Background: Cerebral palsy (CP) is one the most common causes of disability among children in developing countries and is often associated with poor growth. The assessment of growth and nutrition of children is an important aspect of health monitoring and is one of the determinants of child survival. Aim: To assess the nutritional status of children with CP as seen in Lagos University Teaching Hospital (LUTH). Subjects and Methods: A prospective case-control study was conducted on children with CP attending the weekly pediatric neurology clinic of the LUTH between April 2005 and March 2006. Controls were apparently healthy children being followed up at the children's out-patient clinic of LUTH for acute illness that had resolved. Anthropometric measurements of weight, length/height, mid-upper arm circumference, and skinfold thickness were taken according to the protocols recommended by the International Society of the Advancement of Kinanthropometry. Statistical Analysis: EPI-INFO (version 6.04) was used for analysis. Chi-square test was used to determine associations. Student's t-test was used to compare means of patients and matched controls. Probability P < 0.05 were taken as statistically significant. Results: The controls had higher weight than the patients with mean weight (standard deviation) of 13.7 (4.8) kg, and 12.0 (4.5) kg, respectively (P = 0.01). There were also statistically significant differences in the subscapular and biceps skinfold measurements between the patient and control groups (P = 0.00004 and 0.000008), respectively. Twenty-four (25.8%) and 5 (5.4%) of the patients had moderate and severe undernutrition compared to 6 (6.1%) and none, respectively, in the control group (P = 0.00005). Conclusion: Children with CP had significantly lower mean anthropometric parameters and were more malnourished compared with the control group of children matched for age, sex, and social class.

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Background: Health insurance (HI) can serve as a vital risk protection for families and small businesses and also increase access to priority health services. This study determined the knowledge, attitude of artisans toward HI as well as their health-seeking pattern and willingness to join the HI scheme. Methodology: This descriptive cross-sectional survey used a multistage sampling technique to recruit 260 participants, using self-designed, pretested, interviewer-administered questionnaire. Data were analyzed using Epi-info version 7.0. Chi-square test, Fisher's exact test, and logistic regression were used for associations; the level of significance was set at 5%. Results: The respondents were predominantly male, i.e., 195 (75.0%), with a mean age of 32.36 + 6.20 years and mean income of N 29,000 + 5798.5 ($1 ~ N 161). Majority of the respondents, i.e., 226 (86.9%) were not aware of HI. The overall knowledge was poor (6.5%) and the main source of information was through radio/television (41.2%). Nearly, half of the respondents (33 out of 67) identified the concept of HI as a pool of contributors' fund for only healthcare service. A high proportion of the respondents (27 out of 34) were aware of the benefits of HI, although majority, i.e., 27 (79.4%) identified access to medication as the benefit. The majority of the respondents, i.e., 228 (87.7%) expressed negative attitude toward the scheme; however, 76.5% were willing to join the HI scheme. Conclusion: The artisans had low awareness/poor knowledge of HI which translated to a negative attitude toward the scheme. There is need for an aggressive stakeholders' enlightenment campaign for increasing coverage.

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Background and Objectives: Psoriasis is a chronic, papulosquamous disorder of the skin with variable morphology, characterized by periods of remission and reactivity. Psoriasis is less common in the tropics and in dark-skinned persons. Prevalence in West Africans has been noted to be similar to that of the African-Americans suggesting a similarity in genetic ancestry. This study aimed to describe the clinical characteristics of psoriasis and precipitating factors in Nigerian patients. Materials and Methods: This is a retrospective study of all dermatology patients with features of psoriasis who attended the dermatology outpatient clinic of the hospital between January 2007 and May 2012. Data were obtained from the patients' clinic notes and protocol for psoriasis, which documented patients' demographic data, clinical presentations, and precipitating factors. Results: Psoriasis was found in 1.13% (124/11,015) of the study population. There was a male preponderance with a male to female ratio of 1.34:1. The majority of patients seen were in the fourth decade of life. Stress, alcohol, and drugs were the most reported predisposing factors to psoriasis. All types of psoriasis were found, and plaque psoriasis was the most common. Conclusion: This study confirms the increasing frequency of psoriasis among dermatology patients in Nigeria, which may either be due to an increased proficiency in diagnosing the condition by physicians or increase prevalence of environmental factors. The current trend in the management of psoriasis is focused on treating the inflammatory process as well as managing the modifiable environmental triggers.

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Background and Objective: According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity among school children in Lagos State, Nigeria has been established, but specific factors promoting its prevalence are unknown. The aim of this study was to elicit the views of stakeholders on the perceived causes for the rise in child overweight and obesity. Methods: Five focus group discussions were conducted with different groups of stakeholders involved in child care, namely: Parents, teachers, and healthcare givers. Participants were recruited using a purposive sampling method; a structured question guide was employed for the discussion sessions. The discussions were recorded, collated, and analyzed using grounded theory to extract themes. Results: Six themes emerged as factors responsible for the rise, of which civilization and lifestyle imbalance of the populace emerged as the prominent cause. Of the fifty respondents, 76% of respondents identified parents (particularly young mothers) as major contributors to the prevalence of overweight and obesity in children of Lagos State; and 52.3% of the participants reported that a direct relationship exists between income class of parent and weight of a child resident in Lagos. Conclusion: Civilization and lifestyle imbalance, insecurity and congestion, low level of public awareness, inadequate educative and enlightenment programs, myths and societal perception were factors identified to responsible for the rise in the prevalence of child obesity in Lagos, Nigeria. Preventive strategies to control the prevalence of overweight and obesity in children residing in Lagos State should be considered for further studies.

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Introduction: Necrotizing fasciitis (NF) is a rapidly progressive, potentially fatal tissue infection with primary involvement of the subcutaneous fascia and resultant necrosis of the skin and subcutaneous tissues with relative sparing of the underlying muscles and bones. It pursues a fulminant, unrelenting course if treatment is not instituted early and aggressively. The aim of this paper was to document the clinical features and challenges encountered in the management of cervicofacial NF (CNF) in Usmanu Danfodiyo University Teaching Hospital, Sokoto. In addition, the hypothesis that there is a correlation between the duration of disease at presentation and length of hospital stay was tested. Patients and Methods: A retrospective review of cases of CNF managed between December 2014 and November 2015 at our center was done. Demographic and clinical data were retrieved. Patients were managed in strict adherence to the established hospital protocol. Results: Thirteen cases managed for CNF were included in this study, all of whom were of low socioeconomic status. The duration of symptoms before presentation ranged from 2 to 21 days with a mean (΁standard deviation [SD]) of 7.6 (5.2). The length of hospital stay ranged from 7 to 44 days, with a mean (΁SD) of 19.5 (11.3). A statistically significant correlation between the duration of disease before presentation and length of hospital stay was observed (P < 0.05). Conclusion: NF, though rarely seen in some climes, is still a present health challenge in our environment. Despite improvements in healthcare indices, the associated morbidity and mortality rate is still quite high. The management of CNF in a resource-limited environment like ours presents grim challenges.

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Background: Maternal mental health, in particular depression, has been found to negatively impact mother-child interaction, attachment, stimulation, growth, and many important aspects of development in the young child. These early deficits if sustained and unattended may have negative immediate and long-term consequences on the outcomes in the child. The study aimed to assess psychological distress and postpartum depression in mothers, and their relationship to the mother-child interaction. Methodology: This is a descriptive clinic-based study. Eligible and consenting mothers are attending the child immunization clinic in the Lagos University Teaching Hospital, Lagos, Nigeria participated. Consecutive mothers completed the interview questionnaires independently while those who were not literate had the questionnaires administered by trained interviewers. Instruments used were a sociodemographic proforma, the General Health Questionnaire-12, Mother and Infant Attachment Scale (MIAS), and the Zung Depression Scale. Results: In total, ninety-eight women were enrolled, 66.3% were aged between 26 and 35 years, and mean age of 30.9 years (±5.1 standard deviation). Most were aged between 26 and 35 years (66.3%). Over 90% had at secondary school education or more. Over a 10 ^th (13.3%) was unemployed and 96% married. The children were aged between 6 weeks and 1 year, males (63.1%), and females (46.9%), and the majority were born by spontaneous vaginal delivery (82.7%). A 10 ^th (10.2%) of the women had probable psychiatric morbidity, 14.3% had scores suggestive of postpartum depression, and 18 (16.3%) scored below average attachment in interaction with their children on the MIAS. There was an association found between reduced maternal-child attachment interaction and maternal depression (P ≤ 0.05). Conclusions: Emotional disorders, such as depression, in mothers can be associated reduced maternal-child interaction. It is important that integrated mental health care services be offered to women.

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Background: Family planning programs, researches, and studies have focused mainly on women with little attention to men's role in the contraceptive choices by the couple. Men's exclusion from these programs has serious implications on the acceptance and use of contraceptives by the couple. Objective: To determine the influence of male partners on contraceptive use of their spouses. Subjects and Methods: This was a cross-sectional descriptive study at a Tertiary Care Centre in Lagos, Nigeria. It was conducted from January 1 to April 30, 2010, where all consecutive consenting pregnant women were given structured questionnaires to give to their partners so as to evaluate the contribution of the male partners to contraceptives use in their spouses as well as assess their awareness and knowledge of contraception. Categorical variables were analyzed using Chi-square test or Fisher's exact test as appropriate while continuous variables by t-test. P < 0.05 was considered significant. Results: Of the 370 respondents, only 51.9% (192) knew about female contraceptive methods, while 50% (185) were willing to allow their wives to use contraception. Barrier method (17.3%) and periodic abstinence (15.7%) were the leading preferred choice for their wives. However, bilateral tubal ligation was the least preferred method (1.6%). Previous counseling of male partner significantly influenced their decision to allow their wives to use contraceptives (P = 0.001). Conclusion: Involving the male partner in family planning counseling plays an important role in increasing the acceptance and use of contraceptives by the couple.

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Background: Penicillin is recommended as the first-line agent for intrapartum antibiotic prophylaxis (IAP). Although Group B Streptococcus (GBS) strains are generally susceptible to penicillin with only occasional resistance, they show varying resistance to erythromycin, clindamycin, and tetracycline. Therefore, knowledge of the resistance profile of GBS in the local environment will be useful for administration of appropriate intrapartum antibiotics prophylaxis. Methodology: Rectovaginal swabs collected from pregnant women were cultured for GBS using conventional media. Kirby-Bauer disc diffusion method was performed according to the Clinical and Laboratory Standards Institute guidelines on GBS isolates to determine the antibiotic susceptibility patterns of the isolates. Inducible clindamycin resistance was detected by using the D-zone test. Resistance determinants genes were discerned with conventional polymerase chain reaction. Results: Carriage rates of GBS among pregnant women studied were 19.7%. GBS colonizing the pregnant mothers were uniformly susceptible (100%) to penicillin, vancomycin, and ceftriaxone. Only three (6.5%) of the isolates showed inducible clindamycin resistance. ermA gene was present in all three GBS isolates with inducible macrolide-lincosamide-streptogramin resistance. ermB was absent in all the strains tested. mefA/E gene was carried by two of the macrolide-clindamycin resistance isolates. tetM gene was carried by all isolates with tetracycline resistance phenotypes. Conclusion: In this study, all GBS isolates were susceptible to penicillin G, the recommended antibiotic for IAP. The presence of resistance to erythromycin and inducible resistance to clindamycin excludes the use of these agents as alternatives in cases of penicillin allergy. In this case, vancomycin is the drug of choice as recommended in the updated Centers for Disease Control guideline.

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