FACULTY OF CLINICAL SCIENCES
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Item Occular morbidity in children with allergic conjunctivitis: A rural urban survey.(Wolters Kluwer - Medknow, 2023) Abiola V. N.; Ugalahi M.O.; Cadmus E. O.; Baiyeroju A.MBackground: Allergic conjunctivitis occasionally may result in some ocular morbidities. This ranges from innocuous to severe forms of ocular disorders. Aim: This study reports and compares ocular morbidities among children with ocular allergies living in an urban and rural community. Materials and Methods: A comparative cross‑sectional study conducted in urban and rural schools among children aged 5–15 years using a multistage sampling method. Sociodemographic data, past ocular history, history of ocular allergies, and treatment were collected with an interviewer‑based questionnaire and were analysed using the Statistical Package for the Social Sciences (SPSS) software version 25. Descriptive analyses of sociodemographic variables and associated ocular morbidity were carried out. The Chi‑square test was used to test associations between rural and urban groups. A P = 0.05 or less was considered significant. Results: Associated ocular morbidities were seen in 8% (19/238) of the children with allergic conjunctivitis. There was no statistically significant difference in the proportion of ocular morbidities observed between both locations (8.1 vs. 7.9 in the rural and urban location, respectively, with a P = 1.000). Children with mild forms of allergic conjunctivitis were 197 (82.8%), and only 1.7% had severe forms. The moderate and severe form of allergic conjunctivitis were more prevalent in the rural area (P = 0.002) while untreated allergic conjunctivitis was found in 168 (70.6%) of those affected. Conclusion: This study demonstrated a higher proportion of moderate‑to‑severe forms of allergic conjunctivitis among school children in the rural region with the majority being untreated.Item Occular morbidity in children with allergic conjunctivitis: A rural urban survey.(Wolters Kluwer - Medknow, 2023) Abiola V. N.; Ugalahi M.O.; Cadmus E. O.; Baiyeroju A.MBackground: Allergic conjunctivitis occasionally may result in some ocular morbidities. This ranges from innocuous to severe forms of ocular disorders. Aim: This study reports and compares ocular morbidities among children with ocular allergies living in an urban and rural community. Materials and Methods: A comparative cross‑sectional study conducted in urban and rural schools among children aged 5–15 years using a multistage sampling method. Sociodemographic data, past ocular history, history of ocular allergies, and treatment were collected with an interviewer‑based questionnaire and were analysed using the Statistical Package for the Social Sciences (SPSS) software version 25. Descriptive analyses of sociodemographic variables and associated ocular morbidity were carried out. The Chi‑square test was used to test associations between rural and urban groups. A P = 0.05 or less was considered significant. Results: Associated ocular morbidities were seen in 8% (19/238) of the children with allergic conjunctivitis. There was no statistically significant difference in the proportion of ocular morbidities observed between both locations (8.1 vs. 7.9 in the rural and urban location, respectively, with a P = 1.000). Children with mild forms of allergic conjunctivitis were 197 (82.8%), and only 1.7% had severe forms. The moderate and severe form of allergic conjunctivitis were more prevalent in the rural area (P = 0.002) while untreated allergic conjunctivitis was found in 168 (70.6%) of those affected. Conclusion: This study demonstrated a higher proportion of moderate‑to‑severe forms of allergic conjunctivitis among school children in the rural region with the majority being untreated.Item Spectrum of behavioural abnormalities in children with nephrotic syndrome in South Western Nigeria(JsciMed Central, 2015) Balogun, F.; Ademola, A. D.Nephrotic syndrome is a chronic childhood disease characterized by relapses and children with this condition tend to have behavioural problems associated with the disease. These behavioural problems are usually not anticipated in most resource limited settings and can be frightening thereby making the children and the care givers to be distressed. Seven children with nephrotic syndrome who developed various behavioural abnormalities while on admission were discussed. There were four girls and three boys with age range seven to fourteen years. The abnormal behaviours noted were visual and auditory hallucinations, inappropriate speech and behaviour, attempted suicide, attention seeking behaviour and social withdrawal. Those behavioural abnormalities were related to prednisolone therapy in five of the children. Diagnosis made wore psychosis and delirium while treatment given included counselling, Risperidone, Halloperidol, Diazepam and reduction or withdrawal of Prednisolone. Abnormal behaviour was not anticipated in those children so the caregivers were takon unaware. This can be worse in infants or in mild cases. Most of the behavioural abnormalities were also associated with the use of prednisolone. There is an urgent need to design guidelines for the management of behavioural abnormalities in nephrotic syndrome especially steroid therapy in resource limited settings. Harmonisation of the skills of paediatric nephrologist and child psychiatrist is also important to obtain the best outcome.Item Paediatric end-stage renal disease in a tertiary hospital in South West Nigeria(Asian Pacific Society of Nephrology, 2014) Asinobi, A. O.; Ademola, A. D.; Ogunkunle, O. O.; Mott S. A.Background: Children and adolescents with end-stage renal disease (ESRD) in sub-Saharan Africa may have the worst outcomes globally. Barriers to management include late presentation, poor socioeconomic conditions, absence of medical insurance, limited diagnostic facilities and non-availability of chronic renal replacement therapy (RRT). Our study was to determine the incidence, aetiology, management and outcomes of paediatric ESRD in a tertiary hospital in Nigeria. Methods: A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012. Results: 53 patients (56.6% male), median age 11 (inter quartile range 8.5-12) years were studied. Mean annual incidence of ESRD in Ibadan for children aged 14 years and below was 4 per million age related population (PMARP) while for those aged 5-14 years it was 6.0 PMARP. Glomerulonephritis was the cause in 41 (77.4%) patients amongst whom, 29 had chronic glomerulonephritis and 12 had nephrotic syndrome. Congenital anomalies of the kidneys and urinary tract (CAKUT) accounted for 11 (21.2%) cases, posterior urethral valves being the most common. Acute haemodialysis, acute peritoneal dialysis or a combination of these were performed in 33 (62.3%), 6 (11.3%) and 4 (7.5%) patients respectively. Median survival was 47 days and in-hospital mortality was 59%. Conclusions: Incidence of paediatric ESRD in Ibadan is higher than previous reports from sub-Saharan Africa. Glomerulonephritis, and then CAKUT are the most common causes. Mortality is high, primarily due to lack of resources. Preventive nephrology and chronic RRT programmes are urgently needed.Item Kidney disease in hospitalised HIV positive children in Ibadan, South West Nigeria(College of Medicine, University of Ibadan, 2012) Ademola, A. D.; Asinobi, O. O.; Oladokun, R. E.; Ogunkunle, O. O; Okolo, C. A; Ogbole. G. E.Background: There is a paucity of data on the clinicopathologic pattern of kidney disease in Human Immunodeficiency Virus (HIV) seropositive children from sub-Saharan Africa and non from South West Nigeria. Objective: To determine the clinical pattern and outcome of kidney disease among HIV positive children hospitalised at a tertiary hospital South West Nigeria Methodology: A retrospective study of all HIV positive children who were hospitalised and managed for kidney diseases over a period of 78 months at the University College Hospital Ibadan, South West Nigeria was reviewed. Patients were followed up over the duration of hospital admission. Results: Ten children (six males and four females) aged 4 -15(10.4±3.2) years were identified. Four presented in acute kidney injury, (AKI) three with nephrotic syndrome (NS) and two in chronic kidney failure (CKF). One patient had left renal artery stenosis. Renal biopsy performed in three children showed focal segmental glomerulosclerosis in two patients and membranous nephropathy in the third. Management included antiretroviral therapy, Angiotensin Converting Enzyme Inhibitors and acute haemodialysis. Mortality was 40%. Conclusion: AKI, NS and CKF were the predominant clinical patterns of kidney disease in hospitalised HIV positive children and the mortality is highItem Peritoneal dialysis in childhood acute kidney injury: experience in Southwest Nigeria(International Society for Peritoneal Dialysis, 2012) Ademola, A. D.; Asinobi, A. O.; Ogunkunle, O. O.; Yusuf, B. N.; Ojo, O. E.Background: The choices for renal replacement therapy (RRT) in childhood acute kidney injury (AKI) are lim¬ited in low-resource settings. Peritoneal dialysis (PD) appears to be the most practical modality for RRT in young children with AKI in such settings. Data from sub-Saharan Africa on the use of PD in childhood AKI are few. Methods: We performed a retrospective study of chil¬dren who underwent PD for AKI at a tertiary-care hospital in southwest Nigeria from February 2004 to March 2011 (85 months). Results: The study included 27 children (55.6% female). Mean age was 3.1 ± 2.6years, with the youngest being 7 days, and the oldest, 9 years. The causes of AKI were in¬travascular hemolysis (n = 11), septicemia (n = 8), acute glomerulonephritis (n = 3), gastroenteritis (n = 3), and hemolytic uremic syndrome (n = 2). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. Duration of PD ranged from 6 hours to 12 days (mean: 5.0 ± 3.3 days). The main complications were peri¬tonitis (n = 10), pericatheter leakage (n = 9), and catheter outflow obstruction (n = 5). Of the 27 patients, 19 (70%) survived till discharge. Conclusions: In low-resource settings, PD can be suc¬cessfully performed for the management of childhood AKI. In our hospital, the use of adapted catheters may have contributed to the high complication rates. Peritoneal di¬alysis should be promoted for the management of childhood AKI in low-resource settings, and access to percutaneous or Tenckhoff catheters, dialysis fluid, and automated PD should be increased.Item Congenital aniridia: clinical profile of children seen at the University College Hospital, Ibadan, South-West Nigeria(SAGE Publishing, 2021) Ugalahi, M. O.; Ibukun, F. A.; Olusanya, B. A.; Baiyeroju, A. M.Purpose: To describe the clinical features of patients younger than 16 years with aniridia presenting to the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital, Ibadan, Nigeria. Methods: The is a retrospective review of children with aniridia seen between May 2015 and April 2019 at the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital in Ibadan. Data on demographic characteristics, presenting complaints, ocular and systemic examination findings, and interventions were collected and descriptively summarised. Results: A total of 28 eyes of 14 patients were studied. The mean age was 6.37 ± 4.98 years. Seven (50%) patients were male. Aniridia was diagnosed in first-degree relatives of nine patients. The most common complaint at presentation was poor vision in 11 (78.6%) patients. Objective visual acuity assessment was obtained in 22 (78.6%) eyes. Presenting visual acuity was worse than 20/60 in all 22 eyes and worse than 20/400 in 8 (36.4%) eyes. Refraction was performed in 17 (60.7%) eyes and revealed a mean spherical equivalent of −3.93 ± 5.99 diopters. Twenty (71.4%) eyes had corneal opacities, and lenticular opacities were seen in 15 (62.5%) of 24 eyes. Mean intraocular pressure (IOP) at presentation was 21.62 ± 10.4 mmHg; 12 (41.4%) eyes had elevated IOP at presentation. Ten (35.7%) eyes had cataract surgery and six (21.4%) eyes had glaucoma surgery. Conclusion: Familial aniridia was common in this study, and most of the patients presented with moderate to severe visual impairment. The common ocular associations were refractive error, cataract, corneal opacity and glaucoma.Item Ocular morbidity among orphans and vulnerable children living in shelters in Ibadan metropolis(Wolters Kluwer - Medknow, 2024) Ajetunmobi, B. S.; Ugalahi, M. O.; Uchendu, O. C.; Baiyeroju, A. M.Globally, orphans and vulnerable children (OVC) represent a significant population at risk of poor health as well as a high risk of developing ocular disorders. These ocular disorders could lead to childhood visual impairment or blindness if left undetected or untreated. This study therefore focuses on ocular morbidity among OVC living in shelter facilities to provide relevant data for planning eye care interventions. Methods: A descriptive, cross-sectional study was conducted among OVC ages 5–16 years living within shelter facilities in Ibadan, Oyo State. Sociodemographic characteristics were obtained. Ocular examinations, including visual acuity measurements, colour vision test, Hirschberg test, anterior and posterior segments assessment, and cycloplegic refraction were conducted. Descriptive and inferential analysis was done with IBM SPSS Statistics version 24. All analyses were at 5% level of statistical significance. Results: A total of 497 eligible OVC participated in the study. The mean age was 11 ± 3.4 years, and 263 (52.9%) were males. The prevalence of ocular morbidity was 18.1%. The most common types of ocular morbidity were refractive errors 47 (9.5%) and allergic conjunctivitis 18 (3.6%), with more females affected by both conditions, 28 (59%) and 11 (61%), respectively. Ocular morbidity was most common (28.3%) among the 14–16 years age group (P=0.001). Conclusion: Refractive errors and allergic conjunctivitis, which are treatable ocular conditions, were the most common ocular morbidities among these children. Regular eye screening as well as the provision of quality and affordable eye care services is advocated for this vulnerable population of children.Item Otitis media with effusion and hearing loss in childen with orofactial clefts.(2019) Olije, T.; Fasunla, A.J.; Onakoya, P.A.; Ademola, S.A.; Adeosun, A.A.Background: Little or no attention is given to hearing health of children with orofacial cleft. This study was carried out to determine the prevalence of otitis media with effusion (OME) and evaluate hearing thresholds of children with orofacial cleft in Nigeria. Methodology: Eighty-three consecutive children with orofacial cleft comprising, 12 (14.5%) cleft lip alone, 32 (38.5%) cleft lip and palate and 39 (47.0%) cleft palate alone, and 83 healthy controls participated in the study. Structured questionnaire was used to collect socio-demographic and relevant medical information. Participants had ear, nose and throat examinations, visual reinforcement or condition play audiometry and tympanometry tests done. Statistical analysis was done with appropriate statistical tools, level of significance was set at p<0.05. Results: Mean age of cases was 22.83 ± 2.71 months and controls was 23.34 ± 2.54 months. Hearing loss was found in 28 (16.9%) ears of cases and 14 (8.5%) ears of controls (p=0.021). There was a significant difference between mean hearing thresholds of cleft palate ± lip and control (p<0.05). OME was present in 80 (48.2%) ears of cases and 17 (10.2%) ears of the controls (p=0.001). There was a statistically significant association between cleft palate ± lip and OME (p=0.0001, OR = 4.520 [2.353-8.681]). Conclusion: Otitis media with effusion and hearing loss were more prevalent among children with orofacial cleft palate than non-cleft children. Hence, routine early hearing and middle ear evaluations are recommended for inclusion in their management plan.Item Predictors of mortality in paediatric burns at ibadan, Nigeria.(2007) Odeyinde S.O || Ademola S.A || Oluwatosin O.M.Patients and Methods: This was a prospective study of children aged 0-13 years, managed in the bums unit of University College Hospital, Ibadan, Nigeria, between January 2001 and September 2003. Results: There were 62 patients, 42 (67.7%) were females and 20 (32.3%) were males (Male: Female= 1:2. Their ages ranged between 1 month and 13 years (mean = 4.8 ± 3.8 years). Majority of the patients (56.5%) were below 4 years of age. Bum was caused predominantly by flame (57%), followed by inhalation injury in 43.5% of the patients. The percentage total burn surface area (%TBSA) ranged between 1 % and 95% (mean 29.7% ± 22.8%), and 41.4% of the patients sustained a major burn (TBSA=30%). Infective complications were present in 37% of patients. The overall mortality was 33.9%, and occurred in those patients with %TBSA of 14 95% (mean = 48.8%). Mortality rate was 62.9% among those that had inhalation injury compared with 11.4% in those without inhalation injury. There was no mortality in those patients whose %TBSAranged between 1 and 32% (mean = 17.5%). Conclusion: Percentage of the total body surface area burnt and the presence of inhalation injury were important predictors of mortality in childhood bums injury.