Effect of Bacterial Diarrhoea on Serum Zinc Levels in Children with Special Reference to Different Bacterial Pathogens: A Cross-sectional Study

Introduction: Diarrhoea significantly leads to morbidity and mortality in under-five children, particularly in developing countries. Reduced serum zinc levels in acute non infectious diarrhoea has an impact on the frequency, severity and duration. However, evidence is still evolving on the status of zinc level in bacterial diarrhoea. Aim: To assess serum zinc level in bacterial diarrhoea and compare the serum zinc level in children with the different bacterial pathogens. Materials and Methods: This cross-sectional study was conducted in Department of Paediatrics at Federal Medical Centre, Owerri, Imo State, Nigeria, from August 2015 to February 2016, including 201 children aged 6 to 59 months with diarrhoea. Stool specimens were isolated for bacteria, using conventional culture techniques, while serum zinc levels were determined using atomic absorption spectrometry. Serum zinc level <65 µg/dL was regarded as zinc deficiency. The data collected was analysed using the Statistical Package for Social Sciences (SPSS) version 19.0. Results: Out of 201, 58 (28.9%) of the children with diarrhoea had bacteria in the stool. The most common organism isolated was Escherichia coli (33,16.4%) followed by Salmonella (13, 6.5%). All of the children with positive stool culture, irrespective of the type of microbial agent, had zinc deficiency with significant association between infective diarrhoea and zinc deficiency (χ2 =15.437; p-value=0.004). Children with shigella diarrhoea had the lowest mean serum zinc level, compared to other bacterial agents (33.6±4.4 µg/dL, p-value <0.001). Conclusion: Bacterial pathogens contribute significantly to the cause of diarrhoea in under-five Nigerian children, and are significantly associated with zinc deficiency. Thus, reinforcing the need for zinc supplementation and food fortification programs within the population, and maybe for longer in children with identified bacterial diarrhoea.

Acceptance of temporal artery thermometry by Nigerian mothers: a comparison with the traditional methods

Introduction

Temporal artery thermometry may be viewed as a suitable alternative to the traditional thermometry because of its safety and time efficiency. However, it is yet to gain wide acceptance in African settings because it is relatively new. The aim of this study was to compare the choices of Nigerian mothers between the traditional methods (axillary and rectal thermometry) and the temporal artery thermometry.

Methods

Rectal, axillary and forehead temperatures were measured in 113 children using rectal and axillary mercury in glass thermometers and infrared temporal artery thermometer respectively. The thermometry method preferred by each mother and the reason(s) were documented using a semi structured questionnaire. The data was analysed using SPSS version 19.

Results

The highest number of mothers 44(38.9%) preferred the axillary route while 42(37.2%) and 27(23.9%) preferred the temporal and rectal routes respectively. Temporal artery thermometry was the most popular among the mothers with tertiary education 27(39.7%), whereas axillary thermometry was most preferred among mothers with primary and secondary education, although this difference was not statistically significant (χ²=0.62,p = 0.96). Mothers 27(33.9%) who preferred rectal thermometry did so because they felt that since the thermometer is inserted inside the body, it will detect fever better.

Conclusion

Nigerian mothers do not have any particular thermometry preference between the temporal artery thermometry and the traditional methods, so medical personnel in our environment may resort to any method that is convenient, accurate, fast and cost effective.

Prevalence of hepatitis B co-infection amongst HIV infected children attending a care and treatment centre in Owerri, South-eastern Nigeria

INTRODUCTION

Hepatitis B infection impacts negatively on disease progression in HIV infected children thereby increasing morbidity and mortality. In spite of the foregoing, there is paucity of data on Hepatitis B co-infection in children living with HIV in Owerri, South Eastern Nigeria.This study set out to determine the prevalence of Hepatitis B Co- infection in HIV infected children attending the Paediatric HIV Care and Treatment clinic of the Federal Medical Centre Owerri.

METHODS

The study period was between February and July 2010. Testing for Hepatitis B infection was done using the ACON Hepatitis B surface antigen Rapid test strip. (Acon Laboratories Inc. San Diego.CA).

RESULTS

A total of 139 HIV infected children were enrolled during the study period. The overall prevalence of Hepatitis B Co- infection was 5.8% (8/139). The prevalence in males was 8.2% (5/61) while in females it was 3.8% (3/78). The prevalence of Hepatitis B Co- infection amongst patients on antiretroviral therapy was 4.6%. They accounted for 62.5% of Hepatitis B Co- infection in our study. Previous blood transfusion, gender and age of patient did not show statistically significant relationship with Hepatitis B Co-infection.

CONCLUSION

Though our study shows a low prevalence of Hepatitis B co infection in HIV infected children in our centre, reduction of the rate is still strongly desirable. Reduction can be achieved by strengthening the uptake of Hepatitis B vaccine as part of the routine childhood immunization programme.

A Five (5) chamber heart (Cor Triatriatum) in Infancy: A rare congenital heart defect

Five-chambered heart is extremely rare in children. We report a case of asymptomatic five chamber heart detected in infancy. The patient is 2-day-old and managed in a special care baby unit (SCBU) for neonatal sepsis. During routine follow-up at the age of 1 month, she was found to have an asymptomatic murmur. Echocardiograph reported five-chambered heart, concluding that it is Cor triatriatum, supravalvular pulmonary stenosis and secundum atrial septal defect. The child is still been followed-up and is still asymptomatic at 7 months. Five-chambered heart, although rare, can occur even if asymptomatic.