Epilepsy in children in Benin City,Nigeria

The pattern of epilepsy in children in Nigeria showed little difference from that seen in children in western countries, except that birth asphyxia was relatively common as a cause and there was a longer time between onset of seizures and parents seeking medical care. It was estimated that good control of seizures was achieved in 52.9% of children, but more than a quarter attended the clinic only once or twice and the reasons for this are not known. The response to medication was less satisfactory for children under 1 year, a result consistent with most other studies. Some uncommon forms and associations of epilepsy were recognised. An EEG was not essential for management but was useful for the diagnosis of syndromes. Treatment was equally effective when commenced 5 years or more after the onset of seizures. The anti-convulsant used for most children was phenobarbitone which had to be discontinued in only two cases because of side-effects. Phenobarbitone has been successfully used to treat epilepsy by primary health workers in rural Africa and this is expected to continue in the future.     

Trend in childhood tuberculosis in Benin City, Nigeria

In order to determine the trend in childhood tuberculosis, case records of children diagnosed and treated for tuberculosis between January 1981 and December 1995 at the paediatric tuberculosis clinic of the University of Benin Teaching Hospital were reviewed. Of 8,829 paediatric medical cases, 1,026 (11.6%) were managed as tuberculosis. The proportion of tuberculosis cases increased steadily over the study period from 6.9% in 1981 to 22.1% in 1995. An apparent decrease in the number of cases in 1985 (6.6%) was attributable to a strike by medical personnel. The clinical pattern of tuberculosis during the study period shifted toward the adult type with disseminated and cavitating lesions predominating in later years. Additionally, the severity of the disease increased with the incidence of both haemoptysis and finger clubbing increasing from 1.6% in 1981 to 14.2% and 18.2%, respectively, in 1995. Possible reasons for these findings include increased prevalence of malnutrition in childhood, increasing tuberculosis in the adult population and the effects of HIV/AIDS.     

Repair-oriented categorization of circumcision urethral injury in Benin city,Nigeria

BackgroundThe wide spectrum of circumcision urethral injury/fistula makes selection of appropriate repair methods challenging in sub-Saharan Africa. This paper reports on the outcome of repair-oriented categorization in a Nigerian center.MethodsConsecutive children presenting with circumcision urethral injury/fistula at the University of Benin Teaching Hospital were categorized into six repair-oriented groups in 2009–2011.Results21 children were treated. Except in 2 cases, early neonatal circumcision at an average age of 8 days (range 4–14 days) had been performed, the majority (52%) by paramedics at home. Categories of injury/fistula based on severity ranged from isolated fistula (38%) which required fistula excision and repair (category A) to severe ventral urethral/coronal/glanular avulsion (29%) which required urethral plate tubularization/ventral penile reconstruction (category F). Overall, successful first-stage repair was achieved in 19 (91%) children. Meatal stenosis (2), urethral stricture (1), which responded to serial dilatation, and minor urinary leakage (2), which was closed at second stage, were the post-repair complications. Adequate penile size and straight penis on erection were achieved in all cases. Cosmetic outcome was excellent in 16 (76%) cases, good in 4 (19%) and fair in 1 (5%).ConclusionRepair-oriented categorization, which could be useful to practitioners in similar settings, was satisfactory in managing urethral injury/urethrocutaneous fistula.     

Educational rehabilitation of mentally and physically handicapped children in Benin City, Nigeria

Handicapping diseases have remained major problems associated with immense suffering and superstition in the African setting. There are no accurate vital statistics of the incidence of mental and physical retardation in children in Nigeria, but it is presumed to be higher than in the U.S.A. or Europe. This study shows that provision for education and rehabilitation for handicapped children, such as school accommodation, transportation, teaching aids, specialist teachers etc., attract low priority in the minds of the education planners. In developing countries, the efforts of voluntary organizations to supplement government efforts should be encouraged by the Government and by the public. Intensive health education is needed for the public and also for the teachers who come in contact with handicapped children.     

Hemangiomas in Children: Challenges and Outcome of Surgical Management in Benin City,Nigeria

Objective

Treatment of hemangioma/vascular tumors emphasize minimal invasion which require sophisticated facilities. This study reports the role of surgery in the management of symptomatic, and hemangioma which failed to respond to other modalities of treatment in resource-limited subregion.

Methods

A six-year (2004-2009) prospective study on the challenges and outcome of children referred for surgical management of hemangioma/vascular tumors was undertaken at the University of Benin Teaching Hospital, Nigeria.

Findings

Sixty-three children aged between a day and six years (median 5 years) comprising 38 males and 25 females (ratio 1.5:1) were managed. Upper limbs involvement, 18 (28.6%), and face/neck, 12 (19.1%), were most common and were present at birth in 27 (42.9%) babies, appeared between 2-3 weeks in 32 (50.8%), and after six months in 4 (6.3%). Cavernous hemangioma in 19 (30.2%) children, mixed cavernous/strawberry in 31 (49.2%) and strawberry in 13 (20.6), were the major types that ranged from spot-like to extensive huge lesions measuring 12×15 cm in diameter. Failure of 46 (65.1%) cases to respond to non operative treatment, ulceration in 3 (4.8%), infection in 5 (7.9%) and hemorrhage in 2 (3.2%) were indications for surgical intervention. Surgical options included complete excision and primary wound closure in 34 (54%) children, immediate skin graft after complete excision in 10 (15.9%), injection sclerotherapy in 2 (3.2%), serial ligation of feeder vessels in 2 (3.2%), and conservative treatment in 5 (7.9%). Excision and primary wound closure gave better outcome compared with others (P<0.0001). No mortality was recorded on 1-6 years follow-up but ugly scar, 8 (12.7%) and limb deformity, 3 (4.8%) were problems.

Conclusion

Surgical excision and primary wound closure gave good outcome which could be employed in complicated and hemangioma which failed to respond to other treatment in regions with limited resources.     

Intra-uterine Growth, Birthweights and Maturity of the African Newborn

ABSTRACT. The prevalence of low birthweight in many African countries is higher than in developed countries. This is largely because of the greater number of babies who are light for gestational age. In general, mean birthweights of African babies at various gestational ages are lower than those of developed countries. This is due mainly to environmental factors, but an increased prevalence of twinning is one genetic factor. When babies of mothers in optimum health were studied, birthweights for gestational age were similar to Caucasian babies.     

Birthweights in Iceland 70 Years Apart

ABSTRACT. Birthweights of 389 babies born in 1901-1910 and 6303 born in 1972-1981 were compared. There had been a mean increase in birthweight of 85 g and the prevalence of low birthweight had fallen from 5.6% to 3.3%. It is unlikely that this apparent secular increse in birthweight is an artefact due to different methods of weighing. Probably an increase in maternal height accounts for much of the increase in birthweight rather than any other improvement in the quality of the intrauterine environment.     

Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria

ObjectiveTo determine the prevalence and spontaneous resolution of congenital hydrocele diagnosed in male neonates who underwent circumcision at our centre.Patients and methodsAll male neonates presented for circumcision at the University of Benin Teaching Hospital, Benin City, Nigeria between January 2002 and December 2006 were examined for the presence of hydrocele. Those diagnosed with this condition were recruited and followed up in a surgical outpatient clinic for 2 years. The number of cases of spontaneous resolution and age at which this occurred were documented on a structured pro forma.ResultsA total of 2715 neonates were circumcised and 128 (4.7%) were diagnosed with 163 cases of hydrocele, while 27 cases in 25 (0.9%) children failed to resolve at the age of 2 years. Neonatal hydrocele was bilateral in 112 (68.7%), and there were 20 (12.3%) right and 31 (19.0%) left. Among those with hydrocele, 28.1% were delivered preterm and resolution was spontaneous in many of them, with no observed significant statistical difference to those delivered full term (P = 0.4740). Of the 163 hydrocele cases, 136 (83.4%) resolved spontaneously by age 18 months with peak resolution at 4–6 months. No spontaneous resolution occurred after 18 months and no hydrocele-related complication occurred during follow up.ConclusionNeonates with congenital hydrocele should be observed for spontaneous resolution for at least 18 months before being subjected to surgery.     

Intestinal helminthiasis in children with chronic neurological disorders in Benin City, Nigeria: intensity and behavioral risk factors

Background

Behavioral aberrations such as nail biting, finger sucking, and pica have been postulated as risk factors that enhance helminths ova transmission. These aberrations may present commonly in children with chronic neurological disorders and predispose them to heavy intensity of intestinal helminthiasis. This comparative cross-sectional study was to determine the prevalence, intensity, and behavioral risk factors for intestinal helminthiasis in children with chronic neurological disorders and apparently healthy controls.

Methods

Fresh stool samples from 155 children (2–17 years) with chronic neurological disorders seen at the child neurology clinic and 155 age and sex matched controls from nursery and primary schools in Benin City were analyzed using the Kato-Katz technique for detection of ova of helminths from November 2008 to April 2009.

Results

The prevalence of intestinal helminthiasis (31.0%) was significantly higher in children with chronic neurological disorders compared with the controls (19.4%) (P=0.03). The intensity of infections in both groups was light ranging 24–144 eggs per gram. Ascaris lumbricoides, Trichuris trichiura and hookworm were the intestinal helminths isolated in both groups. Behavioral aberrations were significantly more represented in the subjects than in the controls (P<0.0001, OR=2.8). Nail biting and encopresis were the most significant independent predictors of intestinal helminthiasis (P=0.025 and 0.001, respectively) in the subjects only. Hand washing with water and soap after defecation and frequent de-worming exercise were practices significantly associated with decreased prevalence of intestinal helminthiasis in the subjects and controls.

Conclusions

Behavioral modification in children with chronic neurological disorders should be an integral part of the control program for intestinal helminthiasis.     

The expanded programme on immunization (EPI) in Ondo State, Nigeria

The Expanded Programme of Immunization in Ondo State, Nigeria, which began in 1978 has been reviewed. Non-availability of constant electrical supply needed to keep vaccine at their original potency, shortage of trained health manpower, administrative shortcomings and lack of proper health education have been identified as some of the factors hindering effective implementation of the programme.     

Growth status and menarcheal age among adolescent school girls in Wannune,Benue State,Nigeria

Background  

Menarcheal age is a sensitive indicator of environmental conditions during childhood. The aim of study is to determine the age at menarche and growth status in adolescents in a rural area of Tarka, Wannune, Nigeria.