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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]

Fragile X syndrome (FXS) is a significant cause of intellectual disability and autism, while Fragile X Premutation -Associated Conditions (FXPAC) are a significant cause of morbidity and mortality globally. This study assessed the level of knowledge and perceptions about FXS and FXPAC among doctors in Nigeria. It was a web-based, cross-sectional study conducted among a cohort of doctors in Nigeria. Socio-demographic profile, knowledge of FXS, perceptions about FXS, knowledge of FXPAC, experience of doctors, and suggested ways of improving knowledge and management of FXS were obtained. Data were analyzed using STATA 16.0. Chi-square and Fisher's exact tests of association were used to determine the association between variables, with the significance level set at p < 0.05. A total of 274 doctors participated in the study. A significant proportion of respondents had limited knowledge about the clinical features of FXS. Nine of ten (90.0%) participants with good knowledge of FXS had good perceptions of FXS management. This was statistically significant (p < 0.001). There was a high nonresponse rate to what FXPAC is (164/274, 59.9%) among the respondents because of insufficient knowledge. Suboptimal knowledge of FXS which influenced perception was noted among doctors. More strategies should be considered to improve doctors' knowledge and management of FXS and FXPAC in Nigeria., (© 2024 The Author(s). Clinical Genetics published by John Wiley & Sons Ltd.)

Background: Globally, there were 241 million cases of malaria in 2020, with an estimated 627,000 deaths with Nigeria accounting for 27% of the global malaria cases. In sub-Saharan Africa, testing is low with only 28% of children with a fever receiving medical advice or a rapid diagnostic test in 2021. In Nigeria, there are documented reports of over-diagnosis and over-treatment of malaria in children. Therefore, this study examined the diagnosis of malaria at the Benue State University Teaching Hospital, Makurdi., Methods: A 5-year (2018-2022) retrospective study was carried out at the Emergency Pediatric Unit (EPU). Records of all children presenting to the EPU with an assessment of malaria were retrieved and reviewed. Data was analyzed using SPSS 23., Results: Out of 206 children reviewed, 128 (62.1%) were tested using either malaria RDT or microscopy while 78(37.9%) were not tested. Out of the number tested, 59(46.1%) were negative while 69(53.9%) tested positive, of which 14(20.3%) had uncomplicated malaria while 55(79.7%) had severe malaria. However, while 97.1% (n=67) of the positive cases were treated with IV artesunate, 69.5% (n=41) of those who tested negative and 88.5% (69) of those who were not tested also received IV artesunate. Moreover, while 85.5% (n=59) of those who tested positive received oral artemisinin-based combination therapy (ACT), 72.9% (n=43) of those who tested negative and 67.9% (53) of those who were not tested also received oral ACT., Conclusion: There was over-diagnosis of malaria, and subsequently, over-treatment. Hence continued emphasis on parasitological confirmation of malaria before treatment is recommended., (© 2024 Michael A., et al.)

Background: The Coronavirus disease 2019 (COVID-19) has caused millions of mortalities globally. Although the prevalence and fatality rates of COVID-19 among adolescents is low, its impact on their health-related quality of life (HRQoL) is not adequately known. This study was carried out to determine the burden COVID-19 pandemic has on the HRQoL of adolescents., Methods: A cross-sectional descriptive study was carried out among adolescents in public and private secondary schools in Jos North Local Government Area of Plateau State. A multistage sampling technique was employed to select the schools and recruit the participants in April/May 2021. Data was collected using a self-administered questionnaire containing the participants' socio-demographic characteristics, questions on being burdened by COVID-19 pandemic, and the KIDSCREEN-10 tool for assessing the HRQoL. The data was analyzed using SPSS version 25.0 and a p-value of < 0.05 was regarded as significant., Results: A total of 405 adolescents participated in the study with a mean age of 14.6 ± 2.06 years. Majority (52.8%) of the participants were girls. More than half (53.3%) of the participants reported being burdened by the COVID-19 pandemic. Also, 45.7% of the participants experienced a lower HRQoL. There was a statistically significant association between being burdened by the COVID-19 pandemic and their HRQoL (χ2 = 7.108, p = 0.01). In addition, the participants' HRQoL was significantly associated with their age (χ2= 5.112, p = 0.02)., Conclusion: This study highlights the significant burden of COVID-19 pandemic on adolescents' wellbeing. Therefore, there is the need to intensify health intervention strategies among adolescents to reduce the physical, emotional, and mental burden imposed by the COVID-19 pandemic in order to optimize their quality of life., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2022 by West African Journal of Medicine.)

Background: The ongoing Covid-19 pandemic is now a global health emergency with significant morbidity and mortality among different populations of the world. Healthcare professionals are the people in the front line of situations like this. Their perspectives on the pandemic is critical to their safety and the outcomes in patients they manage. The aim of this study is to assess the knowledge, attitude and practice regarding COVID-19 among clinical healthcare professionals in Bingham University Teaching Hospital (BHUTH) Jos., Materials and Methods: A total of 138 clinical health workers from BHUTH completed a questionnaire- based study on the knowledge, attitude and practice on COVID-19 from the April 1st to 30th May 2020. Consecutive sampling method was used for data collection and the distribution of responses was presented as frequencies and percentages. Analysis of Variance (ANOVA) test was used to investigate the level of association among variables at the significance level of p<0.05., Results: The highest mean of correct responses for knowledge were from doctors, pharmacists and nurses with 19.1±2.35, 19.4±1.52 and 18.9±1.73 respectively. The lowest mean was from pharmacist assistant and nurse aids with 17.1±1.81. The difference was statistically significant with Anaysis of Variance (F) of 5.75 and p value of 0.001. The attitude and practice mean were good between the different clinical cadre; however, the difference was not significant., Conclusion: There is good knowledge, attitude and practice among the doctors and pharmacists, nurses, nurse assistants and pharmacist assistants. The doctors and pharmacist had better scores. There is the need for regular training and update., Competing Interests: The author certifies that there is no conflict of interest in connection with the submitted article. All Conflict of Interest Forms are on file with the journal publication and are available on request., (Copyright © 2021 by West African Journal of Medicine.)

Osteogenesis Imperfecta is a genetic disorder of the connective tissue leading to generalised osteoporosis, fragility of the skeletal system and susceptibility to fractures of the long bones and compression of the vertebrae from mild or inconsequential trauma. It is one of the rare diseases known to mankind. It has no definitive cure and treatment is essentially supportive. We present below a preterm male neonate who was seen 5-hours after birth with abnormal posturing, abnormal shape of the head and limbs. There was a positive family history of delivery of a baby with similar history and outcome. A skeletal survey revealed multiple fractures involving the clavicle, humerus, femur, tibia and fibula. He was managed as a case of Osteogenesis Imperfecta. This was the first case out of 1,445 newborns admitted into the Unit. He was discharged after 2-weeks of hospitalisation but died at 6-weeks of age following progressively worsening episodes of respiratory distress.

Background: Adolescence is a vulnerable period of transition and a time for establishing healthy or risky behaviours. Adolescents constitute the strategic link between a nation's past and the future. Adolescent obesity is an epidemic of global proportions which has affected both industrialized and developing countries. Identifying factors that influence adolescent obesity in our environment would help to strengthen preventive measures, reduce the disease burden, and ultimately improve adult health., Methods: A cross-sectional study conducted in secondary schools in Kaduna metropolis, North-West Nigeria. The participants were selected using systematic sampling method. Data were collected using a structured interviewer-administered questionnaire. The data were analyzed using SPSS version 20., Results: One hundred and fifty adolescents were recruited into the study. This consisted of 85(56.7%) girls and 65(43.3%) boys. The mean age of the participants was 14.1 ± 2.3 years. The prevalence of overweight and obesity was 21.3% and 14.0% respectively. Factors identified to be associated with the development of obesity included lack of sporting activities (c2 = 8.18, p= 0.04) and the number of hours of sleep daily (c2 = 17.91, p= 0.01). All except one of the obese adolescents consumed snacks/soft drinks, though the relationship between adolescent obesity and consumption of snacks/soft drinks was not statistically significant (c2 = 5.58, p= 0.13)., Conclusion: Addressing the risk factors associated with adolescent obesity is a key to reversing this global epidemic. Health education on appropriate sleep pattern and engaging in sporting activities should be emphasized in secondary schools.

Background: Epilepsy is associated with impaired physical, psychological and social functioning. Assessing its impact on these parameters is important to improving the wellbeing of those with the disorder., Objective: To assess the impact of epilepsy on the physical, psychological and social status of adolescents in a rural community., Methods: Adolescents with epilepsy (Subjects) were identified in a community house to house survey. Controls (adolescents without epilepsy) matched for age and sex were randomly selected from the community. Information obtained from the subjects, controls and their care givers using a structured questionnaire included: Age, Sex, Social Class, Knowledge of epilepsy, Characteristics of epilepsy, Treatment options utilized, Health-Related Quality of Life (HRQOL), Body Mass Index (BMI), Academic performance and Epilepsy related problems., Results: Eighteen subjects, 10.5/1000 of the adolescent (10-19 years) population, had epilepsy. The mean age was 16.7± 2.6 years and 16.3± 2.6 years for the subjects and controls respectively. Most of the subjects were males (83.3%). All the subjects had generalized epilepsy, were on traditional medication and none was on orthodox medical therapy. Occurrence of seizures, cost of accessing orthodox medical treatment and stigma were the major problems identified. Ingestion of traditional medication was the commonest modality for overcoming the major problems identified. Seven (38.8%) were underweight but it was not significant (p>0.05). Epilepsy was significantly associated with impaired HRQOL, academic performance and social relationships (p>0.05)., Conclusion: Epilepsy had a negative impact on the psychosocial and academic status of adolescents. It highlights the need to provide comprehensive adolescent health and social services in epilepsy management.

Background: A postelection violent conflict in Kaduna resulted in 800 deaths and 65,000 displaced people leading to setting up of camp for internally displaced persons (IDPs). We set out to determine the prevalence and pattern of psycho-traumatic stressful life events, psychological distress, and post-traumatic stress disorder (PTSD) among child/adolescents IDPs., Methods: A descriptive cross-sectional study of 73 child/adolescent IDPs were selected by total sampling. Stressful life event checklist measured conflict-related trauma and reaction of adolescents to traumatic stress (RATS) measured post-trauma reaction of children/adolescents. Hopkins Symptoms Checklist 37 for Adolescents measured psychological distress associated with trauma. Diagnostic Interview Schedule for Children was used for diagnosis of PTSD., Results: Of 73 respondents, 3 (4.1%) had probable PTSD, 2 (2.7%) had definitive PTSD, and mean score of the child/adolescent IDPs on HSCL-37A and RATS was 44.7 (SD = 6.3) and 31.9 (SD = 5.7), respectively. Most frequently occurring psychological distress among female participants was suddenly scared for no reason 7 (19.5%) and becoming angry easily and feeling fearful 5 (13.9%). The average score for female participants were higher than that for males on depressive and anxiety subscale of HSCL-37A., Conclusion: We concluded that children/adolescent IDPs were exposed to psycho-trauma following postelection violent conflict and developed psychological distress. However, the low prevalence of psychological distress and PTSD suggested that living with parents and psychosocial intervention provided could have led to much lower morbidity.

The incidence of natal tooth is uncommon and its management could be fraught with challenges. A 3 day old female presented with features of sepsis and a natal tooth. Treatment for sepsis was permitted and successfully instituted but definitive management of the natal tooth was deferred, for cultural reasons, by the parents. The case documents the occurrence of natal tooth and highlights the impact of cultural beliefs on management of some medical conditions. It underscores the need to develop the relationship between orthodox medical care and cultural beliefs, in susceptible communities, with a view to achieving optimal health care delivery.

Background: Assessment of motor function in children with Cerebral Palsy (CP) is vital to the identification and management of their mobility needs., Objective: To compare the Expanded and Revised Gross Motor Function Classification System (GMFCS-E&R) and Manual Ability Classification System (MACS) in the assessment of motor function in children with CP., Methods: A review of motor activity in children with CP documented at the Departments of Paediatrics and Physiotherapy, Ahmadu Bello University Teaching Hospital, Shika, Zaria, between January 2005 and December 2009., Results: A total of 28 children (16M: 12 F, 1.3:1) with an age range of 4 to 12 years (mean 6.2 ± 2.4 years) were studied. Birth asphyxia (46.43%) and Spastic Hemiplegia (71.43%) were the main identified predisposing factor and clinical type of CP respectively. The GMFCS-E&R identified 13 (46.43%) children with higher levels (I & II) of gross motor function against 4 (14.29%) children identified in the MACS higher levels (p=0.02). Also 6 (21.43%) of the children were identified as being in the GMFCS-E&R lower levels (IV & V) against 16 (57.14%) in MACS lower levels (p=0.00). The difference in the number of children identified as being in level III for GMFCS-E&R 9 (32.14%) and MACS 8 (28.57%) was not significant (p=0.77). Overall correlation between GMFCS-E&R and MACS levels was poor using Kappa statistics (Kappa=0.00)., Conclusion: The GMFCS-E&R and MACS significantly identified higher and lower levels of motor functions respectively in the same children. The disparity underscores the complexity in assessing the motor function of children with CP.

Background: In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource-constrained countries, this study investigated whether AKI associated with DEG could be identified by other means., Methods: This was a multicenter study. Information was obtained from hospital records. Clinicopathological features of all children with AKI over a 6-month period were reviewed., Results: Sixty (50.4%) of 119 children ingested "My pikin" teething syrup. Compared to children who had not ingested it, they were significantly (p < 0.05) younger (11.95 vs. 31 months), more were anuric (98.3 vs. 74.6%), hypertensive (84 vs. 52%), had severe metabolic acidosis (46.7 vs. 20.5%), and died (96.6 vs. 71.2%). They developed increasing metabolic acidosis and multiorgan dysfunction despite peritoneal dialysis. Late presentation, financial difficulties, inadequate facilities for toxicology, and hemodialysis complicated management., Conclusions: Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices, field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.

Background: Neuro-imaging is generally considered as part of the evaluation of seizures and epilepsy. There is limited information about its usefulness in our environment. We describe the pattern of CT findings in children with seizures in our environment., Method: We carried out a retrospective review of the computerized tomography findings in children with recurrent seizures over a one year period, November 2005 to October 2006., Results: During the study period, 49 infants and children had computerized tomography performed on them out of which 19 had CT done for recurrent seizures. They ranged in age from 4 months to 16 years with 13 of them being boys. Generalized tonic--clonic seizures was the most predominant seizure type, being present in 10 of the 19 (52.6%) children while simple partial seizure, myoclonic jerk and mixed seizure types were present in 2 cases each. Abnormal scan was demonstrated in 10 of the 19 children (52.6%) with 3 of them having double cerebral lesions, giving a total of 13 cerebral lesion demonstrated by the CT scan. Cerebral infarct was the most common lesion demonstrated, being present in 5 of the 13 lesions (38.5%). Others were cerebral atrophy in 4 cases (30.8%), moderate ventricular dilatation 2 (15.4%) and 1 each ofporencephalic cyst, hydrocephalus and linear skull fracture. Of the 10 children with abnormal scan, 90% of them had significant past medical history, with birth asphyxia (44.4%) and meningitis (33.3%) being the commonest significant past medical history in them. CCONCLUSION There is a high incidence of abnormal scan findings in children with seizure disorder in our environment compared to what is obtained from the developed countries. Cerebral infarct appears to be the most common abnormal CT findings in our children with seizures.