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Background: Malaria is a major public health problem in sub-Saharan Africa. Several efforts are being made to reduce its prevalence and morbidity in Nigerian children with emphasis on vector control measures. Methods: This was a crosssectional descriptive study conducted on 382 febrile children seen at a tertiary hospital in Nigeria over an eight-month period. A structured questionnaire was used to collect information on ociodemographic, vector control measures and care given to the subjects. Investigations conducted included malaria microscopy and total leukocyte count. Results: Eighty percent (308/382) employed at least one vector control measures to prevent malaria infection, and majority 232 (75.2%) use only one control measure. The commonest control measures used included always keeping doors and windows shut 298 (96.7%) and/or netted 280 (90.9%), use of conventional insecticide sprays 183 (59.4%), use of insecticide treated bed nets (ITNs) 178 (57.8%) and ensuring child sleeps at night with body adequately covered 77 (25%). Approximately half (178/315) of households who owned ITN used it, and only 40.4% (72/178) used it daily. It was noted that children that slept under an insecticide treated bed net (RR 0.56, 95% CI 0.33-0.94; P=0.029) and those who slept well covered at night (RR 0.26, 95% CI 0.12-0.61; P=0.002) had less risk of malaria infection. The use insecticide treated bed net however lost significance following adjustment for other control measures used and socio-demographic factors of interest (RR 0.63, 95% CI 0.36-1.10; P=0.101). Conclusion: There is need to intensify education on appropriate malaria control measures especially proper use of insecticide-treated nets and suitable clothing during sleep at night.

Air pollution is a major global public health issue causing considerable morbidity and mortality. Measuring levels of air pollutants and facilitating access to the data has been identified as a pathway to raise awareness and initiate dialogue between relevant stakeholders. Low-and middle-income countries (LMICs) urgently need simple, low-cost approaches to generate such data, especially in settings with no or unreliable data. We established a network of easy-to-use low-cost air quality sensors (PurpleAir-II-SD) to monitor fine particulate matter (PM2.5) concentrations at 15 sites, in 11 cities across eight sub-Saharan Africa (sSA) countries between February 2020 and January 2021. Annual PM2.5 concentrations, seasonal and temporal variability were determined. Time trends were modelled using harmonic regression. Annual PM2.5 concentrations ranged between 10 and 116 µg/m3 across study sites, exceeding the current WHO annual mean guideline level of 5 µg/m3. The largest degree of seasonal variation was seen in Nigeria, where seven sites showed higher PM2.5 levels during the dry than during the wet season. Other countries with less pronounced dry/wet season variations were Benin (20 µg/m3 versus 5 µg/m3), Uganda (50 µg/m3 versus 45 µg/m3), Sukuta (Gambia) (20 µg/m3 versus 15 µg/m3) and Kenya (30 µg/m3 versus 25 µg/m3). Diurnal variation was observed across all sites, with two daily PM2.5 peaks at about 06:00 and 18:00 local time. We identified high levels of air pollution in the 11 African cities included in this study. This calls for effective control measures to protect the health of African urban populations. The PM2.5 peaks around 'rush hour' suggest traffic-related emissions should be a particular area for attention. [ABSTRACT FROM AUTHOR]

Background: Respiratory illnesses are a major cause of morbidity and mortality in children worldwide. The impact is more profound in low and middle income countries. Objective: To determine the pattern of the respiratory illnesses in children that presented to the Children Emergency Room (CHER) of Nnamdi Azikiwe University Teaching Hospital Nnewi, a tertiary hospital in South-East Nigeria, over a 5-year period. Methodology: Clinical records of all children presenting over a 60-month period (July 2011 to June 2016) were retrieved and analyzed. Their age, gender as well as outcome of admission within 72hours in the CHER were reviewed. Results: A total of 4622 children were admitted over the specified period. Six hundred and sixty-eight (14.45%) had an Acute Respiratory Illness(ARI). Age range of the children was I month to 17years, mean age was 2.33 (± 3.56) years. Bronchopneumonia occurring in 27 (41.01 %)children was the most common diagnosis; followed by Bronchiolitis in 78 (11.68%), Aspiration pneumonitis in 41 (6.14%) and Acute Asthma in 40 (5.99%). There was equal gender distribution among the modal age of presentation. Majority of the cases 367 (54.94%) were transferred to the ward for continued care within 72hours of admission, while 54 (8.08%) died. The aetiology of the respiratory pathology (infectious or not) had a significant association with outcome of 72hours of admission in CHER (p = 0.01). Conclusion: Prevalence of ARIs among toddlers is still high. Efforts have to be re-enforced in order to reduce the negative impact of respiratory illness on child health and survival in the sub region. [ABSTRACT FROM AUTHOR]

Respiratory diphtheria is an acute and infectious disease that can progress to cardiac and neurological complications ultimately resulting in increased morbidity and mortality in affected individuals. Diagnosis was made in line with the WHO clinical case definition for Diphtheria. This is a report of two probable cases of complicated respiratory diphtheria presenting within 3 weeks of each other to the Paediatrics Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Anambra state, South-East Nigeria. The first patient was a 5-year-old female who presented on referral with a history of fever, throat pain, noisy breathing and facial fullness, in whom bull neck appearance and membrane in the throat was observed. She was tachycardic, in respiratory distress, had elevated jugular venous pulse (JVP), soft tender liver and a greyish membrane in the throat. She was managed as a case of Diphtheric Carditis and discharged after 17 days on admission in stable condition. The second patient was also a 5-year-old, male, who presented with a history of fever, difficulty in swallowing, change of voice (progressing from hoarseness to whispers), cough and staggering gait. Onset of the illness was associated with membrane in the throat, bull neck and stridor. Examination revealed cranial nerve deficits, aphonia, hypotonia and staggering gait. CSF analysis was within normal. He was managed as a case of Diphtheric Neuropathy and was discharged home in stable condition after 16 days on admission. C. diphtheria IGG done 2 weeks post discharge was 0.19 IU/ml. The cases suggest that respiratory diphtheria still occurs in children in our environment. A high index of suspicion is needed to diagnose and properly nurse these children back to health. [ABSTRACT FROM AUTHOR]

Background: Adherence to standard precautions (SP) is critical to reducing the burden of nosocomial infections. Objective: We assessed the knowledge and practice of SP among healthcare workers (HCWs). Methodology: A cross-sectional study was conducted among HCWs in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Anambra State, Nigeria using self-administered questionnaire and key informant interview. Results: Mean age and employment duration of subjects were 33.4±11.9 and 6.0 ± 6.7 years, respectively. Majority of the 341 HCWs had heard about SP (82.1%) and agreed that it should be applied to all patient care (78.0%). Only 45.7% of them correctly cited ≥2 components of SP. Two-third of participants reported that SP was poorly practiced in their unit mainly due to inadequate supply of materials (63.1%), inadequate staff training/retraining (62.2%), inadequate support by management (51.4%) and unavailable standard operating procedures (SOPs) on SP (37.8%). Compliance with SP and specifically, personal protective equipment (PPE) use were 65.1% and 76.2%, respectively. Profession (p=0.023), awareness about SP (p<0.001), SOP display in prominent places (p<0.001) and regular supply of running water (p<0.001) were significantly associated with SP compliance. Key informant interview revealed lack of written SP policies or its communication to HCWs, lack of training/retraining of HCWs and lack of materials required for SP practice. Conclusion: Knowledge of basic concept and practice of SP was not satisfactory among HCWs. Major barriers to SP were lack of materials, training and active support by hospital management. Awareness, SOP display in prominent places and regular supply of running water positively influenced SP compliance. Having written policies and communicating such to all HCWs, consistent supply of necessary materials, intensified training, and regular supervision are recommended. [ABSTRACT FROM AUTHOR]

Background: Oral diseases are one of the most common noncommunicable diseases. They are also the most neglected particularly in children. Objective: To determine the pattern and trend of oral diseases among children who presented in the dental clinic of a Nigerian Tertiary hospital over 58 months. Methodology: A retrospective study that assessed for oral diseases among children using the dental health records. Results: 1104 cases presented at the dental clinic, comprising 546 males and 558 females with a ratio of 1:1.02. The mean age of the subjects was 10.6 years ± 4.2 with an age range of 1 month to 17 years. Close to ninety-eight percent of cases reviewed were symptomatic. Across all age groups, dental caries and its sequalae was observed in 62.2% of cases and this was independent of age group and year of presentation (p<0.0001). Conclusion: An increasing trend of oral diseases was observed annually with the leading diagnosis been dental caries and its sequalae. [ABSTRACT FROM AUTHOR]

Background: Stress is a common factor associated with the medical profession. Among female doctors, this unstable mental state would greatly reduce work productivity as well as the quality of life of these female physicians. Objectives: To evaluate the stress level and predictors of this in female medical practitioners in South-East Nigeria. Methodology: A cross-sectional study involving female medical practitioners using the international K-10 stress assessment scoring system. Results: 236 female medical doctors were evaluated in this study. Overall, 37.3% were found to be stressed: 21% mildly stressed, 10% moderately stressed and 6% severely stressed. Significant predictors of stress were age of which those 31-40 years were the greatest proportion, motherhood, marital status and cadre of practice; while non-significant predictors were having a physician as a spouse, years of medical practice and taking night calls. Conclusion: The level of stress observed from this study is high. Advocacy to and interventions by employers of labour will greatly aid in mitigating potential stressors thus enhancing the mental state of female doctors. [ABSTRACT FROM AUTHOR]

Background: Globally, there is dearth of data on non-traumatic adolescent medical emergencies, with most studies focussing on adolescent traumatic, psychotic and obstetric emergencies. There is need for extension of focus to this neglected area, especially in Africa where differences in lifestyle, perception and socioeconomic status may influence adolescent health. Objective: To describe the morbidity pattern of adolescents admitted as medical emergencies in a Nigerian tertiary hospital and to identify factors that correlate with mortality amongst them. Methodology: This was a prospective study of all adolescents aged 10 to 19 years consecutively admitted into the Children Medical Emergency Ward of a Nigerian tertiary hospital, over a 2 year period. Their bio-data, clinical condition at time of presentation and outcome at discharge from the emergency room were documented. Bivariate analysis for correlation of these factors with mortality was done utilizing the Statistical Package for Social Sciences version 20. Results: Two hundred and two adolescents were admitted in the emergency room within the period. Their mean age was 13.3 +2.3 years with male to female ratio of 1.5:1. The major presenting symptom was fever with the predominant disease category being infectious and parasitic diseases in 31.2% of them. A sickle cell disease crisis was responsible for 15% of admissions and was the commonest single disease entity amongst them. The mortality rate was 6.4%. Acute exacerbations of chronic diseases were responsible for 85% of the mortalities. Chronic kidney disease with case fatality of 36% was significantly correlated with mortality [OR 8.4 CI 3.2-22.3]. Gender, age and maternal educational status had no significant correlation to the outcome. Conclusion: Acute exacerbation of chronic medical conditions account for poor outcome of medical emergencies in adolescents in the study centre. This calls for intensification of Preventive Medicare and adoption of the principle of pro active follow up of adolescents living with chronic diseases. [ABSTRACT FROM AUTHOR]