Ikechukwu Ogbonna - Academia.edu (original) (raw)

Papers by Ikechukwu Ogbonna

Asian Pacific Journal of Health Sciences

Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford... more Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford the healthcare professionals (HCPs) opportunities to assess their achievements of the recommended treatment targets for glycated hemoglobin (HbA1C), lipid profile, blood pressure (BP), and body mass index (BMI). Meeting these targets significantly affect treatment outcome in diabetes mellitus (DM). Awareness of the treatment targets by PLWDM attending the diabetes clinic of Abia State University Teaching Hospital (ABSUTH), Aba, Southeast Nigeria, is not known. This study, therefore, set out to bridge this gap in knowledge. Methodology: This was a cross-sectional study in which consenting PLWDM attending the diabetes clinic of ABSUTH, Aba, were consecutively recruited. Interviewer-administered questionnaire was filled for each subject to assess their knowledge and awareness of the treatment target goals for HbA1C, BP, lipid profile, and BMI. Data obtained were analyzed using Statistical ...

International Journal of TROPICAL DISEASE & Health

Adolescent high blood pressure (HBP), now a growing significant health problem with lasting conse... more Adolescent high blood pressure (HBP), now a growing significant health problem with lasting consequences on cardiovascular health, was considered rare at a time. Several end-organ complications could occur if this asymptomatic condition is uncontrolled, and tracks into adulthood. The 2004 Fourth Report was developed to address the cumbersome challenges in the detection of adolescent hypertension. Aims: This study sought to determine high blood pressure prevalence amongst adolescents in Mushin Local Government Area (LGA) using the 2004 Fourth report. Study Design: Cross-sectional study. Place and Duration of Study: Fourteen secondary schools, in Mushin Local Government Area (LGA) between August 2020 and December 2020. Methodology: A two-stage sampling method was utilized in selecting 14 secondary schools. Within selected schools; participants were recruited from each class by proportional allocation using the school’s register. Students were stratified as males and females using the...

International Journal of Medicine and Health Development, 2019

Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the hi... more Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

Case Reports in Clinical Medicine, 2018

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to c... more Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Case Reports in Clinical Medicine

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to c... more Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Nigerian Journal of Medicine, 2019

Introduction: A regular reappraisal of the morbidity and mortality pattern in our children emerge... more Introduction: A regular reappraisal of the morbidity and mortality pattern in our children emergency rooms will go a long way in policy makings that will help in achieving the sustainable development goal (SGD)-3. With such evidence-based policies, childhood morbidity and mortality will surely reduce.Objective: This study was aimed at re-appraising the morbidity and mortality pattern in our children emergency room (CHER), after the initial audit 10 years ago.Methods :This was a retrospective descriptive study over a 7-year period. The study population comprised of all children aged 1 month to 16 years that presented to the CHER of the Abia State University Teaching Hospital, Aba, Nigeria, from January 2011 to December 2017. The age, gender, duration of illness before presentation, diagnoses and disease outcome of these patients, were all retrieved from the CHER register and hospital medical records.Results: Six thousand eight hundred and twenty-five (6825) patients were seen over t...

International Journal of Medicine and Health Development, 2019

Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the hi... more Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

Journal of Tropical Pediatrics, 2018

Background: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may resu... more Background: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may result in significant life stressors, on both the infected children and their caregivers. Methods: This included a hospital-based cross-sectional and comparative study. Subjects and controls who met the inclusion criteria were enrolled consecutively. Their socio-demographic variables were obtained and GHQ-28 was used to assess their psychosocial status. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIVnegative children (controls) were enrolled into this study. In total, 42 (27.3%) and 112 (72.7%) of the subjects were males and females, respectively, compared with 37 (24.0%) and 117 (76.0%) of the controls, respectively. The prevalence of psychosocial disorders among the subjects and controls was 39 and 2.6%, respectively (p < 0.001; odds ratio: 23.936). The patterns of psychosocial disorders among the caregivers of HIV-infected children were somatic symptoms (85%), anxiety/insomnia (80%), social dysfunction (63.3%) and severe depression (48.3%). Conclusion: There is a high prevalence of psychosocial disorders among caregivers of HIV-infected children.

PLoS ONE, 2012

Background: One established means of preventing the adverse consequences of malaria during pregna... more Background: One established means of preventing the adverse consequences of malaria during pregnancy is sleeping under an insecticide treated net (ITN) throughout pregnancy. Despite increased access to this intervention over time, consistent ITN use during pregnancy remains relatively uncommon in sub-Saharan Africa. Methodology/Principal Findings: We sought to identify determinants of ITN use during pregnancy. Utilizing a populationbased random sample, we interviewed 500 women living in Jinja, Uganda, who had been pregnant in the past year. ITN ownership at the start of pregnancy was reported by 359 women (72%) and 28 women (20%) acquired an ITN after the first trimester of pregnancy. Among 387 ITN owners, 73% reported either always sleeping under the ITN during all trimesters of pregnancy, or after acquiring their net. Owning more than 1 net was slightly associated with always sleeping under an ITN during pregnancy (RR: 1.13; 95% CI: 1.00, 1.28). Women who always slept under an ITN during pregnancy were more likely to be influenced by an advertisement on the radio/poster than being given an ITN free of charge (RR: 1.48; 95% CI: 1.24, 1.76). No differences were found between other socio-demographic factors, pregnancy history, ANC use or socio-cultural factors. Conclusions/Significance: While self-reported ITN ownership and use was common throughout pregnancy, we were unable to pinpoint why a sizable fraction of Ugandan women did not always adhere to recommendations for use of an ITN during pregnancy. More data are needed on the capacity of individual households to support the installation of ITNs which may provide insight into interventions targeted at improving the convenience and adherence of daily ITN use.

African Journal of Medical and Health Sciences, 2016

Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypica... more Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypical and genetic manifestations. We present this case to show its rarity and to highlight the need of early diagnosis to avert the numerous complications that follow it. A 7-year-old male, who presented with an abnormal body physique that was noticed at age 2 months, poor vision that was noticed 5 years ago, recurrent chest pain that started 3 years ago, and recurrent easy tiredness that started 3 years ago. He developed poor vision 2 years later. Examination revealed an acutely ill-looking child with dyspnea, grade 4 apical positive surgical margins (PSM), grade 2 diastolic murmur (at the aortic area), multiple skeletal abnormalities with lens subluxation and iridodonesis. Diagnosis of MS was made and he was comanaged with ophthalmologists and orthopedic surgeons.

Asian Pacific Journal of Health Sciences

Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford... more Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford the healthcare professionals (HCPs) opportunities to assess their achievements of the recommended treatment targets for glycated hemoglobin (HbA1C), lipid profile, blood pressure (BP), and body mass index (BMI). Meeting these targets significantly affect treatment outcome in diabetes mellitus (DM). Awareness of the treatment targets by PLWDM attending the diabetes clinic of Abia State University Teaching Hospital (ABSUTH), Aba, Southeast Nigeria, is not known. This study, therefore, set out to bridge this gap in knowledge. Methodology: This was a cross-sectional study in which consenting PLWDM attending the diabetes clinic of ABSUTH, Aba, were consecutively recruited. Interviewer-administered questionnaire was filled for each subject to assess their knowledge and awareness of the treatment target goals for HbA1C, BP, lipid profile, and BMI. Data obtained were analyzed using Statistical ...

Abia State University Medical Students' Association Journal, Jul 2, 2019

Pulmonary tuberculosis (PTB) and sickle cell anaemia (SCA) are endemic in Nigeria and are conside... more Pulmonary tuberculosis (PTB) and sickle cell anaemia (SCA) are endemic in Nigeria and are considered serious public health challenges. They contribute significantly to childhood morbidity and mortality. Immunosuppressive illnesses predispose children to PTB and children with SCA have reduced immunity. Thus, there should expectedly be a high prevalence of PTB among children with SCA. However, the reverse is the case. The occurrence of PTB in children with SCA is rare and scarcely reported in literatures. We present this rare case of PTB in a five-year old male child SCA and also highlight the challenges we had in the management.Keywords: Pulmonary tuberculosis, male, child, sickle cell anaemi

International Journal of Medicine and Health Development, 2018

Background: Accidental poisoning among under-five children remains a recognized cause of morbidit... more Background: Accidental poisoning among under-five children remains a recognized cause of morbidity and/or mortality with highest rates in low-income countries. Its prevalence and types vary from place to place with the presenting features ranging from mild to near-fatal symptoms. Aim: To document the frequency and pattern of accidental poisoning among under-five children seen at the Children's Emergency Room of the Federal Medical Center, Umuahia. Methods: This is a retrospective review of the cases of under-fives with accidental poisoning over an eight-year period (January 2009 to December 2016). Information such as age, gender, type of poison, presenting features, type of home remedy and outcome were retrieved. Results: Of the 9,492 under-fives seen during this period, 53 (0.6%) had accidental poisoning. The mean age was 21.2± 10.1 months and male-to-female ratio was 1.8:1. The mean duration from the time of the incident to presentation was two hours. Most common route of pois...

Tropical Journal of Medical Research, 2017

Ectrodactyly is a Greek word that literally means abortion of a finger. It is a rare congenital d... more Ectrodactyly is a Greek word that literally means abortion of a finger. It is a rare congenital disorder which makes the hands appear like the claws of a lobster. The most common mode of inheritance is autosomal dominant with reduced penetrance although autosomal recessive and X-linked forms of transmission can also occur. Herein, we report a rare case of ectrodactyly in a macrosomic Nigerian male as well as highlight challenges in the management of this genetic condition in a resource-constrained setting.

Current Pediatric Research, 2018

Background: Pneumonia is a major cause of morbidity and mortality in children especially in sub S... more Background: Pneumonia is a major cause of morbidity and mortality in children especially in sub Saharan Africa and Asia. Recent studies suggest that pneumonia may be overdiagnosed at the expense of other acute respiratory conditions with similar features such as asthma and other wheezy conditions, and bronchiolitis. This study examined the prevalence and diagnostic concordance of hospital diagnoses made with an established Case Definition Criteria (CDC) for these three common respiratory disorders in the south east region of Nigeria Materials and Methods: Hospital admission records of all children aged between 2 and 59 months who presented with, catarrh, respiratory distress, cough and fever between January and December 2015 in the children emergency room of three hospitals in South East Nigeria were reviewed. Results: A total of 186 case records met the inclusion criteria and were analyzed. Bronchopneumonia accounted for 41.9%, of the cases admitted; while reactive airway disease a...

Lamellar ichthyosis (LI) is a Greek phrase that literally means ‘the skin of a fish’. It is a rar... more Lamellar ichthyosis (LI) is a Greek phrase that literally means ‘the skin of a fish’. It is a rare autosomal recessive disorder of keratinisation resulting in excessive scaling and dryness of the skin. Babies born with this disorder present at birth as collodion babies. They are encased with semi-translucent membranes which are shed subsequently to reveal the adherent, thick, dark scales and dry skin that continues through-out life. Though LI is not life-threatening, it is disfiguring and results in psychosocial distress. We present a 7-year old Nigerian male child with poor school performance possibly due to LI and highlight the challenges in the management in a resource-poor country. Keywords: Lamellar ichthyosis, Collodion baby, Male, Nigeria

Pediatric Diabetes, 2017

Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of va... more Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of various inflammatory disorders since its discovery in 1940s. However, these useful drugs cause important side effects, such as impairment of glucose tolerance. We sought to determine the prevalence of steroid-induced impairment of glucose tolerance in pediatric patients on long-term steroid use. Materials and Methods: A cross-sectional, descriptive and hospital-based study. Consenting subjects who met the inclusion criteria were screened with random glucometer measurements repeated twice. An average of both readings obtained from the initial measurement of their random blood glucose (RBG) and a repeat during the next clinic visit was taken as the RBG. Results: Hundred patients were studied, 66 males/34 females. Subjects with nephrotic syndrome were 61 while 39 had asthma. Mean age of 10.13 years (range: 0.5-18 years); mean body mass index (BMI): 18.2 kg/m 2 (range: 6.6 to 26.30 kg/m 2). The subjects with nephrotic syndrome were on oral prednisolone while the asthmatics were on inhaled fluticasone, budesonide and oral methylprednisolone. Mean (range) duration of steroid use was 9.74 (0.5-72) months. Mean (range) RBG was 3.49 (3.3-7.5) mmol/L. None of the subjects showed abnormal RBG. However, the RBG was further categorized into low, moderate and high normal RBG. A positive correlation between longer duration of steroid use as well as high doses of both oral and inhaled steroids, and high normal RBG existed (P = .015). No statistically significant relationship existed between body mass index (BMI) percentile and RBG (P = .437). Conclusion: Low to moderate doses of oral and inhaled steroids should be used when indicated as they are associated with lesser risk of impairment of glucose tolerance in the pediatric population.

African Journal of Medical and Health Sciences, 2016

Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypica... more Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypical and genetic manifestations. We present this case to show its rarity and to highlight the need of early diagnosis to avert the numerous complications that follow it. A 7-year-old male, who presented with an abnormal body physique that was noticed at age 2 months, poor vision that was noticed 5 years ago, recurrent chest pain that started 3 years ago, and recurrent easy tiredness that started 3 years ago. He developed poor vision 2 years later. Examination revealed an acutely ill-looking child with dyspnea, grade 4 apical positive surgical margins (PSM), grade 2 diastolic murmur (at the aortic area), multiple skeletal abnormalities with lens subluxation and iridodonesis. Diagnosis of MS was made and he was comanaged with ophthalmologists and orthopedic surgeons.

Annals of African Medicine, 2016

Asian Pacific Journal of Health Sciences

Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford... more Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford the healthcare professionals (HCPs) opportunities to assess their achievements of the recommended treatment targets for glycated hemoglobin (HbA1C), lipid profile, blood pressure (BP), and body mass index (BMI). Meeting these targets significantly affect treatment outcome in diabetes mellitus (DM). Awareness of the treatment targets by PLWDM attending the diabetes clinic of Abia State University Teaching Hospital (ABSUTH), Aba, Southeast Nigeria, is not known. This study, therefore, set out to bridge this gap in knowledge. Methodology: This was a cross-sectional study in which consenting PLWDM attending the diabetes clinic of ABSUTH, Aba, were consecutively recruited. Interviewer-administered questionnaire was filled for each subject to assess their knowledge and awareness of the treatment target goals for HbA1C, BP, lipid profile, and BMI. Data obtained were analyzed using Statistical ...

International Journal of TROPICAL DISEASE & Health

Adolescent high blood pressure (HBP), now a growing significant health problem with lasting conse... more Adolescent high blood pressure (HBP), now a growing significant health problem with lasting consequences on cardiovascular health, was considered rare at a time. Several end-organ complications could occur if this asymptomatic condition is uncontrolled, and tracks into adulthood. The 2004 Fourth Report was developed to address the cumbersome challenges in the detection of adolescent hypertension. Aims: This study sought to determine high blood pressure prevalence amongst adolescents in Mushin Local Government Area (LGA) using the 2004 Fourth report. Study Design: Cross-sectional study. Place and Duration of Study: Fourteen secondary schools, in Mushin Local Government Area (LGA) between August 2020 and December 2020. Methodology: A two-stage sampling method was utilized in selecting 14 secondary schools. Within selected schools; participants were recruited from each class by proportional allocation using the school’s register. Students were stratified as males and females using the...

International Journal of Medicine and Health Development, 2019

Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the hi... more Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

Case Reports in Clinical Medicine, 2018

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to c... more Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Case Reports in Clinical Medicine

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to c... more Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Nigerian Journal of Medicine, 2019

Introduction: A regular reappraisal of the morbidity and mortality pattern in our children emerge... more Introduction: A regular reappraisal of the morbidity and mortality pattern in our children emergency rooms will go a long way in policy makings that will help in achieving the sustainable development goal (SGD)-3. With such evidence-based policies, childhood morbidity and mortality will surely reduce.Objective: This study was aimed at re-appraising the morbidity and mortality pattern in our children emergency room (CHER), after the initial audit 10 years ago.Methods :This was a retrospective descriptive study over a 7-year period. The study population comprised of all children aged 1 month to 16 years that presented to the CHER of the Abia State University Teaching Hospital, Aba, Nigeria, from January 2011 to December 2017. The age, gender, duration of illness before presentation, diagnoses and disease outcome of these patients, were all retrieved from the CHER register and hospital medical records.Results: Six thousand eight hundred and twenty-five (6825) patients were seen over t...

International Journal of Medicine and Health Development, 2019

Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the hi... more Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

Journal of Tropical Pediatrics, 2018

Background: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may resu... more Background: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may result in significant life stressors, on both the infected children and their caregivers. Methods: This included a hospital-based cross-sectional and comparative study. Subjects and controls who met the inclusion criteria were enrolled consecutively. Their socio-demographic variables were obtained and GHQ-28 was used to assess their psychosocial status. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIVnegative children (controls) were enrolled into this study. In total, 42 (27.3%) and 112 (72.7%) of the subjects were males and females, respectively, compared with 37 (24.0%) and 117 (76.0%) of the controls, respectively. The prevalence of psychosocial disorders among the subjects and controls was 39 and 2.6%, respectively (p < 0.001; odds ratio: 23.936). The patterns of psychosocial disorders among the caregivers of HIV-infected children were somatic symptoms (85%), anxiety/insomnia (80%), social dysfunction (63.3%) and severe depression (48.3%). Conclusion: There is a high prevalence of psychosocial disorders among caregivers of HIV-infected children.

PLoS ONE, 2012

Background: One established means of preventing the adverse consequences of malaria during pregna... more Background: One established means of preventing the adverse consequences of malaria during pregnancy is sleeping under an insecticide treated net (ITN) throughout pregnancy. Despite increased access to this intervention over time, consistent ITN use during pregnancy remains relatively uncommon in sub-Saharan Africa. Methodology/Principal Findings: We sought to identify determinants of ITN use during pregnancy. Utilizing a populationbased random sample, we interviewed 500 women living in Jinja, Uganda, who had been pregnant in the past year. ITN ownership at the start of pregnancy was reported by 359 women (72%) and 28 women (20%) acquired an ITN after the first trimester of pregnancy. Among 387 ITN owners, 73% reported either always sleeping under the ITN during all trimesters of pregnancy, or after acquiring their net. Owning more than 1 net was slightly associated with always sleeping under an ITN during pregnancy (RR: 1.13; 95% CI: 1.00, 1.28). Women who always slept under an ITN during pregnancy were more likely to be influenced by an advertisement on the radio/poster than being given an ITN free of charge (RR: 1.48; 95% CI: 1.24, 1.76). No differences were found between other socio-demographic factors, pregnancy history, ANC use or socio-cultural factors. Conclusions/Significance: While self-reported ITN ownership and use was common throughout pregnancy, we were unable to pinpoint why a sizable fraction of Ugandan women did not always adhere to recommendations for use of an ITN during pregnancy. More data are needed on the capacity of individual households to support the installation of ITNs which may provide insight into interventions targeted at improving the convenience and adherence of daily ITN use.

African Journal of Medical and Health Sciences, 2016

Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypica... more Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypical and genetic manifestations. We present this case to show its rarity and to highlight the need of early diagnosis to avert the numerous complications that follow it. A 7-year-old male, who presented with an abnormal body physique that was noticed at age 2 months, poor vision that was noticed 5 years ago, recurrent chest pain that started 3 years ago, and recurrent easy tiredness that started 3 years ago. He developed poor vision 2 years later. Examination revealed an acutely ill-looking child with dyspnea, grade 4 apical positive surgical margins (PSM), grade 2 diastolic murmur (at the aortic area), multiple skeletal abnormalities with lens subluxation and iridodonesis. Diagnosis of MS was made and he was comanaged with ophthalmologists and orthopedic surgeons.

Asian Pacific Journal of Health Sciences

Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford... more Background: Diabetes clinic visits by persons living with type 2 diabetes mellitus (PLWDM) afford the healthcare professionals (HCPs) opportunities to assess their achievements of the recommended treatment targets for glycated hemoglobin (HbA1C), lipid profile, blood pressure (BP), and body mass index (BMI). Meeting these targets significantly affect treatment outcome in diabetes mellitus (DM). Awareness of the treatment targets by PLWDM attending the diabetes clinic of Abia State University Teaching Hospital (ABSUTH), Aba, Southeast Nigeria, is not known. This study, therefore, set out to bridge this gap in knowledge. Methodology: This was a cross-sectional study in which consenting PLWDM attending the diabetes clinic of ABSUTH, Aba, were consecutively recruited. Interviewer-administered questionnaire was filled for each subject to assess their knowledge and awareness of the treatment target goals for HbA1C, BP, lipid profile, and BMI. Data obtained were analyzed using Statistical ...

Abia State University Medical Students' Association Journal, Jul 2, 2019

Pulmonary tuberculosis (PTB) and sickle cell anaemia (SCA) are endemic in Nigeria and are conside... more Pulmonary tuberculosis (PTB) and sickle cell anaemia (SCA) are endemic in Nigeria and are considered serious public health challenges. They contribute significantly to childhood morbidity and mortality. Immunosuppressive illnesses predispose children to PTB and children with SCA have reduced immunity. Thus, there should expectedly be a high prevalence of PTB among children with SCA. However, the reverse is the case. The occurrence of PTB in children with SCA is rare and scarcely reported in literatures. We present this rare case of PTB in a five-year old male child SCA and also highlight the challenges we had in the management.Keywords: Pulmonary tuberculosis, male, child, sickle cell anaemi

International Journal of Medicine and Health Development, 2018

Background: Accidental poisoning among under-five children remains a recognized cause of morbidit... more Background: Accidental poisoning among under-five children remains a recognized cause of morbidity and/or mortality with highest rates in low-income countries. Its prevalence and types vary from place to place with the presenting features ranging from mild to near-fatal symptoms. Aim: To document the frequency and pattern of accidental poisoning among under-five children seen at the Children's Emergency Room of the Federal Medical Center, Umuahia. Methods: This is a retrospective review of the cases of under-fives with accidental poisoning over an eight-year period (January 2009 to December 2016). Information such as age, gender, type of poison, presenting features, type of home remedy and outcome were retrieved. Results: Of the 9,492 under-fives seen during this period, 53 (0.6%) had accidental poisoning. The mean age was 21.2± 10.1 months and male-to-female ratio was 1.8:1. The mean duration from the time of the incident to presentation was two hours. Most common route of pois...

Tropical Journal of Medical Research, 2017

Ectrodactyly is a Greek word that literally means abortion of a finger. It is a rare congenital d... more Ectrodactyly is a Greek word that literally means abortion of a finger. It is a rare congenital disorder which makes the hands appear like the claws of a lobster. The most common mode of inheritance is autosomal dominant with reduced penetrance although autosomal recessive and X-linked forms of transmission can also occur. Herein, we report a rare case of ectrodactyly in a macrosomic Nigerian male as well as highlight challenges in the management of this genetic condition in a resource-constrained setting.

Current Pediatric Research, 2018

Background: Pneumonia is a major cause of morbidity and mortality in children especially in sub S... more Background: Pneumonia is a major cause of morbidity and mortality in children especially in sub Saharan Africa and Asia. Recent studies suggest that pneumonia may be overdiagnosed at the expense of other acute respiratory conditions with similar features such as asthma and other wheezy conditions, and bronchiolitis. This study examined the prevalence and diagnostic concordance of hospital diagnoses made with an established Case Definition Criteria (CDC) for these three common respiratory disorders in the south east region of Nigeria Materials and Methods: Hospital admission records of all children aged between 2 and 59 months who presented with, catarrh, respiratory distress, cough and fever between January and December 2015 in the children emergency room of three hospitals in South East Nigeria were reviewed. Results: A total of 186 case records met the inclusion criteria and were analyzed. Bronchopneumonia accounted for 41.9%, of the cases admitted; while reactive airway disease a...

Lamellar ichthyosis (LI) is a Greek phrase that literally means ‘the skin of a fish’. It is a rar... more Lamellar ichthyosis (LI) is a Greek phrase that literally means ‘the skin of a fish’. It is a rare autosomal recessive disorder of keratinisation resulting in excessive scaling and dryness of the skin. Babies born with this disorder present at birth as collodion babies. They are encased with semi-translucent membranes which are shed subsequently to reveal the adherent, thick, dark scales and dry skin that continues through-out life. Though LI is not life-threatening, it is disfiguring and results in psychosocial distress. We present a 7-year old Nigerian male child with poor school performance possibly due to LI and highlight the challenges in the management in a resource-poor country. Keywords: Lamellar ichthyosis, Collodion baby, Male, Nigeria

Pediatric Diabetes, 2017

Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of va... more Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of various inflammatory disorders since its discovery in 1940s. However, these useful drugs cause important side effects, such as impairment of glucose tolerance. We sought to determine the prevalence of steroid-induced impairment of glucose tolerance in pediatric patients on long-term steroid use. Materials and Methods: A cross-sectional, descriptive and hospital-based study. Consenting subjects who met the inclusion criteria were screened with random glucometer measurements repeated twice. An average of both readings obtained from the initial measurement of their random blood glucose (RBG) and a repeat during the next clinic visit was taken as the RBG. Results: Hundred patients were studied, 66 males/34 females. Subjects with nephrotic syndrome were 61 while 39 had asthma. Mean age of 10.13 years (range: 0.5-18 years); mean body mass index (BMI): 18.2 kg/m 2 (range: 6.6 to 26.30 kg/m 2). The subjects with nephrotic syndrome were on oral prednisolone while the asthmatics were on inhaled fluticasone, budesonide and oral methylprednisolone. Mean (range) duration of steroid use was 9.74 (0.5-72) months. Mean (range) RBG was 3.49 (3.3-7.5) mmol/L. None of the subjects showed abnormal RBG. However, the RBG was further categorized into low, moderate and high normal RBG. A positive correlation between longer duration of steroid use as well as high doses of both oral and inhaled steroids, and high normal RBG existed (P = .015). No statistically significant relationship existed between body mass index (BMI) percentile and RBG (P = .437). Conclusion: Low to moderate doses of oral and inhaled steroids should be used when indicated as they are associated with lesser risk of impairment of glucose tolerance in the pediatric population.

African Journal of Medical and Health Sciences, 2016

Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypica... more Marfan syndrome (MS) is a disorder of the connective tissues characterized by various phenotypical and genetic manifestations. We present this case to show its rarity and to highlight the need of early diagnosis to avert the numerous complications that follow it. A 7-year-old male, who presented with an abnormal body physique that was noticed at age 2 months, poor vision that was noticed 5 years ago, recurrent chest pain that started 3 years ago, and recurrent easy tiredness that started 3 years ago. He developed poor vision 2 years later. Examination revealed an acutely ill-looking child with dyspnea, grade 4 apical positive surgical margins (PSM), grade 2 diastolic murmur (at the aortic area), multiple skeletal abnormalities with lens subluxation and iridodonesis. Diagnosis of MS was made and he was comanaged with ophthalmologists and orthopedic surgeons.

Annals of African Medicine, 2016