Background and Objective: In P. falciparum malaria (PFM) infestation there are marked changes in cytokine production as the body mounts an immune response to it. Hence we set out to study these changes.Methods: A total of 158 cases of PFM among children attending the paediatric unit of our hospital and 56 healthy controls were studied. Children with febrile illness were screened for malaria using 10% Giemsa stained blood smear. Patients with positive smears were recruited; co-infected patients – those infected by another organism in addition to plasmodium specie.- were excluded. Whole blood was collected, some into plain tubes for serum cytokine testing and some into EDTA bottles for complete blood count and parasite density (PD) determination. Controls with asymptomatic parasitaemia were excluded.Results: Using the World Health Organization criteria for defining severe malaria; we identified 15 cases of severe and 143 cases of uncomplicated PFM. Significantly elevated levels of interleukin-1 (IL-1), interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) were seen in the uncomplicated and severe forms of PFM. It was observed that the elevated cytokine values correlated with PD (in uncomplicated PFM but not in the severe forms). The difference between PD/absolute monocyte count (AMC) ratio was not significant (p=0.13); while PD/platelet count (PC) and PC/ AMC ratios were significant (p=0.01, and 0.03 respectively) when compared between uncomplicated and severe disease.Conclusion: Our data seems to suggest that subjects with an adequate immune response to the parasite density, in terms of pro-inflammatory cytokine levels, presented with uncomplicated disease; while those who have an inadequate response presented with severe disease. The ratios of (PD/PC) and (PC/AMC), in the positive and negative directions respectively, may be predictors of increased disease severity. These observations may have implications for predicting disease outcome and PFM therapy.Key Words: plasmodium falciparum malaria, pro-inflammatory cytokines, Parasite density/Platelet count ratio, Platelet count/Absolute monocyte

Background: Internet addiction (IA) is a global public health problem that significantly impacts adolescents' well-being, with a notable increase in the rate of Internet use during the coronavirus disease 2019 (COVID-19) period. However, few studies have explored the rate and pattern of IA in a holiday camp, which provides an inclusive haven for adolescents from diverse backgrounds to interact together. Objective: To determine the prevalence and pattern of IA among adolescents in a holiday camp in Nigeria post-COVID-19 pandemic. Materials and Methods: Data on the demographic profile and the Internet addiction test (IAT) were collected using an IAT questionnaire, and analysis was conducted using STATA 16. 0 with a significance level set at P < 0. 05. Results: Of the 243 participants, 136 had IA, resulting in an IA prevalence of 56. 0%; 71/243 (29. 2%) had mild IA, 62/243 (25. 5%) had moderate IA, and 3/243 (1. 2%) had severe IA. The IA rate was higher among late adolescents (80. 0%) compared to early (35. 0%) and middle adolescents (55. 0%) (p = 0. 009). On logistic regression, late adolescence (odds ratio (OR) = 2. 71; 95 CI 1. 39-5. 27), male sex (OR = 2. 67; 95 CI 1. 36-5. 24), and spending more than 3 h online daily (OR = 13. 67; 95 CI 6. 24-29. 91) were associated with increased risk of IA. Conclusion: As a result of the COVID-19 pandemic, there is a significant prevalence of IA among adolescents in a holiday camp in Nigeria, impacting 56% of the population. This addiction is strongly linked with late adolescence, male sex, and spending more than 3 h online each day.

Background : Malaria remains a major cause of morbidity and mortality, thus there is need for quick, reliable inexpensive diagnostic tool to facilitate its prompt treatment especially in resource poor settings. Objectives : To compare the sensitivity of a locally available Histidinerich protein-2 based rapid diagnostic test (RDT) with the standard microscopy. Methods : This study was carried out to test the performance of an histidine rich protein -2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria among febrile under-five children attending Paediatric Clinic of NAUTH Nnewi. A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through an interviewer administered questionnaire. Blood sample was collected in EDTA bottle after observing universal precautions. All of them were tested with both Giemsa stained blood smear and Histidine rich protein-2 (HRP-2) rapid diagnostic test (RDT). Results : There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Average number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1- 14 days. Body temperature ranged from 35.9-40.40C with average of 37.7+0.80C. Forty (20%) were positive by microscopy while 42 (21%) were positive by rapid diagnostic test. Twenty-percent of those positive by microscopy (n=8) were negative by RDT while 23.8% of those positive by RDT (n=10) were negative by microscopy. Using microscopy as a gold standard, the sensitivity of the RDT was 80%, the specificity was 93.8%. The positive and negative predictive values were 76.2% and 94.9% respectively. Conclusion : Based on these findings, the RDT demonstrated reasonable concordance with microscopy and was recommended for use at every level of healthcare in the diagnosis of malaria. Keywords : Malaria, RDT, Microscopy, under- five.

Introduction: Globally,acute watery diarrhoea is amajor cause of childhood morbidityand mortality. It is the fourthleading cause of death in childrencontributing as high as 11% of allchildhood deaths. In Nigeria,acute watery diarrhoea causes240,106 deaths per year. Out ofpocket expenditure is a majorsource of healthcare funding inNigeria, hence treatment of acutewatery diarrhoea places extra financialburden on the familiesespecially those in the low socioeconomicclass.Objective: To determine the costof treatment of acute watery diarrhoeain children aged 6 to 36months.Methodology: This was a crosssectional study conducted on children aged 6-36 months who presented with acute watery diarrhoea from January through October 2017. Data obtained using interviewer-administered questionnaire, included sociodemography, duration of illness, treatment cost of the index diarrhoeal episode before presenting to our facility, transportation cost, food and other incidental cost, duration of hospitalization. Diagnostic tests requested and medications prescribed were obtained from the patient’s medical file. Information on drug cost, diagnostic test cost and hospital bed day cost were obtained from Nnamdi Azikiwe University Teaching Hospital (NAUTH) central pharmacy, NAUTH main laboratoryand account section respectively. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis. Result: Seventy two patients were recruited for the study, of whom 47(65.0%) were males giving a male female ratio of 1.9:1. Forty eight (66.6%) of the study participants belonged to the lower socioeconomic class while 22(30.6%) and 2(2.8%) belonged to the middle and upper socioeconomic class respectively. A mean total treatment post per diarrhoea episode derived from this study was # 37,572.2 ± #12,479.0 which at the time of the study was equivalent to US$ 104.7 ± US$ 34.8. This is well above the then Nigerian minimum monthly wage of 18,000.0 (US$ 50.1). Conclusion: The result of this study showed that the economic burden of acute watery diarrhoea is quite enormous especially to the low socio-economic group. Prevention and improvement of home treatment of diarrhoea may reduce the treatment cost. Key words: Acute watery diarrhoea, Cost, Children, Hospital

Background: The prevalence of obesity among adolescent has been on the increase worldwide.This is probably a result of increase in the sedentary life style and the increasing shift to western diet.Obesity in children and adolescents has adverse consequences.These include increase in the rate of Diabetes Mellitus, hypertension, dyslipidemia, cardiovascular diseases, etc with resultant increase in premature deaths.Objectives: To determine the sociodemographic and behavioral factors associated with overweight and obesity in apparently healthy secondary school adolescents.Methods: This was a cross-sectional study of secondary school adolescents aged 10 -19 years randomly selected from two public schools and three private schools.The weight and heights of study subjects were measured using standard equipment.Body mass index (BMI) was appropriately calculated and the WHO growth reference standard for age and gender, specific percentile for BMI was used to define overweight 85 th to 97 th and obese (97 th percentile and above).Results: Data were initially collected from 1250 participants, but 52 were excluded due to improperly completed questionnaires.Thus, a total of 1198 students were ultimately included in the study, giving a response rate of 95.8%.These included 621 females (51.8%) and 577 males (48.2%) aged 10 -19 years giving a F:M ratio of 1:0.9.The mean age of the students was 15.07 ± 1.96 years overall, 15.13 ± 2.08 years for males and 15.03 ± 1.83 years for females.There was no statistically significant difference between male and female in the distribution of age groups (p = 0.12).The mean BMI was 21.51 ± 3.57 kg/m 2 for fe-How to cite this paper:

Abstract Background Exercise Induced Bronchospasm(EIB) is not equivalent to asthma. As many as 20%of school aged children are estimated to have EIB. In Nigeria, there is still a dearth of information on EIB as a clinical entity. This study determined the presence of EIB(using pre and post-exercise percentage difference in peak expiratory flow rate(PEFR) and associated factors such as age, gender, social class and nutritional status in primary school children in Nnewi, Anambra state, South-East Nigeria. The study also grouped those with EIB into those with asthma(EIBA) and those without asthma(EIBWA). Methods This was a community based cross-sectional study involving 6–12 year olds. The PEFR was taken at rest and after a 6 min free running test on the school play-ground using a Peak Flow Meter. A diagnosis of EIB was made if there was a decline of ≥ 10%. Those who had EIB were grouped further based on the degree of decline in post-exercise PEFR (a decline ≥ 10% < 25% → Mild EIB, ≥ 25% < 50% → Moderate EIB and ≥ 50% → Severe EIB) and then categorized as those with EIBWA/EIBA. Results EIB in the various minutes post-exercise was as follows: 19.2%(1stmin), 20.9%(5thmin), 18.7%(10thmin), 10%(20thmin), 0.7%(30thmin). Mild EIB accounted for the greater proportion in all minutes post-exercise and none of the pupils had severe EIB. Using values obtained in the 5thmin post-exercise for further analysis, EIBWA/EIBA = 84.1%/15.9% respectively. Mean difference in the post-exercise PEFR of EIB/no EIB and EIBWA/EIBA was -48.45(t = -7.69, p = < 0.001) and 44.46(t = 3.77, p = 0.01) respectively. Age and gender had a significant association to the presence of EIB and 58% of the pupils with EIB were of high social class. The BMI for age and gender z-scores of all study subjects as well as those with EIB was -0.34 ± 1.21, -0.09 ± 1.09 respectively. Other features of allergy(history of allergic rhinitis: OR–5.832, p = 0.001; physical findings suggestive of allergic dermatitis: OR–2.740, p = 0.003)were present in pupils diagnosed with EIB. Conclusion EIB has a high prevalence in primary school children in Nnewi and the greater proportion of those with EIB had EIBWA. EIB therefore needs to be recognized as a clinical entity and stratified properly based on the presence or absence of asthma. This will help the proper management and prognostication.

Background: The COVID-19 pandemic is a highly infectious disease caused by a novel corona virus. Preventive strategies are vital in controlling its spread and the mass media play a central role in disseminating needed information to the public. This study was carried out to determine how mass media has impacted on the health behaviour of individuals globally in view of the COVID-19 pandemic.Methods: This was a cross-sectional study targeting individuals in all inhabited continents of the world using an online anonymous pre-tested self-administered questionnaire.Results: The data of 485 respondents were analysed. Respondents who had heard of COVID-19 were 98.4% (477) and those who knew it was a disease caused by a new corona virus were 92.4% (448); 81.9% (397) believed COVID-19 had no cure. Information on COVID-19 was from the mass media 77.5% (376); 52.8% (256) was from the internet while 23.5% (114) was from the television. All information on COVID-19 were thought to be authentic and believable 58.8% of the time (285). Respondents would always use a face mask when away from home 47.8% (232), maintain at least an arm length from others in public 32.4% (157), wash their hands with soap and water 58.6% (284) or use an alcohol based hand-sanitizer 45.2% (219). Source of information was significantly associated with knowledge on COVID-19 (p=0.002).Conclusions: Preventive practices to militate against the spread of COVID-19 are suboptimal in view of the spread and severity of this pandemic. Most information on COVID-19 were obtained from mass media. The mass media can therefore be actively and better mobilized as means of disseminating vital information on COVID-19.

Background:This study sought to evaluate the association between serum vitamin D levels and acute respiratory infection (ARI) in under-five children in Nnamdi Azikiwe University Teaching Hospital (NAUTH) in Nigeria.Methodology:This study was conducted in NAUTH, Nigeria, in 2017, in 250 children with ARI, classified into those with acute upper respiratory infection (AURI) and those with acute lower respiratory infection (ALRI). and 250 children without ARI, matched for age and gender. Sociodemographic data and serum vitamin D were obtained. The data were compared between the study and the control groups. The data were compared between those with AURI and those with ALRI.Results:The mean serum 25(OH)D of (52.2±25.6 ng/ml) in the study subjects was lower than the (57.0±23.9 ng/ml in the control group (t=2.20, p=0.03).The mean serum 25(OH)D levels in children with ALRI [39.8±23.8 ng/ml] was lower than in those with AURI [56.0±24.9ng/ml] (t= 14.83, p <0.001). In addition, the association between low levels of serum 25(OH)D and severity of ALRI was significant (x2 = 9.45, p = 0.002).Conclusion:In under-five children, serum vitamin D levels were low, and these low levels were associated more with ALRIs than AURIs in this study.

Background: The prevalence of obesity is increasing worldwide, both in developed and developing countries. In Nigeria, obesity is emerging as an important public health problem. Childhood and adolescent obesity results in adult obesity with the resultant morbidities. Objectives: This study determines the prevalence of overweight and obesity in apparently healthy secondary school adolescents. Methods: This study was a cross-sectional study of secondary school adolescents aged 10-19 years randomly selected from two public schools and three private schools. The weights and heights of the study subjects were measured using standard equipment. BMI was computed using the standard formula weight (kg) / height2 (m). Using the WHO; 2007 age and sex-specific BMI percentile cut-offs, the subjects were classified as underweight (3rd to <15th percentile), normal (15th to <85th percentile), overweight (85th to <97th percentile) or obese ≥97th percentile. Results: Data were initially collected from 1250 participants, but 52 were excluded from improperly completed questionnaires. Thus, 1198 students were ultimately included in the study, giving a response rate of 95.8%. These included 621 females (51.8%) and 577 males (48.2%) aged 10-19 years, giving an F: M ratio of approximately 1: 0.9. The mean age of the students was 15.07 ±1.96 years overall, 15.13 ± 2.08 years for males and 15.03 ± 1.83 years for females. There was no statistically significant difference between males and females in the distribution of age groups (p=0.12). The mean BMI was 21.51±3.57kg/m2 for females and 20.22±3.16kg/m2 for males. The BMI was significantly higher in females in all age groups (p<0.001) except for those aged 10-<12 years (p=0.13). The prevalence rates of overweight and obesity were 14.4% and 5.1%, respectively. The prevalence rates of overweight and obesity were significantly higher in females than males (17.7% vs 10.7%, 5.6% vs 4.5% respectively (p<0.001) and most prevalent among the early adolescence (10<12yrs; p= 0.04). Conclusion: Prevalence of overweight and obesity is high among secondary school adolescents in Onitsha, Anambra state. There is a need for regular monitoring of weight and height as an early measure to prevent and control overweight and obesity.

Aim: To determine the prevalence of malnutrition among HIV- infected under-five children and effect of highly active antiretroviral therapy (HAART) on the nutritional status. Method: This cross-sectional and descriptive study was conducted among under-fives presenting at the Paediatric HIV clinic in a tertiary centre in Nigeria. HIV positive children aged less than five years, who were on HAART and whose parents/caregivers gave consent were included. Odds ratios (ORs) and their 95% confidence intervals (CIs) were determined in a multivariate logistic regression analysis and p-values of <0.05 were considered significant. Result: A total of 92 HIV positive children comprising 52 (56.5%) males and 40 (43.5%) females were recruited, giving a ratio of 1.3:1. Children who were more than 48 months of age were (46.7%), while (9.8%) were aged 24 months or less. The mean age of the children was 44.5+12.9 months, while that of the male and female children were 43.9 +13.1 months and 45.2+12.6 months, respectively, and their age difference was statistically insignificant. The prevalence of undernutrition was 40.2% with a significantly higher proportion of them being male children (P= 0.02) while 1.1% of the children was overweight. The prevalence of severe wasting, severe underweight and severe stunting were 2.1, 3.3 and 17.4% respectively. A total of 12 (13.0%) were wasted, 14 (15.2%) were underweight, and 26 (28.3%) were stunted. Children who received HAART for more than 12 months were less likely to be wasted (P=0.02). Multivariate logistic regression also showed that being a male increased the risk of being underweight (OR=2.55, 95%CL=1.06-6.16) and stunted (OR=2.67, 95%CL=1.32-5.40). Conclusion: Malnutrition remains a problem of children living with HIV even while they are on HAART. The longer duration of HAART is significantly associated with better nutritional status.

Background: Growth monitoring is one of the most effective measures for the prevention of malnutrition in childhood. Aim: The aim of this research was to determine caregivers' knowledge and value of growth monitoring in under-five children. Materials & Methods: This was a descriptive cross-sectional study in which Interviewer-administered questionnaires were used for data collection and growth charts were given to the caregivers to identify different growth patterns. Results: Under-fives sampled were 323. Males comprised 54.5%(176/323), females 45.2%(146/323). Mothers brought the children to the hospital 78.6%(254/323) of the time, fathers 10.2%(33/323), both parents 5.9%(19/323). Respondents who had heard of growth monitoring were 52.9%(171/323); 30.7%(99/323) had been taught how to use the growth chart; 53.6%(173/323) had seen a growth chart; 63.2%(204/323) were able to identify the growth charts correctly. Of those who had been taught to use the growth chart, 87.9%(87/99) were able to identify the charts correctly while 99.0%(98/99) believed that growth charting in childhood was important (p=0.03). Conclusion: While many parents appreciated the importance of growth monitoring in childhood, a small proportion of them had heard about growth monitoring or had actually been taught how to use the growth chart or were able to correctly identify the growth chart. A similar survey among health care professionals needs to be done in order to properly investigate the root of this problem. The importance of growth monitoring in childhood needs to be reemphasized and will go a long way to improve the health indices of children in Nigeria.

Background: The disease burden associated with HIV/AIDS is a key factor in the etiopathogenesis of undernutrition in growing children. This is aggravated by resultant social factors in HIV such as orphaning, low socioeconomic status, food insecurity, and marital status of caregivers. Objectives: The relationship between sociodemographic factors and malnutrition in the background of HIV was evaluated. Methods: A cross-sectional descriptive survey was conducted among underfive HIV positive children in Anambra State, Nigeria. Results: A total of 370 HIV positive under-five children comprising 208(56.2%) males and 162(43.8%) females were recruited. The mean age of the children was 44.5±12.9 months. One hundred and forty-seven (39.7%) were globally undernourished: 15.7.0% (58) underweight (WFA <-2SD), 13.3% (49) wasted (WFH < -2SD), and 27.9% (103) stunted (HFA <-2SD). Males were significantly more stunted than females (p<0.001). 77% (285) were of low socioeconomic class (SEC), 47.3% (175) had advanced HIV disease, and 68.1% (252) had been on HAART for >12 months. 26% (96) were orphans, while 28.6% (106) were cared for by single parents. Being on HAART for >12 months was associated with less undernutrition, while advanced HIV disease seemed to enhance it. Children of low SEC were more likely to be undernourished. Not having been breastfed, introduction of complementary feeds at age 3mo or less, poor food variety and suboptimal feeding frequency increased susceptibility to undernutrition. Orphans were more wasted and stunted than underweight. Single parenthood predisposed to undernutrition. Conclusions: HIV-infected children are vulnerable to malnutrition by virtue of the disease process, further compounded by interwoven social dilemma associated with HIV. It, therefore, behooves the health care provider to ensure a proactive growth monitoring and nutritional support, with prompt treatment of co-morbid debilitating infections. There is also a dire need for public health interventions targeted at single parents of low socioeconomic means.

Background and Objectives: Childhood acute respiratory infection is a public health problem with significant morbidity and mortality in developing countries.The present study was to assess the sociodemographic determinants of vitamin D levels in patient with acute respiratory infections (ARIs) receiving care in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Southeast Nigeria.Methodology: This was a cross-sectional study, conducted in Nnewi, Nigeria, on 250 children with ARI.Sociodemographic data were collected and serum vitamin D levels of the subjects were assayed.The association between sociodemographic variables and vitamin D was evaluated using multivariate logistic regression analysis.Results: A total of 250 children with ARI aged 1 -59 months were enrolled in this study, with slight male preponderance (57.2%).About 60% of the population was less than 2 years.The majority (85.6%) of the subjects had adequate vitamin D levels (≥20 ng/dL).The mean serum vitamin D level in the subjects was (52.2 ± 25.6 ng/mL).Multivariate logistic regression showed that only gender was significantly related to vitamin D levels with males found to have a lower risk of vitamin D deficiency.{OR = 0.05 (0.004 -0.77)}, p = 0.03.Conclusion: The association between male gender and high levels of vitamin D in acute respiratory infection was significant in this study.Further studies, however, should explore a probable role for vitamin D supplementation in children with ARI.

Background: Adolescence constitutes a vulnerable age group where the actual prevalence of sexual abuse may remain largely unknown due to lack of knowledge, delay in and lack of reporting of such incidences. Objectives: To determine the knowledge and history of sexual abuse in adolescents and the associated factors. Methods: A self-administered pretested questionnaire was used to collect data from children aged 10 to 19 years at an adolescent summer camp. Results: Two hundred and seventy-six adolescents participated in this research out of which 41.3% had correct knowledge of sexual abuse, and 12.0% claimed they had been sexually abused. Among the 33 respondents with a history of sexual abuse, 39.4% (13/33) had correct knowledge of sexual abuse. Gender had a significant association with a history of sexual abuse (p = 0.008). Layered by age group, gender had a significant association with being sexually abused in mid-adolescence (p = 0.029) but not in late adolescence (p = 0.445). Age category had no significant association with being sexually abused. Conclusion: The knowledge of sexual abuse was inadequate among adolescents. A high proportion claimed to have been previously sexually abused and interestingly, had insufficient knowledge of sexual abuse There is a need to educate adolescents on sexual abuse to empower them to protect themselves and get help as appropriate.

Background Currently, there is a paucity of data on the knowledge and practice of preventive measures for Hepatitis E infection in Nigerian populations. This study provided data on the prevalence, knowledge and practices of prevention in an adolescent population from Nigeria. Methods This cross-sectional study was conducted over 3 months among rural Nigerian secondary school adolescents. An interviewer-based questionnaire was used to collect data on sociodemographic profile, knowledge, and practice of preventive measures for Hepatitis E infection. Blood samples collected from participants were analysed for Hepatitis E IgG using Elisa Kits (Sigma Diagnostics, USA). Data were analysed using SPSS software version 20.0. Tests of association were done with a level of significance set at 5%. Results A total of 9 out of the 414 participants tested positive for Hepatitis E IgG antibodies giving a prevalence of 2.2%. Significant factors for Hepatitis E infection were male gender { P = 0.004} and school { P < 0.001, however logistic regression gave infinite value. Most participants (98.6%) had poor knowledge of Hepatitis E infection, 239(57.7%) had good preventive practices, while 175(42.3%) had average preventive practices. Conclusion A low prevalence of HEV infection was recorded among study participants. There was poor knowledge of Hepatitis E, and association could not be established between HEV infection and individual preventive practices.

Background. Hypoglycaemia is a common presenting feature of illness among children admitted with various conditions into the paediatric emergency room. Objective. To determine the prevalence of hypoglycaemia among children admitted into a Nigerian teaching hospital, identify some of its associated factors and assess its relationship to patient outcome. Methods. In this cross-sectional study, 388 children were consecutively recruited. Their sociodemographic characteristics, clinical features and management outcome were obtained. Plasma glucose was measured using the glucose oxidase method and classified as hypoglycaemia (<3.4 =ton), low glycaemia (3.4 - <4.4 mmol/L) normoglycaemia (4.4 - 7.7 mmol/L) and hyperglycaemia (>= 7.8 mmol/L). Results. 1 lypoglycaemia occurred in 50 (12.9%) subjects, while 55 (14.2%) had low glycaemia. At bivariate analysis, hypoglycaemia was associated with age (p=0.012), >= 6 hours from the last meal (p=0.004), medication use before presentation (p=0.014) and some markers of illness severity such as loss of consciousness (p<0.001), respiratory distress (p=0.004), dehydration (p=0.002), shock (p=0.004), and hypoxia (p=0.001). After logistic regression, a time >= 6 hours from last meal (adjusted odds ratio (aOR) 2.98; 95% confidence interval (CI) 1.27 - 6.98), hypoxia (aOR 3.10; 95% CI 1.39 - 6.90), and passage of watery stools (aOR 2.92; 95% CI 1.26 - 6.78) were associated with hypoglycaemia. Hypoglycaemic subjects were 2.9 times more likely to die than normoglycaemic ones (p<0.001) but this association was lost at multivariable analysis. Conclusion. Hypoglycaemia complicates common childhood illnesses and may be associated with poorer outcomes. Plasma glucose measurement and subsequent appropriate action should be core parts of the immediate management of ill children.

Background: Globally, acute watery diarrhea (AWD) is a major cause of childhood morbidity and mortality. It is the fourth leading cause of death in children contributing as high as 11% of all childhood deaths. In Nigeria, AWD causes 240,106 under five deaths per year despite the interventions aimed at preventing diarrhoea disease. Objective: This work was to determine the prevalence and patterns of acute watery diarrhoeal admissions among children presenting to Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria. Methods and Materials: This was an observational study. Children aged 6-36 months, admitted for acute watery diarrhea, who met inclusion criteria and whose caregivers gave informed consent. The caregivers of these children were interviewed using interviewer-administered questionnaire. Information obtained included socio-demography (age, gender, social class among others), symptoms of diarrhoea, duration of illness and medications given to these children at home. Data were analyzed using SPSS 21. Results: Of the159 study participants admitted for AWD, 103(65.0%) were males. Those of lower socio-economic class comprised 66.6%(106) while 49(30.6%) and 4(2.8%) belonged to the middle and upper socio-economic classes respectively. A total of 921 inpatients were admitted for the period of the study (January 2017 to October 2017), giving an AWD prevalence of 17.3%(159). The highest number of admissions occurred from January to March 2017, with highest prevalence in March. There is poor utilization of oral rehydration solution (40.3%; 64) with abuse of antibiotics in the home management of diarrhea. Conclusion and recommendations: The result of this study showed that the prevalence of AWD is still unacceptably high. Interventions aimed at prevention (such as promotion of exclusive breastfeeding, health education on hand and environmental hygiene, and inclusion of rota virus and cholera vaccine in our national program on immunisation etc) should be encouraged and strengthened by the policy makers and monitored for proper uptake by the populace. Key words: Prevalence, Acute watery diarrhoea, children, Admissions

Respiratory diphtheria is an acute and infectious disease that can progress to cardiac and neurological complications ultimately resulting in increased morbidity and mortality in affected individuals. Diagnosis was made in line with the WHO clinical case definition for Diphtheria. This is a report of two probable cases of complicated respiratory diphtheria presenting within 3 weeks of each other to the Paediatrics Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Anambra state, South-East Nigeria. The first patient was a 5-year-old female who presented on referral with a history of fever, throat pain, noisy breathing and facial fullness, in whom bull neck appearance and membrane in the throat was observed. She was tachycardic, in respiratory distress, had elevated jugular venous pulse (JVP), soft tender liver and a greyish membrane in the throat. She was managed as a case of Diphtheric Carditis and discharged after 17 days on admission in stable condition. The second patient was also a 5-year-old, male, who presented with a history of fever, difficulty in swallowing, change of voice (progressing from hoarseness to whispers), cough and staggering gait. Onset of the illness was associated with membrane in the throat, bull neck and stridor. Examination revealed cranial nerve deficits, aphonia, hypotonia and staggering gait. CSF analysis was within normal. He was managed as a case of Diphtheric Neuropathy and was discharged home in stable condition after 16 days on admission. C. diphtheria IGG done 2 weeks post discharge was 0.19 IU/ml. The cases suggest that respiratory diphtheria still occurs in children in our environment. A high index of suspicion is needed to diagnose and properly nurse these children back to health. Keywords: Corynbacterium diphtheriae, Paediatric Pulmonology

It accounts for greater than a tenth of cases of chronic hepatitis in Nigerian children. Early detection is paramount as there is currently no vaccine for its prevention and approved treatment protocols are for older children. This study was done to determine the prevalence of HCV antibody and its associated risk factors in apparently well school children aged 5 to under 18 years in Nnewi, a city in South-East Nigeria. This was a cross–sectional study of 618 children from public and private nursery, primary and secondary schools across Nnewi. Two questionnaires were used to obtain social behavioral information from the children and their parents respectively. Three rapid diagnostic test strips were used to test blood samples for HCV antibodies. Data obtained was analyzed using SPSS21with the level of significance set at P ≤ 0.05. antibody in apparently well school children. Health enlightenment campaigns to sustain a reduction in and possible elimination of HCV infection in all categories of children are recommended.