Etiologic agents and outcome determinants of community-acquired pneumonia in urban children: a hospital-based study.

Etiologic clues and prognostic indicators of community-acquired pneumonia (CAP) were sought in a 30-month study of under-5 admissions for acute lower respiratory infections (ALRIs). Investigative tools included blood culture, hemogram, immunofluorescence and serology. Associations of variables were tested using standard statistical tools.

Acute laryngotracheobronchitis in Nigerian children.

In a prospective study of cases of severe acute respiratory infections seen at the University College Hospital, Ibadan over a 30-month period, 39 cases were found to have acute upper airway obstruction; out of this number, acute laryngotracheobronchitis (croup) accounted for 35 (90%). The ages of the 35 ranged from 2 to 53 months with 86% being less than 3 years old, while there was a male preponderance (M:F ratio, 1.7:1).

Acute bronchiolitis in tropical Africa: a hospital-based perspective in Ibadan, Nigeria.

In a 30-month prospective study of severe acute lower respiratory infections in hospitalized pre-school Nigerian children, acute bronchiolitis was diagnosed in 67 cases; 19 (28.4%) and 2 (3.0%) of these had concomitant pneumonia or croup, respectively.

Microbial inciters of acute asthma in urban Nigerian children.

Background: In tropical Africa the role of microbial agents of acute respiratory infections in acute exacerbations of bronchial asthma remains largely unexplored. However, empirical antibacterial therapy is frequently initiated in moderate to severe cases of acute asthma with symptoms of acute respiratory infection. A study was set up to determine how often acute respiratory infection is associated with acute asthma, to identify the associated pathogens, and to proffer appropriate therapeutic suggestions.

Respiratory syncytial virus--associated lower respiratory diseases in hospitalised pre-school children in Ibadan.

An analysis of the features of lower respiratory diseases (LRD) associated with Respiratory Syncytial Virus (RSV) in 21 children aged 1-23 months, indicated that the clinical features did not differ appreciably from those described for LRD due to other infective agents. It was however, remarkable that none of the children was grossly malnourished, neither was there any death. The final respiratory diagnoses were bronchiolitis alone (6 cases), bronchopneumonia (6 cases), empyema/pleural effusion (3 cases, including one with bronchopneumonia), lobar pneumonia (3 cases, including one with associated bronchopneumonia).

Acute lower respiratory infections in hospitalised urban pre-school Nigerian children: a clinical overview.

One hundred and three hospitalised urban pre-school Nigerian children aged 2 weeks to 4 years with various acute lower respiratory tract infection (ALRI), were studied prospectively over a 9- month period (August 1985 - April 1986). Overlapping seasonal peaks, corresponding to the rainy/early harmattan months of August through November were most noticeable for the two major viral ALRI syndromes namely, bronchiolitis and croup. The overall M:F ratio was 1.

Staphylococcal lower respiratory infection in children.

A prospective study of staphylococcal lower respiratory infection in 31 children aged 1-48 months has shown that radiologically, patchy consolidation was the single most common lesion, followed by pleural effusion with or without pneumothorax. Although the mean respiratory rate was 65/minute, it was below 50/minute in 8 cases. Complications include heart failure in 9 cases and severe anaemia necessitating blood transfusion in 9 others, seven (78%) of whom had pleural effusion.

Bacterial aetiology of acute lower respiratory infections in pre-school Nigerian children and comparative predictive features of bacteraemic and non-bacteraemic illnesses.

In a 9-month surveillance of the microbial agents causing acute lower respiratory infections (ALRI) in hospitalized preschool Nigerian children, 24 bacterial isolates were made from 22 (33 per cent) out of 66 blood cultures, including seven (70 per cent) of the 10 cultures from subjects with pleural effusion. Of the 24 positive isolates, Staphylococcus aureus accounted for 14 (58 per cent), Klebsiella pneumoniae for four (17 per cent), Streptococcus pneumoniae and Staphylococcus albus for two (8 per cent) each, and Haemophilus influenzae for only one case. Seven subjects had a mixed aetiology, comprising one bacteraemic case with measles and six with concomitant viral identifications.

Viral pathogens of acute lower respiratory infections in pre-school Nigerian children and clinical implications of multiple microbial identifications.

In a prospective study of acute lower respiratory infections (ALRI), at the University College Hospital, UCH, Ibadan, 35 viral pathogens were identified by immunofluorescence (IF) techniques from 24 (68.6%) respiratory specimens from 35 hospitalised pre-school children. The respiratory diagnoses comprised croup, bronchiolitis, pneumonia and pleural effusion.

Host factors and acute lower respiratory infections in pre-school children.

The relationship between certain host-related variables and the short-term outcome of hospitalization for severe acute lower respiratory infections was studied prospectively in a cohort of 103 pre-school Nigerian children. The respective mean ages of those with bronchiolitis and croup were 3.2 months and 18.

The association of household pollutants and socio-economic risk factors with the short-term outcome of acute lower respiratory infections in hospitalized pre-school Nigerian children.

In a 9-month study of acute lower respiratory infections (ALRI), the short-term prognostic implications of socio-economic and household risk factors were examined in 103 hospitalized pre-school Nigerian children. Seventy-nine (77%) subjects were potentially exposed to the combustion products of kerosene stoves, 16 (16%) to wood smoke and five (5%) to the products of cooking gas combustion. Only 17 subjects (17%) were exposed to household cigarette smoke.

Serum alpha 1-antitrypsin levels in asthmatic children.

Serum levels of alpha 1-antitrypsin (AAT) were determined by an enzymatic assay method in fifty-five asthmatic children and in the same number of controls. The mean AAT level was significantly lower in asthmatics (1.65 mumol/min/ml) than in controls (2.

Plasma vitamin C (ascorbic acid) levels in asthmatic children.

Plasma concentration of ascorbic acid was determined in fifty-one asthmatic children and a group of matched controls. The mean ascorbic acid level of 0.54 mg/100 ml among the asthmatics was significantly lower than a mean of 0.

Electrocardiograms in children with bronchial asthma.

Electrocardiograms (ECG) from 124 asthmatic children were analysed with a view to defining the cardiac complications of bronchial asthma. Thirty-three percent of the patients had airway obstruction when the ECG were recorded; yet none had any significant cardiac arrhythmia. The P waves and P-R interval were each normal in all but one patient.

Serum IgG, IgA and IgM in asthmatic children.

Serum levels of immunoglobulins G, A and M were determined in forty-five asthmatic children and in the same number of controls. Mean IgG and IgA levels in the asthmatics were not significantly different from those in the controls. Conversely, mean IgM values in female controls and all the controls taken as a group, were significantly higher than those in their asthmatic counterparts.

Ventilatory capacity in Nigerian school children.

Forced expiratory volume in one second (FEV1.0) and forced vital capacity (FVC) were determined in 1001 healthy Nigerian school children, aged between four and 16 years. The results were analysed with respect to the ages, heights, weights and body surface areas of the subjects.

Observations on some aetiological factors in Burkitt's lymphoma.

A prospective study of the socio-economic status and physical growth of seventy-six children aged 3-10 years, with Burkitt's lymphoma (BL), has revealed that most of the patients were from the lowest socio-economic classes. Majority of the fathers were farmers, labourers or petty traders. The BL children were, as a group, significantly lighter in weight and shorter than controls.

Ascaris and bronchial asthma in children.

Skin tests with the Ascaris antigen were carried out in 270 children with bronchial asthma and 220 controls. Faecal and sputum specimens were also examined for helminths. Twenty-seven per cent of the asthmatic children had positive reactions to the Ascaris antigen compared with 8% of controls (P less than 0.

Plasma cortisol responses to cortrosyn treatment in asthmatic children.

Treatment trial over a period of 3 months was conducted with intermittent intramuscular injections of Cortrosyn depot in fourteen children with severe and frequent asthmatic attacks. The basal plasma cortisol levels were generally high, but higher than normal in four (29%) of the patients. At a period of 24 h after the initial Cortrosyn injection was administered, plasma cortisol increases ranging between 4-52 micrograms/100 ml above the basal levels were recorded.

Physical growth of nigerian children with bronchial asthma.

The weights and heights of 280 Nigerian children with bronchial asthma were compared with those of apparently healthy Nigerian children from a similar socio-economic background. No statistically significant differences were found between the asthmatics and their healthy counterparts. Although children with severe asthma were, on average, lighter in weight and shorter in stature than those with mild or moderate disease, weights and heights within the asthmatic group were more dependent upon the social class of the family and, to a lesser extent, the duration of asthma.

Enteric fever in childhood.

A detailed analysis of 117 cases of enteric fever in Nigerian children shows that fever, abdominal pain, vomiting and diarrhoea were the main presenting features. Disorders of sensorium occurred in 50%. Associated conditions and bizarre manifestations often delayed the diagnosis and this, coupled with complications such as intestinal haemorrhage and perforation, adversely affected the mortality which was 32% in this study.

Skin sensitivity reactions in Nigerian children with bronchial asthma.

Skin sensitivity reactions to a variety of antigens in 290 unselected urban Nigerian children suffering from bronchial asthma of varying severity, are reported. The percentages of positive skin reactions to the first four antigens were as follows: Ascaris (25%), Dermatophagoides pteronyssinus (21%), house dust (12%) and feathers (12%). The sizes of reaction were generally smaller than those reported in European and American children.

Radiological patterns of pulmonary tuberculosis in Nigerian children.

The radiological features of pulmonary tuberculosis in 273 Nigerian children are presented. The commonest lesion lymphadenopathy, was present in 79% followed by parenchymal lesions which were present in 68%. Seventy-two per cent of children with pleural effusions were below 5 years of age while 2 of 13 with cavitation were infants.

Pyomyositis in childhood.

Twenty-five per cent of 63 Nigerian children aged between 6 months and 12 years with pyomyositis were found to have associated osteomyelitis. Even though the clinical features were generally similar to those in other series, there was a higher incidence of complications and associated disorders, particularly anaemia and septicaemia. Septicaemia was demonstrable at presentation in all these who developed osteomyelitis.