Vitamin A is involved in the proliferation and maintenance of the epithelial cells of the respiratory tract. Since maintenance of the integrity of the respiratory epithelium is important for pulmonary functions, vitamin A may contribute to the reduced pulmonary functions noted in children with sickle cell anemia (SCA). This study aims to relate serum vitamin A levels with pulmonary function indices in children with SCA. This cross-sectional analytical study recruited 70 children with SCA aged 6–17 years using systematic random sampling technique. Ethical clearance was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital (UNTH), Enugu while informed consent and assent were appropriately obtained. Serum vitamin A levels were determined using the atomic absorption spectrophotometry method while lung function test (LFT) was carried out using the spirometer. The relationship between numerical variables was tested with Pearson’s correlation coefficient whereas Chi square was used to test for association between differences in proportions. Level of statistical significance was set at p-value < 0.05. The mean serum vitamin A levels of the children was 20.22 ± 4.51mcg/dl (normal is 25-70mcg/dl). The FEV1 and FVC mean percentage predictive values were 68.7 ± 16.9

Background: Oxidative stress underlies the concept of disease severity in sickle cell anemia (SCA), and a significant relationship has been noted between oxidative stress and SCA disease severity. As vitamin A deficiency leads to oxidative stress generation, it is possible that the disease severity may be related to inadequate levels of vitamin A. Objective: This study sought to relate serum vitamin A levels with disease severity in children with SCA. Materials and Methods: This is a cross-sectional study that recruited 70 children with SCA aged 6-17 years using a systematic random sampling technique and 70 age- and sex-matched haemoglobin AA controls via a consecutive method. Serum vitamin A levels were determined using the atomic absorption spectrophotometry method, while disease severity was obtained using the pretested questionnaire adapted from Adegoke and Kuti. Results: The prevalence of low vitamin A among the subjects was significantly higher when compared to that in the controls (chi(2)(y) = 98.47, P = <0.001). The mean serum vitamin A was significantly lower in the subjects compared to the controls (t = -10.73, P = <0.001). The majority of subjects (61.4%) had mild disease, while eight (11.4%) had severe disease. Serum vitamin A had no significant correlation with severity in SCA (r = -0.001, P = 0.992). Conclusion: Children with SCA have lower serum vitamin A levels compared to their normal peers, and no relationship exists between disease severity and serum vitamin A in children with SCA. Thus, vitamin A supplementation may not be required in case of severe SCA.

Objective:Peer physical violence (PPV) has been shown to be an early marker for development of other health-risk behaviours. This study assessed the prevalence and risk factors of PPV among in-school adolescents in a state in South-east, Nigeria. Methods:This was a cross sectional study conducted among 1,296 in-school adolescents using the Global School-based students Health Survey questionnaire. Data on socio-demographic characteristics and factors associated with PPV were obtained and p-value <0.05 was considered significant. Result:The overall mean age (S.D) of participants was 15.0 ± 2.0 years and the prevalence of PPV was 43.1%. In multivariate logistic regression, predictors of PPV were gambling (AOR: 1.56; 95%CI:1.13-2.16; p = 0.007), cigarette smoking (AOR: 1.85; 95%CI:1.01-3.40; p = 0.047), serious injury in the past 1 year (AOR: 2.29; 95%CI:1.78-2.95; p < 0.001) and bully victims (AOR: 1.70; 95% CI:1.28-2.25; p < 0.001). Older adolescent age (AOR:0.37; 95%CI:0.25-0.53; p < 0.001] and being religious (AOR: 0.70; 95%CI: 0.53-0.92; p = 0.011) were protective. Conclusion:There is high prevalence of PPV in the study population. The risk factors were young adolescence age, bullying, gambling, cigarette smoking, having had a serious injury and not being religious. Stricter regulations on gambling through legislation, especially as it concerns age, and adoption of school policies against bullying and cigarette smoking are recommended.

Objective: Zinc is an essential trace element that plays a critical role in various physiological processes, including immune function and antioxidant defense. Serum zinc levels are often used as a marker to assess nutritional status and potential deficiencies. This study aims to compare serum zinc levels between stable asthmatic children and non-asthmatic controls at ESUT Teaching Hospital, Parklane Enugu, to understand whether asthmatic children have different zinc status compared to their non-asthmatic counterparts. Materials and Methods: A comparative cross-sectional study was conducted involving 85 asthmatic and 85 non-asthmatic children aged 5–11 years. Serum zinc levels were assessed using a Flame Atomic Absorption Spectrophotometer (FAAS). Data were analyzed using SPSS version 20. Results: The median serum zinc levels were 11.95 µmol/L in asthmatic children and 8.81 µmol/L in non-asthmatic children (p < 0.001). Nutritional status and socio-economic class did not significantly affect serum zinc levels. Conclusion: Stable asthmatic children have higher median serum zinc levels compared to non-asthmatic children. There was no significant relationship between serum zinc levels and socio-economic or nutritional status in the asthmatic group. Blind zinc supplementation in asthmatic children should be approached with caution.

Introduction: Sickle cell anaemia (SCA) is prevalent in Nigeria and affected children are predisposed to several complications. Amongst these are morbidities involving the cardiovascular system which ordinarily should predispose them to hypertension (HTN). Fortuitously, however, hypotension rather than HTN was commonly reported in children with SCA. Recently, the rising incidence of HTN amongst such patients is being noted, especially when ambulatory blood pressure (BP) monitoring is done. There are therefore conflicting the reports on the BP profile of children with SCA. The study was undertaken to correctly determine the BP profile of children with SCA. Methods: The cross-sectional and comparative study was undertaken at the University of Nigeria Teaching Hospital, Enugu, over an eight-month period. It involved 212 participants aged 3–17 years (106 subjects with HbSS and 106 age/gender matched controls with haemoglobin genotype AA). Sociodemographic, clinical and anthropometric parameters were obtained using a semi-structured questionnaire. BP was measured using Accoson mercury sphygmomanometer. Mann–Whitney U, Chi-square, Student’s t and Fisher’s exact tests (where appropriate) were used to evaluate the intergroup and intragroup associations. Results: A significant proportion of subjects had systolic and diastolic BP (DBP) readings that were below the 50th centile (70.8% and 61.3%, respectively). Only 1 (0.9%) subject had DBP above the 95th centile. Compared with controls, there was a significant difference in the systolic BP (SBP) of subjects (χ2 = 9.09, P = 0.01). Subjects were approximately two times less likely than controls to have a SBP readings that are within <50th centiles (odds ratio, [95% confidence interval], 0.43 [0.22–0.84]). However, there was similar distribution of DBP (P = 0.10). Although not statistically significant, mean SBP (mSBP) and mean DBP (mDBP) in subjects were higher than values in controls. (95.51 ± 12.25 mmHg vs. 94.25 ± 11.23 mmHg [mSBP] and 58.25 ± 8.05 mmHg vs. 56.56 ± 8.03 mmHg [mDBP]). Conclusions: Subjects with SCA have BP profile that is predominantly <50th centile. Compared to controls; however, subjects had higher mSBP and mDBP. Recommendations: Patients with SCA should be monitored more frequently for HTN since this study shows that their BP profile is relatively higher than that of their genotype AA counterparts.

Background: Zinc is an abundant trace element in the body involved in many physiological processes. Its deficiency has been described in HIV-infected children, especially in advancing illness. This study, therefore, seeks to assess zinc levels in HIV-positive children attending the HIV clinic at University of Nigeria Teaching Hospital (UNTH). Materials and Methods: This was a descriptive, cross-sectional study among HIV-positive children aged 5–60 months attending the HIV clinic at UNTH. A 100 participants were enrolled from August 2013 to May 2014. Data were obtained using a pro forma developed by researchers, and blood samples were collected and analysed using an absorption spectrophotometer. Serum zinc level deficiency was defined as the values <80 μg/dL. Data analysis was conducted using the SPSS version 26. Results: Most participants were males (53.0%). Their mean age was 47 months (standard deviation = 15.7). The median serum zinc level was 55.5 μg/dL (IQR = 35.0–84.8). The majority of the participant (72%) had zinc deficiency. There was a statistically significant relationship between serum zinc level and participants’ socioeconomic status ( P < 0.05) – higher socioeconomic status was associated with higher zinc levels. Conclusion: The study showed a high prevalence of zinc deficiency in children living with HIV, with a significant relationship between serum zinc level and the participants’ socioeconomic status. There is a need for zinc supplementation for HIV children, especially the indigent ones.

Abstract Background: Zinc plays vital roles in all the systems of the human body. To reduce neonatal mortality in developing countries, cost-effective and evidence-based interventions that can enhance growth, development, and immunity need to be considered. About 60% of foetal zinc is acquired during the third trimester of pregnancy, when foetal weight increases three-fold. Therefore, low birth weight infants are more likely to have low zinc levels than normal birth weight term infants. Determining the zinc levels of neonates and how it relates to birth weight is, therefore, imperative. Materials and Methods: The study was a descriptive cross-sectional, carried out at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria. It aimed at determining the umbilical cord serum zinc levels among neonates and their relationship with birth weight. Two hundred and seventy-five neonates of gestational age 28–42 weeks were enrolled into the study. The weight of each neonate was measured using a weighing scale. Serum zinc levels were determined using the Flame Atomic absorption spectrophotometer (AAS model no. FS 240 AA. USA, Agilent Technology Ltd). Results: Of the 275 neonates, 27 (9.82%) were very preterm, 28 (10.18%) were moderate to late preterm, and 220 (80%) were term neonates. The mean serum zinc level of all neonates was 87 ± 16.07 μg/dL and this was within the normal limit of serum zinc. The mean serum zinc levels of the neonates increased as their weight increased ( r = 0.701, P < 0.001). Females had higher mean cord serum zinc (90.71 ± 16.06 μg/dL) than males (84.57 ± 15.54 μg/dL, P = 0.001). This study revealed that serum zinc level was positively and strongly correlated with the weight of the neonate at birth. It was also noted that female neonates had a significantly higher mean serum zinc level than males. Routine zinc supplementation at birth should be considered in low birth weight neonates to avoid the untoward effects of zinc deficiency. Conclusion: There was a significant relationship between serum zinc and birth weight, with serum zinc increasing with gestational age and birth weight. Females had a significantly higher level of serum zinc than male neonates

IntroductionSickle cell anaemia (SCA), a disease common in people of African ancestry, is caused by a mutation in the beta globulin gene.[1, 2] Due to red blood cell sickling, they are prone to various complications one of such being abnormal blood pressure (BP) profiles.[2] Children with SCA have always been documented to have lower BP profiles than the norm for their age and gender.[3] This trend seems to have however changed over recent years especially with the onset of ambulatory BP monitoring in resource rich settings which has shown them trending towards higher BP profiles.[4–6] In resource limited settings however, where such BP monitoring may be difficult and the complications of hypertension have a huge morbidity and mortality profile, it is important to investigate their BP profile once again following these new findings and ascertain its possible determinants in order to prevent these complications.MethodsThis cross-sectional study was undertaken at the University of Nigeria Teaching Hospital, Enugu, Nigeria over an eight-month period: July 2020 to February 2021. It involved 106 participants aged 3–17 years with HbSS. Blood pressure was measured using Accoson mercury sphygmomanometer and values were interpreted using the Fifth Report [7] BP charts. Socio-demographic, clinical and anthropometric parameters were obtained using a semi-structured questionnaire. Presence of renal injury was determined using microalbuminuria and proteinuria as markers. Mann Whitney U, Chi square, Student t and Fisher’s Exact tests (where appropriate) were used to evaluate the inter-group and intra-group associations while logistic regression analysis was used in assessing determinants of BP profile in children with SCA.ResultsA significant proportion of subjects had systolic and diastolic blood pressure readings that were below the 50th centile (70.8% and 61.3%, respectively). Only 1 (0.9%) subject had diastolic blood pressure (DBP) above the 95th centile (figure 1). Using bivariate analysis, presence of renal injury, Body Mass Index (BMI) and adolescent age were associated with the presence of elevated DBP and hypertension but were however not independent predictors (table 1). Disease severity and gender were not associated with the BP.ConclusionAlthough the prevalence of hypertension and elevated BP is low, it is however associated with factors such as increasing BMI, adolescence and presence of renal injury. It is therefore important clinicians managing them promptly identify those with these risk factors and keenly monitor their blood pressure profile to prevent morbid complications.ReferencesSerjeant G. Natural history of sickle cell disease. Cold Spring Harb Perspect Med; 2013;3:a011783. Rees DC, William TN, Gladwin MT. Sickle-cell disease. Lancet 2010;376:2018–31. Gladwin MT. Cardiovascular complications and risk factors for death in sickle cell disease. Lancet 2016;387:2565–74. Shatat IF, Jakson SM, Blue AE, Johnson MA, Orak JK, Kalpatthi R. Masked hypertension is prevalent in children with sickle cell disease: a Midwest Pediatric Nephrology Consortium Study. Pediatr Nephrol 2013;28:115–20. Becker AM, Goldberg JH, Henson M. Blood pressure abnormalities in children with sickle cell anaemia. Pediatr Blood Cancer 2014;61:518–22. Moodalbail DG, Falkner B, Keith WS, Mathias RS, Araya EC, Zarinsky JJ, et al. Ambulatory blood pressure in a pediatric cohort of sickle cell disease. J Am Soc Hypertens 2018;12:542–50. Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carrol AE, Daniel SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140:e20171904.

Children with sickle cell anemia (SCA) usually face psychological complications especially depression. Assessment of depression in resource-limited settings may help identify the extent to which the children with SCA in such settings may need its introduction as part of routine care. This study aimed to assess depression in children and adolescents with SCA in a low-resource setting. This cross-sectional observational study involved 84 children and adolescents with SCA aged 7-17 years who were selected using a systematic random sampling technique. Their controls were 84 age- and sex-matched individuals with AA hemoglobin genotype. A structured questionnaire was used to collect socio-demographic data while depression was assessed with the Children's Depression Inventory. The prevalence of depression was non-significantly higher in subjects compared to the controls (8.3% vs. 2.4%) (Fisher's chi(2) = 1.88, p = 0.171). Though not statistically significant, the subjects had 3.7 times higher odds of having depression compared to the controls (OR = 3.7; 95% CI 0.75-18.50; p = 0.107). Of the 5 depression subscales, the subjects had a significantly higher difference in the negative mood (p = 0.042). Despite the comparable prevalence of depression with their normal controls, children and adolescents with SCA had a higher negative mood and higher odds of having depression than normal individuals. Thus, there is a need for the introduction of depression assessment as a complement to routine care of these children with SCA in resource-poor settings.

Background Haemostatic derangements are thought to be due to an imbalance between hepatic synthesis of pro-coagulants and urinary losses of anticoagulants. Objectives This study evaluated the coagulation profile of Nigerian children with nephrotic syndrome and examined the relationship between coagulation variables, disease state and steroid responsiveness. Methods A cross- sectional hospital based study on evaluation of coagulation profile of children with nephrotic syndrome compared with their age- and gender- matched controls. Results The median fibrinogen level in subjects and controls was the same (2.9 g/L). Sixteen of 46 (35%) children with nephrotic syndrome had hyperfibrinogenaemia. The median fibrinogen level of children in remission was 2.3 g/L and differed significantly when compared with those of children in relapse ( p = 0.001 ). The median APTT of children with nephrotic syndrome was 45.0 s and differed significantly compared with those of controls (42.0 s) (p value = 0.02 ). The median prothrombin time in children with and without nephrotic syndrome were 12.0 and 13.0 s respectively , (p = 0.004). About 90% of children with nephrotic syndrome had INR within reference range. Thrombocytosis was found in 15% of children with nephrotic syndrome. The median platelet count in children with new disease was 432 × 10 3 cells/mm 3 and differed significantly when compared with those of controls (p = 0.01 ). INR was significantly shorter in children with steroid resistant nephrotic syndrome (SRNS) (median 0.8 s; IQR 0.8 -0.9 s) compared with controls (median 1.0 s; IQR 1.0 -1.1 s) (p = 0.01) . Steroid sensitivity was the strongest predictor of remission in children with nephrotic syndrome; steroid sensitive patients were 30 times more likely to be in remission than in relapse (OR 30.03; CI 2.01 – 448.04). Conclusion This study shows that the haemostatic derangements in childhood nephrotic involve mostly fibrinogen, APTT, PT, INR and platelet counts. Antithrombin levels are largely unaffected. Variations in fibrinogen, APTT, PT and INR values may be due to the heterogeneous nature of the disease.

Background: Adolescent obesity is a serious public health issue. Inconsistent findings on its association with mental health problems are reported. Objective: This study aimed to determine the prevalence, pattern, and sociodemographic correlates of psychosocial disorders among obese adolescents in Enugu metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted over a 5-month period in 16 secondary schools in Enugu, Nigeria. A multi-staged systematic sampling technique was used to select participating schools. A total of 4364 adolescents aged 10–19 years from these schools were screened for obesity by measuring their height and weight, and calculating their body mass indices (BMIs), which were plotted on the Centers for Disease Control and Prevention BMI percentile chart. Seventy-four obese students were identified, and from their respective class registers, systematic sampling scheme was applied in selection of equal number of apparently healthy normal BMI (5th–84th percentile) controls matched for age and sex. The youth version of the Pediatric Symptom Checklist was used to screen for psychosocial disorder in the study participants. Results: The prevalence of psychosocial disorder was 17.6% and 12.2% among the obese and control adolescents, respectively (P = 0.02). Attention and externalizing problems were the highest among the obese adolescents, whereas psychosocial disorders were more in females than males (28.1% vs 9.5%; χ2 = 4.34, P = 0.04). Conclusion: Obese adolescents have a higher prevalence of psychosocial disorder compared to controls, with attention and externalizing problems being most common, and this was influenced by gender. Periodic assessment of the mental health of obese adolescents is advocated.

Introduction Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis. Aim To determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype. Method This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment. Results The median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001). Conclusion Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state.

Background: Although Bacillus Calmette Guerin (BCG) vaccine remains one of the most important public health preventive measures against tuberculosis (TB), the presence of a BCG scar may not imply an immune response. Tuberculin reactivity after BCG vaccination has been the most common measure of the effect of the BCG vaccine. Post-vaccination BCG-induced tuberculin reactivity ranges from no induration to an induration diameter of 15 mm. However, tuberculin conversion in infants is usually about 10 mm in more than 90% of infants tested at 12 weeks post-vaccination age. Objective: This study sought to assess the tuberculin conversion rate after BCG vaccination. Materials and Methods: It was a hospital-based cross-sectional study. Two hundred and eighty (280) infants aged 13 to 15 weeks who received BCG vaccination within one month of birth were enrolled. The BCG scar diameter was measured, and Mantoux test was done. Data were analyzed by using the Statistical Package for Social Sciences (SPSS), version 20 (Chicago Il). Results: Among the 280 BCG-vaccinated infants, tuberculin conversion rate was 64%, whereas scar failure rate was 28.9%. Overall, 75.9% of infants with a BCG scar had a positive Mantoux test. The BCG-vaccinated infants with a BCG scar were about six times more likely to have a tuberculin conversion than those without a BCG scar (OR =5.641, 95% C.I = 3.227 to 9.859). Conclusion: There was a 64% conversion rate among the BCG-vaccinated infants. The presence of the BCG scar correlated well with the tuberculin conversion rate.

Adolescence is an important period, marked by significant changes in biological and psychosocial domains. Epilepsy is a chronic neurologic disorder associated with social stigma and prejudice. The etiology of depression in epilepsy appears to be a complex interplay between psychosocial and neurobiologic factors. This period may be too taxing for the adolescent with epilepsy to steer, as epilepsy can affect the development of independence by its social, educational, and mental health effects. The study aimed to compare the burden of depression in adolescents with epilepsy with the general population.One hundred forty-five adolescents with epilepsy and their classmates matched for age and gender were studied over a 9-month period. Zung Self-rating Depression Scale was used to determine the burden of depression in the study population.Among the subjects, 70 (48.3%) had scores in the depressive range to varying degrees compared to 38 (26.2%) controls. The difference in scores was significant (OR=2.628, P < .001). Among the population with positive scores, mild depression category was the commonest for both groups (40% and 22.8%, respectively). There was a statistically significant relationship between gender, seizure type, and depression, whereas there was no significant relationship between age, social class, number of antiepileptic drugs, seizure frequency in the last 12 months, and depression.Adolescents with epilepsy had higher rates of depression than the general population. Hence, there might be need for routine screening of adolescents with epilepsy for early detection and management of depression to improve their overall well-being and quality of life.

Hepatitis B infection (HBV) remains a significant clinical and public health problem and is hyperendemic in Nigeria. In highly endemic regions, infections spread from mother to child, or by horizontal transmission, with the burden of infection being highest in under-fives. Nigeria has a large number of orphans and vulnerable children, with reports of high seroprevalence of HBV infection in orphanages. There is no such report from our locality, despite having a high number of orphans.

This study was cross-sectional and hospital-based. One hundred and forty-five adolescents with epilepsy were recruited over nine months. Apparently healthy adolescents who were their classmates and matched for age and gender served as controls. The Paediatric Symptom Checklist –youth report version (PSC-YR) was used to assess psychosocial problems.

Abstract Background Sickle cell anaemia (SCA) is the commonest monogenic haematologic disorder resulting from the inheritance of homozygous mutant haemoglobin genes from both parents. Some factors have been identified as important in explaining the variability in depression in sickle cell anaemia (SCA). Information on this is limited in a resource-limited setting like Nigeria. This study aims to determine factors which influence depression in children and adolescents with sickle cell anaemia in a resource-limited setting. Methods Systematic random sampling technique was used in this cross-sectional study to select children and adolescents aged 7–17 years at the weekly sickle cell clinic of the University of Nigeria Teaching hospital (UNTH) Enugu, Nigeria. Pretested, structured questionnaire was used to collect sociodemographic and disease severity data while depression was assessed using the Children’s Depression Inventory. Results Age and educational level had significant positive linear relationships with depression (r = 0.253, p = 0.02; r = 0.225, p = 0.04 respectively) while gender (χ2 = 0.531, p = 0.466), socioeconomic status (χ2 = 0.451, p = 0.798) and disease severity (χ2 = 0.422, p = 0.810) had no relationship with depression in children and adolescents with SCA. Conclusion Depression in children and adolescents with SCA increased with increasing age and educational level. Psychological evaluation should be integrated into routine assessment of children with SCA during their follow up visits as they get older and progress in class.

Background: Repeated crises in children with sickle cell anaemia (SCA), which is a manifestation of disease severity, results in depletion of their minimal tissue folate stores, with higher likelihood of folate deficiency. The study aimed to determine the relationship between disease severity and the folate status of children with SCA attending University of Nigeria Teaching Hospital (UNTH), Enugu. Methods: This was a hospital based, cross-sectional study conducted between September 2018 and March 2019. One hundred participants were recruited, consisting of 50 children having sickle cell crisis and 50 age and gender matched haemoglobin AA genotype controls. Relevant information was documented using a pretested questionnaire. Sickle cell severity score was determined using frequency of crisis, admissions and transfusions in the preceding one year, degree of liver and splenic enlargement, life-time cummulative frequency of specific complications of SCA, leucocyte count and haematocrit. Results: Folate deficiency was observed in eight percent of the subjects and none of the controls. The difference was not significant (Fisher's exact = 4.167, p=0.117). The odds of being folate deficient was 8.5 times more likely during anaemic crisis than in vaso-occlusive crisis, though not significant (95% C.I 0.05 - 89.750, p = 0.075). The mean SCA severity score was 8.06 +/- 3.64, signifying a moderate SCA severity in the study population. There was a no relationship between folate status and severity of SCA (Fisher's exact = 0.054, p = 0.949) Conclusion: Folate status in children with SCA is not affected by their disease severity. Therefore, there may be no need for additional folate supplementation with increasing severity of sickle cell anaemia.

Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P < 0.001), as well as a significant increase in high knowledge level (χ2 = 105.13, P < 0.001) after education. Conclusion: Health education improved the knowledge and awareness of sickle cell among adolescents in secondary schools, especially the chances of having children with SCA in carrier couples. Inculcating health education on sickle cell in secondary school curriculum will help in informed decision on marriage and birth, ultimately reducing the birth of children with SCA.