Parents' Attitude to Abdominal Scarification as Therapy for Splenic Enlargement in Children: A Community-Based Study in Southern Nigeria (original) (raw)
Related papers
ABSTRACT To achieve sustainable reduction in malaria burden in Africa, cultural practices that foster increased malaria burden must be addressed. In Edo state Nigeria, scarification/tattooing on the left hypochondrium presumably over an enlarged spleen arising mainly from malaria is widely practiced. This practice is deleterious, diversionary and causes complications. To evaluate the beliefs and practice, regarding abdominal wall scarification in children and within the context of malaria control. This was carried out among experienced women in child care selected from Egor Local Government Area of Edo State, Nigeria. Information relating to beliefs, knowledge and their practices including possible socio-cultural/economic determinants were obtained with use of questionnaires in a cross-sectional and descriptive study. Of the 400 questionnaires administered 394 were responded to. The modal age bracket was 26-30 years. (Range, 18 - 56 years) Respondents were mainly Binis, Esan, and Ibos amongst others. About 27.0% of respondents considered the spleen a "bag of worms". Other views included "collection of bad blood", 27.2% and as a sickness of its own, 14.7%. Named causes of splenomegaly were fever, 59.6% and evil spirit, 15.5%. Over 45.0% of respondents would consult the herbalists for splenomegaly. Less educated (chi(2) = 40.0, p< 0.005), women over 40 years of age (chi(2) = 13.5, p < 0.05) and Esan/Bini ethnic groups (chi(2) = 15.6, p < 0.05) are more prone to the practice. Reasons for widespread use included perceived effectiveness, low cost and accessibility. Information on scarification was obtained mainly from family members, 49.5%; neighbours, 25.1%; and friends/colleagues, 16.7%. Practice of scarification is deep rooted and widespread in the study location. It has potentials to negate efforts involved in malaria control. Education including public enlightenment campaign should effectively check the practice.
International Journal of Tropical Diseases and Health, 2020
Background: The practice of inflicting cuts (incisions) on the anterior abdominal wall to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis (especially in children who are the major targets); massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients. This Original Research Article Salami et al.; IJTDH, 41(14): 9-19, 2020; Article no.IJTDH.61120 10 practice is a long-term practice of the Esan people of the central part of Edo State Nigeria. This study aims to identify the factors that continue to make this practice attractive to members of the community, the common complications encountered, and how to develop an advocacy tool for health education and promote the health-seeking behavior of the populace. Methods: This was a prospective community based cross-sectional descriptive study that was conducted in all the 5 Esan speaking local government areas of Edo State where this practice is very common. The study was done between January 2017 and June 2018. Participants were interviewed using a structured questionnaire by previously trained researchers, after pretesting and validation. The questionnaire was administered on 700 adults, however, 500 were returned. The data obtained were summarized as frequencies and percentages. Results: The majority of the participants were middle-aged. Ninty-five percent (95%) of respondents were aware of the practice of abdominal scarification and 80% of them think it is effective. It was mainly carried out by herbalists in 95% of the respondents. Half of the respondents were unaware of any complications associated with the procedure. Conclusion: Abdominal scarification is a common practice among the Esan people of south-south Nigeria. They believe it's effective, affordable, and risk-free. This is despite the availability of effective alternatives in orthodox medicine. There is, therefore, a need for advocacy and health education considering the dangers and complications associated with the practice.
East and Central African Journal of Surgery, 2017
Background: Surgical abdomen traverses all age groups. We sought to define the aetiology, patients' characteristics, and outcome of management amongst children Methods: Two years prospective review of patients aged 5-15 years managed for surgical abdomen at the Wesley Guilds Hospital Ilesa and Mishmael Medical Centre Akure, Nigeria. Results: Fifty two patients were treated. The male: female ratio was 1:1. The age range was 5years to 15years (mean=11.25 ±2.24years). Mean duration of illness was 29.5hours (range 2-72hours). Gut perforation was the most common aetiology (n=39; 75%); with perforations due to infections most prevalent (n= 34; 87.2%). Ten cases (19.2%) were trauma related and showed male predominance. Obstructed gut accounted for 15.4% (n=8) of cases; and showed female predominance. Five out of the eight small bowel obstructions (62.5%) were due to post operation adhesions. Pre-operative and post-operative diagnoses were congruent in 90.4% (n=47) of cases. Major post-operative complications were surgical site infection (20; 38.5%), and pneumonia (5; 9.6%). The average hospital stay was 9days (range 4-21days). Mortality rate was 1.9% (n=1). Conclusion: Acute abdomen requiring surgical intervention is mainly infective origin. The male child is more at risk of abdominal trauma while gut obstruction was more common in females.
International Journal of Paediatrics and Geriatrics, 2019
Introduction: Splenomegaly is defined as enlargement of spleen. Splenomegaly is a sign which is prominent among infants and children. Aim of this study is to assess the various etiological factors and clinical outcome of splenomegaly among the pediatric cases admitted in RVM Institute of Medical Sciences and Research Centre, Siddipet, Telangana state. Methodology: Hospital based observational study conducted between July 2019 to December 2019. 50 children from 6 months to 18years, with varying grades of Splenomegaly of different etiologies, admitted to pediatric ward of RVM Institute of Medical Sciences, Siddipet. Detailed History was collected by administering semi-structured questionnaire on each case, physical examination and necessary investigations were done wherever required. Results: Male preponderance was seen in present study. Maximum incidence of Splenomegaly was seen between 6 months to 6 years age group (56%).Majority of the cases had moderate Splenomegaly (46.15%). Fever was the most common presenting feature associated with Splenomegaly. Infections (44%) were the most common Cause of Splenomegaly in all study followed by hematologic diseases (36%). Conclusion: Occurrence of Splenomegaly is commonly due to various infections in present study. Males are predominantly having splenomegaly; majority of cases had moderate Splenomegaly.
Nigerian Journal of Clinical Practice, 2014
Background/Objective: Ultrasonogrphy is a good modality for the detection of splenomegaly even when it is not clinically palpable. The objective of this study was to establish the normal values of splenic length in healthy school children in SouthEast , Nigeria and to correlate them with body indices. Materials and Methods: This is a cross-sectional prospective study of 1315 children (633 boys and 682 girls) between the ages of 5 and 17 years. The splenic length was measured between the most superiomedial and the most inferiolateral margins, at the level of the hilum. Only the spleens that had normal shape and echotexture were measured. The mean splenic length and the 5 th and 95 th percentiles were determined for each age. The length was correlated with the sex, age, weight (WT), height, body mass index (BMI) and body surface area (BSA) of the subjects. A regression model for prediction of spleen dimension from age and body habitus was computed. Results: There was a significant correlation between splenic length and age, P < 0.001. Males had statistically significant longer spleen length than females. The splenic length correlated best with BSA, followed by body WT and least with BMI. Conclusions: This study noted racial variation between the established Nigerian values and results from other countries of the world. For the first time, a baseline value for splenic size for the Nigerian Children of various ages has been established with a regression model for predicting the splenic sizes.
Paediatric elective surgical conditions as seen at a referral hospital in Kumasi, Ghana
ANZ Journal of Surgery, 2002
Background : Data on paediatric surgical conditions in sub-Saharan countries, including Ghana, are scanty and sketchy. Using hospital-based data, it is possible to assess the epidemiology of diseases among children, and the morbidity and mortality rates. Methods : Between January 1997 and December 2000, records of 1200 children treated consecutively with elective surgery at Komfo Anokye Teaching Hospital in Kumasi, Ghana, were analysed for name, age, sex, postoperative diagnosis, procedure carried out and outcome of treatment Results : The ages of the children ranged from 0 to 14 years, with a mean age of 3.5 years (95% confidence interval: 3.3-3.7) with a boy/girl ratio of 3.1:1. Congenital anomalies were the most common problem (83%), followed by tumours (4%), cysts (3%), uncircumcised penis (2%), and lymphadenopathy of varying aetiologies (2%). The most common congenital anomaly was inguinal hernia, and the rarest, biliary atresia. Eighty-two percent of the children in this series were treated as day-care cases. Overall mortality in the series was 0.8%. Conclusions : The data reviewed here demonstrate that there is a wide range of surgical conditions among children in the developing world. This poses a significant health-care problem and calls for improved management of such paediatric surgical problems to prevent high morbidity and mortality rates in African children.
European Journal of Clinical and Biomedical Sciences
Background: Paediatric abdominal surgical emergencies (PASE) constitute a significant workload of the paediatric surgeon. The objective of this study was to characterize the pattern of PASE in a tertiary hospital in Enugu and determine any change in pattern and outcome. Methodology: This was a retrospective study of children aged 1 day to 16 years who presented with abdominal surgical emergencies to Enugu State University Teaching Hospital (ESUTH), Enugu. Result: There were 152 patients recruited for the study. There were 122 males and 30 females. The mean age at presentation was 6 years while the mean duration of symptoms before presentation to the hospital was 3.5 days. Thirty eight (25%) patients presented within 48 hours of the onset of their symptoms while 114 patients (75%) presented after 48 hours. The emergencies were intussusception 56 (36.8%), typhoid intestinal perforation 30 (19.7%), obstructed hernia 20 (13.2%), appendicitis 17 (11.2%), abdominal trauma 10 (6.6%), neonatal intestinal obstruction 6 (4%), ruptured appendix 6 (3.9%), Hirschsprung's disease 4 (2.6%), adhesive bowel obstruction 2 (1.3%), and Gastroschisis 1 (0.7%). The mean hospital stay was 6.7 days. Thirty four patients (22.4%) who had surgery developed post-operative complication. The most common complication was surgical site infection and this occurred most in patients who had typhoid intestinal perforation (P = 0.017). There were 12 (7.9%) deaths. Conclusion: In this series, intussusception was the most common paediatric abdominal surgical emergency seen in Enugu unlike in the past when it used to be typhoid intestinal perforation. Mortality was less in the current study. This illustrates a change in pattern and outcome.