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Background: Cardiac disease is an important noncommunicable disease encountered among paediatric populations with varying patterns in different regions. This study is aimed at finding the spectrum of cardiac diseases among the paediatric patients seen at Benue State University Teaching Hospital (BSUTH), Makurdi Nigeria. Method: A retrospective review of all cardiology patients seen at both in- and out-patient units of the paediatric department of BSUTH between June 2012 to December 2015. Data on age, gender, presenting complaints, final diagnosis, investigations, intervention and treatment outcome were obtained from the case folders. The analysis of the data was done with Excel spreadsheet and the results were presented as frequency and percentages. Results: Of the 8590 patients seen, 39 (0.45%) had cardiac diseases. The mean age of the patients was 60.2±59 months with Male: Female of 1.1:1. Twenty-eight (71.7%) of them had congenital heart disease (CHD) with the most prevalent type been acyanotic CHD among 21(53.8%). Ventricular septal defect (VSD) accounted for 15(71.4%) of the 21 (53.8%) patients. Hypertensive heart disease was found in one (2.6%) patient who was an obese adolescent. Conclusion: Congenital heart disease (CHD) and acquired heart disease (AHD) were all represented in this cohort with CHD being the most prevalent.

Hypersomnia, a disorder of sleep characterized by excessive quantity of sleep and excessive daytime sleepiness (EDS), could adversely affect health outcomes in childhood. To highlight diagnostic challenges and the impact of childhood hypersomnia in a resource limited setting, a 14 year old Nigerian who presented with a seven year history of hypersomnia was studied. Screening for sleep disorder using BEARS sleep algorithm and assessment for EDS using the Epworth Sleepiness Scale were both positive for EDS. The assessment of sleep hygiene using the Adolescent Sleep Hygiene Scale was normal and the use of Raven’s Progressive Matrices to assess intelligence was also normal. There was no contributory past medical history or demonstrable etiology. Magnetic Resonance Imaging (MRI) of the brain, Electro Encephalogram (EEG), assay of serum electrolytes were all normal while screening test for trypanosomiasis was negative. Poor level of awareness, high cost of evaluation and limited facilities for diagnosis of sleep disorder were the major diagnostic challenges. Depression, poor academic performance, suicidal ideation and stigmatization were all associated with hypersomnia in the patient.

Background: The death of growth and development screening tools in developing countries has grave implications for child health outcomes. The aim of the study was to determine the effectiveness of a novel screening tool in a rural Nigerian community. Method: Speech and language, Motor, Appearance and Temperament (SMAT) parameters of under- fives were queried using a novel tool, the SMAT Score. The effectiveness of the tool was assessed in three phases. In the first two phases the tool was administered to 210 under- fives (Subjects) independently. Those screened as having anomalies are classified as NOT SMAT while those screened otherwise as SMAT. In the third phase all NOT SMAT subjects and a number of randomly selected SMAT subjects were clinically evaluated. Outcomes of SMAT Score administration and clinical evaluation were subjeced to psychometric assessments. Results: There were 210 subjects with age range of 0.5 to 4.9 years (mea 2.3 ± 1.3 years) studied. Outof these 34 (16.2%) were screened as NOT SMAT. All the 90 (51.1%) randomly selected SMAT subjects as against 1 (2.9%) of the NOT SMAT subjects were clinically evaluated as normal. Inter rater and test – retest agreement rate in SMAT Score administrators was 100%. SMAT Score sensitivity and negative predictive value was 100% respectively in all age groups. The specificity was 98.9% overall and 96.3% among infants. Higher SMAT Score positive predictive value (97.1%) was observed with the entire study population as against 87.5% among infants. Conclusion: SMAT Score effectively identified subjects with growth and developmental disorders. Its use has potential for improving health systems and consequently child health outcomes in developing countries.

Background: The campaign against epilepsy is hampered by the difference between those with the active disorder and the number of them receiving appropriate treatment (treatment gap) in sub-Saharan Africa. Identifying the determinants of this gap is crucial to providing and achieving optimal care. Objective: To identify the determinants of epilepsy treatment gap (ETG) in children and adolescents (Subjects) with epilepsy in a rural community. Methods: Subjects were identified through a community house to house survey. Information obtained from Subjects and their care givers included: sociodemographic characteristics, type and frequency of epileptic seizures, current and past treatment options utilized, reasons for treatment options used, and treatment options utilized for other health complaints. Results: Twenty three Subjects (6.4/1000 of the child and adolescent population) were identified as having epilepsy. Their age range was 4-19 years (mean 14.3±4.7 years). Most were males (82.6%) and adolescents (78.3%). Seizures were mostly generalized (95.7%) and occurred most frequently daily. Current treatment modalities were use of traditional medication (100%) and prayers (34.8%).None was currently on orthodox medical therapy (ETG, 100%) but 5(21.7%) had utilized orthodox medical therapy in the past. The main determinants of the ETG were strong cultural belief, weakness in the health system to epilepsy treatment and low socioeconomic status. Fever was the commonest other health complaint and use of orthodox medical therapy was significantly (p˂ 0.05) the main (16, 69.6%) treatment option utilized. Conclusion: Cultural belief, weak health system ad low socioeconomic status were determinants of an absolute ETG. It highlights the need to strengthen initiatives that enhance accessibility to standard epilepsy treatment.

Background: Care of the children with mental health disorders is fraught with challenges particularly in developing countries and, where the family is the major source of care. Consequently assessing the impact of these disorders on the family is relevant to providing these children with optimal care. Objective: To assess the impact of childhood mental health disorders on family function and parental burden. Method: A monogamous family that had 3 children diagnosed as having childhood onset schizophrenia using the International Classification of Disease version 10(ICD 10) Classification was studied. Family function was assessed using the Family APGAR Score and the Zarit Burden Interview (ZBI) Score used in assessing parental burden. Results: The Family APGAR Scores were low (highly dysfunctional family) and the ZBI Scores high (highly burdened) in the family. Areas of serious dysfunction in the family were in adaptation, partnership and growth. In the ZBI Scores feelings about quality and cost of care offered, stress and other negative attributes associated with providing care, inability to meet other parental obligations and uncertainty about the future, were the major contributors to the highly burdensome outcome. Conclusion: The study highlights significant family burden and dysfunction in a family who had three children with schizophrenia. It underscored the need for provision of more comprehensive health and social support services to children with mental health disorders and their families.

Background: Febrile seizure is the most common seizure of childhood and has a good prognosis. However its presentation is fraught with poor management, with grave consequences, in our environment. Thus a review of its current status is important. Objective: To review the status of febrile seizures in Kaduna metropolis. Materials and Methods: A review of cases seen in the Department of Paediatrics, 44 Nigeria Army Reference Hospital, Kaduna between June 2008 and June 2010. Results: Out of the 635 cases admitted in the department 17 (2.7%) fulfilled the criteria for febrile seizures. There were 11 Males and 6 Females (M: F, 1.8:1). Age range was from 9 months to 5 years with a mean of 2.2 years ± 1.1 and peak age of 3 years. Twelve (70.6%) were in the upper social classes (I-III). Fever, convulsion, catarrh and cough were major presenting symptoms. Incidence of convulsion was least on the 1st day of complaint. Fourteen (82.4%) of the cases were simple febrile seizures while 3 were complex. There was a positive family history in 5 (29.4%) of the cases. Eleven (64.7%) had orthodox medication at home, before presentation, 5 (29.4%) consulted patient medicine sellers and 7 (41.7%) received traditional medication as part of home management. Malaria and acute respiratory infections were the identifiable causes. Standard anti-malaria and anti-biotic therapy were instituted, where indicated. All recovered and were discharged. Conclusion: There was a low prevalence of febrile seizures among the hospitalized children and a poor pre-hospitalization management of cases. It highlighted the need for improved community awareness on the prevention and management of febrile seizures. [ABSTRACT FROM AUTHOR]

Background. Adolescents with epilepsy experience significant academic difficulties. However, little is known about the effects of epilepsy on the academic performance of adolescents with the disorder in Northern Nigeria. Objective. To assess the academic performance of adolescents with epilepsy and factors associated with poor performance in this population in a Northern Nigerian setting. Methods. The socio-demographic/clinical characteristics of 77 consecutive adolescents (aged 12 - 17 years) with epilepsy attending the Child and Adolescent Clinic of Federal Neuropsychiatric Hospital, Kaduna, North-West, between March 2008 and September 2010 and the socio-demographic characteristics of 76 controls (matched for age and sex) were recorded. Information concerning school attendance and academic performance of the subjects and the controls were obtained from the adolescents and their parents or caregivers. Results. The mean ages of the subjects and the controls were 15.1 (standard deviation (SD) 2.1) and 14.7 (SD 1.7) years, respectively (p>0.05), the mean duration of illness was 6.1 (SD 4.6) years, the mean seizure-free period was 16.8 (SD 15.6) weeks, and 64.9% of the subjects and 57.9% of the controls were males. Forty-six subjects (59.7%) and 12 controls (15.8%) had poor academic performance (p<0.001). Long duration of illness, short seizure-free periods and irregular school attendance were significantly associated with poor academic performance (p<0.05). Conclusions. Poor academic performance is common among adolescents with epilepsy and is associated with early onset, poor seizure control and missing school. Efforts should be made to control seizures and educate society about the illness. [ABSTRACT FROM AUTHOR]