine ,Public Health, Environmental and Occupational Health ,Disease ,Specific knowledge ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,Genotype ,medicine ,General knowledge ,030212 general & internal medicine ,business ,Demography ,Reproductive health - Abstract
Objective Our study sought to assesses the knowledge and awareness of individual sickle cell genotype among adolescents. Methods Participants were recruited from a large school in Southeast Nigeria where adult prevalence of sickle cell trait is 25%. Data was collected through a 50-item survey with previously pretested questions that assessed awareness of individual genotype, general knowledge of sickle cell disease, perception of sickle cell trait and sickle cell anaemia (SCA). Additionally, self-reported genotype was compared to the school’s admission records to determine accuracy of self-reported genotype. The knowledge scores were summed on a binary basis with one point assigned for a correct answer while zero was given for an incorrect response. Results Four hundred and nine (409) students were approached and enrolled in the study. A vast majority (94%) of the respondents reported being aware of their genotype and two-thirds had the awareness during school admission. However, in specific knowledge of sickle cell, majority (89.7%) of the participants miscalculated the probability of having a child with SCA in married carrier couple and 71.9% misidentified the proportion of Nigerians with sickle cell trait. Assessing level of knowledge of sickle cell, only very few of the adolescents (7.3%) were found with the expected high knowledge scores of 7–8. Conclusion Although a significant proportion of respondents were aware of their genotype, most were unaware of the implications of sickle cell trait and thought that people with sickle cell trait also have symptoms of sickle cell disease. Also, only a few of the respondents have the expected level of sickle cell knowledge. A focused educational intervention among this age group is crucial as they embark on making reproductive health decisions.
- Published
- 2020
48. Glanzmann's thrombasthenia: a rare bleeding disorder in a Nigerian girl
- Author
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Anthony N Ikefuna, Barth F Chukwu, Ifeyinwa L Ezenwosu, Osita U Ezenwosu, Ndubuisi A Uwaezuoke, and Ifeoma J Emodi
- Subjects
Gastrointestinal bleeding ,Pediatrics ,medicine.medical_specialty ,030231 tropical medicine ,Glanzmann's thrombasthenia ,Nigeria ,Consanguinity ,Medroxyprogesterone Acetate ,Injections, Intramuscular ,03 medical and health sciences ,0302 clinical medicine ,Rare Diseases ,Thrombasthenia ,medicine ,Humans ,Vaginal bleeding ,Child ,Menorrhagia ,business.industry ,Nigerian girl ,General Medicine ,Articles ,medicine.disease ,Bleeding diathesis ,Contraceptive Agents, Hormonal ,Menarche ,Female ,Fresh frozen plasma ,medicine.symptom ,business - Abstract
Introduction: Glanzmann’s Thrombasthenia (GT) is a rare autosomal recessive bleeding disorder due to defective platelet membrane glycoprotein GP IIb/IIIa (integrin αIIbβ3). The prevalence is estimated at 1:1,000,000 and it is commonly seen in areas where consanguinity is high. Case Presentation: The authors report a 12 year old Nigerian girl of Igbo ethnic group, born of non-consanguineous parents, who presented with prolonged heavy menstrual bleeding which started at menarche 3 months earlier, weakness and dizziness. She had a past history of recurrent episodes of prolonged epistaxis, gastrointestinal bleeding and gum bleeding during early childhood. On examination, she was severely pale with a haemic murmur and vaginal bleeding. The initial diag- nosis was menorrhagia secondary to bleeding diathesis possibly von Willebrand’s Disease. She was on supportive treatment with fresh whole blood, fresh frozen plasma and platelets until diagnosis of GT was made in the USA. Currently, she is on 3 monthly intramuscular Depo-provera with remarkable improvement. Conclusion: To the best of our knowledge, this is the first documented report of GT in our environment where consan- guinity is rarely practised. Our health facilities require adequate diagnostic and treatment facilities for rare diseases like GT. Keywords: Glanzmann’s thrombasthenia; Menorrhagia; Nigerian girl.
- Published
- 2020
49. Prevalence and severity of depression among caregivers of HIV-infected children in Enugu, South-East Nigeria
- Author
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Nneka Chioma Okoronkwo, Anthony N Ikefuna, Ugo N. Chikani, Adaobi I. Bisi-Onyemaechi, Marcellinus Nkpozi, and Ikechukwu Frank Ogbonna
- Subjects
medicine.medical_specialty ,caregivers ,Depression scale ,business.industry ,Human immunodeficiency virus (HIV) ,hiv ,General Medicine ,medicine.disease_cause ,nigeria ,children ,Sample size determination ,Hiv infected ,Internal medicine ,depression ,South east ,Medicine ,business ,Depression (differential diagnoses) - Abstract
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.
- Published
- 2020
50. Prevalence and Patterns of Psychosocial Problems among Adolescents with Epilepsy in Enugu, Nigeria: A Cross-Sectional Study
- Author
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Nnajekwu Uchenna Chiagoziem, Ojinnaka Ngozi Chinyelu, Ikefuna Anthony Nnaemeka, and Nnajekwu Chukwubike Onyebuchi
- Subjects
Age and gender ,Epilepsy ,business.industry ,Cross-sectional study ,medicine ,medicine.disease ,business ,Psychosocial ,Checklist ,Clinical psychology - Abstract
This study was cross-sectional and hospital-based. One hundred and forty-five adolescents with epilepsy were recruited over nine months. Apparently healthy adolescents who were their classmates and matched for age and gender served as controls. The Paediatric Symptom Checklist –youth report version (PSC-YR) was used to assess psychosocial problems.
- Published
- 2021
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