Cardiac complications contribute significantly to morbidity in children with sickle cell anaemia (SCA). Little is known about the geometry and contractile function of the left ventricle (LV) of affected children in sub-Saharan Africa, which has the greatest burden of this disease. To compare the LV systolic function of children with SCA in the steady state with that of matched haemoglobin AA controls. Clinical, laboratory and LV M-mode echocardiographic parameters of 120 steady-state SCA patients aged 3–14 years were compared with those of matched Hb AA controls. Univariate and multivariate analyses were performed using SPSS software, version 22 (IBM, Armonk, NY, USA). The median ejection fraction of 62.00 (IQR = 55.0–67.0) for the subjects was significantly less than that of 68.00 (IQR = 65.8–73.0) for the controls (p < 0.001) and correlated negatively with age (ρ=-0.25, p = 0.006), BSA (ρ=-0.24, p = 0.008), systolic BP (ρ=-0.23, p = 0.022), and diastolic BP (ρ=-0.31, p = 0.002). Left ventricular systolic dysfunction (LVSD) was present in 27

Cardiac remodeling has been reported in HIV-exposed but uninfected (HEU) infants. Inflammatory biomarkers have also been observed to be associated with cardiac remodeling in older HEU children but have not been widely studied in infants. We identified left ventricular (LV) cardiac changes in HEU infants exposed to current ARV therapy in utero and determined their association with the inflammatory biomarkers, C-reactive protein (CRP), and cardiac troponin. This comparative cross-sectional study included 196 HEU infants and 198 matched HIV-unexposed controls. We evaluated LV structure and function using echocardiography and tested blood samples using highly sensitive CRP (hsCRP) and cardiac troponin I (cTnI-plus) measurements. Data were analyzed using the R statistical software package; p values of < 0.05 were considered statistically significant. The HEU infants had thicker LV posterior walls and interventricular septa in diastole (median difference 0.55 and 0.30, 95

Background: Epilepsy is the most common neurologic disorder affecting children in Nigeria. It is often associated with other neurologic comorbidities in addition to epileptic seizures, such as attention deficit hyperactivity disorder (ADHD) and cognitive, visual and hearing impairments, which can be unrecognized while focusing on the seizures. Methods: This cross-sectional study assessed the prevalence, pattern and predictors of neurologic comorbidities among 100 children with Epilepsy (CWE) attending the pediatric neurology clinic of Jos University Teaching Hospital, Jos, Nigeria, and age and sex-matched controls selected consecutively. Data were summarized using frequencies and proportions. Chi-square and Mann-Whitney U tests were used to test categorical values, while logistic regression was used to determine predictive factors for neurologic comorbidities. Results: The prevalence of neurologic comorbidities among CWE vs controls was 65% vs 15% (P<0.001). Factors associated with neurologic comorbidities in CWE include younger age at onset of epileptic seizures (P<0.003), severity of seizures (P<0.001), history of status epilepticus (P<0.044), background history of intracranial infections (P<0.029) and the use of combination antiepileptic drugs (P<0.001). Predictors of comorbidities in CWE were treatment with Sodium Valproate and polytherapy. Conclusion: Neurologic comorbidities are more frequent among CWE than controls; therefore, screening for neurologic comorbidities should be routine when assessing and managing CWE.

Background : Sickle cell anaemia (SCA) is an important case of morbidity and mortality in tropical Africa. Recurrent episodes of vaso-occlusive crisis often lead to organ ischaemia and/or infarction. Anythmias are common and reliable manifestations of myocardial ischaemia and often follow infarction. The prevalence and pattern of cardiac arrhythmias among SCA patients has not been studied extensively, particularly in children. Objective: To determine whether or not, patients with SCA are more prone than others to Cardiac arrhythmias. Patients and Methods: The standard 12-lead ECGs of 35 patients with SCA presenting during 40 episodes of vaso-occlusive crisis (Group A) were compared with those of 40 age- and sex matched sicklers in the steady state (Group B) and with 40 age- and sex-matched patients with anaemia due to causes other than haemoglobinopathy (Grup C). Results: Cardiac arrhythmias were detected in four (10 percent) of the crisis episodes in Group A patients compared to three (7.5 percent) of patients in Group B and only onc (2.5 percent) of the patients in Group C (p>0.3). In Groups A and B, the arrhythmias were all of atrial origin. The mean haematocrit level of Group A subjects with arrhythmias was significantly lower than those without (p= 0.037). Conclusions: Although differences did not reach statistical significance, the results suggest that patients with SCA appear to be more prone to cardiac arrhythmias than others, whether or not they are in crisis. Further studies involving larger populations are indicated.

Background: Perinatal mortality rate is very high in North Eastern Nigeria mainly due to a large number of still births.The causes and factors related need to be identified so as to proffer solutions with a view to improving obstetric practice and perinatal survival.Objectives: To identify the causes and factors related to stillbirths in Dukku Local Government Area of Gombe state.Methodology: A prospective study that was both hospital and community based, in which parturients were recruited in their last trimester and followed up till delivery.The fetal outcome was recorded and still birth rate calculated.Results: Five hundred and two parturient mothers were recruited.They delivered a total of 520 babies, amongst whom were eighteen sets of twins; five hundred of these were live births.There were 20 still births, giving a stillbirth rate of 38.5/1000.Causes of stillbirth include unbooked and early pregnanacies as well as deliveries unattended to by trained health personnel.Conclusion: Lack of antenatal Care, home delivery and teenage pregnancy were important factors contributing to high still birth rate in Dukku LGA of Gombe State.

A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to observe and follow up 86 and 101 patients (in the pre-and post-intervention periods respectively) from the time of arrival to the time of being seen by the doctor. Also a cause and effect diagram and countermeasure matrix were used to identify and solve the problems of poor timeliness of health service delivery. There were no significant differences in the ages, weights and heights of the pre-and post-intervention children studied (p>0.05). The overall mean excess (wasted) time from arrival to actually being seen by the doctor was 133121.8 minutes. Sixty-three percent of this excess time was the time between retrieving the patients' folders and actually being seen by the doctor, which was significantly reduced from 89 minutes to eight minutes (p0.05) in the mortality rate between the two periods. Timely health care service is very important in the provision of quality care which in turn, will most likely improve the utilization of health services. Nigerian Journal of Paediatrics 2002 ; 29 :71-74.

Background and Objectives: The pattern of paediatric heart diseases at the Jos University Teaching Hospital has not been described previously. The objective of this study was to document the pattern of heart diseases in children undergoing echocardiography at Jos University Teaching Hospital during an eight-month period and to identify the problems encountered. Patients and Methods: The indications and findings in 48 children undergoing routine trans-thoracic echocardiography from December 1999 to July 2000 were retrospectively analyzed. The problems encountered were also noted. Results: The main indications for echocardiography were rheumatic heart disease (RHD) in 15 (31.5 percent), acyanotic congenital heart disease (CHD) in 10 (20.8 percent) and cyanotic CHD in six (12.5 percent) children. Others were evaluation of cardiac murmurs in six (12.5 percent), unexplained heart failure in three (6.3 percent), pericardial effusion in two (4.2 percent) and cardiac arrhythmia in two (4.2 percent). Significant abnormalities were found in 38 (79.2 percent) of the patients; these were congenital heart diseases in 16 (33.3 percent) and acquired heart diseases in 22 (45.8 percent). Ventricular septal defect (VSD) was an isolated lesion in six (37.5 percent) but was associated with other congenital lesions in nine others. Fallot tetralogy was the commonest cyanotic heart condition encountered. Doubling of cost during the second half of the period of review reduced the access of our patients to the investigation by one third. Excessive strain on the machine from overuse, multiple users and power fluctuations were identified as some of the factors that led to the breakdown of the equipment after only eight months. Conclusions: The pattern of paediatric heart disease in the hospital is similar to those reported from other parts of the country. The cost of paediatric echocardiography should be kept to a minimum, while the lifespan of the machine could be prolonged by restricting its use to echocardiography and vascular procedures and by the provision of stable power supply. Key Words: Echocardiography, Children, Heart, Lesions Nigerian Journal of Paediatrics Vol.30(4) 2003: 143-149

Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality. Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates. Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatal anthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight, prematurity, birth asphyxia and need for admission. SPSS version 25 was used in all analysis. Significance testing was set at p=0.05. Results: The women with preeclampsia were significantly heavier at booking (BMI 29.0±6.9 Kg/ m2 vs 25.0±5.2. p=0.005), have higher mean booking systolic blood pressure (122.±22.6 mmHg vs 111.5±12.7mmHg, p=0.003) and diastolic blood pressure (79. 8 ± 1 4 . 3 mm Hgv s 68.8±9.0mmHg, p<0.001). Neonates of women with preeclampsia were significantly more premature ( m e a n g e s t a t i o n a l a g e = 3 6 . 8 ± 3 . 2 w e e k s v s 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p><0.001). Overall, 22 (49.4%) of the neonates of women with preeclampsia had significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome. Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02) Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males Key words: infant outcome, preeclampsia, Nigeria> = 0.001). Neonates of women with preeclampsia were significantly more premature (m e a n g e s t a t i o n a l a g e = 3 6 . 8 ± 3 . 2 w e e k s v s 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p<0.001). Overall, 22 (49.4%) of the >. 0.001 Overall, 22 (49.4%) of the neonates of women with preeclampsia had significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome. Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02) Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males

EDITORIAL article Front. Pediatr., 26 July 2023Sec. Children and Health Volume 11 - 2023 | https://doi.org/10.3389/fped.2023.1198673

Introduction: there is growing interest in the link between maternal and infant vitamin D (VD) levels. Breast milk transmission and the fact that the mother and her child may share risk factors for VD, such as exposure to sunlight, diet, and sociocultural influences may impact VD status, the magnitude of which is largely unknown in our topical low-middle income setting. We assessed the connection between maternal and infant VD status including their correlates. Methods: this cross-sectional study investigated 95 maternal -infant pairs in Jos. Mothers were interviewed using a questionnaire. Blood sampling and analysis of serum total 25 hydroxy VD were performed using the chemiluminescent immunoassay method. Maternal and infant VD levels were classified as VD deficient (VDD), VD insufficient (VDI), and VD sufficient (VDS). The mean maternal and infant VD were compared, and the Spearman correlation between them was assessed, a stepwise linear regression was also performed with infant vitamin D as a dependent variable. For all statistical analysis, p<0.05 was considered significant. Results: the median maternal and infant VD was 29.68 ng/ml and 29.41 ng/ml, respectively. The mean infant VD (32.19 +/- 10.61 ng/ml) was comparable to maternal VD (31.12 +/- 12.94 ng/ml) (p=0.483), with a Spearman correlation coefficient of 0.3 (p=0.037). Maternal vitamin D (beta=0.539, duration of exclusive breastfeeding (beta=-3.490), and infant age (beta=1.655) were found to be significant independent predictors of infant vitamin. Conclusion: beyond neonatal age, a significant positive relationship between maternal and infants VD levels exists and suggests that family-focused vitamin D intervention might be an effective public health approach in the tropical city of Jos.

Background: The genetics of rheumatic heart disease (RHDGen) Network was developed to assist the discovery and validation of genetic variations and biomarkers of risk for rheumatic heart disease (RHD) in continental Africans, as a part of the global fight to control and eradicate rheumatic fever/RHD. Thus, we describe the rationale and design of the RHDGen study, comprising participants from 8 African countries. Methods: RHDGen screened potential participants using echocardiography, thereafter enrolling RHD cases and ethnically-matched controls for whom case characteristics were documented. Biological samples were collected for conducting genetic analyses, including a discovery case-control genome-wide association study (GWAS) and a replication trio family study. Additional biological samples were also collected, and processed, for the measurement of biomarker analytes and the biomarker analyses are underway. Results: Participants were enrolled into RHDGen between December 2012 and March 2018. For GWAS, 2548 RHD cases and 2261 controls (3301 women [69%]; mean age [SD], 37 [16.3] years) were available. RHD cases were predominantly Black (66%), Admixed (24%), and other ethnicities (10%). Among RHD cases, 34% were asymptomatic, 26% had prior valve surgery, and 23% had atrial fibrillation. The trio family replication arm included 116 RHD trio probands and 232 parents. Conclusions: RHDGen presents a rare opportunity to identify relevant patterns of genetic factors and biomarkers in Africans that may be associated with differential RHD risk. Furthermore, the RHDGen Network provides a platform for further work on fully elucidating the causes and mechanisms associated with RHD susceptibility and development.

Background Rheumatic heart disease (RHD) remains a major source of morbidity and mortality in developing countries. A deeper insight into the pathogenetic mechanisms underlying RHD could provide opportunities for drug repurposing, guide recommendations for secondary penicillin prophylaxis, and/or inform development of near-patient diagnostics. Methods We performed quantitative proteomics using Sequential Windowed Acquisition of All Theoretical Fragment Ion Mass Spectrometry (SWATH-MS) to screen protein expression in 215 African patients with severe RHD, and 230 controls. We applied a machine learning (ML) approach to feature selection among the 366 proteins quantifiable in at least 40% of samples, using the Boruta wrapper algorithm. The case–control differences and contribution to Area Under the Receiver Operating Curve (AUC) for each of the 56 proteins identified by the Boruta algorithm were calculated by Logistic Regression adjusted for age, sex and BMI. Biological pathways and functions enriched for proteins were identified using ClueGo pathway analyses. Results Adiponectin, complement component C7 and fibulin-1, a component of heart valve matrix, were significantly higher in cases when compared with controls. Ficolin-3, a protein with calcium-independent lectin activity that activates the complement pathway, was lower in cases than controls. The top six biomarkers from the Boruta analyses conferred an AUC of 0.90 indicating excellent discriminatory capacity between RHD cases and controls. Conclusions These results support the presence of an ongoing inflammatory response in RHD, at a time when severe valve disease has developed, and distant from previous episodes of acute rheumatic fever. This biomarker signature could have potential utility in recognizing different degrees of ongoing inflammation in RHD patients, which may, in turn, be related to prognostic severity.

Importance Rheumatic heart disease (RHD), a sequela of rheumatic fever characterized by permanent heart valve damage, is the leading cause of cardiac surgery in Africa. However, its pathophysiologic characteristics and genetics are poorly understood. Understanding genetic susceptibility may aid in prevention, control, and interventions to eliminate RHD. Objective To identify common genetic loci associated with RHD susceptibility in Black African individuals. Design, Setting, and Participants This multicenter case-control genome-wide association study (GWAS), the Genetics of Rheumatic Heart Disease, examined more than 7 million genotyped and imputed single-nucleotide variations. The 4809 GWAS participants and 116 independent trio families were enrolled from 8 African countries between December 31, 2012, and March 31, 2018. All GWAS participants and trio probands were screened by use of echocardiography. Data analyses took place from May 15, 2017, until March 14, 2021. Main Outcomes and Measures Genetic associations with RHD. Results This study included 4809 African participants (2548 RHD cases and 2261 controls; 3301 women [69%]; mean [SD] age, 36.5 [16.3] years). The GWAS identified a single RHD risk locus, 11q24.1 (rs1219406 [odds ratio, 1.65; 95% CI, 1.48-1.82; P = 4.36 × 10-8]), which reached genome-wide significance in Black African individuals. Our meta-analysis of Black (n = 3179) and admixed (n = 1055) African individuals revealed several suggestive loci. The study also replicated a previously reported association in Pacific Islander individuals (rs11846409) at the immunoglobulin heavy chain locus, in the meta-analysis of Black and admixed African individuals (odds ratio, 1.16; 95% CI, 1.06-1.27; P = 1.19 × 10-3). The HLA (rs9272622) associations reported in Aboriginal Australian individuals could not be replicated. In support of the known polygenic architecture for RHD, overtransmission of a polygenic risk score from unaffected parents to affected probands was observed (polygenic transmission disequilibrium testing mean [SE], 0.27 [0.16] SDs; P = .04996), and the chip-based heritability was estimated to be high at 0.49 (SE = 0.12; P = 3.28 × 10-5) in Black African individuals. Conclusions and Relevance This study revealed a novel candidate susceptibility locus exclusive to Black African individuals and an important heritable component to RHD susceptibility in African individuals.

Background: Omphalitis is an important cause of neonatal sepsis (NNS) and mortality. Quantitative estimates of risk of omphalitis-related neonatal death is about 10%–19%. Topical applications of antiseptics have been shown to reduce this risk burden but has not been well investigated. Aim: To demonstrate non-inferiority of methylated spirit to chlorhexidine (CHX) gel for prevention of omphalitis, NNS and mortality at day 28. Methods: This was a randomized, non-inferiority trial of methylated spirit versus CHX gel with 161 and 162 mother–baby pairs, respectively, conducted between July 2017 and May 2018. SPSS version 23.0 was used for data analysis to examine for incidence of omphalitis, time-to-cord separation, NNS and mortality. Relative risk and 95% confidence interval were used as point and interval estimates, respectively, with a non-inferiority margin of 10% set for CHX gel while a P values <0.05 was statistically significant. Results: The median age of newborns was 18 h; (IQR: 8–24) h with the risk of omphalitis being 2% higher with CHX gel compared to methylated spirit (RR = 1.020; 95% CI; 0.988-1.053; P = 0.053). The median times-to-cord separation were 7.0 days (IQR: 2–17) and 7.0 days (IQR: 2–18) for methylated spirit and CHX gel, respectively (mean difference: ‒0.2145; 95% CI = ‒0.9085–0.4759; P = 0.544). There was no difference in the risks of NNS and mortality among those treated with methylated spirit compared to those exposed to CHX gel (RR: 1.0; 95% CI = 0.984–1.017; P = 1.000) and (RR: 1.0; 95% CI = 0.994–1.018; P = 0.986) respectively. Conclusions: There is no evidence that 96% methylated spirit is inferior to 4% CHX gel in preventing neonatal omphalitis; hence, it may be considered a safe and effective alternative where CHX gel is unavailable.

This was a comparative cross-sectional study where the left ventricular dimensions and functional parameters of 41 children (aged 1 to 18 years) with sickle cell anaemia were compared with those of 52 age-and-sex matched HbAA controls using transthoracic echocardiography. Majority of the left ventricular dimensions were significantly larger in the study group than the controls (p<0.05). The mean indices for left ventricular systolic function were higher in the study group than the controls though not statistically significant (p>0.05). Left ventricular dimensions correlated positively with age and body surface area in both groups (p<0.05) but inversely with haematocrit in the study group especially the left ventricular internal diameters in diastole and systole and left ventricular mass (p=0.001). Although 14.6% - 59.5% of the changes in cardiac dimensions were attributable to age, haematocrit level and body surface area in the study group (p<0.05), most of this effect was due to haematocrit.

BACKGROUND:There are few reports of the prevalence of CHD in the neonatal period in sub-Saharan Africa. The only available study in Nigeria was carried out before the widespread availability of echocardiography in the country. We sought to determine the prevalence and spectrum of congenital heart defects (CHD) among neonates in Jos, Nigeria.METHODS:This cross-sectional study enrolled neonates less than one week of age from the two largest hospitals and their immunisation centres. Relevant information was obtained and an echocardiogram was performed on each neonate.RESULTS:There were 3 857 neonates recruited over a two-year period; male-to-female ratio was 1.1:1. A total of 111 babies had CHD, with a prevalence of 28.8 per 1 000. Sixty-four neonates had mild CHD, with a prevalence of 16.6 per 1 000, while moderate and severe CHD were found in 27 (7.0 per 1 000) and 20 (5.2 per 1 000), respectively.CONCLUSIONS:CHD is prevalent in Nigerian neonates and there is therefore a need for advocacy to improve access to its diagnosis at birth for appropriate management.

BACKGROUND AND OBJECTIVES Preeclampsia is a significant public health problem associated with increased risk of hypertension for offsprings. We compared the blood pressure and presence of hypertension between neonates born to women with preeclampsia and those with normal pregnancy as well as its relationship to anthropometric indices. METHODS This is a comparative cross-sectional study of 40 neonates born to women with preeclampsia and those born following normal pregnancy in four tertiary health facilities located in Jos, Nigeria. Anthropometric and blood pressure values were measured within 6-12 hours of delivery using standard protocols. SPSS version 25 was used in all analyses. Statistical significance was taken at p <0.05. RESULTS The mean birth weight for neonates of preeclamptic women was 2,476.1±810.8 grams, compared with 2,994.2±529.6 grams in babies of normal pregnancy (p=0.002). The mean birth length for neonates of preeclamptic women was 45.4±6.2 cm compared with 49.8±3.1 cm in babies of normal pregnancy (p<0.001). The mean ponderal index (PI) in neonates of preeclamptic women was 2.6±0.6 g/cm3 compared with 2.4±0.4 g/cm3 in babies of normal pregnancy (p=0.17). The mean systolic blood pressure in neonates of women with preeclampsia was 74.53±16.99 mmHg compared with 75.26±15.20 mmHg in neonates following normal pregnancy (p=0.85). The mean diastolic blood pressure in neonates born following preeclampsia was 47.52±15.76 mmHg compared with 45.12±16.9 mmHg in those following normal pregnancy (p=0.46). Six (16%) of the neonates born to women with preeclampsia had systolic hypertension compared with 3(8%) of neonates of women with normal pregnancy. Similarly, 5(14%) of neonates born to women with preeclampsia had diastolic hypertension compared with 2(5%) of neonates of women with normal pregnancy. No significant association between neonatal hypertension and anthropometric indices. CONCLUSION Newborns of women with preeclampsia have associated higher odds of elevated blood pressure. Elevated blood pressure has no significant relationship to birthweight, length or ponderal index. Early infant blood pressure surveillance is advocated in order to monitor and hence prevent complications ensuing in later life.

Background: Over the past three decades, double burden of malnutrition (DBM), a situation where high levels of undernutrition (stunting, thinness, or micronutrient deficiency) coexist with overnutrition (overweight and obesity), continues to rise in sub-Saharan Africa. Compared to other countries in the region, the evidence on DBM is limited in Nigeria. Objective: This paper aimed to determine the comparative prevalence of population-level and individual-level DBM among adolescents in two emerging cities in northern and southern Nigeria. Methods: This was a comparative cross-sectional study among apparently healthy secondary school adolescents aged 10-18 years in Gombe (northern Nigeria) and Uyo (southern Nigeria) between January 2015 and June 2017. A multistage random sampling technique was implemented to recruit adolescents from 24 secondary schools in both cities. Measures of general obesity (body mass index) and stature (height-for-age) were classified and Z-scores generated using the WHO AnthroPlus software, which is based on the WHO 2006 growth reference. Population-level DBM was defined as the occurrence of thinness and overweight/obesity within the population. Individual-level DBM was defined as the proportion of individuals who were concurrently stunted and had truncal obesity or stunted and were overweight/obese. Findings: Overall, at the population-level in both settings, 6.8% of adolescents had thinness, while 12.4% were overweight/obese signifying a high burden of population-level DBM. Comparatively, the population-level DBM was higher in Gombe compared to Uyo (thinness: 11.98% vs 5.3% and overweight/obesity: 16.08% vs 11.27% in Gombe vs Uyo respectively). Overall, at the individual level, 6.42% of stunted adolescents had coexisting truncal obesity, while 8.02% were stunted and had coexisting general overweight/obesity. Like the trend with population-level DBM, individual-level DBM was higher in Gombe (northern Nigeria) compared to Uyo (southern Nigeria). Conclusion: High levels of population-level and individual-level DBM exist in Gombe and Uyo. However, the level of DBM (under- and over-nutrition) is higher in Gombe located in northern Nigeria compared to Uyo in southern Nigeria.