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Adaeze C Ayuk, Vivian O Onukwuli, Ijeoma N Obumneme-Anyim, Joy N Eze, Uzoamaka C Akubuilo, Ngozi R Mbanefo, Kenechukwu K Iloh, Osita U Ezenwosu, Israel O Odetunde, Henrietta U Okafor, Ifeoma J Emodi, Tagbo Oguonu College of Medicine University of Nigeria, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, NigeriaCorrespondence: Adaeze C AyukCollege of Medicine University of Nigeria, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, NigeriaEmail adaeze.ayuk@unn.edu.ngIntroduction: When a child reaches a certain age, he or she moves over to the adult physician. For this to maximally benefit the child, there has to be a process of equipping the child with skills required for taking on more responsibilities. Transitioning involves a process in which the adolescent with chronic illness is prepared ahead of time to enable them to eventually transfer to adult care with good outcomes. In high-income countries with well-organized health financing, the transitioning process begins as early as 12 years. In Africa, this process is not as organized and most hospitals would write a referral letter once the child turns 18 and transfer to adult clinic. In four of our chronic disease clinics (asthma, HIV, sickle cell anaemia and chronic kidney diseases) patients up to 24 years old are still attending the paediatric clinics. Understanding transition readiness among African adolescents remains a gap. Our findings will form a basis for informed practices for adolescent clinics in African countries.Methods: This was a descriptive cross-sectional study of pre-transition readiness in adolescents and young adults with chronic illnesses attending four outpatient specialist clinics in a tertiary hospital in Enugu Nigeria. This was done using the validated STARx Questionnaire. Total scores were computed and scores nearer the upper limit of 90 were acceptable, while mean subdomain scores of 4 and above were considered as optimal level of transition readiness. Demographic and clinical data were also collected. Acceptability to move on to adult-oriented care was documented using binary response (yes/no). Cross tabulations were done, and likelihood ratios obtained for predictors of acceptability of transition. Significant value was set at p-value of ≤ 0.05.Results: A total of 142 adolescents and young adults aged 12 to 24 years were studied. There were 38.0% (54), 24.6% (35), 22.5% (32) and 14.8% (21) from HIV, sickle cell anaemia, asthma and nephrology clinics, respectively. Their mean age was 15.6 years ± 2.4, and 48.6% (69) were male. The mean total transition readiness score was 56± 14 and this was not nearer the higher spectrum of total scores obtainable. Highest mean scores (3.7) occurred in the knowledge subdomain while least mean score (2) was noted in the use of medication reminders. The males had highest scores in the knowledge subdomain while the females were better informed about medication adherence and were more inquisitive about their chronic illness. Only about 37% (53) of the adolescents and young adults welcomed the idea of moving on to adult-care clinics. Children who had less frequent emergency hospital visits and better treatment outcome accepted the idea of transfer to adult care. Irrespective of the age all participants had suboptimal subdomain scores. High scores did not influence the participants’ choice to embrace transfer to adult care.Conclusion: There is suboptimal transition readiness irrespective of the age. The older age groups were less willing to transfer to adult care. Better disease knowledge and better communication skills did not positively influence acceptability of transfer to adult care.Keywords: adolescent, African, chronic, readiness, transition, transfer

Background: Several controversies surround mothers' willingness to vaccinate against the COVID-19 pandemic especially when mortality is not frequently reported in children. Objectives : This study aimed to ascertain the willingness of mothers of children attending two institutions in Southeast Nigeria to accept the COVID-19 vaccine and factors that may be associated with their choices., Methodology: This was a cross-sectional study carried out among 577 mothers who presented with their children in two tertiary health institutions in southeast Nigeria., Results: Majority of the respondents (93.9%) were aware of the COVID-19 vaccine. Majority of the respondents, 89.4%, noted that children were not in high priority groups for COVID-19 vaccination in Nigeria. Only 6.9% of the respondents intend to receive the COVID-19 vaccination. Also, a minor proportion of the respondents (4.9%) were willing to vaccinate their children with the COVID-19 vaccine. The odds of receiving the Covid-19 vaccine were four times greater in those who believed that they could be infected than in those who believed that they could not be infected (AOR = 4.0. 95% CI:1.8-8.7). The odds of receiving the Covid-19 vaccine were six times greater in those who were aware of someone that died from COVID-19 than in those who did not know anyone who died from COVID-19 (AOR = 5.7, 95% CI: 2.1-15.8)., Conclusion: A high level of awareness but low acceptance level for COVID-19 vaccination for mothers and their children was noted. Socioeconomic class, maternal age, and level of education did not influence the willingness of the mother to receive COVID vaccination. Having a belief of possibility of infection with the COVID-19 as well as being aware of someone who died from the disease were important positive variables that could predict vaccine acceptance from this study.

Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histologyThe objective of this study was to determine the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, 1 adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper airway obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio., Competing Interests: The authors declare no competing interests.

Background: Urinary tract infection is one of the infections that could lead to chronic kidney disease. Most of the offending isolates are usually Gram-negative bacteria such as Escherichia coli. Adolescent age groups are a special group of individuals who indulge in some risk behavior that could predispose them to urinary tract infections with possible mixed flora., Aim: The aim was to determine the burden of Gram-positive significant bacteriuria among adolescents in Enugu., Subjects and Methods: A survey of 628 adolescents attending secondary schools in Enugu was studied. Information on sociodemographic profile was obtained using a self-administered questionnaire. Clean-catch urine sample was collected using a sterile boric acid bottle, and this was cultured in both anaerobic and aerobic media. Significant isolates were Gram-stained in order to determine their characteristics. Data were analyzed using SPSS version 15.0.(Chicago Illinois USA)., Results: There were 324 females and 304 males. Significant bacteria growth was identified in 61 samples giving a prevalence rate of 9.7% (61/628). Gram-positive bacteria were isolated in 77.1% (47/61) of samples, while Gram-negative bacteria were isolated in 22.9% (14/61) of samples. Staphylococcus saprophyticus was the most common Gram-positive organism isolated this consists 38.3% (18/47) while E. coli was the most common Gram-negative bacteria isolated comprising 64.2% (9/14). Other Gram-positive bacteria isolated were Staphylococcus auerus, Staphylococcus epididimis. All isolated bacteria were more common in females 44/61 (72.1%) than males 17/61 (27.9%)., Conclusion: Gram-positive bacteriuria is prevalent among secondary school adolescents, and S. saprophyticus is the most common Gram-positive organism implicated. Further studies should be undertaken to determine the risk factors and possible sensitivity pattern among the age group.