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Background: Community Health Workers (CHWs) have played a key role in the holistic care of sickle cell disease (SCD) in the developed world. However, in Nigeria and other African countries which harbour the largest burden of SCD globally, the poor involvement of CHWs in the care of individuals with the disease may be related to their knowledge about the disease. Objective: To assess the adequacy of knowledge or otherwise of CHWs-in-training (students of School of Health Technology) in SCD identification, screening and crises prevention. Methods: This cross-sectional study involved 600 students of the College of Health Technology, Ilesa, southwest Nigeria. A pre-tested self-administered forty-point questionnaire was used to assess information on what SCD is and how it is transmitted (6 questions); major clinical presentations (8 questions); ideal timing for diagnosis (7 questions); common methods of crisis prevention (7 questions); basic counselling of individuals with the disease (6 questions); and knowledge on the relevance of record keeping, home visit, immunisation and prompt referral in SCD care (6 questions). Results: Only 239 (39.8%) had good knowledge of SCD in the assessed domains. Knowledge on crisis prevention including roles of record keeping, home visits, immunisation and prompt referral in SCD care was particularly poor. Age group, gender and course of study were not significantly associated with the overall knowledge of the disease. Conclusion: The overall knowledge of Health Technologists-in-training in Nigeria on SCD is poor. Focused and comprehensive modules on SCD should be incorporated into the training curriculum of students in the Colleges of Health Technology in Nigeria.

In utero exposure to gestational diabetes mellitus (GDM) is associated with adverse long-term outcomes. Little is known about how mothers perceive these outcomes and the support they need for optimal outcomes for their children. We aimed to explore how women perceive the risk of adverse outcomes for their children exposed to GDM and the support they require for their optimal health. We conducted semistructured interviews with women who experienced GDM in at least one previous pregnancy. Data collection continued until saturation, and analysis followed an iterative thematic approach. Twenty-five mothers participated, and their perceptions about later outcomes for children exposed to GDM varied. Five themes were identified: relating GDM to the offspring's later health; reactions to the potential for poor later outcomes; impact on child growth, development, and behavior; maintaining optimal health from childhood to adulthood; and recommendations for long-term care. Most mothers received no information about potential later child outcomes; some based their views on assumptions. Some mothers who believed their children were at increased risk of poor outcomes expressed fear and worry, while others proactively ensured their children engaged in healthy lifestyle choices. Mothers emphasized the need for support within health facilities (information provision, linking antenatal with child records, and risk assessment) and in the community (social groups, home visits) to ensure optimal health of their children. These findings have potential implications for policy and practice changes to optimize later health outcomes for children exposed to GDM., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Oluwatoyin I. Oladimeji et al.)

Aim: Hypoglycaemia is common in neonates born to mothers with gestational diabetes mellitus (GDM). We aimed to determine predictors of hypoglycaemia among neonates of women with GDM and association with short-term outcomes., Methods: We conducted a secondary cohort analysis of data from a multi-centre randomised trial (the TARGET trial) conducted across ten maternity hospitals in New Zealand between May 2015 and November 2017. Data were analysed using univariate analysis and multivariable forward stepwise logistic regression., Results: Among 1085 neonates, those born to Asian mothers had reduced odds of hypoglycaemia (OR [95% CI]: 0.54 [0.38, 0.75], p = 0.001), as did those born at higher gestational ages (0.76 [0.68, 0.85], p < 0.001). Neonates born to Pacific mothers had increased odds of hypoglycaemia (OR [95% CI]: 1.57 [1.04, 2.39], p = 0.034). Neonates who experienced hypoglycaemia were more likely to experience neonatal intensive care unit admission (8.3% vs. 2.1%; p ≤ 0.001), hyperbilirubinaemia (8.6% vs. 3.3%; p ≤ 0.001) and receive respiratory support (11.4% vs. 4.8%; p ≤ 0.001) and less likely to be breastfed at discharge (92.4% vs. 96.2%; p = 0.009)., Conclusion: Among neonates of women with GDM, maternal ethnicity and gestation at birth are independent predictors of hypoglycaemia, and hypoglycaemia is associated with short-term comorbidities. Additional surveillance may be appropriate for neonates in these high-risk groups., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Background: Worldwide, many guidelines recommend the use of expressed breast milk (EBM) and maternal expression of breast milk for the prevention and treatment of neonatal hypoglycemia. However, the impact of both practices on neonatal hypoglycemia is unclear. This study aims to determine the effectiveness of EBM and maternal expression of breast milk in preventing and treating neonatal hypoglycemia., Methods: We registered our review in PROSPERO (CRD42022328072). We systematically reviewed five databases and four clinical trial registries to identify randomized controlled trials (RCT), non-randomized studies of intervention (NRSI), and cohort studies that compared infants who received EBM to infants who did not, and similar study designs that compared infants whose mothers expressed breast milk to infants whose mothers did not. Two independent reviewers carried out screening, data extraction, and quality assessment. The quality of included RCT, NRSI, and cohort studies were respectively assessed with the Cochrane Risk of Bias 2, Risk Of Bias In Non-randomised Studies-of Interventions, and the Newcastle-Ottawa Scale tools. Results from studies on EBM were synthesized separately from those on maternal expression of breast milk. Meta-analysis was undertaken using Revman 5.4. and fixed-effect models., Results: None of the ten included studies was specifically designed to determine the effect of EBM or maternal expression of breast milk on neonatal hypoglycemia. The effect of EBM on neonatal hypoglycemia was not estimable. There was no difference in the risk of hypoglycaemia among neonates whose mothers expressed breast milk compared to those whose mothers did not [RR (95%CI); one RCT: 0.92 (0.77, 1.10), high-certainty evidence; one cohort: 1.10 (0.74, 1.39), poor quality study]., Conclusions: There is insufficient evidence to determine the effectiveness of EBM for preventing or treating neonatal hypoglycemia. Limited data suggests maternal breast milk expression may not alter the risk of neonatal hypoglycemia. High-quality randomized controlled trials are needed to determine the effectiveness of EBM and maternal expression of breast milk for the prevention and treatment of neonatal hypoglycemia., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: By providing timely actionable results for prompt management, point-of-care testing (POCT) kits have revolutionised medical care for various diseases, ranging from infectious diseases like malaria to genetic disorders, such as sickle cell disease (SCD). They are, however, underutilised in the diagnosis of SCD in developing countries, where the need is greatest., Objective: The study was aimed at assessing the sensitivity of HemoTypeSC POCT among a cohort of children with SCD, previously diagnosed by Alkaline cellulose acetate hemoglobin electrophoresis (ACAE), with or without high-performance liquid chromatography (HPLC)., Methods: In this descriptive cross-sectional study, HemoTypeSC test was conducted on all participants and its sensitivity was determined by comparing results with those obtained using ACAE. Discordance was verified with HPLC., Results: One hundred and forty-five children aged one to 19 years were studied. There were 84 males and 61 females (male: female ratio = 1.4: 1). The HemoTypeSC was able to correctly diagnose sickle cell anemia (SCA) and hemoglobin SC in all (100%) of the children tested., Conclusion: The HemoTypeSC shows high sensitivity in detecting SCA and hemoglobin SC. Hence, it is useful for targeted screening of individuals suspected of having SCD, leading to rapid diagnosis of these hemoglobinopathies, even in resource-constrained settings., (Copyright © 2021 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Sickle cell disease (SCD) ranks high among genetic disorders worldwide. It is characterised by repeated vaso-occlusion with resultant end-organ damage. This process can occur in all vascular beds in the body, including ocular blood vessels and may cause irreversible blindness in advanced stages. Little is known of the relationship between the prevalence of ocular abnormalities among children with SCD and their disease severity., Methods: A descriptive cross-sectional study was carried out at the Paediatric Haematology Clinics and the Eye Centre of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Children with SCD in steady state were recruited from the Haematology Clinics and examined for ocular abnormalities at the Eye Centre of the hospital. The subjects SCD severity grade was determined using a previously validated scoring system., Results: One hundred and twenty (120) children aged 5 to 15 years were examined. Of these, 72 had one or more ocular abnormalities giving the prevalence of ocular abnormalities among them to be 60.0%. Though a higher proportion of children with moderate disease, 23 (65.7%) of 35, compared to those with mild disease, 49 (57.6%) of 85 had ocular abnormalities, this difference was not statistically significant, p  = 0.412., Conclusion: Ocular abnormalities among Nigerian children with SCD are common even in steady-state, but not significantly associated with disease severity. Periodic screening for ocular abnormalities should thus be done on them irrespective of disease severity.

Background: Short-term emergency department (ED) observation care may prevent prolonged and unnecessary hospital admission in patients with sickle pain. This study highlights the outcomes of short-term ED care of acute pain in children with sickle cell disease (SCD)., Methods: Children aged 6 mo to 19 y with SCD and painful crises who were managed by short-term ED care from July 2017 to June 2019 were studied retrospectively. Biodata, pain score, type of care, length of hospital stay, inpatient transfer rate (the proportion that required transfer for full admission) and return rate (the proportion that returned to the hospital for retreatment of unresolved pain) were documented., Results: From July 2017 to June 2019, 122 children with SCD were admitted to the ED for painful crises, of whom 118 (96.7%) with 167 hospital visits were managed by short-term ED observation care. The median length of stay was 10.5 h. In 50.3% of encounters, patients were successfully managed without requiring further care. However, in 17.4% of encounters, they had their ED observation care terminated and converted to full admission. The overall return rate for acute care within 1 wk for either persistence of symptoms or any other complaint was 31.7%., Conclusions: Dedicated short-term ED observation care has the potential to provide effective and timely management of acute pain in children with SCD., (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: The effect of socio-demographic and nutritional factors on lung functions of African children is poorly studied. This study set out to determine the effects of these factors on lung functions of Nigerian school children., Methods: Rural and urban secondary schools students in Ilesa, Nigeria were selected by multistage sampling. The socio-demographic, nutritional status as well as lung function parameters measured using incentive Spirometry (MIR Spirolab III srl, Italy) of the children were obtained and compared among the rural and urban children., Results: A total of 250 children (128 rural and 122 urban) aged 9 to 17 years participated in the study over a 12 month period. Mean (SD) age was 12.6 (1.9) years and Male: Female 1:1.1. The urban children were heavier, taller and have larger lung volumes than their age and sex matched rural counterpart. Stunted rural males [Mean (SD) FVC 1.8 (0.3) L vs. 2.2 (0.6) L t-test = 2.360; p = 0.022], underweight females [Mean (SD) FVC 1.8 (0.4) L vs. 2.2 (0.6) L; t-test = 2.855; p = 0.006] and those exposed to unclean fuel [Mean (SD) FVC 2.1 (0.6) L vs. 2.4 (0.5) L; t-test = 2.079; p = 0.041] had significantly lower lung volumes compared to their counterparts without these conditions., Conclusion: Undernutrition, low socio-economic class and use of unclean fuels adversely affect the lung functions of Nigerian children. Improved standard of living, use of clean fuel and adequate nutrition may ensure better lung health among these children.