Pneumonia hospitalizations and mortality in children 3 - 24-month-old in Nigeria from 2013 to 2020: Impact of pneumococcal conjugate vaccine ten valent (PHiD-CV-10)

Pneumococcal conjugate vaccine ten valent (PCV 10) was introduced into Nigeria in three phases. Phase 3 introduction started in August 2016. However, its impact on pneumonia admissions and mortality among vaccinated Nigerian children has not been determined. Data in the period before PCV-10 introduction (3 August 2013-2 August 2016), and after (3 August 2017-2 August 2020) were retrospectively extracted from the medical charts of eligible patients aged 3-24 months with hospitalized radiological pneumonia at the University College Hospital (UCH), Ibadan; National Hospital (NH), Abuja; and Federal Teaching Hospital (FTH), Gombe, allowing for an intervening period of 1 year. Proportions of the patients with hospitalized pneumonia and case fatality rates were determined during both periods. The results were compared using z-test, multiple logistic regression analysis and p < .05 was considered significant. Adjusted pneumonia hospitalization rates between the two periods increased at the NH Abuja (10.7% vs 14.6%); decreased at the UCH, Ibadan (8.7% vs 6.9%); and decreased at the FTH, Gombe (28.5% vs 18.9%). Case fatality rates decreased across all the sites during the post-PCV introduction period: NH Abuja, from 6.6% to 4.4% (p = .106); FTH, Gombe, 11.7% to 7.7% (p = .477); and UCH, Ibadan, 2.0% to 0% (p = .045); but only significant at Ibadan. Overall, proportion of hospitalized pneumonia cases decreased after 3 years of PCV 10 introduction into the National Immunization Programme in Nigeria. The case fatality rate during post-PCV 10 introduction decreased at all the three sites, but this difference was significant at the UCH, Ibadan.

METABOLIC SYNDROME AND ASSOCIATED RISK FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN NORTHEAST NIGERIA

Introduction

Metabolic syndrome (MetS) is a cluster of risk factors that may predispose to cardiovascular diseases and type 2 diabetes mellitus. These risk factors include hypertension, central obesity, hyperglycaemia, hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C). The presence of at least three of these risks factors defines MetS. Globally, MetS now affects children and adolescents with increasing obesity prevalence. This study determined the prevalence of MetS and associated risk factors among secondary school adolescents in Gombe Local Government Area(LGA), Northeast Nigeria.

Methods

A cross-sectional study; 688 participants from 12 secondary schools in Gombe LGA, Northeast Nigeria. Data were obtained using structured questionnaire. Anthropometry and blood pressure were measured. Fasting plasma glucose, serum triglyceride and HDL-C were determined. Data were analysed using SPSS version 21.

Result

The prevalence of MetS was 1.3%. Low serum HDL-C was the commonest risk factor. MetS was significantly higher in upper socio-economic class and private school participants. Lifestyle and family medical history were not significantly associated with MetS.

Conclusion

This study showed that the prevalence of metabolic syndrome was low in the overall study population but high among centrally obese adolescents. Metabolic syndrome occurred in normal weight and underweight participants. Low HDL-C was the commonest risk factor for metabolic syndrome and lifestyle and family medical history were not associated with metabolic syndrome.

Haematological Profile of Children With Sickle Cell Anaemia in Steady State

Introduction

Sickle cell anaemia (SCA) is an inherited, autosomal recessive condition that results from a mutation in the β-globin gene. Vascular occlusion is the underlying mechanism behind a myriad of complications encountered. This vascular occlusion is primarily caused by the increased tendency of red blood cells (RBC) to adhere to the vascular endothelium, and the activation of platelets and total leucocyte count (TLC), hence the need for a steady-state haematological profile in these patients.

Method

This was a cross-sectional study conducted over four months at a sickle cell clinic. Haemoglobin (Hb) concentration, haematocrit, platelet, TLC, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) of the subjects were recorded and analysed.

Results

Ninety-nine subjects aged 1-18 years were recruited for the study. There were 53 (53.5%) males. Leucocytosis was seen in 80 (80.8%), anaemia in 99 (100%), and thrombocytosis in 30 (30.3%) patients. The mean Hb, TLC and platelets were 7.9 ± 1.3g/dl, 14.3 ± 4.5 x 10³/mm³ and 391.5 ± 182.6 x 10³/mm³ respectively. Mean MCV, MCH and MCHC were 81.3 ± 7.1 fl, 28.6 ± 2.9 pg and 35.2 ± 1.7 g/dl respectively. Children aged one to four years had the highest TLC (p=0.002) but the lowest mean Hb and platelet (p=0.094 and 0.06) respectively. The mean MCV, MCH and MCHC were lowest in children aged one to four years (p=0.047, 0.001 and 0.001).

Conclusion

Anaemia, leucocytosis and thrombocytosis are characteristics features of children with SCA, especially in male and younger subjects. Although Iron markers are generally normal in children with SCA, those under the age of five years tend to have lower values.