No abstract

Background:In many developing countries, malnutrition remains an important cause of morbidity and mortality particularly in under-five children. The factors responsible for malnutrition could be immediate, underlying or basic, acting either alone or together. It has been shown that children who are malnourished have poorer outcomes from other illnesses than well-nourished children. It is important therefore to periodically describe the extent and pattern of childhood malnutrition so that effective preventive measures can be put in place.Objective:To describe the prevalence and pattern of malnutrition in children presenting with acute illnesses at the Jos University Teaching Hospital.Patients and Methods:A cross-sectional descriptive study in children aged 6 to 59 months seen at the paediatric emergency unit from April to October 2012. The subjects were recruited consecutively. Each child had both clinical assessment and appropriate laboratory evaluations done alongside anthropometric measurements. The nutritional/dietary and socio-demographic histories were also obtained.Results:Of the 379 children, 224 (59.1%) were males and 155 (40.9%) females. The median age was 17 months, range (6-57). Wasting (WFH z-scores ≤−3 to <−1SD) was evident in one hundred children, giving an overall prevalence of 26.9%. Severe wasting (WFH z-score <−3), was present in 22 (5.9%) children indicating the prevalence of marasmus, whereas only two children (0.53%) had oedematous malnutrition (kwashiorkor). Stunting or chronic malnutrition, (HFA z-scores ≤−3 to <−1SD) was present in 67 children (18.0%). Seventeen (4.6%) were severely stunted (HFA z-score <−3).Conclusions:Wasting was the most common form of malnutrition in the study.

Background The attitude of healthcare workers (HCW) towards organ donation is cardinal to the successful implementation and sustainability of transplant programs. We present the outcome of a survey among HCW in a single tertiary institution in Nigeria regarding their willingness to be living-related kidney donors. Methods Self-administered questionnaires were randomly distributed to HCW evaluating their attitude towards living-related kidney donation. Results Of the 650 questionnaires distributed only 502 responded (clinical medical students 51%, physicians 31.7% and nurses 17.3%); 75.6% of respondents were willing to be living donors while 5.8% were against it, and 18.5% were undecided. Multivariate analysis identified willingness to receive, perceived risk associated with kidney donation, and attitude towards cadaveric donation as independent predictors of willingness of HCW to be living donors. Conclusion Nigerian HCW have a positive attitude toward kidney donation.

Objectives:To determine the utility of mid-upper arm circumference (MUAC) in identifying acutely malnourished children compared with weight-for-height (WHZ), body mass index (BMI) for age (BAZ) and MUAC z-score (MUACZ) in clinical and field practice. Design: Cross-sectional study. Setting: Children from immunisation and paediatric outpatient clinics of Jos University Teaching Hospital and two schools in Jos, Plateau state, Nigeria. Subjects: Children 6-59 months with parental consent, and no chronic medical condition or pedal oedema. Outcome measures: MUAC, height and weight were measured. The WHZ, BAZ and MUACZ were determined using the World Health Organisation (WHO) Anthro software 3.0. Prevalence of acute malnutrition was compared between these data and those given by MUAC. The World Health Organisation (WHO) z-score cut-off of < -3 and < -2 and MUAC of ≤ 11.5 cm and 11.6 -12.5 cm was used to define severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), respectively. Stata 12SE was used to determine frequency distribution, means and significance. Results: The mean age of subjects was 22.4 ± 15.5 months. The mean MUAC was 14.7 ± 1.5 cm. The MUAC differed between males and females in the age-groups of 6-11 (p = 0.02) and 36-47 (p = 0.006) months. The prevalence of SAM by WHZ was 3.4%, MUAC was 1.5%, BAZ was 4.3% and MUACZ was 1.0%. When compared, WHZ and BAZ were concordant in 77.8% (p = 0.001) of SAM subjects. MUAC and MUACZ indicated that none of the subjects were classified as SAM by WHZ and BAZ. Conclusion: Neither WHZ or MUAC as a single parameter identifies all children with acute malnutrition. A re-definition of MUAC criteria for malnutrition or consistent application of both parameters is required.