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Introduction: Micronutrients are essential minerals and vitamins needed for optimal health. There are however conflicting reports about the roles of micronutrients in severity and outcomes of childhood pneumonia. This study aims to determine the socio-demographic and serum micronutrients – Zinc (Zn), Selenium (Se), Vitamins (Vit) A, C and E status of Nigerian children with or without pneumonia and relate these to pneumonia severity and outcome. Methodology: Children aged two months to 14 years with severe and non-severe pneumonia were recruited with age and sex-matched controls over 12 month period in a Nigerian tertiary health centre. Relevant history and serum micronutrients were compared in the two groups and related to pneumonia severity and length of hospitalisation (LOH). Results: One hundred and forty-four children (72 for each group) were recruited with median (IQR) age 1.6 (0.6 – 4.0) years and fifty-six (38.8%) had severe pneumonia. Pneumonia incidence was associated with undernutrition, inappropriate immunisation and Zn deficiency (p < 0.05). Hypovitaminosis A [60.8(22.2)µg/dl vs. 89.5(34.7)µg/dl; p < 0.001], low serum Zn [71.6(32.5)µg/dl vs. 92.6(24.6)µg/dl; p=0.019] and indoor air pollution (IAP) were associated with pneumonia severity. However, only IAP (OR = 4.529; 95%CI 1.187–17.284; p=0.027) and Zn deficiency (OR=6.144; 95%CI 1.157–32.617; p=0.033) independently predicted severe pneumonia. No significant correlation between serum micronutrients and LOH. Conclusions: Exposure to IAP and low serum micronutrients particularly Zn and Vit A were associated with pneumonia incidence and severity in Nigerian children. Routine micronutrient supplementation may assist to reduce the burden of childhood pneumonia in developing countries.

Abstract:Background: Hypoxaemia is often poorly detected and treated in emergently-ill children in resource-poor centres because of the non-availability of pulse oximeters and similar facilities to detect it. This study sets out to determine the prevalence and simple predictors of hypoxaemia among children with or without respiratory features at the emergency unit of the Wesley Guild Hospital, Ilesa, Nigeria Methods: Children aged one month to 14 years were consecutively recruited and prospectively studied over an eight month period. All the children had their peripheral oxygen saturation (SpO 2 ) measured at presentation using a portable pulse oximeter (Nellcor (R) N-200, USA) and hypoxaemia was defined as SpO 2 < 90%. Relevant history and examination findings were compared among hypoxaemic and nonhypoxaemic children. Multivariate analysis was used to predict the presence of hypoxaemia. Results: Four hundred and two children were recruited with male to female ratio of 1.3:1 and105 (26.1) presented with respiratory features. Eighty three (20.6%) were hypoxaemic including 40 (38.1%) of those with respiratory features at admission. Infancy, chest in-drawing, cyanosis and grunting were associated with hypoxaemia (p < 0.05) among those with respiratory features, while infancy, pallor and tachycardia were significant among those with no respiratory features. Grunting (OR = 7.875; 95% CI=1.029-15.797; p = 0.045) and Cyanosis (OR =13.579; 95% CI = 1.360-14.379; p = 0.009) independently predict hypoxaemia among the children with respiratory features. Conclusion: Hypoxaemia occurred in approximately one out of five ill children admitted to the emergency unit of the WGH, Ilesa and was significantly associated with mortality. Emergently ill children with cyanosis and grunting especially infants should preferentially be placed on oxygen therapy even when hypoxaemia cannot be confirmed.

Carpopedal spasm have various causes ranging from dsyselecrolytemia, syndromic, metabolic or endocrine causes. Any of these could cause a decrease in ionized calcium and tetany. Excessive vomiting leading to alkalosis, hypokaleamia and decreased ionised calcium should be kept in mind for early etiological diagnosis of carpopedal spasm. We report a case of 4-year-old boy presenting with a history of recurrent painful spasm and flexion of bilateral hands following excessive vomiting and electrolyte derangement.