I C Anochie

University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria

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Publications (25)13.35 Total impact

  • AN Okpere · IC Anochie · I Yarhere
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    ABSTRACT: Background: Central diabetes insipidus (CDI) is rare in children. About 30 - 50% of cases are idiopathic. Early and accurate diagnosis are crucial for safe and effective treatment. This is the first report of Central diabetes insipidus in a child in Nigeria.Case report: We report a case of central diabetes insipidus in a female toddler who presented at the University of Port Harcourt Teaching Hospital with polydipsia and polyuria with a urine specific gravity of 1.000 and normal blood sugar. The diagnosis of CDI was confirmed by her inability toconcentrate urine after a water deprivation test followed by an increase in urine osmolality from 59mOsm/kg to 158mOsm/kg and serum osmolality from 286mOsm/kg to 321Osm/kg following intravenous administration of desmopressin. The patient responded well to oral desmopressin.Conclusion: Central diabetes insipidus occurs in Nigerian children and responds to oral desmopressin. We recommended high index of suspicion in children with polyuria and polydipsia.
    Nigerian journal of paediatrics 02/2014; 41(2):147. DOI:10.4314/njp.v41i2.16
  • A N Okpere · I C Anochie · F U Eke
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    ABSTRACT: The rate and prevalence of hypertension in children is increasing. Childhood hypertensionif untreated can lead to hypertension in adulthood with its consequent cardiovascular and renal complications. Early detection of paediatric hypertension may lead to improvement in cardiovascular health in adults. This study aims to determine the blood pressure (BP) pattern and prevalence of hypertension in asymptomatic secondary school children and factors associated with hypertension in these adolescents. A cross-sectional study of 820 adolescents selected from 12 secondary schools in Port Harcourt was conducted. BP was measured by the auscultatory method. The average of three readings was taken as the actual blood pressure. Hypertension was defined as systolic and/or diastolic blood pressures equal to or greater than the 95th percentile for age, sex and height. Data was analysed using SPSS version 17.0. Systolic and diastolic BP increased with age in all subjects. Male subjects had a higher systolic BP compared to females. Hypertension was seen in 26 (3.2%) subjects; 13males and 13females. The proportional prevalence was higher in the age group 15-17 years (3.9%); in those in social classes V (9.1%) and with family history of hypertension (3.6%), (p ã 0.05 in all cases). It was however significantly higher in the obese subjects (p = 0.000). The prevalence of hypertension in adolescents in Port Harcourt is high and is strongly associated with obesity. We recommend blood pressure measurement as part of the school health programme in secondary schools.
    West African journal of medicine 08/2013; 32(2):93-8.
  • I C Anochie · F U Eke · A N Okpere
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    ABSTRACT: Focal segmental glomerulosclerosis (FSGS) is a significant cause of end-stage renal disease. It is generally considered to be sporadic but familial cases have been reported in varied ethnic groups. Genetic mutations implicated in familial FSGS involving NPHS1, NPHS2, WTI and APOL1 have not been studied in African children living outside America. This is the first report of familial FSGS and genetic study from children living in Africa. We reported two siblings; a 4year old male and a 15-year old female from a non-consanguineous family with renal biopsy-confirmed FSGS who presented with Nephrotic syndrome (NS). The male was steroid dependent NS and achieved long term remission after two courses of oral cyclophosphamide, while the elder sister is steroid resistant and has not achieved remission with cyclosporine. We performed mutational analysis on the family by sequencing both strands of all exons of NPHS2, WT1 and APOL1 using exon flanking primers. There was absence of common gene mutations in NPHS2, WT1 and APOL1 gene in any of the two children. We present for the first time mutational analysis of NPHS2, WT1 and APOL1 in a sibling with familial FSGS from Nigeria. There may be different and unidentified gene mutations responsible for FSGS in indigenous African children.
    West African journal of medicine 03/2013; 31(4):273-6.
  • AN Okpere · IC Anochie · FU Eke
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    ABSTRACT: Background: Obesity is a risk factor for metabolic syndrome with insulin resistance. Its effect on renal and cardiovascular diseases is reported in developed countries, but rarely established among adolescents in developing countries.Subjects and methods: A crosssectional study of 846 adolescents selected from 12 secondary schools in Port Harcourt, Nigeria. Obese subjects with Body Mass Index (BMI) equal to or greater than the 95th percentile for age and sex on the United States CDC growth chart were selected and studied. Urine samples of subjects without overt proteinuria were tested for microalbuminuria using the micral test strips.Results: Seventy-three of the subjects were obese giving the prevalence of obesity to be 8.6%. Microalbuminuria was present in 23 (35.4%) of the 65 obese subjects without overt proteinuria. The proportional prevalence was higher in females (42.9%), in age group 10-14years (42.2%), in subjects with hypertension (57.1%), and family history of hypertension (50.0%) and diabetes mellitus (37.5%) [p > 0.05].Conclusion: There is high prevalence of adolescent obesity, and a high prevalence of microalbuminuria among obese adolescents in Port Harcourt. We recommend efforts at reducing obesity as a means of preventing renal disease in adolescents.
    Nigerian journal of paediatrics 05/2012; 39(3). DOI:10.4314/njp.v39i3.8
  • Jaja T · Yarhere I · Anochie IC
    01/2011; 01(03). DOI:10.4172/2161-0665.1000106
  • I.C Anochie · P.N Tabansi
    12/2010; 5(1). DOI:10.4314/phmedj.v5i1.62936
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    ABSTRACT: Microalbuminuria is an early manifestation of HIV associated nephropathy (HIVAN). This study was to determine the prevalence and risk factors for microalbuminuria in children with HIV infection in Port Harcourt, Nigeria. Urine specimen of 50 children with HIV infection seen over a 4 months period (October 2007-February 2008) was assayed for albumin and creatinine to determine urinary albumin to creatinine ratio (ACR). Microalbuminuria was defined as urinary albumin to creatinine ratio (ACR) of greater than 2.5-25 mg/mmol. The glomerular filtration rate (GFR) was calculated using the Schwartz formula. There were 28 (56%) males and 22 (44%) females with a male to female ratio of 1.3:1. They aged 1 month to 18 years with a mean age of 4.07 +/- 3.61 years. Microalbuminuria occurred in 6 (12%) patients; 3 males and 3 females, mean age of 5.5 +/- 4.6 years. Five (83.3%) of the patients with microalbuminuria had clinical AIDS and CD4+ cell count less than 200 cells/microL. All the patients with microalbuminuria were not receiving highly active antiretroviral therapy (HAART) at the time of study. One (16.7%) patient had overt HIV-associated nephropathy (HIVAN) with ACR greater than 2.5 mg/mmol, elevated serum creatinine 400 micrommo/L, urea of 20 mmol/L and a GFR of 69 ml/min/1.73m2. The prevalence of microalbuminuria in Nigerian children with HIV infection is high, and it occurs mainly in older children with clinical AIDS who are not on HARRT.
    Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria 09/2010; 19(3):298-301. DOI:10.4314/njm.v19i3.60214
  • GK Eke · IC Anochie · FU Eke
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    ABSTRACT: Urinary tract infection (UTI), a significant but preventable cause of morbidity in children, is an important risk factor for development of renal insufficiency. Having simple and reliable means of screening children facilitate its prompt treatment.To evaluate the use of dipstick test for leukocyte esterase (LE) and nitrite as screening tool in the diagnosis of UTI in children.This cross-sectional study was done in the department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from February to October 2005. Children 2 to 15 years with symptoms suggestive of UTI were studied. Midstream urine specimen was collected from each patient forLEtest, nitrite test and culture.Out of 139 children, 72(51.8 percent) males and 67(48.2 percent) females studied, 33(23.7 percent) had positive urine culture. The prevalence of UTI was significantly higher in females than in males (p=0.001). The LE dipstick test correctly identified 17 of the 33 patients with culture proven UTI, with 51.5 percent sensitivity and 79.2 percent specificity. The nitrite dipstick test showed 42.4 percent sensitivity and 93.3 percent specificity. The combination ofLEand nitrite correctly identified 24, giving 73 percent sensitivity and 75.5 percent specificity. The LE seemed to have a higher sensitivity as a screening tool in the diagnosis of UTI than nitrite, but the difference was not statistically significant (p=0.46). However, the combination of LE and nitrite provided a higher sensitivity than either of them with a statistically significant difference (p=0.04).
    The Nigerian medical practitioner 08/2010; 57(4). DOI:10.4314/nmp.v57i4.57939
  • 08/2009; 3(3). DOI:10.4314/phmedj.v3i3.45268
  • IC Anochie · PI Opara · N Inimgba
    08/2009; 3(2). DOI:10.4314/phmedj.v3i2.45237
  • Ifeoma Anochie · Felicia Eke · Augustina Okpere
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    ABSTRACT: Acute glomerulonephritis (AGN) is an important cause of renal morbidity and mortality in children. The incidence varies across the countries with lower rates in developed countries due to improved environmental hygiene and socio-economic status. A prospective study of patients admitted with the diagnosis of AGN was carried out in the Department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from June 2006 to June 2008. The patients' demographic data, presenting complaints; antecedent history of sore throat or skin infections, clinical findings including blood pressure; investigations, management and outcome were obtained. Data was compared with a previous study done in UPTH 14 years ago and in other countries. A total of 31 patients aged 3 to 16 years had AGN, giving an annual incidence of 15.5 cases. They comprised 16 (51.6%) males and 15 (48.4%) females with a M:F ratio of 1.1:1. There is no significant change in the annual incidence of AGN when compared with the 14.5 cases per year reported in our centre 14 years ago. Fourteen (45.2%) of the patients were between 5-10 years. The highest incidence occurred during the dry cold windy (harmattan) season of October to February in 19 (61.3%) patients. Twenty-four (77.4%) of the patients were from low socio-economic classes (social class IV and V). Sore throat was the commonest infection preceeding AGN (66.6%). Hypertensive encephalopathy with seizure occurred in 5 (16.1%) patients. There were 4 (12.9.1%) patients with nephrotic range proteinuria, and 12 (38.7%) patients had renal failure. Urinary tract infection occurred in 7 (22.6%) patients; klebsiella being the commonest organism isolated. All patients received conservative treatment while dialysis was done in 5 patients; one peritoneal dialysis (PD) and 4 haemodialysis. The recovery rate was 83.9% and a hospital mortality of 3 (9.7%). The annual incidence of AGN has remained almost the same in Port Harcourt despite the increased urbanization and overcrowding in this oil rich state of Nigeria.
    Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria 08/2009; 18(2):162-7. DOI:10.4314/njm.v18i2.45056
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    ABSTRACT: One hundred and thirty teachers were studied to evaluate their knowledge of congenital Color Vision Deficiency (CVD), and their ability to perform the Ishihara color vision test, so as to determine if they can provide color vision screening services for their pupils. The teachers were randomly selected from 13 schools in Port Harcourt City (PHC) and given a six hours training workshop on vision disorders in children and congenital color vision screening. They were given a self administered pre and post test questionnaires before and after training respectively. Subsequently, they screened 1,300 of their school pupils for congenital vision deficiency using the Ishihara color vision chart; and their results compared to that of the research team. Female teachers constituted 84.6% and males 15.4% of the study population. Seventy three teachers (53.8%) were from public schools while 46.2% were from private schools. Prior to the training workshop, only 6.2% of teachers had heard of the Ishihara color vision chart and none of the teachers could identify or knew how to use the chart. However with training there was significant improvement in knowledge of CVD. Comparison of the teachers' performance of color vision screening using the Ishihara chart to that of the research team showed a sensitivity of 67.6% with a specificity of 99.1%. The prevalence of congenital color vision deficiency in the 1,300 primary school screened was 2.6%, with males having a significantly higher prevalence than females. The study thus concludes that congenital color vision deficiency is prevalent amongst primary school children in Port Harcourt City, and with training, teachers can effectively perform color vision screening, and as such modify their teaching methods to accommodate the child with color vision deficiency.
    Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria 11/2008; 17(4):428-32. DOI:10.4314/njm.v17i4.37427
  • I C Anochie · K E O Nkanginieme · N Eke · I Gbogo
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    ABSTRACT: The use of a structured guideline in medical education to reach a diagnosis provides accurate information which is relatively free from bias. The purpose of this paper is to assess the performance of medical students using unstructured and structured format in case summary. One hundred and sixty- nine medical students in Part III MB; BS Programme in the University of Port Harcourt were studied. There were 83 students in Paediatics [SP] and 86 students in Obstetrics and Gynaecology [SOG] postings. The students had video recorded presentation of three clinical cases comprising of two paediatrics [PC1&PC2] and one surgical case [SC3]. The summary for the first case [PC1] was done using an unstructured format, while the second case [PC2] was done with both unstructured PC2a and structured PC2b format. The Surgical case [SC3] was done using only the structured format. The discrete pieces of important information in each case were quantified and scored by trained assessors. PC1and SC3 had a total of 16 points each while PC2 had a total of 24 points. The pre-exposed SOG students scored significantly higher than none-exposed SPG students in PC1 and SC3; P<0.05. In PC2 75.1% students scored above 12 points using structured summary format compared to 38.5% students with unstructured format , P<0.05. The students had significantly higher score using structured format in SC3 than PC1. The use of structured summary format enabled better case summary than unstructured format, and it's transferable across different departments.
    Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria 09/2008; 17(3):300-3. DOI:10.4314/njm.v17i3.37399
  • P I Opara · I C Anochie · F U Eke
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    ABSTRACT: Background: Diabetes mellitus (DM) is the commonest endocrine disorder seen in children. A previous study, done in Port Harcourt, showed a prevalence of 1.2/1000, with all the cases being type 1, and a high mortality rate of 28.4%. This study was carried out, to determine if there had been any changes in the type of DM and the outcome. Method: A retrospective search of diabetic patients admitted into our Children\'s medical wards, over a 6-year period (January 2000- December 2005) was done. Their case files were analyzed for patients\' characteristics, type and duration of DM, frequency of hospitalization, complications and outcome. All the patients were managed by the Paediatric endocrinology unit which was set up in 2000. Results: Out of 6,715 admissions, 11 patients had DM, giving a hospital prevalence of 1.6/1000. The male: female ratio was 1: 1.2. The patients were aged 10months- 16years, with a mean age of 11.8 ± 1.53 years. All the patients were newly diagnosed type 1 DM. Nine (81.8%) were from low socioeconomic background and two (18.2%) had a positive family history of diabetes. The mean body mass index of the patients was 18.5 ±0.88 kg/m2. All the patients were managed with parenteral insulin and diabetic ketoacidosis (DKA) was seen in 10 (90.1%). There was no hospital mortality, showing a marked improvement compared to the previous study. Conclusion: Type 1 DM is still the commonest type of diabetes seen in children in Port Harcourt, and has improved outcome.
    03/2008; 2(2). DOI:10.4314/phmedj.v2i2.38908
  • Ifeoma C Anochie · Felicia U Eke · Augustina N Okpere
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    ABSTRACT: Human immunodeficiency virus-associated nephropathy (HIVAN) has rarely been reported in African children. In this single-center study, we analyzed ten children diagnosed with HIVAN from January 2000 to October 2006. There were eight boys and two girls, with a male:female ratio of 4:1. Their ages were from 5 months to 15 years (mean 6.8+/-6.2 years), with a peak age of 5-9 years. The presenting complaints included generalized edema (60%) and hypertension (50%). All patients had proteinuria on urine dipstick, with four (40%) at nephrotic range (proteinuria >or=500 mg/dl). Nine (90%) patients were in renal failure, with elevated serum creatinine (6.3-24 mg/dl) and serum urea (70-120 mg/dl). Renal disease was the first manifestation of HIV infection in six patients, whereas the diagnosis was made on autopsy in three. The duration from HIV infection to development of HIVAN ranged from 5 months to 10 years. CD4(+) cell count, done in only three patients due to financial constraints, was below 200/mm(3). The kidneys were hyperechoic on abdominal ultrasound in all patients, and three (30%) showed grossly enlarged kidneys. Histology of renal tissues available by autopsy in three patients showed mainly collapsing focal segmental glomerulosclerosis. Treatments given were angiotensin-converting enzyme (ACE) inhibitors and highly active antiretroviral therapy (HAART) in four and two patients, respectively, and one patient underwent peritoneal dialysis. On outcome analysis, seven (70%) patients died, two were lost to follow-up, and one was alive on HAART therapy at the writing of this article. In conclusion, HIVAN occurs in Nigeria children, and the mortality is very high from uremia.
    Pediatric Nephrology 01/2008; 23(1):117-22. DOI:10.1007/s00467-007-0621-0 · 2.86 Impact Factor
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    Ifeoma Anochie · Felicia Eke · Augustina Okpere
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    ABSTRACT: In our center, childhood nephrotic syndrome (NS) had been reported for over a decade to be steroid sensitive contrary to reports in other parts of Nigeria. The purpose of this study was to determine if there are changes in presentation and response to steroids, with reviews of the literature on NS. Analysis of 28 patients seen at the University of Port Harcourt Teaching Hospital, Nigeria, from 1999-2004 with the diagnosis of NS was performed. There were 14 girls and 14 boys with NS. The peak age was 1-4 years. Twenty (71.4%) children had idiopathic nephrotic syndrome (INS). Four had chronic renal failure, one had sickle cell disease (HbSS), two were positive to human immunodeficiency virus (HIV) 1 and 2, and one had pulmonary tuberculosis. Anemia was found in 13 patients, while 17 had Plasmodium falciparum. Plasmodium malariae and hepatitis-B surface antigen were not isolated. Renal biopsy was performed in four patients and revealed minimal-change disease in one child, focal segmental glomerulosclerosis in two and no conclusive result in one patient. Oral prednisolone was used in INS. After one month of therapy, 16 of 20 responded, of which 12 (75%) were <5 years. The NS relapsed in 15 of 16 steroid-sensitive patients. Cyclophosphamide and levamisole were used in four and one patients with FRNS, respectively. Four (14.3%) patients died; all were secondary NS. INS remains common in our center, and the majority respond to steroid therapy
    Journal of the National Medical Association 01/2007; 98(12):1977-81. · 0.96 Impact Factor
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    Barbara Edewele Otaigbe · Ifeoma Comfort Anochie · Ifefoma Gbobo
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    ABSTRACT: Enterocutaneous fistulae (ECFs) after typhoid perforation have been previously recorded postoperatively due to repair leak or new perforation. Spontaneous ECF formation due to primary intra-abdominal pathologic processes has been attributed to infectious diseases such as tuberculosis and Crohn's disease. A review of the literature has shown no previous report of spontaneous ECF caused primarily by salmonella typhi infection. To report a case of spontaneous ECF due to salmonella typhi infection. An eight-year-old female presented with high fever and weight loss of two weeks' duration and a one-week history of a foul-smelling umbilical discharge. She was ill looking, wasted, with evidence of peritonitis. An emergency exploratory laparotomy revealed multiple perforations at the antimesenteric border of the ileocecal valve. With intestinal resection and anastomosis and the use of broad spectrum antibiotics, her clinical state improved. Tissue biopsy showed hemorrhagic necrosis with infiltration by mononuclear inflammatory cells. ECF is a rare complication of enteric fever, Enteric fever should therefore be considered in ill children presenting with ECF in the absence of a history of previous surgery, or blunt or penetrating trauma.
    Journal of the National Medical Association 11/2006; 98(10):1694-6. · 0.96 Impact Factor
  • IC Anochie · FU Eke
    Nigerian journal of paediatrics 07/2006; 31(4). DOI:10.4314/njp.v31i4.12099
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    I C Anochie · F U Eke
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    ABSTRACT: Acute peritoneal dialysis (APD) is the preferred treatment for isolated failure of the kidney. The authors reviewed children with acute renal failure (ARF) who had APD in Port Harcourt, Nigeria. 221 patients, 147 boys and 74 girls (M: F, 1.99:1), mean (SD) age 5.4 (4.9) years had ARF. Dialysis was indicated in 112 cases. The main clinical indication being convulsion/uraemia 30 (26.8%) Only 27 patients (21 boys and 6 girls) had APD, giving an access rate of 24.1%. The commonest dialysis related complication was catheter malfunction 12 (44.4%). The mortality rate among the dialysed patients was 22.2%. Lack of dialysis and intractable hypertension significantly increased mortality (chi2 = 7.13, p<0.01) and (chi2 = 14.9, p<0.001) respectively. APD is effective in reducing mortality of children with ARF. However, there were low dialysis access rate and few complications.
    Postgraduate medical journal 03/2006; 82(965):228-30. DOI:10.1136/pgmj.2005.039834 · 1.45 Impact Factor
  • Ifeoma C Anochie · Felicia U Eke
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    ABSTRACT: Acute renal failure (ARF) is a significant cause of morbidity and mortality in children. It may be pre-renal, intrinsic, or post-renal (obstructive) in aetiology. ARF was investigated in children in the south-southern part of Nigeria to determine the prevalence, aetiology, management and outcome of ARF. A retrospective review of data from all children from birth to 16 years of age admitted into the Department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH), with the diagnosis of ARF over an 18 year period (January 1985 to December 2003) was performed. Information was obtained about the age, sex, clinical features, blood pressure, laboratory and radiological investigations, aetiology, and treatment received including dialysis. Information on the outcome, factors influencing outcome, and possible causes of death were reviewed. There were 211 patients, 138 (65.4%) males and 73 (34.6%) females (M:F, 1.9:1), with a hospital prevalence of 11.7 cases/year. The patients were aged 5 days to 16 years (mean 5.6+/-4.7 years). Oliguria was the most common clinical presentation in 184 (87.2%) patients. Hypertension was seen in only 39 (18.5%) patients. The causes were age-related. The neonates had ARF from severe birth asphyxia 27 (35.5%), septicaemia 17 (22.4%), with tetanus 4 (5.3%) and congenital malformations 11 (14.5%). Sixty-one (28.9%) and 29 (13.7%) patients had ARF from gastroenteritis and malaria respectively. The patients with leukaemia were all more than 10 years old and had acute lymphoblastic leukaemia. Two patients (1.9%) had Burkitts lymphoma involving the abdomen and 3 patients had HIVAN. 112 (53%) patients had anaemia with a mean haematocrit of 20.25+/-6.9%. Dialysis was indicated in 108 patients, but only 24 patients (22.2%) had peritoneal dialysis (PD), because of financial constraints and lack of dialysis equipment. Mortality rate was 40.5%. The causes of death were uraemia 60 (70.6%), overwhelming infection 5 (5.9%), and recurrent anaemia 20 (23.5%). Hypertension (X2 15.7, P<0.001) and lack of dialysis (X2 7.96, P<0.01) significantly affected outcome. Other factors associated with demise were delayed presentation (58.8%), use of herbal treatment (35%), and unaffordability of treatment (40%). ARF is a significant cause of mortality in Nigerian children. The patients are not adequately managed because of poverty and lack of facilities for dialysis. The causes of ARF in our environment are preventable, and should be expected.
    Pediatric Nephrology 11/2005; 20(11):1610-4. DOI:10.1007/s00467-005-1984-8 · 2.86 Impact Factor