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Search Results: 1 - 10 of 358 matches for " Okafor Henrietta Uchenna "
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Screening for Microalbuminuria in HIV-Positive Children in Enugu
Ezeonwu Bertilla Uzoma,Okafor Henrietta Uchenna,Ikefuna Anthony Nnaemeka,Oguonu Tagbo
International Journal of Nephrology , 2012, DOI: 10.1155/2012/805834
Abstract: Background. Human immunodeficiency virus associated nephropathy (HIVAN) is a rapidly progressive chronic renal parenchymal disease that occurs in HIV-infected individuals and manifests commonly as proteinuria, which is preceded by microalbuminuria (MA). This clinical entity is defined as a spot urine albumin of 20–200?mg/L. Objectives. To determine the prevalence of microalbuminuria in HIV positive children in UNTH, Enugu and compare it with that of HIV-negative children. Methods. A total of 154?HIV positive children aged 18 months to 14 years and 154?HIV-negative children of corresponding attributes were screened for microalbuminuria, using Micral test II strip which has a sensitivity of 90–99%. Results. No child among the groups (HIV positive and negative) had microalbuminuria. Majority (96.0%) of HIV-positive children had nonadvanced HIV disease at the time of the study ( ). About 77.3% were using HAART ( ), the mean CD4 cell count of the subjects was cells/mm3; while 78.0% had nonsevere immunosuppression ( ). Furthermore, HIV-positive children with severe immunosuppression were younger and had shorter duration of treatment. Conclusion. Microalbuminuria may not be very common in Nigerian children irrespective of their HIV status. 1. Introduction Nigeria contributes 9% to global HIV burden, and has a seroprevalence of 4.6% with 220,000 children already living with HIV infection as of 2008 [1, 2]. Human immunodeficiency virus (HIV) affects many organs including the kidney [3]. HIV renal parenchymal disease is varied and may result from direct effect of the virus on renal epithelial cells, immune-complex mediated vasculitis, hyperviscosity of blood secondary to hyperglobulinaemia, various opportunistic infections, and also drugs [4]. The commonest chronic renal parenchymal disease in HIV-positive patients is HIV-associated nephropathy (HIVAN) [5, 6], which occurs in childhood [6–9] and has been documented in Nigerian children too [9, 10]. HIVAN progresses to ESRD but if detected early, this progression can be slowed or even halted with the use of HAART [6]. The commonest manifestation of HIVAN is proteinuria, [5, 11] which has been described in HIV-positive children [6, 9] and Esezobor and colleague [9] in Nigeria documented a prevalence of 20.5% in HIV-positive Nigerian children. Microalbuminuria is a predictor of subclinical renal involvement in systemic diseases including HIVAN [3]. It precedes proteinuria [3] and has been shown to be an early manifestation of HIVAN [3]. Therefore, the detection of microalbuminuria as well as the prompt institution
Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management
Odutola Israel Odetunde,Oluwatoyin Arinola Odetunde,Adesoji Oludotun Ademuyiwa,Henrietta Uche Okafor,Uchenna Ekwochi,Jonathan Chukwuemeka Azubuike,Nene Elsie Obianyo
International Journal of Nephrology , 2012, DOI: 10.1155/2012/345298
Abstract: Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide. 1. Introduction Posterior urethral valves (PUV) are the commonest cause of lower urinary tract obstruction in male infants [1–3]. The incidence of this congenital anomaly in our setting is unknown, although reports from Unites States and Europe indicates that it occurs in about 1?:?8000 and 1?:?25,000 male live births [1, 3, 4]. Prolonged and unrelieved lower urinary tract obstruction leads to back pressure effects on the kidneys resulting in obstructive uropathy with renal impairment [5]. PUVs are also a common cause of chronic renal failure in children if treatment is delayed [6–8]. Late presentation in patients with PUV is associated with urosepsis, uremia, and anemia and these form the bulk of patients seen in our centre. Early diagnosis and prompt commencement of treatment is therefore germane to the overall outcome of these patients [9, 10]. This is particularly important in a resource—limited environment like ours where facilities for renal replacement therapy in children is not readily available. The aim of this study is to document the pattern of presentation in our centre and outcome of management. 2. Materials and Methods This is a retrospective descriptive study. Records of patients with PUV at the University of Nigeria Teaching Hospital (1997–2004) and Enugu State University of Technology Teaching
Prevalence and Correlates of Microalbuminuria in Children with Sickle Cell Anaemia: Experience in a Tertiary Health Facility in Enugu, Nigeria
Christopher Bismarck Eke,Henrietta Uche Okafor,Bede Chidozie Ibe
International Journal of Nephrology , 2012, DOI: 10.1155/2012/240173
Abstract: Microalbuminuria is a pre-clinical marker of renal damage in children with sickle cell anaemia and can predict renal failure. Reported prevalence rates increased with age. In Nigeria, burden of disease and prevailing poor health facilities necessitate its screening, determination of prevalence and associated risk factors. It is a cross-sectional as well as descriptive study. Screening microalbuminuria used subjects’ early morning urine. Socio-demographic as well as clinical details were ascertained using semi-structured questionnaires and case files. Associations and statistical relationship of prevalence rates and clinical/epidemiological data were ascertained using chi-squared and multivariate analysis . Two hundred children with sickle cell anaemia (4–17 years) in steady state and 200 age/gender-matched controls were enrolled. Prevalence of microalbuminuria was ,respectively, 18.5% and 2.5% for subjects and controls . Microalbuminuria was commoner in females (19.8%) than males (17.4%) , increased with age , significantly associated with haemoglobin level and hospitalizations (0.001). Subjects had normal renal function. Hospitalizations and haemoglobin levels showed statistical significance on multivariate analysis. Prevalence of microalbuminuria is 18.5%. Age, haemoglobin concentrations, and higher hospitalizations influenced microalbuminuria among subjects. Screening for microalbuminuria should be incorporated in the case management of subjects with identified risk factors. 1. Introduction Sickle cell nephropathy is a major complication of sickle cell disease and results from recurrent renal vasoocclusion, ischaemia-reperfusion injury, and loss of renal mass [1]. It is characterized by glomerular hypertrophy and focal glomerulosclerosis [2, 3]. Proteinuria is one of the most common clinical manifestations of sickle cell nephropathy [4, 5]. Lowest level of albuminuria (20–200?mg/L) known as microalbuminuria [6] is a preclinical marker of glomerular damage predicting progressive renal failure in conditions like diabetes mellitus also associated with hyperfiltration, and hyperperfusion [7]. Microalbuminuria has been defined as an abnormally or supranormal urinary excretion of albumin in the absence of clinical proteinuria (i.e., proteinuria detectable by use of conventional dipstick like Albustix) [8]. Marshall et al. [9] defined microalbuminuria in terms of timed overnight urine collection as an albumin excretion rate greater than 20?μg per minute. Various proportional rates of microalbuminuria have been reported in children with sickle cell anaemia
Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria
Bartholomew F Chukwu, Henrietta U Okafor, Anthony N Ikefuna
Italian Journal of Pediatrics , 2011, DOI: 10.1186/1824-7288-37-45
Abstract: This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin.One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml) on two consecutive cultures were regarded as having asymptomatic bacteriuria.Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1) when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%). All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones.The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.Urinary tract infection (UTI) is a common cause of renal disorder in the tropics[1] and causes significant morbidity[2,3] and mortality[4] in children, especially when it is asymptomatic, not detected and treated promptly.Sickle cell anemia is common in Nigeria with prevalence values ranging from 2% to 3% of the population [5,6] and is associated with increased frequency and severity of infections especially with encapsulated bacteria such as Streptococcus pneumoniae and Haemophilus influenza as well as salmonella and Escherichia coli. Children with sickle cell anemia have increased susceptibility to develop UTI because of altered blood flow in the renal vasculature which causes papillary necrosis and l
An in-depth study of patent medicine sellers' perspectives on malaria in a rural Nigerian community
Theodora A Okeke, Benjamin SC Uzochukwu, Henrietta U Okafor
Malaria Journal , 2006, DOI: 10.1186/1475-2875-5-97
Abstract: The study was conducted in Ugwugo-Nike, a rural community in south-east Nigeria. It involved in-depth interviews with 13 patent medicine sellers.A majority of the medicine sellers were not trained health professionals and malaria is recognized as a major health problem by them. There is poor knowledge and poor dispensing behaviour in relation to childhood malaria episodes. Although referral of severe malaria is common, there are those who will not refer. Verbal advice is rarely given to the care-givers.More action research and interventions to improve prescription and referral practices and giving verbal advice to care-givers is recommended. Ways to integrate the drug sellers in the health system are also recommended.Malaria is a major public health problem in Nigeria, being one of the five leading causes of out-patient visits and mortality, especially in children under five years of age [1]. Prompt access to early diagnosis and effective antimalarial treatment are major strategies for reducing morbidity and mortality from malaria [2,3].However, most of the early treatments for fever in most developing countries occur through self-medication with antimalarial drugs bought from patent medicine sellers (PMS) [4-6]. In Nigeria, PMS are usually the first choice in health care and a recognized primary source of orthodox drugs for both rural ad urban populations, especially the poor [7,8]. In addition to selling drugs, they are also a major source of advice about illness and drug therapy [9].The patent medicine seller can be defined as a person without formal pharmacy training, who sells orthodox pharmaceutical products on a retail basis for profit [10]. Patent medicine stores are owned by the holders of patent and proprietary medicine vendors licenses. Ordinarily the patent medicines should be sold in their original packs. Over-the- counter (OTC) drugs are the only drugs authorized to be sold by the vendors, but they generally sell all types of drugs as determined by the
Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria  [PDF]
Beckie Nnenna Tagbo, Jason Mwenda, Christopher Eke, Tagbo Oguonu, Sebastin Ekemze, Uchechukwu Obiora Ezomike, Benedict Edelu, Ogechukwu Amadi, Ifeyinwa Okeke, Okechukwu Ani, Roservelt Okechukwu Nnani, Vina Okafor, Henrietta Uche Okafor, Egbuna Obidike, Emmanuel Abanida, Chris Elemuwa, Toyin Odetunde
World Journal of Vaccines (WJV) , 2014, DOI: 10.4236/wjv.2014.43015
Abstract:
Background: Assessment of the safety profile of the new rotavirus vaccines in Africa requires base-line epidemiological data on intussusception. Hence, this study was aimed at describing the prevalence and associated factors of intussusception in under-five children in Enugu, Southeast, Nigeria. Methods: This was a retrospective descriptive study involving the sixty reported cases of intussusception in under-five children admitted in a hospital in Enugu between 2007 and 2012. Cases of intussusception were selected using the Brighton collaboration intussusception working group level I diagnostic criteria. Information sought from the patients’ folders included demographic characteristics and clinical manifestations including history of previous rotavirus vaccination, duration of illness prior to presentation, diarrhoea, vomiting, passage of red currant jelly-like stool, abdominal mass and distension, method of diagnosis, treatment option(s) employed and their outcomes. The data was analyzed using SPSS version 17.0. Results: The majority of the cases were aged less than one year (53; 88.3%) while the average incidence of intussusception was 0.1 per 1000. None of the cases had received rotavirus vaccinations. The common clinical presentations were vomiting, 55 (17.2%), passage of red currant stool 50 (15.6%), fever 50 (15.6%) and abnormal/absent bowel sound 43 (15.9%). Diagnosis was essentially with the aid of abdominal ultrasonography, 38 (63.3%) while surgery (laparotomy) was the treatment of choice in most cases 48 (80.0%). The case fatality rate was 3 (5.0%). Conclusion: None of the cases studied could be directly linked to rotavirus vaccinations. But seasonal peak incidence coincided with rotavirus diarrhea peak incidence. Efforts should be made to institute post-rotavirus vaccine licensure prospective surveillance study in order to fully determine any relationship between rotavirus vaccination and intussusception in Enugu, South east, Nigeria.
Erratum to “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria” [World Journal of Vaccines Vol.4 No.3 (August 2014) 123-132]  [PDF]
Beckie Nnenna Tagbo, Jason Mwenda, Christopher Eke, Tagbo Oguonu, Sebastian Ekenze, Uchechukwu Obiora Ezomike, Benedict Edelu, Ogechukwu Amadi, Ifeyinwa Okeke, Okechukwu Ani, Roservelt Okechukwu Nnani, Vina Okafor, Henrietta Uche Okafor, Egbuna Obidike, Emmanuel Abanida, Chris Elemuwa, Toyin Odetunde
World Journal of Vaccines (WJV) , 2015, DOI: 10.4236/wjv.2015.53016
Abstract: The original online version of this article (Tagbo, B. N., et al. 2014 “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria”, 2014, 4, 123-132, http://dx.doi.org/10.4236/wjv.2014.43015) was published in August 2014. The author wishes to correct the author’s name and the Table 3 in the text.
A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy
Christine Manyando, Kassoum Kayentao, Umberto D'Alessandro, Henrietta U Okafor, Elizabeth Juma, Kamal Hamed
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-141
Abstract:
How to Implement Change in Asthma Management in a Developing Country  [PDF]
Uchenna Onubogu
Open Journal of Respiratory Diseases (OJRD) , 2019, DOI: 10.4236/ojrd.2019.91003
Abstract: The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma; as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented; as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.
Parental Exposure of Children to New Experiences and Learning Outcome: A Perspective of Home Factor in Productive Child Education  [PDF]
Ajake Uchenna Egodi, Tamunoimama Jamabo
Open Journal of Social Sciences (JSS) , 2015, DOI: 10.4236/jss.2015.36007
Abstract:

Survey data collected from 1000 primary school children in Calabar metropolis, Nigeria were analysed to determine the extent of parental exposure of children to new experiences and its influence on their learning outcome. One research question and one hypothesis were formulated to guide the study. The instrument for data collection was captioned Pupils Opinion and Achievement Test Questionnaire (POATQ). Descriptive statistics was used in answering the research question while the independent t-test was used in testing the hypothesis at 0.05 alpha level. The result showed low parental exposure of children to new experiences. The result also revealed that there is a significant influence of parental exposure of children to new experiences on their learning outcomes. Based on the findings it is recommended that for productive learning outcome, parents are encouraged to fully be involved in every aspect of the child’s education for all round development of the child.

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