Echocardiographic Comparison of Left Ventricular Systolic Function and Aortic Blood Flow Velocimetry in Children with Ventricular Septal Defect

BACKGROUND

The assessments of left ventricular (LV) longitudinal systolic dynamics in children with ventricular septal defect (VSD) have achieved a major milestone in the evaluation of LV systolic function.

OBJECTIVES

This study aims to evaluate the LV function, LV mass (LVM), and the descending aorta blood flow in children with VSD compared to that obtained in age and sex-matched controls.

RESULTS

The mean LVM of the control, 113.5 ± 123.9 was higher than that of those who had VSD, 75.8 ± 83.9, and the difference in mean was found to be statistically significant (Mann-Whitney U = 2.322, P = 0.022). The mean EF of the control, 67.9 ± 10.3 was comparable to that of those with VSD, 65.6 ± 13.9, (Student's t = 1.223, P = 0.223). Similarly, the mean descending aorta blood flow of control, 1.6 ± 2.2 was comparable to that of those with VSD, 3.9 ± 16.1, (Mann-Whitney U = 1.002, P = 0.321). There was a very weak positive correlation between LVM and descending aorta blood flow among the subjects (n = 85, r = 0.117, P = 0.425). There was a very weak negative correlation between LVM and descending aorta blood flow among control. (n = 85, r = -0.065, P = 0.609).

CONCLUSION

The LVM among children with VSD is lower than controls but there is no difference between LV function in subjects and controls. There is a linear increase of LVM with descending aorta blood flow.

Normalization of Cardiac Structural dimension and Function to Body Surface Area in South East Nigeria Children

BACKGROUND

Standardizing cardiac valve structures and function to body surface area will help the clinician and surgeons in decision-making.

AIM

To evaluate the z-scores of the sizes of cardiac structures and function and to present them in Gaussian curves and reference values.

MATERIALS AND METHODS

This was a cross-sectional study that involved 300 apparently healthy children. This study was performed among healthy children from birth to 18 years. Children with a normal echocardiogram, those with no chronic illness, no congenital heart defect, and no acquired heart defect were included in the study.

RESULT

The majority fell within the normal limits, as shown in the Gaussian curves. For instance, 40 (13.3%) of atrioventricular (AV) valve diameters were +1 Z-score above the normal, and only 5 (1.7%) were +2 Z-score above the normal. About 9.3% (28/300) had below -2 Z-score below normal, while only 5% had -1 Z-score below normal. Similarly, the left ventricular function z-scores were also derived at -3 Z-scores to +3 Z-scores. The standard reference values were compared with the results obtained from our Z score values. There was no significant difference noted in the Z-scores. P values ranged from 0.07 to 0.84 for all the cardiac structures except for gender, where Z-scores of the mitral valve and left pulmonary artery varied significantly (P = 0.02).

CONCLUSION

Reference values of cardiac structure and function were presented using Z scores, and we noted no significant difference when compared with the Western standard values except for the mitral valve and left pulmonary artery.

Problem gambling among secondary school adolescents in Enugu, Nigeria

Background

Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction.

Objectives

To determine the pattern of problem gambling and factors that predict gambling among adolescents that attended secondary schools in southeast Nigeria.

Methodology

This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary school adolescents from eight secondary schools in Enugu State, Nigeria.

Results

The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was a weak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a very weak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5; (95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling when compared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8).

Conclusion

The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internet addiction. The male respondents were more likely to have problem gambling than their female folk.

Willingness of college students aged 10 to 24 years to get vaccinated against COVID-19 disease: a cross-sectional study in South-East Nigeria

Background

Willingness to be vaccinated against COVID-19 is a topical issue that may change the course and distribution of the pandemic in the country.

Objectives

This study was aimed to determine the willingness to receive the COVID-19 vaccine among college adolescents and associated factors.

Methodology

This was a cross-sectional study carried out among one thousand college adolescents in six secondary schools in Enugu from April to August 2021. A pretested, self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software version 25. Descriptive statistics were used to describe college adolescents' characteristics. Categorical variables were reported as frequencies and percentages. Predictors of willingness to vaccinate were assessed using binary logistic regression.

Results

A minor proportion of the respondents, 13.2% (153) were willing to receive the COVID-19 vaccine. The respondents who were males were 1.6 times more willing to receive the COVID-19 vaccination when compared with those who were females. (AOR=1.6, 95%CI: 1.1- 2.3). The respondents who were aware they could be infected with COVID-19 were twice more likely to receive COVID-19 vaccination when compared with those who felt they could not be infected. (AOR=2.0, 95%CI: 1.1-3.1). The respondents who had good knowledge of COVID-19 vaccination were 2.2 times more likely to receive COVID-19 vaccination when compared with those who had poor knowledge. (AOR=2.2, 955CI: 1.5-3.3).

Conclusion

A small fraction of college adolescents were willing to receive the COVID-19 vaccine. Male gender, knowledge of vaccine and possibility of transmitting infection are predictors of willingness to receive the vaccination.

Maternal level of awareness and predictors of willingness to vaccinate children against COVID 19; A multi-center study

BACKGROUND

Several controversies surround mothers' willingness to vaccinate against the COVID-19 pandemic especially when mortality is not frequently reported in children.Objectives: This study aimed to ascertain the willingness of mothers of children attending two institutions in Southeast Nigeria to accept the COVID-19 vaccine and factors that may be associated with their choices.

METHODOLOGY

This was a cross-sectional study carried out among 577 mothers who presented with their children in two tertiary health institutions in southeast Nigeria.

RESULTS

Majority of the respondents (93.9%) were aware of the COVID-19 vaccine. Majority of the respondents, 89.4%, noted that children were not in high priority groups for COVID-19 vaccination in Nigeria. Only 6.9% of the respondents intend to receive the COVID-19 vaccination. Also, a minor proportion of the respondents (4.9%) were willing to vaccinate their children with the COVID-19 vaccine. The odds of receiving the Covid-19 vaccine were four times greater in those who believed that they could be infected than in those who believed that they could not be infected (AOR = 4.0. 95% CI:1.8-8.7). The odds of receiving the Covid-19 vaccine were six times greater in those who were aware of someone that died from COVID-19 than in those who did not know anyone who died from COVID-19 (AOR = 5.7, 95% CI: 2.1-15.8).

CONCLUSION

A high level of awareness but low acceptance level for COVID-19 vaccination for mothers and their children was noted. Socioeconomic class, maternal age, and level of education did not influence the willingness of the mother to receive COVID vaccination. Having a belief of possibility of infection with the COVID-19 as well as being aware of someone who died from the disease were important positive variables that could predict vaccine acceptance from this study.

Serum folate levels in children on long-term anti-seizure medication in a Nigerian tertiary center-Implications for practice and public health

BACKGROUND

Epilepsy is the most common childhood neurological disorder in Nigeria. Treatment of epilepsy is long-term and sometimes lifelong with anti-seizure medications. There are conflicting reports on the effect of anti-seizure medications on serum folate. There is therefore a need to determine the effect of a commonly used anti-seizure medication's on serum folate levels of children. This would provide an evidence-based consideration for folic acid supplementation in children on anti-seizure medication as has been suggested by some studies.

STUDY OBJECTIVES

To determine whether serum folate levels were lower in children taking long-term carbamazepine or sodium valproate, compared to a control group.

METHODS

Serum folic acid levels were measured from well-nourished children between the ages of 1-17 years on carbamazepine and sodium valproate monotherapy and their age/sex-matched controls, using spectrophotometry.

RESULTS

The mean serum folate levels of patients on carbamazepine (43) and sodium valproate (22) were 0.032 mg/l ± 0.009 and 0.028 mg/l  ±  0.008, respectively. The mean folate levels of the controls were 0.046 mg/l  ±  0.03 (p = 0 001). No statistically significant difference was observed between the serum folate levels of children on the two anti-seizure medications, that is, carbamazepine and valproate.

CONCLUSION

The children on treatment with carbamazepine and sodium valproate for more than 6 months had statistically significantly lower serum levels of folic acid compared to the standard reference range and controls. The serum folate levels of children on carbamazepine were not statistically different from those on sodium valproate.

Reliability of generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome: a systematic review

INTRODUCTION

Most of the studies reporting the negative impact of idiopathic nephrotic syndrome on health-related quality of life in children and adolescents were conducted with generic quality-of-life instruments rather than disease-specific instruments. The consistency of these studies' findings using these generic instruments is not well established.

AIM

This systematic review aims to determine the reliability of current generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome.

METHODS

We searched the PubMed, MEDLINE, EMBASE, and Google Scholar databases for articles published between 2000 and 2020, using appropriate descriptors. We included primary studies that met the eligibility criteria, independently screened their titles and abstracts, and removed all duplicates during the study-selection process. We resolved disagreements until a consensus was reached on study selection. We independently retrieved relevant data, including the generic quality-of-life instruments and the subjects' and controls' aggregate health-related quality of life scores, using a preconceived data-extraction form.

RESULTS

Ten original articles were selected for qualitative and quantitative analyses. Some of the studies reported the following significant findings. The mean health-related quality of life scores for children with prevalent and incident nephrotic syndrome were 68.6 (range, 52.6-84.6) and 73.7 (range, 55.9-91.5), respectively. Children with idiopathic nephrotic syndrome and their controls with other chronic diseases had median scores of 65 (interquartile range, 59-68.75) and 62.2 (interquartile range, 58.05-65.78). Patients on oral immunosuppressive drug and intravenous rituximab reportedly had median scores of 76.2 and 72.6 and mean scores of 71.4 (range, 55.4-87.4) and 61.6 (range, 42.1-81.1) respectively for quality-of-life assessment on the 'school functioning domain.'

CONCLUSIONS

The health-related quality of life scores in patients with idiopathic nephrotic syndrome are consistently low. Lower scores occur in prolonged disease duration and severe clinical phenotypes, whereas the scores are higher than the scores obtained in other chronic diseases. These consistent findings underscore the reliability of the current generic instruments in assessing health-related quality of life in patients with idiopathic nephrotic syndrome.

Health-related quality of life in children and adolescents with epilepsy in Enugu: Need for targeted intervention

Background

Epilepsy, a chronic brain disorder, predisposes children to low Health-Related Quality of Life (HRQOL).

Objective

This study aimed at assessing the HRQOL in Nigerian children with epilepsy and compare it with that in healthy children.

Methods

A cross-sectional study of 166 children with epilepsy (CWE), aged 5-18 years on anti-epileptic drugs (AEDs) for at least 6 months and 166 age and sex-matched apparently healthy children was conducted. A generic version of the Pediatric Quality of Life (Peds QoL version 4) scale was used to assess HRQOL.

Results

There were significant differences in Quality-of-Life mean scores in the domains of social functioning, psychosocial combination, and psychosocial plus physical activities between cases and controls. The school function scores of <50, indicating low QOL, were significantly more (Chi square = 35.37) (P = 0.0001) among the cases (32.5%) compared to the controls (6.3%). Similarly, low quality of life in the psychosocial combination were observed significantly (P_ = 0.042) more among the cases (12.7%) compared to the controls (6.3%). Low quality of life in emotional feeling domain were noted significantly (Chi square = 12.9) (P = 0.0002) more in subjects aged between 8 and 12 (20%). QOL scores of below 50 in the social function domain were observed significantly (Chi square = 6.49) (P = 0.039) more in subjects aged between 5 and 7 years (44.8%). There was significant gender difference in Quality-of-life index in school functioning domain in subjects. (Chi Square = 6.49) (P value = 0.039). Children in the upper social class scored higher in the social functioning domain, and social class was significantly associated with scores in the social domain of functioning. (F = 3.75 and P = 0.03). QOL scores below 50 in the emotional domain were significantly more among subjects aged 8-12 years/13-18 year, s and QOL scores of <50 in the school function domain were significantly more in subjects aged 5-7 years. (P = 0.0002) (P = 0.039), respectively.

Conclusion

HRQOL is reduced in CWE in all domains of Peds QoL. Significant predictors of reduced HRQOL include age, gender, and socioeconomic class. Beyond seizure control, epilepsy management should be oriented towards ensuring the optimal health-related quality of life.

COVID-19: Knowledge of Mode of Spread and Preventive Practices among College Adolescents in Nigeria

BACKGROUND

Corona virus pandemic (COVID 19) has emerged as the single most important topical issue and poses a challenge to medicine. Adolescent school children are exposed to a varying degree.

OBJECTIVES

The study is aimed to determine the knowledge of the mode of spread and preventive practices among college adolescents attending six secondary schools in Enugu metropolis.

METHODOLOGY

This was a cross-sectional study carried out in 6 secondary schools among 500 college adolescents. A pretested, interviewer-administered questionnaire was used for data collection.

RESULTS

Majority of the respondents, 98.4% were aware of COVID-19. Although, a higher proportion of the respondents, 52.0% were aware COVID-19 could be transmitted through contact with infected persons, only a minor proportion of them, 42.4% had a good knowledge of the mode of spread of COVID-19. However, a high proportion of the respondents, 69.2% practiced good preventive measures against COVID-19. Also, respondents whose parents were self-employed were 1.4 times more likely to have good knowledge of the mode of spread of COVID-19 when compared with those whose parents were on paid employment [adjusted odd ratio (AOR) = 1.4, 95% confidence interval (CI): 0.9-2.0]. The respondents whose fathers have attained tertiary education were 1.6 times more likely to have good preventive practices against COVID-19 when compared with those who had secondary school and below (AOR = 1.6, 95% CI: 1.04-2.5).

CONCLUSION

Though college adolescents were aware of COVID-19, not a significant proportion practiced good preventive measures against COVID-19. Knowledge of mode of spread and preventive practices were significantly enhanced by fathers' educational status and being a female adolescent child.

Pattern of Female Genital Mutilation among Adolescents Attending Secondary Schools' in Enugu Metropolis

BACKGROUND

Female genital mutilation (FGM) is a public health menace and it study among adolescents is not exhaustive.

OBJECTIVES

The aim is to study the prevalence, pattern, cultural values, health implications and consequences of FGM among adolescent females attending secondary schools in Enugu metropolis.

METHODS

A descriptive study involving female adolescents aged 13-21 years recruited by multistage sampling in three Girls Secondary Schools in Enugu Metropolis.

RESULTS

Four hundred and fifty (450) questionnaires were distributed and four hundred and fourteen (414) were retrieved. The parents with moderate value for culture and tradition had the highest circumcised respondents (7.8%) (p = 0.056). Majority of the respondents, 93.7% were aware of female circumcision. The major complications of female circumcision according to the respondents were painful urination and menstrual problems. The prevalence of female circumcision among the respondents was 9.4%. A minor proportion of the respondents, 5.8% were of the opinion that all females should be circumcised. Respondents whose fathers attained tertiary education were three times less likely to be circumcised when compared with those whose fathers attained secondary education and less (adjusted odds ratio  = 0.3; 95% CI: 0.3-1.5).

CONCLUSION

Prevalence of FGM among adolescents aged 13-21 years in Enugu metropolis was 9.4%. Majority of the respondents had good knowledge of FGM, and major complications noted were painful urination and menstrual problems. Fathers education level is a very strong reason for this high awareness of FGM among female adolescents.

Maternal perception of masking in children as a preventive strategy for COVID-19 in Nigeria: A multicentre study

BACKGROUND

The use of face masks by children for the prevention of COVID 19 is still controversial, especially with regards to who should wear the face mask and at what age.

OBJECTIVES

The study aimed to ascertain the perception of mothers on masking in children as a preventive strategy for COVID-19.

METHODOLOGY

This was a cross-sectional study carried out in two health institutions among 387 mothers who presented with their children for the first time in the hospital during the COVID 19 pandemic. A pretested, semi-structured, interviewer-administered questionnaire which was designed by the researchers was used for data collection.

RESULTS

Minority (44.7%) of the mothers perceived masking in children as an appropriate measure for the prevention of COVID-19. The frequent reasons given by majority (55.3%) of the mothers for the inappropriateness of face mask in children included perceived difficulty in breathing (38.5%) and the child's readiness to pull it off (29.3%). A significantly higher proportion of the children whose mothers were 35 years and above, 64.2% would wear face masks when compared with 31.7% of those whose mothers were < 30 years of age (χ2 = 28.632, p<0.001). Similarly, a significantly higher proportion (51.0%) of the children who were more than one year of age would wear a face mask when compared with 20.5% of those aged eight days to one year (χ2 = 19.441, p<0.001). The children whose mothers were <30 years were about four times less likely to wear a face mask when compared with those whose mothers were aged 35 years and above. (AOR = 0.273; 95%CI: 0.155-0.478). The children whose fathers have attained tertiary education were about twice less likely to wear face masks when compared with those whose fathers have attained secondary education and less. (AOR = 0.554; 95%CI: 0.334-0.919). Mothers' perception of COVID-19 had no significant influence on children's use of face mask (χ2 = 2.337, p = 0.127).

CONCLUSION

Maternal perception of masking in children as an appropriate strategy for preventing COVID-19 is adjudged low in this study. Right perception is significantly enhanced by maternal educational status, employment and marital status.

Right ventricular function among South East Nigeria children with sickle cell anaemia

BACKGROUND

Sickle cell anaemia (SCA) is characterized by attendant ischemia-reperfusion injury especially to the heart.

METHODS

The aim of this work is to compare the right ventricular function of children with SCA in steady state (subjects) with those with haemoglobin AA genotype (controls), using echocardiography. It is a cross-sectional study, which echocardiographic measurements to assess right ventricular function among children with SCA and their controls.

RESULTS

The mean trans annular plane systolic excursion (TAPSE) in subjects, 28.24 ± 5.23 (Z score: 0.258 ± 1.10) was higher than that in control, 25.82 ± 3.59 (Z score: - 0.263 ± 0.80), and the difference in mean was statistically significant, (t = 2.703, p = 0.008). Significantly higher proportion of subjects with sickle cell anaemia had right ventricular dysfunction (Abnormal TAPSE), 25 (50.0%) when compared with those in control, 11 (22.0%), {χ2 = 8.5, p = 0.0035}. A higher proportion of subjects with sickle cell anaemia (25.5%) had Pulmonary hypertension (RVP) when compared with control (2.0%) and the difference in proportions was found to be statistically significant, (χ2 = 11.668, p = 0.001). The prevalence of right ventricular diastolic dysfunction in subjects was 9.8% while control was 0%.

CONCLUSION

Children with sickle cell anaemia present with right ventricular dysfunction. Prevalence of right ventricular systolic and diastolic dysfunction were higher in subjects. More of the subjects in this study (25.5%) had pulmonary hypertension.

Comparison of plasma electrolytes of perinatally asphyxiated and normal term babies

OBJECTIVES

The objective of this study is to document and compare plasma electrolytes of asphyxiated newborns of different degree within 48 hours of life.

STUDY DISIGN

A comparative cross-sectional study was conducted in the newborn special care unit at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria. Sodium, potassium, bicarbonate and ionized calcium levels were estimated in the plasma samples of neonates with perinatal asphyxia of different degree and healthy newborns (control group) within 48 hours of birth.

MAIN OUTCOME MEASURES

The plasma sodium, potassium, bicarbonate and ionized calcium levels were estimated in both, the study subjects and controls.

RESULTS

Mean plasma sodium level was significantly lower (134.93±5.24 mmol/l vs 141.90±3.36 mmol/l; P < 0.05), mean plasma bicarbonate level was significantly lower (16.98±3.99 mmol/l vs 18.54±2.36 mmol/l; P < 0.05), and mean plasma ionized calcium level was significantly lower (1.10±0.14 mmol/l vs 1.25 0.11 mmol/l; P < 0.05) in subjects compared to controls while mean plasma potassium was significantly higher (5.07±0.93 mmol/l vs 4.65±0.51 mmol/l P < 0.05) in subjects compare to controls.

CONCLUSION

The tendency to have hyponatremia, hyperkalemia, acidosis and hypocalcemia is very high among the study subjects which underscores the need for great vigilance in electrolyte monitoring when managing an asphyxiated baby.

Influence of gender on prevalence of overweight and obesity in Nigerian schoolchildren and adolescents

Overweight and obesity are serious health concerns for children. However, only a few studies have investigated the influence of gender on prevalence of overweight and obesity in children and adolescents in Nigeria. The objective of this study was to investigate gender influence on prevalence of overweight and obesity among Nigerian school children and adolescents. Information on age and gender of the participants was collected from the school register. Data on height, weight and BMI was collected using standard techniques. A total of 9,014 children and adolescents (male = 4392; female = 4622), aged 2-18 years, from 28 randomly selected schools were analyzed. Overweight and obesity were determined using the International Obesity Task Force cut-off points by age and gender. Males had higher BMI than females at age group 2-6 years, whereas females had higher BMI than males at age groups 11-14 years and 15-18 years. Females had significantly higher prevalence of overweight (P < 0.05) than males at age group 11-14 and 15-18 years. However, there was no gender difference in the prevalence of obesity from childhood through adolescence. In conclusion, BMI is larger in males in early childhood but larger in females in during adolescence. More female adolescents are at risk of obesity than males.

Prevalence and pattern of child abuse and associated factors in four secondary institutions in Enugu, Southeast Nigeria

In our society, child abuse is most often not recognized. In addition, little attention is focused on child abuse due to the menace of severe acute malnutrition and infections, which are the major pediatric problems in our setting. There is need therefore for public awareness of the existence of the various forms of child abuse in the society. The objective of this study is to determine the prevalence, pattern, socioeconomic implication, and factors associated with child abuse among secondary school students attending four secondary schools in Enugu. This is a prospective study where cases of child abuse were investigated using a convenience sampling of students attending four secondary schools in Enugu. A total of 372 subjects participated in the study comprising 192 (51.6 %) females and 180 (48.4 %) males (χ (2) = 7.74, p = 0.38). Their median age was 15.0 (12-18) years. One hundred and sixty-six of 370 (44.8 %) made up of 85 (51.2 %) females and 81 (48.8 %) males reported that they had been hit repeatedly with an implement, showing no significant difference in the gender of respondents physically abused. Thirty-eight (10.2 %) respondents admitted that they have been forced or persuaded to have sexual experience against their wish as teenagers. A total of 58/346 (16.8 %) respondents admitted that they have been abused emotionally in one way or the other by either birth parents or other relatives who brought them up.

CONCLUSIONS

Child abuse is a notable problem among secondary school students and adolescents, though this is highly underreported as seen in this study.

Sonographic determination of spleen to left kidney ratio among Igbo school age children of south east Nigeria

BACKGROUND

Clinical determination of mild splenomegaly is notoriously inaccurate.

OBJECTIVES

To determine sonographically the spleen to left kidney ratio according to age and somatometric parameters among school age children in a tropical environment.

METHODS

A cross sectional study and convenience sampling were done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6-17 years at the University of Nigeria Medical Centre, Nsukka. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen and left kidney lengths were obtained using appropriate techniques. The weight and height of the subjects were obtained with the participants wearing light weight street clothes without shoes.

RESULTS

Measurement of spleen and left kidney lengths were reliable within and between sonographers. The spleen and left kidney lengths were not statistically different in boys and girls (p > 0.05). The spleen to left kidney ratio according to age and somatometric parameters is constant at about 1.13 with 1.3 as the upper limit of normal in the studied population.

CONCLUSION

Sonography can be used to detect mild splenomegaly if the spleen to left kidney ratio is greater than 1.3 in the absence of renal disease among school age children.

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.

Behavioral problems of siblings of epileptic children in Enugu

BACKGROUND AND OBJECTIVE

The existence of a psychosocial dysfunction in the siblings of children with chronic illness has been documented. There are very few reports on siblings of children with epilepsy. The aim of this study is to investigate to what extent the children's epilepsy has affected their healthy siblings in our own center.

MATERIALS AND METHODS

Epileptic patients who consecutively referred to the Pediatric Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu, from October 1999 to September 2000 were recruited. Demographic data were obtained, with a questionnaire administered to the parents. Information on the behavior of the school-age siblings and control was obtained by the class teachers using Rutter's behavior scale (B2) for children (Teacher's Scale).

RESULTS

One hundred and fifty-six children with epilepsy, of age four to fifteen years, 124 males and 32 females, with a Male: Female ratio of 4: 1, were recruited; and 156 school-age siblings of the epileptic children (index children) and 156 controls were studied. Prevalence of behavioral problems was 38.5 and 15.4%, respectively, among the index and control children ( P < 0.001). There was no significant sex difference in the two groups. There was a significant difference in the distribution of the types of behavior problems between the index and controls ( P < 0.05). The duration of epilepsy did not affect the prevalence of behavior problems ( P < 0.05), but seizure control had a significant effect on the prevalence of behavior problems ( P < 0.001).

CONCLUSIONS

Siblings of children with epilepsy have more behavioral disturbances than controls. A strong association was found between poor seizure control and the prevalence of behavioral problems.