中国小学生欺侮行为和受欺侮者的发生率

本文报告了对北京一小学6年级267名12～13岁小学生中欺侮行为和受欺侮者发生率的研究结果。尽管中国社会反对攻击行为和控制攻击的力量很强,但在学龄儿童中欺侮人的行为以及受欺侮者仍容易见到。本文是在著者对中国儿童攻击行为原有研究基础上进行的。     

Partograph utilization and associated factors among obstetric care providers in North Shoa Zone,Central Ethiopia: a cross sectional study

Background

Globally, prolonged and obstructed labor contributed to 8% of maternal deaths which can be reduced by proper utilization of partograph during labor.

Methods

An Institution based cross-sectional study was conducted in June, 2013 on 403 obstetric care providers. A pre-tested and structured questionnaire was used to collect data. Data was entered to EpiInfo version 3.5.1 statistical package and exported to SPSS version 20.0 for further analysis. Logistic regression analyses were used to see the association of different variables.

Results

Out of 403 obstetric care providers, 40.2% utilized partograph during labor.Those who were midwives by profession were about 8 times more likely to have a consistent utilization of the partograph than general practitioners (AOR=8. 13, 95% CI: 2.67, 24.78). Similarly, getting on job training (AOR=2. 86, 95% CI: 1.69, 4.86), being knowledgeable on partograph (AOR=3. 79, 95% CI: 2.05, 7.03) and having favorable attitude towards partograph (AOR=2. 35, 95% CI: 1.14, 4.87) were positively associated with partograph utilization.

Conclusion

Partograph utilization in labor monitoring was found to be low. Being a midwife by profession, on job training, knowledge and attitude of obstetric care providers were factors affecting partograph utilization. Providing on job training for providers would improve partograph utilization.     

The prevalence and associated factors of birth asphyxia among neonates delivered in Public Hospitals,Northern Ethiopia

IntroductionA body of evidences showed that birth asphyxia is a serious public health problem in low income countries including Ethiopia. There are sparse data on the prevalence of birth asphyxia and its associated factors among neonates in low income countries like Ethiopia, as well as the research area.ObjectiveTherefore, this study determined the prevalence and associated factors of birth asphyxia among newborns administered in public hospitals in Northern Ethiopia, 2019.Methods and materialsA cross-sectional study of health institution was carried out in December 2019. Systematic sampling technique was used. Data was collected through interviews and chart review. Multivariate logistical regression analysis was done to control confounders and identify significantly associated variable. AOR with 95% confidence intervals were computed to identify the factors independently assoiated with birth asphyxia.ResultsThe finding showed that the prevalence of birth asphyxia was 20.0%. Induction of labor (AOR=3.59, 95% CI: 1.36–9.46), Prolonged labor (AOR=3.59, 95% CI: 1.36–9.46), meconium-stained amniotic fluid (AOR=3.49), referred mothers (AOR=3.68, 95 % CI: 1.46–9.28), instrumental delivery (AOR=2.87, 95% CI: 1.09–7.55)and primiparous mothers (AOR=2.048 95% CI: 1.10–3.80). were significantly associated with birth asphyxia.ConclusionThe Prevalence of birth asphyxia notable high. Therefore; intra-partum care services should be strengthened to prevent birth asphyxia.     

First line antiretroviral treatment failure and associated factors among people living with HIV in northwest Ethiopia

BackgroundAnti-retroviral treatment enhances the immune status and reduces unwanted outcomes. However, development of treatment failure and drug resistance raises concern over lifelong treatments to chronic diseases such as HIV/AIDS.ObjectivesThis study determined proportion of treatment failure (TF) and identified factors associated with TF among people living with human immunodeficiency virus (HIV) in Bahir Dar, Northwest Ethiopia.MethodsFacility based cross sectional study was carried out from November, 2017 to April, 2018. Sociodemographic and clinical data were collected using structured questioner. Blood sample was collected and analyzed for viral load, complete blood count (CBC), liver and kidney function test and CD4 count. A patient is declared as treatment failure when viral load value is higher than 1000 RNA copies/ml in two consecutive viral load analyses within three months interval. Data were entered and analyzed using SPSS version 23. To identify factors associated with TF, logistic regressions model was employed.ResultsA total of 430 people who had six months and above antiretroviral treatment (ART) follow up were enrolled in the study. Of these, 57.9% were females & the mean age was 38 years. The mean month of ART follow up was 83 months. In the first viral load analysis, 106 (24.7%) of the cohort were virologically failed. These failed people were followed for 3 months with intensive adherence support; then second viral load analysis showed a viralogical failure among 65 people of the second cohort. Thus, the overall viralogical failure or TF was 15.1%. The re-suppression rates were 41(38.7%). Male gender, people with history of drug discontinuation, poor adherence, irregular time of drug intake, multiple sexual practice showed significant association with TF. Moreover, base line and current CD4 counts of <200 cells/ml also demonstrated significant association with TF.ConclusionSignificant proportion of treatment failure was reported in the present study. Moreover, behavioral factors such as drug discontinuation, poor adherence, multiple sexual partner were associated with treatment failure. Hence, to avoid TF, regular patient counseling and monitoring should be in place. To identify the predictors for treatment failure, further follow-up study is desirable.     

A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia

BackgroundAnemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia.MethodThe studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined.ResultsThe forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children.ConclusionIn this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem.     

Sonographic biometry of spleen among school age children in Nsukka,Southeast, Nigeria

Background

Normative value of spleen size among school age children is important for objective assessment of the spleen.

Objectives

This study was aimed at determining sonographically the normal limits of the spleen size according to age, sex, and somatometric parameters among school age children.

Methods

A cross sectional study was done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6 – 17 years. The subjects were recruited from some primary and secondary schools within Nsukka metropolis and also from out patients in the study centre. A pilot study was done to determine the intra- and inter rater reliability of sonographic measurements of the spleen. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen sizes were obtained with the subject in a right lateral decubitus position.

Results

Measurement of spleen length was reliable while measurement of spleen width was less reliable within and between sonographers. Dimensions of the spleen were not statistically different in boys and girls (p > 0.05). Height correlated best with spleen dimensions.

Conclusions

Normogram of the spleen size with respect to height is important in the determination of some pathology associated with changes in its size.     

Factors associated with risky sexual behaviour among secondary and preparatory students in Wolaita Sodo town,Southern Ethiopia; Institution based cross-sectional study

BackgroundYoung people in Ethiopia aged between 18 and 24 who have had sex before age 18 has increased from 35% in 2005 to 40% in 2016 among women and from 9% to 12% among men.ObjectivesThis study aimed to assess the prevalence and factors associated with risky sexual behavior among secondary and preparatory students in Wolaita Sodo town, Wolaita zone, Southern Ethiopia; 2020.MethodsA school-based cross-sectional study was conducted from February 4 to 25, 2020. Multistage sampling was employed to select a random sample of 830 study participants from 2 randomly selected secondary and preparatory schools. Bivariate and multivariate logistic regression analysis was used to examine the relationship between the outcome variables and independent variables.ResultAmong the 306 participants who reported ever having sex, 196 (24.7%) engaged in risky sexual behaviors. Factors significantly associated with risky sexual behavior were; ever used alcohol, ever smoked cigarettes, parent monitoring, and having sexually active close friend/s.ConclusionSubstantial proportion of study participants engaged in risky sexual behavior calling for more interventions on school student''s addictive behaviors. Parents should have frequent, open and informative discussions about substance use and the associated problems with their adolescents.     

Determinants of early marriage among female children in Amhara Region,Ethiopia

BackgroundEarly Marriage is one of the global problems that undermine the personal development and the rights of women seriously. It is delicate among the developing countries such as Ethiopia. It has major consequences for public health, national security, social development, human rights, economic development, and gender equality.MethodsThe analyzed data were obtained from the 2016 EDHS and 1120 samples were considered in this analysis. Both bivariate and multivariable binary logistic regression model were used to identify the determinants of early marriage practice.ResultsThe prevalence of early marriage practice was 48.57% in the study area. The odds of early marriage practice were 2.04(AOR=2.04, 95% CI: 1.88, 2.45) times higher among rural residents compared to urban. The odds of early marriage practice was 0.94(AOR=0.94, 95%CI: 0.57, 1.98) times lower among women who had primary education compared to uneducated women. Those who did not know the legal marital age were 1.61(AOR=1.61, 95%CI: 1.26, 2.07) times more likely to practice early marriage compared to parents who knew the legal marital age.ConclusionEducation level, family monthly income, residence, literacy level and knowledge of legal marital were significant determinants of early marriage practice.     

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone,Southwest Ethiopia: Community based cross-sectional study

BackgroundHepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity.ObjectiveThe aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia.MethodsA community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables.ResultsA total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.ConclusionsThe sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection.     

Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study

Background

Access to antenatal care (ANC) and postnatal care (PNC) services has a great deal of impacts on major causes of infant death and significantly affects trends of mortality in a population. Antenatal care may play an indirect role in reducing maternal mortality by encouraging women to deliver with assistance of a skilled birth attendant or in a health facility. In most rural settings of Ethiopia, there are challenges in increasing such health care service utilization mainly due to the fact that the decisions that lead women to use the services seem to occur within the context of their marriage , household and family setting.

Objective

Examining the prevalence and factors associated with antenatal Care (ANC) and Postnatal Care (PNC) service utilizations.

Methods

This was a cross-sectional population based study undertaken in 10 rural villages of the Sidama zone, southern Ethiopia. The data were collected from a representative sample of 1,094 households drawn from the study population using a combination of simple random and multistage sampling techniques. Two dependent variables were used in the analysis: The ANC, measured by whether a woman got the service (at least once) from a health professional or not during her last pregnancy and PNC which was approximated by whether the last born child completed the required immunization or not. Household and women''s characteristics were used as explanatory variables for both dependent variables.

Results

The study revealed that the level of ANC and PNC service utilizations is 77.4 % and 37.2% respectively. The predicted probabilities, using logistic regression, showed that women who are literate, have exposure to media, and women with low parity are more likely to use both ANC and PNC services.

Conclusion

Antenatal care service utilization was generally good while the postnatal care given to new born children was very low compared to other population groups in the region. Promoting women''s education and behavioral change communication at grass root level, provision of the services at both home and health facilities, and improving the quality and capacity of the health providers are some of the recommendations forwarded.     

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone,Southwest Ethiopia: community based cross-sectional study

BackgroundHepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity.ObjectiveThe aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia.MethodsA community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables.ResultsA total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of HBsAg among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI =3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI =1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.ConclusionsThe sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection.     

Perceived stigma and associated factors among people with epilepsy at Gondar University Hospital,Northwest Ethiopia: a cross-sectional institution based study

Background

Epilepsy is the world''s most common neurological disorder, affecting approximately 69 million people worldwide. Perceived stigma affects many domains of the lives of people with epilepsy. However, in Ethiopia there is dearth of study on perceived stigma specifically among people with epilepsy.

Objective

To assess the prevalence of perceived stigma and associated factors among people with epilepsy (PWE) attending the outpatient department of the University of Gondar hospital, Northwest Ethiopia, 2014.

Methods

Institution based quantitative cross — sectional study was employed among 408 individuals people with epilepsy. Single population proportion formula was used utilized to calculate sample size. The participants were selected using systematic random sampling technique. Perceived stigma was measured using by the modified Family Interview Schedule (FIS) tool. Binary logistic regression analysis and adjusted odds ratio with 95% confidence interval were used to identify the associated factors with perceived stigma..

Results

Overall, the prevalence of perceived stigma was found to be 71.6%. Marital status [single (AOR = 0.23, CI: 0.25, 0.90), widowed ( AOR = 0.37, CI: 0.15, 0.90) duration of illness [2–5 years (AOR = 4.38, CI:1.98,9.62, 6–10 years (AOR =4.29, CI:1.90,9.64, ≥11 years (AOR = 4.31,CI:1.84,10.00) and seizure frequency of [1–11per year (AOR=2.34, CI:2.21,3.56), ≥1per month (AOR = 5.63, CI:3.42,10.32)] were factors associated with perceived stigma.

Conclusion

Overall, the prevalence of perceived stigma was found to be high. Marital status, long duration of illness and seizure frequency were factors associated with perceived stigma.     

Relationships between different nutritional anthropometric statuses and health-related fitness of South African primary school children

Background: A double burden of both under- and over-nutrition exists among South African children.

Aim: To describe associations between nutritional statuses and health-related fitness test performances.

Subjects and methods: Height and weight of 10 285 children (6–13 years; n?=?5604 boys and 4681 girls) were measured and used to calculate body mass index (BMI) and prevalence of overweight and obesity, stunting, wasting and underweight. Physical fitness scores for standing long jump, shuttle run, sit-and-reach, sit-up (EUROFIT) and cricket ball throw were assessed. Age- and gender-specific z-scores were calculated for these variables. Physical fitness for each nutritional status group was compared to children of normal weight.

Results: Compared to normal weight children, overweight and obese children scored lower on all fitness tests (p?p?=?.235) and sit-and-reach (p?=?.015). Stunted and underweight children performed poorer than normal weight children on most fitness tests (p?p?=?.829; underweight: p?=?.538) and shuttle run (underweight: p?=?.017). Performance of wasted children was not as highly compromised as other under-nourished groups, but they performed poorer on the cricket ball throw (p?Conclusions: When compared to normal weight children, both under- and over-nourished children performed poorer on some, but not all, health-related fitness tests.     

Time in bed, quality of sleep and school functioning of children

This study describes the relationship of time in bed and quality of sleep with concentration and functioning at school. Neurotic and psychosomatic symptoms have been used as control variables. The sample consisted of 449 Dutch children in the seventh and eighth grades of elementary school. The age of the children varied between 9 y 5 mo and 14 y 5 mo. Seven schools participated in the research, with a total of 18 classes. The results indicated that 43% of the children had difficulty getting up in the morning. Furthermore, 15% of the children reported sleep problems and 25% did not feel rested at school. Time in bed and sleep quality show no relationship with concentration. Sleep quality, feeling rested at school and less distinct bedtimes were clearly related to school functioning. Another result was that children who had no difficulty getting up displayed more achievement motivation. Being open to the teacher's influence and achievement motivation depended mainly on sleep characteristics. Not getting bored at school, self-image as a pupil and control over aggressive behaviour were also influenced by gender, age, neuroticism and neurosomaticism.     

Perceived stigma and school attendance among children and adolescents with epilepsy in South Western Uganda

BackgroundEpilepsy is a neurological disorder that has a high worldwide prevalence with eighty percent of the global burden being in low and middle-income countries. There is a high level of perceived stigma among children and adolescents with epilepsy, which has severe debilitating effects and affects school attendance.ObjectiveTo assess the effect of perceived stigma on school attendance patterns among children and adolescents with epilepsy.MethodsWe conducted a cross sectional study among 191 children and adolescents aged from 6–18 years with epilepsy at one large semi-urban hospital and a small rural health center in SouthWestern Uganda. Epilepsy-related perceived stigma was measured using the adapted Kilifi Stigma Scale of Epilepsy and school attendance patterns were assessed using a piloted investigator-designed questionnaire.ResultsChildren with high-perceived stigma were more likely to have never attended school (13.8%) or started school late (average age 5.7 years) compared to those with low-perceived stigma (average age 4.9 years). Additionally, those with high epilepsy-related perceived stigma repeated classes 2.5 times more compared to those with low-perceived stigma.ConclusionThese preliminary findings suggest correlation between high-perceived stigma and disrupted school attendance patterns among children and adolescents with epilepsy, hence the need to address this social challenge.     

Adolescent low back pain among secondary school students in Ibadan,Nigeria

Background

Adolescent low back pain (ALBP) can be considered a signal or precursor of a serious organic disease or telltale sign of future incidence of low back pain in adulthood. Published articles on ALBP in Nigeria are not readily available.

Objectives

The study''s objectives were to investigate the prevalence of Adolescent Low Back Pain (ALBP) among secondary school students in Ibadan, Nigeria and the prevalence''s association with some socio-demographic variables.

Methods

Participants were adolescent students from 15 secondary schools in Ibadan. Data was collected using a respondent-administered, validated questionnaire on low back pain in adolescents. Participants (Female: 298; Male: 273) aged 14.23 ±2.27 years (range 10–19) were recruited through multi-stage random sampling. Five hundred and seventy-one (83.97%) of the 680 copies of the questionnaire administered were returned. Data was analysed using mean, standard deviation, frequency, percentages, and Chi-square test with alpha level at 0.05.

Result

Lifetime, twelve-month, one-month and point prevalence rates of ALBP were 58.0%, 43.8%, 25.6% and 14.7% respectively. Age at first experience of ALBP was 11.86 ± 2.36 years. Gender was not significantly associated with any rate (p ≥0.317). Age (p ≤ 0.043) and engagement in commercial activities (p ≤ 0.025) were significantly associated with all period prevalence rates while injury to the back was significantly associated with all period prevalence rates except point prevalence (p = 0.087).

Conclusion

Adolescent low back pain is common among secondary school students in Ibadan and its prevalence is significantly associated with age and engagement in commercial activities, but not with gender.     

Nose and throat complications associated with passive smoking among Congolese school children

Objective

To assess associations between nose-throat (NT) diseases and passive smoking prevalence among school children.

Methods

A cross-sectional survey was carried out on a randomized multistage sample of 381 school children (50.9% males, aged 9.8 ± 3.5 years) from Kinshasa town. Parents and children were asked to fill in a questionnaire detailing their smoking habits. The NT symptoms and diseases were assessed by the survey NT specialist.

Results

The prevalence of passive smoking was 38.6% (n=147). Residence in peripheral areas, catholic school system, elementary level, exposure of family to passive smoking ,history of NT surgery, medicines and menthol inhaling, headache, nasal pain, dysphagia, odynophagia, dysosmia, dysphonia, pharyngeal irritation, dry throat, snooze, and chronic pharyngitis were more reported by passive smokers. After adjusting for confounding factors, passive smoking (OR=16.7 95%CI 3.3–83.3), catholic system(OR=2 95%CI 1.2–3.2), and elementary degree(OR=1.4 95%, CI 1.1–2.1) were identified as independent determinants of chronic pharyngitis.

Conclusion

Parents should not smoke in the same room used by their children.     

Preterm birth and its associated factors in Ethiopia: a systematic review and meta-analysis

BackgroundPreterm birth is a public health concern globally. In low- and middle-income countries, like Ethiopia, preterm birth is under reported and underestimated. Therefore, this systematic review and meta-analysis assessed the pooled prevalence and associated risk factors for preterm birth in Ethiopia.MethodsIn this review the databases used were PubMed, Google scholar, EMBASE, HINARI and African journal online. Publication bias was checked using a funnel plot and Eggers test.ResultsA total of 30 studies were included in this systematic review and meta-analysis. The overall pooled prevalence of preterm birth in Ethiopia was 11.4% (95% CI; 9.04, 13.76). On pooled analysis, preterm birth was associated with pregnancy-induced hypertension being HIV-positive, premature rupture of membrane, rural residence, the mother having a history of abortion, multiple pregnancies, and anemia during pregnancy.ConclusionThe national prevalence of preterm birth in Ethiopia was low. Early identifying those pregnant women who are at risk of the above determinants and proving quality healthcare and counsel them how to prevent preterm births, which decrease the rate of preterm birth and its consequences. So, both governmental and non-governmental health sectors work on the minimization of these risk factors.     

Academic performance of school children with behavioural disorders in Uyo, Nigeria

Introduction

Behavioural disorders can have a negative influence on the academic performance of school children. There are no similiar published is no known studies in Nigeria.

Objective

To compare the academic performance of primary school children with behavioural disorders with that of their controls.

Methods

A total of 132 primary school pupils aged 6–12 years with behavioural disorders using Rutter scale for teachers (Scale B₂) and their matched-controls were selected. Their academic performance was assessed and compared using the overall scores achieved in the first and second term examinations in the 2005/2006 academic sessions, as well as the scores in individual subjects. Number of days absent from school was documented.

Results

While 26.5% and 12.9% pupils with behavioural disorders had high and poor academic performance respectively, 38.6% and 9.1% pupils without such disorders had high and poor performances respectively. The difference in the ooverall academic performance was statistically significant (p=0.04). The mean scores of the pupils with behavioural disorders on four core subjects compared well with those of the controls. Pupils with antisocial behaviour underachieved more than others. School absence rate had no significant influence on their performance.

Conclusion

Behavioural disorders are associated with poor academic performance in school children in Uyo.