Open Access Case Study

Hookworm Infection in Infant: A Case Study and Review of Literature

S. M. Arshad, . Arifa, Usmani Zakiya, Pangti Sakshi

Asian Journal of Pediatric Research, Page 11-16
DOI: 10.9734/ajpr/2022/v8i230238

Background: Hookworms are nematode parasites belonging to Ancylostomatidae helminth family that causes variety of clinical problems. They are often termed as soil transmitted helminths (STH) because human infection occurs by ingestion of eggs and /or skin contact with contaminated soil. Hookworm infection is common in tropical countries and transmission is influenced by climatic and socio-economic conditions. Hookworm infection in neonatal and infantile period are rarely reported. Here, we describe a case of two months old infant with hookworm infection and review the relevant literature.

Case Presentation: A two-month-old institution delivered male baby on exclusive breastfeeding with no significant ante natal or post natal history referred to our hospital with complains of black tarry stool since birth and progressive paleness of body requiring multiple packed cell transfusion. On investigation, child has severe anaemia with eosinophilia and positive stool for occult blood. Upper gastrointestinal endoscopy revealed hookworm in duodenum. The child was treated with oral mebendazole and discharged in good condition.

Discussion: Hookworm is a major public health problem in tropical and sub tropical countries. Most of the cases are asymptomatic and rarely detected. Hookworm infection can lead to growth retardation, failure to thrive, cognitive impairment and other manifestations also. Most of the cases are reported in older children and very few cases are reported in newborns and infants. Mechanism of transmission of infected larvae in such young infant in unclear. Transmission may occur vertically either through trans-placental route or by breastfeeding. Hookworm infection should be considered in differential diagnosis newborns and infants presented with unexplained weight loss, melena, anaemia with eosinophilia. The disease can be managed effectively through simple and easily available medications and adverse outcome can be prevented.

Conclusion: Very young infants residing in helminth endemic area with low socioeconomic status and presenting with severe anaemia with melena and/or failure to thrive, one should consider possibility of hookworm infection.

Open Access Original Research Article

Umbilical Cord Care Knowledge and Practice: What is the Status of National Chlorhexidine Gel Scale-Up in Nnewi Nigeria?

C. U. Onubogu, K. N. Okeke, E. F. Ugochukwu, C. E. Ezeudu, W. C. Igwe, E. O. Muokwugwo, E. S. Edokwe, N. V. Agu

Asian Journal of Pediatric Research, Page 1-10
DOI: 10.9734/ajpr/2022/v8i230237

Background: Use of chlorhexidine gel for cord care was scaled up in Nigeria to address the high burden of neonatal deaths from severe sepsis but there is scarcity of data on its uptake.

Aim: A cross-sectional study was conducted to examine the cord care practices of mothers in Nnewi.

Methods: Data was obtained using an interviewer-administered semi-structured questionnaire, and analyzed with SPSS version 21. P-value < 0.05 was considered statistically significant. 

Results: Mean age of the 214 studied mothers was 29.6 ± 5.53 years.  Majority had at least secondary education (93.5%), were income earners (83.2%), attended ante-natal clinic (ANC) (83.1%) or delivered (81.8%) in a health facility with skilled provider, and received health education on cord care during pregnancy for the index baby (80.4%). Health education was mostly received during ANC (75.6%[130/172]) and from nurses (73.3%[126/172]). Majority knew about methylated spirit use (89.3%) and the consequence of poor cord care (75.7%) but only 2.8% were aware of chlorhexidine gel use.

Umbilical stump was commonly cleaned with methylated spirit (89.3%) and or hot compress (24.8%). Thereafter, 47.7% applied nothing while others applied petroleum jelly (33.2%), toothpaste (8.9%), dusting powder (3.3%) etc. Reasons given for adopting a particular practice included efficacy (54.7%), advice by people (25.7%), peer’s influence (8.4%) and convenience (8.4%).  Factors significantly associated with using an antiseptic agent for cord care were maternal age, educational level, access to or source of health education, and frequency of ANC visits.

Conclusion/Recommendation: Respondents demonstrated good knowledge and practice of standard cord care but awareness and use of chlorhexidine gel was almost non-existent. .

Hindrances to effective national chlorhexidine scale-up should be identified and addressed. There’s serious need for enlightenment campaigns on chlorhexidine efficacy using public media channels such as radio jingles.  

Open Access Original Research Article

Stress and Coping Strategies of Parents of Preterm Infants in Selected Tertiary Health Institutions in Ekiti State

Alade, Modupe Irene, Ibitoye, Olabisi Fatimo, Ogunkorode, Agatha Sr, Akpor, Oluwaseyi Abiodun

Asian Journal of Pediatric Research, Page 17-27
DOI: 10.9734/ajpr/2022/v8i230239

Background: Preterm birth is one the leading causes of death among children below the age of five years and involves all births that occur before 37 weeks of gestation. This study therefore examined the stress and coping techniques of preterm infants parents in Ekiti State University Teaching Hospital and Federal Teaching Hospital, Ekiti State.

Methodology: This study adopted quantitative research method and study was conducted among parents of preterm infants in two selected teaching hospital Ekiti State Nigeria. Sample size was determined using Fischer’s formula and the sample consisted of 82 respondents selected using purposive sampling technique. Data were collected using a standardized instrument (Family Inventory of Life Events and Changes) developed by McCubbin & Patternson (1983) with reliability index of 0.83. Data collected were analyzed using descriptive statistics of frequency, percentages, mean, standard deviation and tables while inferential statistics of chi-square and correlation were used to test stated hypothesis at 0.05 level of significance.

Results: The results showed that majority (32.1%) of preterm babies were jaundiced and were male (58.9%). Parents of preterm infants experienced moderate (85%) level of stress. However, finances and business strains were identified as major stress experienced by preterm infant parents. Overall coping level was high (65.2%) and coping strategies employed were seeking information and advice; positive reframing; and seeking for assistance. The findings also revealed no correlation between perceived stress and coping technique; no significant association between the socio-demographic factors and stress experienced by parents of preterm infants.

Conclusion: This study showed that parents of preterm infants experienced stress but developed coping techniques to suppress their level of stress. It is therefore recommended that nurses should develop proper understanding about the parents’ stressful situations to provide a holistic care to the neonates and their parents.

Open Access Original Research Article

Comprassion the Lipid Profile among Children Suffreing from Nephrotic Syndrome before and after Remission

Pinky Atal, Kalpana Choudhary, Meenakshi .

Asian Journal of Pediatric Research, Page 28-33
DOI: 10.9734/ajpr/2022/v8i230240

Aims: The study aimed to investigate serum cholesterol, triglycerides, LDL (low density lipoprotein), VLDL (very low-density lipoprotein), and HDL (high density lipoprotein) levels in nephrotic syndrome at the onset and during remission in first episode and relapse cases, as well as the relationship between dyslipidemia persistence and severity and disease duration and relapse frequency.

Materials and Methods: A hospital-based prospective study including 30 children aged 0 to 12 years with nephrotic syndrome. They were steroid responsive in 22 cases and steroid dependent in 8 cases. They were assessed clinically and a lipid profile was taken at the start, during remission, and after treatment. A total of 30 children without liver or kidney disease were included as controls.

Results: The mean blood cholesterol, triglycerides, LDL, and VLDL all increased significantly (p0.005). When compared to controls, HDL levels increased dramatically (P value 0.001) after nephrotic syndrome treatment. Lipid levels (serum cholesterol, triglycerides, LDL, VLDL) were significantly lower during remission in first-episode nephrotic syndrome cases, whereas lipid levels were significantly greater even during remission in recurrent cases. After treatment, total cholesterol and TGL levels were found to be higher, with P values of 0.004 and 0.004 respectively, as the duration of disease increased.

Conclusion: The current investigation demonstrates that widespread hyperlipidemia is present in nephrotic syndrome. When compared to recently diagnosed with NS, this was much higher in relapse cases. Lipid profiles return to normal during remission recently diagnosed with NS, but they are considerably higher in recurrence instances, even during remission. As a result, there is a justification for treatment.

Open Access Original Research Article

Clinical Profile of COVID-19 Infection and SARS-Cov-2 IgG Antibody Response in Children under 18 Years of Age in a Tertiary Care Centre in North Kerala

T. R. Anjali, Vidhu Ashok, A. V. Gopalan, K. Sasidharan

Asian Journal of Pediatric Research, Page 34-40
DOI: 10.9734/ajpr/2022/v8i230241

Background: The Global Pandemic Coronavirus disease, was first reported in December 2019 in Wuhan and in March 11, 2020, got declared as global pandemic by  World Health Organisation (WHO) . The morbidity and mortality of the disease have been rising with second wave of pandemic hitting worldwide.

Objectives: To study the clinical profile of children under 18 years of age with COVID-19 infection and to study the IgG antibody response in covid infected children.

Materials and Methods: Children under 18 years of age except neonates who had COVID-19 infection and recovered from MMC Covid hospital were included for the study. After discharge blood samples were tested for COVID-19 IgG Antibody using SARS-CoV-2 IgG Reagent Kit 6R86 by Abbott Ireland diagnostics division. Data was entered into Microsoft excel   sheet and statistical analysis done with SPSS VERSION 21.

Results: Children who fulfilled the inclusion criteria were taken up for the study. Median age in this study was 10 years. All affected   children got infection from their family members. Fever as the presenting symptom were found in 62% children. Ninteen children showed positive IgG antibody  and 2 out of 21 children showed negative IgG antibody level . There is significant association between IgG titre and timing of  antibody testing after infection by the SARS-CoV-2 virus

Conclusion: Clinical profile and spectrum of COVID-19 infection were similar in all family members. Measures to prevent transmission of infection from family members to children will decrease infection by the SARS-CoV-2 virus in children. Antibody following infection by the SARS-CoV-2 virus will last only for few months, making children susceptible to covid infection again. Vaccination among children is necessary to prevent rapid spread of covid   infection.