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Biomedical subjects

O Taiwo

Publications and source records attributed to O Taiwo.

15 recordsLinked to original sources

Comparative study of nutritional status of urban and rural Nigerian school children.

Nutritional assessment in the community is essential for accurate planning and implementation of intervention programmes to reduce morbidity and mortality associated with under-nutrition. The study was, therefore, carried out to determine and compare the nutritional status of children attending urban and rural public primary schools in Ife Central Local Government Area (ICLGA) of Nigeria. The schools were stratified into urban and rural, and studied schools were selected by balloting. Information obtained on each pupil was entered into a pre-designed proforma. The weight and height were recorded for each pupil, and converted to nutritional indices (weight for age, weight for height, height for age). A total of 749 pupils (366 and 383 children from the rural and urban communities, respectively) were studied. The overall prevalent rates of underweight, wasting and stunting were 61.2, 16.8 and 27.6%, respectively. In the rural area these were 70.5, 17.8 and 35.8%, while in the urban they were 52.2, 15.9 and 19.8%, respectively. The mean nutritional indices (Weight for Age, Weight for Height and Height for Age) were found to be significantly lower among the rural pupils than urban pupils (P < 0.001 in each case). The present study shows that malnutrition (underweight, wasting and stunting) constituted major health problems among school children in Nigeria. This is particularly so in the rural areas. Therefore, prevention of malnutrition should be given a high priority in the implementation of the ongoing primary health care programmes with particular attention paid to the rural population.

Body Height↗

Septicaemia in high risk neonates at a teaching hospital in Ile-Ife, Nigeria.

OBJECTIVES: To determine the incidence, predisposing factors, clinical features, bacteriological pattern and antibiotic sensitivity in septicaemia in high-risk newborns. DESIGN: A prospective study. SETTING: Neonatal unit, Ife State Hospital, a unit of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. SUBJECTS: All newborns admitted with clinical features and/or risk factors suggestive of neonatal septicaemia from February 1994 to March 1995. MAIN OUTCOME MEASURES: Culture results and mortality rates. RESULTS: The incidence of neonatal septicaemia among new born was 22.9 per 1000 livebirths. The predisposing perinatal factors were low socio-economic status, lack of antenatal care, maternal peripartum pyrexia and congenital malformations. Gram-positive bacteria were found to be the most prevalent causative organisms (59.4%). Staphylococcus aureus (36.2%), Pseudomonas aeruginosa (18.8%) and Coagulase negative Staphylococcus (15.9%) were the commonest causes of septicaemia. Meningitis and UTI were associated diagnoses in 16.7% and 18.2% of the septicaemic babies, respectively. The bacterial isolates showed a high degree of in-vitro antimicrobial resistance. However, all the isolates were sensitive to ofloxacin. Amongst the commonly used antibiotics, gentamicin had the lowest resistance. The overall mortality rate was 33.3%. CONCLUSION: Improvement in the socio-economic status of the populace and availability of affordable antenatal care would reduce the incidence of neonatal septicaemia in Nigeria. Continuous surveillance in every unit, as well as close attention to preventive strategies would be necessary to reduce morbidity and mortality from neonatal septicaemia. We recommend the inclusion of gentamicin in the initial treatment of septicaemia in the neonatal unit of OAUTHC, Ile-Ife, Nigeria.

Drug Resistance, Microbial↗

Antibacterial activities of extracts from Nigerian chewing sticks.

Ten aqueous extracts from wooden chewing sticks widely used in Nigeria for teeth cleaning were studied for antibacterial activities against 25 different bacteria using an agar diffusion assay. The extracts from five sticks, namely Garcinia kola, Anogeissus leiocarpus, Terminalia glaucescens, Sorindeia warneckei and Vitex doniana, exhibited strong activities against a wide spectrum of bacteria including medically and dentally relevant bacteria. Notably, these five chewing stick extracts showed potent activities against methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and multidrug-resistant Burkholderia cepacia and Pseudomonas aeruginosa. Extracts from Vernonia amygdalina, Fagara zanthoxyloides and Massularia acuminata also showed activities against bacteria significant to periodontal disease. Methanol extracts prepared from G. kola, A. leiocarpus and V. doniana were further fractionated by solvent extraction. Results showed that the antibacterial activities were distributed into different fractions suggesting that the sticks contain different active antibacterial principles. In conclusion, the results showed that most of the Nigerian chewing sticks do contain antibacterial activities which may contribute to the reported anticaries effect of chewing sticks. These sticks may be sources for new lead antibacterial agents for therapeutic or preventive applications.

Anti-Bacterial Agents↗

Haematogram and serum iron status of malnourished Nigerian children.

Haematological parameters, total serum iron, and total iron binding capacity (TIBC) concentrations were estimated in twenty protein energy malnourished (PEM) children, five kwashiorkor (K), five marasmus (M), five marasmic-kwashiorkor (M-K), and five undernourished (U) aged between one and five years on admission and after 18 days hospitalisation at Obafemi Awolowo University Teaching Hospital Complex. The Hospital diet for K and M-K consisted of 8% protein and 802 calories per litre while that for M and U consisted of 30% protein and 1350 calories per litre. After the period of 18 days of rehabilitation there was no significant (p > 0.05) difference (Student's t-test) in the weight for age. None of the haematological parameters was significantly different after rehabilitation for all the four types of PEM. Of the four types only Kwashiorkor with mean serum iron values of 15.6 +/- 1.51 micrograms/100 ml and 21.17 +/- 0.33 micrograms/100 ml on admission and after rehabilitation respectively was significantly (P < 0.05) different. More attention by the OAUTHC authorities needs to be paid to the management, feeding and diet given to these children so that there will be a greater and more rapid improvement in their rehabilitation.

Body Weight↗

Severe anemia: a risk factor for glomerular injury in sickle cell disease.

Approximately 15% to 20% of patients with sickle cell disease have proteinuria. Proteinuria, particularly albuminuria, is the hallmark of glomerular injury. This study examines risk factors for glomerular injury as indicated by urinary albumin excretion (UAE) 30 microgram/minute, directly related to sickle cell disease. A total of seven patients were enrolled between September 1992 and March 1993. Fasting blood chemistries, complete blood cell count, 24-hour urine for protein and creatinine clearance, and glomerular filtration rate determined by 125 I-iothalamate were obtained for each patient. The results indicated that the lower the hematocrit, the higher the UAE rate. Low hematocrits have served as a protective mechanism in sickle cell disease by reducing blood viscosity and thus decreasing the number of vaso-occlusive crises. However, severe anemia appears to have an indirect adverse effect on the kidney in sickle cell disease.

Adult↗

A study of urinary tract infections at Ile-Ife, Nigeria.

Clinical laboratory records and case files of 1,038 cases of urinary tract infections (UTI) were examined for the spectrum of bacterial and candida isolates for age and sex distribution of the UTI cases and antibiotic susceptibility pattern of isolates. The results show that 867 (83.5%) of the cases were aged 21 years and above, of which 81.3% in that age group were females. While only 20.7% of the cases were males, 74.0% of those in that category were also 21 years and older. Eleven organisms were isolated, with E. coli, Klebsiella spp and Staphylococcus aureus respectively representing 36.1%, 22.8% and 15.4% of the total bacterial isolates. The prevalence of S. aureus isolates in cases of UTI in this centre suggests the increasing role of these microorganisms in the aetiology of urinary tract infections in Nigeria.

Adolescent↗

Electrocardiographic changes in measles.

Electrocardiograms (ECGs) were recorded in 100 Nigerian children with measles admitted to our paediatric wards or treated on an out-patient basis. The patients were aged 5 months-8 years (mean, 19 months) and the male:female ratio was 1.3:1. Similar recordings were obtained in 100 age- and sex-matched controls. The electrocardiographic changes observed include T wave inversion in 28 patients and prolonged P-R interval in 22. Other changes are prolonged Q-Tc (13 patients), low QRS amplitude (13 patients), abnormal QRS axes in the frontal plane (5 patients) and T wave flattening (4 patients). A statistically significant difference between patients and controls with respect to the above changes was demonstrated in T wave inversion and prolonged P-R interval--the latter in the 5 months-1 year age group. Hence, 35 patients had at least one statistically significant ECG change, giving a prevalence rate of 35%. The implications of the above findings are discussed and the need to intensify efforts aimed at immunizing all children against measles is stressed.

Child↗

Electrocardiographic changes after recovery from measles.

Children with measles seen at our hospital had an initial electrocardiogram (ECG) and a repeat after 3 months. The patients were aged 5 months to 8 years (mean 19 months). The ECG changes observed after clinical recovery included T-wave inversion in eight patients (16%), flattening in eight patients (16%), prolonged PR interval in six (12%), prolonged Q-Tc in three (6%) and low QRS amplitude in four (8%). At least one ECG change was present in 18 patients (36%) after recovery, 14 of these were due to persistence of the changes noted during measles. The implication of above findings and the need for a longer-term follow-up study are discussed.

Cardiomyopathies↗

Bacterial isolates involved in cases of septicaemia in a Nigerian hospital.

Of the nine hundred and twenty patients clinically diagnosed of having septicaemia at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between 1980-1987, 233 (25.3%) had blood samples positive by culture. Thirteen different bacterial species were identified from positive blood cultures of which six predominated: Staphylococcus aureus (30.5%), Coliforms (17.6%), Klebsiella spp. (14.2%), Pseudomonas aeruginosa (9.2%), Escherichia coli (7.9%) and Salmonella typhi (5.9%). The in vitro antibiotic, disc sensitivity pattern of the isolates showed they were relatively resistant to ampicillin and penicillin G but comparatively sensitive to antibiotics commonly used in the treatment of infections caused by these organisms. Septicaemia cases were recorded in all age groups but incidence in females was slightly but not significantly higher than in males (p less than 0.05). The study reveals the predominance of S. aureus strains in case of septicaemia in Nigeria.

Adolescent↗

Class-specific antibodies to Bordetella pertussis, Haemophilus influenzae type b, Streptococcus pneumoniae and Neisseria meningitidis in human breast-milk and maternal-infant sera.

Children under 2 years of age are most susceptible to acute respiratory infections caused by Bordetella pertussis, Haemophilus influenzae type b, Streptococcus pneumoniae and Neisseria meningitidis. We analysed milk samples and sera from mother-infant pairs for specific antibodies that may enhance protection against the bacterial pathogens. The results show that the breast-milk samples contained significant titres of specific IgG and IgA antibodies to the four organisms, although the mean IgG antibody levels were higher in maternal sera than in breast-milk. On the other hand, the mean IgA antibody levels to the four organisms were higher in breast-milk than in both maternal and infant sera. IgM antibodies to these organisms were relatively low or absent in many milk and serum samples. Nevertheless, the significant concentrations of specific IgG and IgA antibodies in milk samples may indicate a protective role for breast-milk against the four infections in early childhood.

Antibodies, Bacterial↗

Plant protein rehabilitation diets and iron supplementation of the protein-energy malnourished child.

Thirty-eight children admitted to the paediatric ward of Obafemi Awolowo University Teaching Hospital, Ile-Ife, were treated using a local therapeutic regimen for protein-energy malnutrition (PEM). Serum transferrin concentration was measured at weekly intervals to determine the response to and nutritional adequacy of the dietary component of this therapeutic regimen. At discharge, weight for height measurements in the children showed a significant (P less than 0.001) increase in growth although the expected weight for height was not attained. Serum transferrin concentration rose significantly from a mean basal level of 132.1 +/- 17.2 mg/dl to 222.0 +/- 24.6 mg/dl at the end of the first week of hospitalization and at discharge was 403.2 +/- 27.8 mg/dl. Although not statistically significant, mortality was highest amongst children for whom iron supplementation started early on admission. Earlier studies on the aetiology and treatment of anaemia in PEM have argued in favour of routine treatment with iron to prevent the development of anaemia during the recovery phase, but data from this study suggest that iron therapy should not be instituted during the first week of treatment.

Anemia, Hypochromic↗

Plasma somatomedin-C in Nigerian malnourished children fed a vegetable protein rehabilitation diet.

Plasma somatomedin-C (pSm-C) was measured by immunoassay in Nigerian malnourished children treated with a mainly vegetable diet. In oedematous children, the mean intake was 4.31 +/- 0.23 g protein and 611 +/- 46 kJ per kg body weight per day, and in marasmic children 5.22 +/- 0.62 g protein and 795 +/- 131 kJ/kg body weight/d. PSm-C concentration (U/ml) was measured at weekly intervals to determine the response to this rehabilitation diet. By our assay the value for 39 normal children (age range 6-36 months) was 0.315 +/- 0.035 U/ml. The average initial level of pSm-C in the malnourished children was 0.19 +/- 0.03 (n = 24). The values were higher (P less than 0.05) in the 7 marasmic children (0.26 +/- 0.1) than in the 11 with oedema (0.15 +/- 0.02). Eight days after admission pSm-C had risen to 0.20 +/- 0.02 (n = 24) and at discharge after approximately 19 d, pSm-C concentration was normal, 0.30 +/- 0.05. In oedematous malnutrition, pSm-C level at discharge was lower than in marasmus, 0.27 +/- 0.06 (n = 17) compared with 0.37 +/- 0.06 (n = 7) (P less than 0.05). Because the childrens' stay in hospital was short (average 19 d), they were far from attaining normal weight for height by the time of discharge. However, they had gained on average 0.9 kg and their clinical condition was satisfactory. It is concluded that the vegetable-based diet produced satisfactory recovery, at least in the initial stages. Increases in pSm-C compared well with those found in an earlier study with milk-based diets.

Child, Preschool↗

Rotavirus as an aetiological agent of acute childhood diarrhoea in Ile-Ife, Nigeria.

Of the 456 urban children aged 14 days and 4 years examined for rotavirus in this study, 376 had diarrhoea while 80 were without diarrhoea and serve as control. Among the 376 diarrhoeic children, 57 (15.2%) had rotavirus while none of the 80 control children had the virus. Rotavirus was significantly higher (p less than 0.05) among the in-patients (19.8%) than in the out-patients (10.3%) and among children of 7-12 months compared with other aged groups. The majority of the children that had the rotavirus lived in areas without pipe-borne water and similarly belonged to the low-socio-economic level. It is therefore possible to deduce from this work that rotavirus is still a major aetiology of acute childhood diarrhoea in Nigeria and its incidence can be affected by hygienic practices, the environment and socio-economic level.

Acute Disease↗

Acute appendicitis in Nigerian children.

This study reports on 46 cases of acute appendicitis in children during a nine year period (1963-1971) in the University College Hospital, Ibadan, Nigeria. The disease does not appear to be (yet) a common paediatric surgical problem here. The clinical features are similar to those reported for other populations, though there was a tendency to late presentation with a more advanced stage of the disease. A review on the aetiology of acute appendicitis, clinical features, diagnosis, course and prognosis in children is also presented.

Acute Disease↗

Glomerular filtration rate in Nigerian children with homozygous sickle cell disease.

The study proposed to assess glomerular filtration rate as determined by endogenous creatinine clearance in steady state Nigeria children with homozygous sickle cell disease and normal controls. Twenty-four hours urinary creatinine clearance was estimated over a 6-month period in 54 steady-state homozygous sickle cell disease and 57 normal control children aged 5 to 13 years. Each child was admitted and a 24-hour urine sample (8.00 am to 8.00 am) was collected both for volume measurement and creatinine concentration determination. Blood was also collected from each child 30 minutes to end of urine collection for plasma creatinine concentration determination, haematocrit and reticulocyte counts. The results were compared between the two groups of children using student's t-test and the chi (X2) square test where necessary. The mean glomerular filtration rates +/- SD (ml/min/1.73 M2) for homozygous sickle cell disease children and normal controls were not significantly different (p > 0.05). Glomerular filtration rate did not differ significantly between the age groups in both patients and normal controls; haematocrits correlated weakly with glomerular filtration rates in the patients (r = +0.213; p < 0.001). Nigerian children with homozygous sickle cell disease who are in steady states have normal glomerular filtration rate that is hardly influenced by increasing age and low haematocrit level.

Adolescent↗