BackgroundDespite the high prevalences of Human Papilloma Virus (HPV) infections and cervical cancer in Nigeria, utilization of the HPV vaccine as a highly effective preventive measure remains low. The aim of this study was to find out the awareness and attitudes of caregivers to HPV infections and the factors that determine acceptance of an HPV vaccine for their pre-adolescent girls.MethodsThis was a cross-sectional descriptive study of 508 caregivers of female children in Enugu Nigeria. A semi-structured questionnaire was used to collect information on knowledge of HPV, cervical cancer as well HPV vaccine and its acceptance for pre-adolescent female children. The data was analysed using descriptive statistics.ResultsFive hundred and eight (508) caregivers of female children were interviewed. Less than half, 221,(43.5%) of them knew about HPV, among these, 163 knew how HPV is transmitted. Only 12 (2.4%) of the caregivers know that an HPV infection is a major risk factor for cervical cancer. Among the 221 participants who knew the meaning of HPV, 132 (59.7%) were aware of an HPV vaccine. Only 26 (19.7%) of those aware of a vaccine agreed it can effectively prevent cervical cancer. Lack of awareness about the vaccine and accessibility were the major reasons given by parents on why the vaccine has not been received by their female children.ConclusionDespite high levels of education, awareness of HPV, HPV vaccine and the risks for cervical cancer remains low among caregivers in Enugu, south-east, Nigeria. Awareness and accessibility were the major determinants of HPV vaccine uptake among the caregivers. There is a need for massive and sustained awareness creation to increase HPV vaccination uptake in Nigeria.
Background:Clinically evident microvascular complications are rarely seen among children and adolescents with type 1 diabetes mellitus (T1DM), although early signs develop during childhood and accelerate during puberty.Aim:The aim of this study was to determine the prevalence of early signs of microvascular complications in children and adolescents aged 9–19 years with a short duration of T1DM by screening for retinopathy and nephropathy.Methods:A cross-sectional study and participants were consecutively enrolled from the Endocrinology Clinic at Federal Teaching Hospital, Abakaliki. Physical examination and mydriatic ophthalmoscopy were conducted. Three early morning spot urine specimens for albumin/creatinine ratio were estimated 3 months apart. Serum creatinine levels were estimated, and the glomerular filtration rate was calculated. Glycosylated hemoglobin (HbA1c) was determined.Results:Twenty-four individuals participated, 15 (62.5%) were male and the mean age at diagnosis was 12.4 ± 2.3 years. The mean duration of diabetes was 23.8 ± 20.6 months. The mean HbA1c was 11.4%. Retinopathy was seen in 16.7%, whereas 33.3% had microalbuminuria. Blood pressure range was within the 50th–90th percentile for all the participants.Conclusion:The study outcome demonstrated a high prevalence of early signs of microvascular complications such as retinopathy and nephropathy among youths with short duration of T1DM. Poor glycemic control, if not halted, is associated with early signs of microvascular complications which may become clinically evident; contrary to the belief that they are rare in childhood.
Diabetic ketoacidosis (DKA) is the most severe complication in pediatric cases of type 1 diabetes and also the leading cause of death in these children. There is a broad geographic variation in the frequency of DKA at the onset of diabetes. This study sought to determine DKA's prevalence and pattern in Enugu and review the treatment and outcome over ten years. This retrospective study conduct in the Children Emergency Rooms (CHER) of the two tertiary institutions in Enugu State, southeast Nigeria: Enugu State University Teaching Hospital (ESUTH) and the University of Nigeria Teaching Hospital (UNTH). The biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) base on the presence of hyperglycemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L), and ketonuria (urine ketone ?1+). A total of 16,488 children were admitted during the ten years, of which 21 children presented with DKA, representing a prevalence of 0.13%. Six (28.6%) of the patients were newly diagnosed diabetics, while fifteen (71.4%) known diabetics, of which 9 (60%) were presenting with DKA for the first time. A total of two patients died, giving a mortality rate of 9.5%. The rest treated and discharged. The total hospitalization duration ranged from 1–31 days, with a mean duration of 13.3 ± 7.5 days. This study has revealed some of the challenges with the management of children with DKA and the unacceptably high mortality rate.
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