<a href="https://www.pexels.com/photo/scrabble-tiles-on-a-light-blue-surface-8428356/">Photo by Anna Tarazevich</a><h1 style="margin-left:0cm;">Overview</h1>When the heavy bleeding started, she never imagined it could be anything worse. Mrs. B, a 28-year-old mother of two has had a heavy bleeding in the past, some of which she took pills for, others went on their own. Her gynaecologist attributed her last heavy flow to an anovulatory cycle, something to do with her ovaries not releasing an egg for the month. It was nothing to worry about, she had said. So when this came, she didn’t think much of it until it refused to go.Mrs. B went to the hospital where she had several tests done. Full blood count, ultrasound scan, urinalysis. Nothing extraordinary was found, safe for an unusual finding in her urine. Her PCV, which indicates the blood level in her body, was normal. The abdominal ultrasound done didn’t show anything abnormal. Only the urinalysis discovered red blood cells. The doctor told her not to worry but recommended she go for a biopsy, where a tiny cut of her cervix will be taken and viewed with a microscope. The biopsy report came back and the unimaginable had happened: she has cervical cancer&nbsp;For many people like Mrs. B., cervical cancer is a strange thing. Cancer is common. It’s on the news. Everyone talks about, but not much or anything at all is ever said about cervical cancer. Or not much that she had heard or read. All she knew about were breast cancer, lung cancer, and prostate cancer. Here she was having to deal with a cancer she's never heard about.<h3 style="margin-left:0cm;">So what’s cervical cancer?</h3>Cervical cancer is the cancer of the cervix, the lower, narrow end of the uterus that connects to the vagina. Around 660,000 women were newly diagnosed with cervical cancer in 2022, making it the fourth most common cancer in women globally.&nbsp;Other notable statistics about cervical cancer include:<ul><li>&nbsp;It accounts for death every two minutes</li><li>Nearly 22.5% of these deaths occur in Africa</li><li>About 8% of the cancer is associated with infections with high-risk strains of human papillomavirus (HPV)&nbsp;</li><li>More than&nbsp; 75,000 new cases and close to 50,000 deaths are reported annually in sub-Saharan Africa</li><li>The World Health Organization projects that by 2030, cervical cancer will claim the lives of more than 443,000 women worldwide, with almost 90% of these fatalities in sub-Saharan Africa.&nbsp;</li></ul>This surge in cervical cancer cases threatens to reverse the advancements made by African women in reducing maternal mortality and enhancing life expectancy. Nevertheless, cervical cancer is a largely preventable non-communicable disease, with effective strategies available for primary (vaccination), secondary (early detection), and tertiary (management of diagnosed cases) prevention.&nbsp;<h1 style="margin-left:0cm;">What are the causes of cervical cancer?</h1>&nbsp;The primary cause of cervical cancer is a long-lasting infection with specific types of human papillomavirus (HPV). HPV is a transmitted virus that spreads through sexual contact.&nbsp;It is estimated that at least half of sexually active individuals will contract HPV at some point in their lives; however, only a small percentage of women will develop cervical cancer.&nbsp;<h3 style="margin-left:0cm;">Who's at risk for cervical cancer?</h3>Cervical cancer is often associated with identifiable risk factors. Some of these factors can be modified, while others are beyond your control.&nbsp;Here are some risk factors you can control:<ul><li>Sexual intercourse at an early age:&nbsp;</li><li>HPV infection</li><li>HIV infection</li><li>Weakened immune system</li><li>Multiple pregnancies</li><li>Long term use ofirth control pills</li><li>Smoking: Cigarette smoking has been linked to a heightened risk of cervical cancer.</li></ul>While these risk factors re controllable, some are not.Example of an uncontrollable risk factor:<ul><li>Family history</li><li>Age&nbsp;</li></ul><h1 style="margin-left:0cm;">What are the symptoms of cervical cancer?&nbsp;</h1>In its early stages, cervical cancer typically does not present any symptoms, making early detection challenging. Symptoms often emerge only after the cancer has progressed.&nbsp;When early-stage cervical cancer symptoms do manifest, they may include:<ul><li>Irregular vaginal bleeding or heavier menstrual periods</li><li>Vaginal bleeding after menopause</li><li>Vaginal bleeding post-intercourse</li><li>Unusual vaginal discharge that may be watery, foul-smelling, or blood-stained</li><li>Pelvic pain or discomfort during intercourse</li></ul>As cervical cancer advances, symptoms may encompass those of early-stage cancer, along with:<ul><li>Painful or difficult bowel movements</li><li>Bleeding from the anus during bowel movements</li><li>Painful urination&nbsp;</li><li>Blood in the urine</li><li>Persistent lower back pain</li><li>Swelling in the legs</li><li>Abdominal pain</li><li>Fatigue</li></ul>These symptoms can also be found in other conditions other than cervical cancer. Consulting a Doctor is essential for an accurate diagnosis. Delaying treatment for cervical cancer due to ignored symptoms can lead to less effective management.<h2 style="margin-left:0cm;">Stages of cervical cancer</h2>The staging of cervical cancer indicates the degree of spread.There are 4 stages of cervical cancer progression and they are:<ul><li>Stage I: Cancer is confined to the cervix.</li><li>Stage II: Cancer has spread beyond the cervix and uterus but not to the pelvic wall or vagina.</li><li>Stage III: Cancer has spread to the lower vagina and possibly the pelvic wall and nearby lymph nodes.</li><li>Stage IV: Cancer has spread to the bladder, rectum, or other distant parts of the body.</li></ul><h1 style="margin-left:0cm;">Preventing cervical cancer</h1>HPV vaccineThe HPV vaccine is designed to protect against the specific strains of HPV responsible for nearly all cervical cancer cases. Gardasil 9 is effective against nine HPV types, which together account for about 90% of cervical cancers. For optimal efficacy, the second dose should be administered six to twelve months after the first.Receiving the HPV vaccine does not eliminate the need for regular cervical cancer screening. Women vaccinated against HPV should have their first screening at age 25 and continue every five years thereafter.<h1 style="margin-left:0cm;">How is cervical cancer diagnosed?</h1><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_582d7737fd_6fccdf28fd.webp"></figure><a href="https://www.freepik.com/free-photo/doctor-holding-radiography-side-view_32338454.htm#fromView=search&amp;page=1&amp;position=31&amp;uuid=bbcea39a-f3bf-4fab-a3e3-86bd249d91bf">Image by freepik</a>Cervical cancer develops slowly over many years, hence the need for regular Pap smear ( The Pap smear is a procedure that screens for cervical cancer by collecting cervical cells from the lower part of the uterus that connects to the vagina. It can also reveal precancerous changes in these cells, enabling early intervention when required.In this test, a healthcare provider uses a speculum to gently open the vagina, providing access to the cervix. They then collect cell samples using a soft brush or spatula, which they preserve in a solution and send to a laboratory for analysis. The entire process typically takes just a few minutes and may cause slight discomfort, but it is usually not painful.) To detect early signs of cancer, if positive, a biopsy is ordered.The biopsy could be any of the following:<ul><li>Colposcopic biopsy</li><li>Loop electrosurgical excision procedure (LEEP)</li><li>Cone biopsy&nbsp;</li><li>Endocervical curettage&nbsp;</li><li>Cold knife cone biopsy&nbsp;</li></ul>An HPV DNA test too can be ordered.Should the biopsy test come out as positive further investigations would be required to determine if the cancer has spread (metastasized) and to what extent.The other test include:&nbsp;<ul><li>Renal function test</li><li>Liver function test</li><li>X-ray of bladder, bowels, intestines</li><li>Urine Test</li><li>Ultrasound&nbsp;</li></ul><h2 style="margin-left:0cm;">Treatment</h2>Treatment of cervical cancer depends on:<ul><li>The stage of the cancer</li><li>The size and shape of the tumor</li><li>The woman's age and general health</li><li>Her desire to have children in the future</li></ul>Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. There are surgical ways to do this without removing the uterus or seriously damaging the cervix, so that a woman can still have children in the future.The following treatment options are available depending on the stage of the cancer:<ul><li>Laser therapy&nbsp;</li><li>Cryotherapy&nbsp;</li><li>Hysterectomy&nbsp;</li><li>Radiation therapy&nbsp;</li><li>Loop Electrosurgical Excision Procedure(LEEP)</li><li>Chemotherapy&nbsp;</li></ul><h3 style="margin-left:0cm;">Support Groups</h3>Joining a cancer support group can provide emotional relief and connection with others facing similar challenges. Sharing experiences can help alleviate feelings of isolation.<h1 style="margin-left:0cm;">Conclusion</h1>Early detection of cervical cancer is key to effective treatment, making regular Pap smear screenings essential. The HPV vaccine, now available in three different versions, provides crucial protection against the virus that often leads to cervical cancer. Staying on top of both vaccinations and screenings is important for reducing risk. Furthermore, involving family and connecting with support networks can greatly support your journey through treatment.

Understanding Cervical Cancer, Causes, Symptoms and Management

Health News and Research

Women's Health

The human heart pumps approximately 23,000 litres of blood throughout the body daily. Heart failure occurs when the heart fails to pump sufficient blood to meet the body’s needs.&nbsp;This article will explore the causes, prevention, and management of heart failure.&nbsp;<h2 style="margin-left:0cm;">What is heart failure?</h2>Heart failure is a complex clinical syndrome characterized by your heart’s inability to pump blood sufficiently to meet your body’s needs.Initially, your body compensates for the inadequate blood supply through different mechanisms, such as:&nbsp;<ul><li>Enlargement of the heart: your heart stretches to generate a greater force to pump blood.</li><li>Increased heart muscle mass:&nbsp;your heart muscles expand to generate a stronger force of contraction.</li><li>Narrowing of the arteries: your arteries, the blood vessels that carry blood from your heart, may narrow to increase the contracting pressure to help your failing heart maintain arterial pressure.</li><li>Blood shunting: If heart failure is severe, the body may redirect blood from peripheral areas like the skin to vital organs like the heart, kidneys, and brain.</li></ul>Because of these compensatory mechanisms, you may not have symptoms initially. However, the compensation is temporary and may not solve the underlying problem.&nbsp;If the heart failure is not properly managed, the compensatory mechanisms may fail, and you may start to have symptoms like breathlessness, fatigue, persistent dry cough, and other signs of heart failure.&nbsp;<h2 style="margin-left:0cm;">Signs and symptoms of heart failure&nbsp;</h2>Patients with&nbsp; heart failure may have signs and symptoms such as:&nbsp;<ul><li>Shortness of breath</li><li>Dry cough&nbsp;</li><li>Cold extremities with bluish lips</li><li>Pallor</li><li>Tiredness&nbsp;</li><li>Fatigue from&nbsp; minimum exertion</li><li>Swelling of the legs and/or abdomen from fluid retention</li><li>Poor appetite&nbsp;</li><li>Nausea&nbsp;</li></ul><h2 style="margin-left:0cm;">Types of heart failure</h2>Heart failure can be classified based on the location of the failure and the type of heart function&nbsp;that fails.<h3 style="margin-left:0cm;">Heart failure types based on location</h3>You could have either a right-side heart failure or a left-side heart failure.<ul><li>Right-sided heart failure affects the right side of the heart, where the right ventricle pumps blood to the lungs. When the right side fails, blood backs up into the veins, causing your legs, ankles, and abdomen to swell.</li><li>Left-sided heart failure occurs when the left ventricle can’t efficiently pump blood to the rest of the body. Fluid builds up in the lungs, causing shortness of breath.&nbsp;</li></ul>If the heart failure is from both the right and the left ventricles, it is called congestive heart failure.&nbsp;<h3 style="margin-left:0cm;">Heart failure types based on function</h3>Depending on which aspect of heart function that fails, you could experience either systolic heart failure or diastolic heart failure.<ul><li>Systolic heart failure happens when the heart can’t pump blood because it’s weak or enlarged.</li><li>Diastolic heart failure happens when the heart muscle doesn’t relax because it’s stiff, which leads to inadequate filling of the heart.</li></ul><h2 style="margin-left:0cm;">Causes of Heart Failure in Africa</h2>The causes of heart failure in Africa vary across the continent, but the common causes among the general population include:&nbsp;<ul><li>Hypertension</li><li>Coronary artery disease (CAD)</li><li>Cardiomyopathy</li><li>Rheumatic heart disease</li><li>Chronic lung disease</li><li>&nbsp;Pericardial diseases like constrictive pericarditis, pericardial effusion</li><li>HIV</li></ul>Hypertension is the leading cause of heart failure in&nbsp; Nigeria.&nbsp;Unlike hypertension, coronary artery disease (CAD) and its complications are less common in Africa but are gradually becoming more prevalent due to:&nbsp;<ul><li>Lifestyle modifications,&nbsp;</li><li>Smoking&nbsp;</li><li>Drinking of alcohol</li><li>Urbanization</li></ul>Other causes of heart failure include:<ul><li>Excessive salt intake&nbsp;</li><li>Smoking or sniffing tobacco of any kind</li><li>Excessive alcohol intake</li><li>Infection&nbsp;</li><li>&nbsp;Use of certain medications like anticancer drugs, stimulants, etc.</li><li>Autoimmune diseases like lupus erythematosus&nbsp;</li></ul><h2 style="margin-left:0cm;">Risk factors&nbsp;</h2>Risk factors for heart failure in sub-Saharan Africa include:<ul><li>Hypertension</li><li>Diabetes</li><li>Dyslipidaemia</li><li>Kidney disease</li><li>Smoking</li><li>High alcohol intake&nbsp;</li><li>Myocarditis</li><li>HIV</li><li>Pregnancy</li></ul>Other risk factors include:<ul><li>Rheumatic Heart Disease</li><li>Obesity</li><li>Dilated cardiomyopathy</li><li>Anaemia</li></ul><h2 style="margin-left:0cm;">Diagnosis</h2>Your doctor will take your medical history, examine you, and ask you to do:&nbsp;<ul><li>A chest x-ray,</li><li>An ECG (electrocardiogram)</li><li>Blood test</li><li>Echocardiogram</li></ul>A heart MRI or CT scan, PET scan, or angiogram may sometimes be requested.&nbsp;<h2 style="margin-left:0cm;">Treatment and Prevention of Heart Failure&nbsp;</h2>The treatment of heart failure depends on the cause of your heart failure and the type and severity of your heart failure.If the cause is hypertension, you may need to take anti-heart failure drugs plus anti-hypertensives and adjust your diet and lifestyle.&nbsp;If it’s an infection, you may need antibiotics.&nbsp;If the problem is with your heart valves, you may need surgery.If these treatments don’t work, a heart transplant may be recommended for you.Whatever the cause, heart failure management is both pharmacological and non-pharmacological.<h3 style="margin-left:0cm;">Pharmacological management</h3>This type of management includes drugs such as:<ul><li>Angiotensin receptor blockers (ARB)</li><li>Angiotensin-converting enzyme (ACE) inhibitors</li><li>Angiotensin receptor-neprilysin inhibitors (ARNIs)</li><li>Diuretics</li><li>Vasodilators&nbsp;</li><li>Digitalis</li><li>Beta-blockers</li><li>Aldosterone blockers</li><li>Statins&nbsp;</li></ul>The drugs help to<ul><li>Reduce your blood pressure&nbsp;</li><li>Relax your blood vessels</li><li>Reduce the amount of fluid and sodium in your body&nbsp;</li><li>Strengthen the contraction of your heart muscles</li><li>Reduce your heart rate</li><li>Reduce the level amount of unhealthy cholesterol in your blood</li></ul><h3 style="margin-left:0cm;">Non-pharmacological management</h3>This type of management does not include drugs. It only requires you to:<ul><li>Reduce your salt intake</li><li>Reduce your alcohol intake&nbsp;</li><li>Quit smoking</li><li>Exercise regularly as much as you can tolerate</li><li>Control your blood sugar if you’re diabetic&nbsp;</li><li>Reduce your body weight if you’re overweight or obese</li></ul>Heart failure caused by physical damage to the heart may require surgery, such as:<ul><li>Valvular repair or replacement</li><li>Device implantation</li><li>Heart transplantation</li></ul><h2 style="margin-left:0cm;">Complications of Heart Failure</h2>If your heart failure is not treated at all or is treated poorly, it may lead to life-threatening complications like congestive heart failure, which is a failure of both the right and left sides of your heart. This causes worse and more dangerous symptoms.Other complications of heart failure include:<ul><li>Pulmonary hypertension&nbsp;</li><li>Kidney or liver damage</li><li>Cardiac arrest</li><li>Pulmonary oedema</li><li>Irregular heartbeat</li><li>Stroke</li></ul><h2 style="margin-left:0cm;">What is the prognosis of heart failure?</h2>The outlook (prognosis) for heart failure is poor. People with the disease have a life expectancy of about five years from diagnosis, so it’s necessary to seek expert care as soon as you realise that your heart may be failing.<h2 style="margin-left:0cm;">Conclusion</h2>Heart failure is better prevented than treated. Once it has begun, there is no permanent cure, and no treatment can reverse the damage.&nbsp;If you’re at risk, like if you are hypertensive, have diabetes or any other chronic disease, adjust your diet and lifestyle as recommended, and be regular with your drugs and clinical checkups.Having heart failure doesn’t mean the end of the world. You can still enjoy life if you follow the steps outlined in this article and your doctor’s advice.

Heart Failure: Causes, Prevention and Management

Lifestyle and Wellness

Disease prevention and management

<a href="https://www.freepik.com/free-vector/kidney-realistic-organs-anatomy-poster_29875081.htm#query=human%20kidney&amp;position=3&amp;from_view=keyword&amp;track=ais_user&amp;uuid=fb359a69-327f-488e-b1c5-80e2237f8a0e">Image by gstudioimagen1 on Freepik</a><h2 style="margin-left:0cm;text-align:justify;">What is acute kidney injury?&nbsp;</h2>Acute&nbsp;kidney&nbsp;injury (AKI) is a sudden decrease in the ability of the kidney to filter the blood, resulting in a reduction in urine production. This decrease disturbs the balance of body fluids and electrolytes, causing the body to retain wastes.&nbsp;Although a problem worldwide, acute kidney injury is more common in Africa than elsewhere. Available data indicates that the disease is common among 10 - 40% of adults in sub-Saharan Africa.<h2 style="margin-left:0cm;text-align:justify;">Symptoms and signs of AKI</h2>Most patients&nbsp;do not know that they have an acute kidney injury because the condition does not often present with clinical symptoms. However, the following symptoms might be present in some:<ul><li>Decreased urine output&nbsp;</li><li>Edema: generalized body swelling</li><li>Hypertension&nbsp;</li><li>Weakness&nbsp;</li><li>Nausea</li><li>Coma, in severe cases</li></ul><h1 style="margin-left:5.0pt;text-align:justify;">Classification of AKI</h1>Acute kidney injury is classified based on the location of the cause of the injury. The classifications could be:<ul><li style="text-align:justify;">Pre-renal AKI - if the cause of the injury is before the kidney</li><li style="text-align:justify;">Renal or intrinsic AKI - if the injury is within&nbsp;the kidney</li><li style="text-align:justify;">Post renal AKI - if the injury is caused by factors after&nbsp;the kidney, such as the obstruction of the ureter, a tube that carries urine from the kidney to the bladder, by a stone.</li></ul>Only the intrinsic acute kidney injury represents true kidney disease.&nbsp;Pre-renal and post-renal forms of the disease are the consequences of non-kidney diseases that lead to a decreased glomerular filtration rate (GFR).<h2 style="margin-left:0cm;text-align:justify;">Stages of acute kidney injury&nbsp;</h2>There are four main stages in the development of an acute kidney injury:&nbsp;<ul><li style="text-align:justify;">Initiation</li><li style="text-align:justify;">Oligo-anuria&nbsp;</li><li style="text-align:justify;">Polyuria&nbsp;</li><li style="text-align:justify;">Restitution&nbsp;</li></ul>These four stages restore kidney functions and should last a maximum period of three months, if the injury does not cause significant damage to the kidney.&nbsp;However, the injury can progress to a chronic kidney disease if it persists for more than three months.<h1 style="margin-left:5.0pt;text-align:justify;">Causes of AKI in sub-Saharan Africa (SSA)</h1>The most common causes of acute kidney injury in Africa include:<ul><li style="text-align:justify;">Malaria</li><li style="text-align:justify;">HIV</li><li style="text-align:justify;">Nephrotoxic agents such as&nbsp;traditional&nbsp;herbal concoctions&nbsp;</li><li style="text-align:justify;">Envenomation from snakebite&nbsp;</li><li style="text-align:justify;">Chronic conditions like diabetes mellitus and&nbsp;hypertension</li><li style="text-align:justify;">Obstetric complications</li><li style="text-align:justify;">Use of skin&nbsp;lightening (bleaching) creams containing mercury&nbsp;</li></ul><h2 style="margin-left:0cm;text-align:justify;">Who is at risk of acute kidney injury?</h2>Anyone can come down with acute kidney injury but some classes of people are especially at higher risk. These sets of people include:<ul><li style="text-align:justify;">People&nbsp;living with chronic illnesses like&nbsp;diabetes&nbsp;mellitus,&nbsp;hypertension,&nbsp;and sickle&nbsp;cell&nbsp;disease</li><li style="text-align:justify;">Patients with sepsis</li><li style="text-align:justify;">Patients with poorly treated&nbsp;urinary tract infection&nbsp;</li><li style="text-align:justify;">People who abuse nonsteroidal anti-inflammatory drugs (NSAIDs)</li><li style="text-align:justify;">Elderly&nbsp;patients</li><li style="text-align:justify;">People with blocked urinary tract&nbsp;</li><li style="text-align:justify;">Users of certain antibiotics like&nbsp;aminoglycosides</li><li style="text-align:justify;">Patients with dehydration from&nbsp;diarrhea or exercise&nbsp;</li><li style="text-align:justify;">Patrons of traditional practices&nbsp;that involve lacerations of people with unsterilised tools</li><li style="text-align:justify;">People observing prolonged fasting without water</li><li style="text-align:justify;">Poor people who drink herbal concoctions</li></ul><h2 style="margin-left:0cm;text-align:justify;">Complications of acute kidney injury</h2>When the kidney cannot filter waste and electrolytes from the blood&nbsp;or&nbsp;maintain the water or electrolytes balance due to an injury, the patient&nbsp;may develop complications such as:<ul><li style="text-align:justify;">Edema: generalized body swelling</li><li style="text-align:justify;">Arrhythmia: abnormal heart rhythm</li><li style="text-align:justify;">Metabolic acidosis: acid buildup in the blood due to reduced excretion</li></ul>Vomiting, drowsiness and breathlessness also can occur.<h2 style="margin-left:0cm;text-align:justify;">Diagnosis and laboratory tests for AKI</h2>Your&nbsp;doctor may order&nbsp;a range of tests to confirm an acute kidney injury or determine its severity These tests include:<ul><li>Urinalysis&nbsp;</li><li>Blood test</li><li>Abdominopelvic ultrasound</li><li>CT scan</li><li>Biopsy of the kidneys in extreme cases</li></ul><h1 style="margin-left:0cm;text-align:justify;">Treatment for acute kidney injury</h1>Prompt medical treatment is necessary to reverse an acute kidney injury, restore kidney functions, and prevent the injury from progressing to a chronic disease or degenerating into renal failure.&nbsp;Treatment options include:<ul><li style="text-align:justify;">Medications to restore fluid and electrolyte balance</li><li style="text-align:justify;">Diuretics to help eliminate accumulated waste</li><li style="text-align:justify;">Dialysis support for people with severe acute kidney injury&nbsp;</li><li style="text-align:justify;">Dietary restrictions, especially from potassium-rich foods like bananas, oranges, spinach, potatoes, and tomatoes</li></ul><h1 style="margin-left:0cm;text-align:justify;">How to prevent acute kidney injury</h1>A healthy lifestyle, balanced diet, and adequate hydration are key to preventing acute kidney injury. These healthy habits&nbsp;can reduce your chances of having an acute kidney injury, but may require you to:<ul><li>Reduce alcohol intake&nbsp;</li><li>Avoid the abuse of NSAIDS like Ibuprofen and aspirin</li><li>Exercise regularly&nbsp;</li></ul><h2 style="margin-left:0cm;">Challenges in the Management of Acute Kidney Injury in Africa</h2>Acute&nbsp;kidney&nbsp;injury is still a major challenge in Africa as compared to other parts of the world. This is due to:<ul><li style="text-align:justify;">Inadequate facilities and diagnostic tools</li></ul>Poor communities don't have standard hospitals and laboratories. This makes it difficult for patients to access care on time.<ul><li style="text-align:justify;">Few specialists, many patients&nbsp;</li></ul>The number of people with acute kidney injury far outnumbers the number of specialists to care for them. While some patients with the injury may need to see a specialist, those who need specialists must compete with tens of other patients, which may lead to treatment delays and avoidable complications.&nbsp;<ul><li style="text-align:justify;">Late presentation</li></ul>Patients with AKI often present late to the clinic due, in part, to poverty, ignorance, and self-treatment. Some patients start with self medications, only to present at the hospital when they don't see any improvement.&nbsp;<ul><li style="text-align:justify;">Poverty and illiteracy</li></ul>Poverty and illiteracy go hand-in-hand to complicate AKI care in Africa. Some patients who&nbsp;have AKI and need to see a doctor help don't know they do need medical attention,&nbsp;while those&nbsp;who do&nbsp;may not have the financial means to get well.<ul><li style="text-align:justify;">High disease burden&nbsp;</li></ul>African patients are disproportionately affected by AKI, along with other diseases like HIV, malaria, and&nbsp;diarrhoea, and triggers like nephrotoxins (chemicals that hurt the kidneys). This high disease burden increases the risk of worse outcomes for African patients with AKI.<h1 style="margin-left:0cm;text-align:justify;">What next?&nbsp;</h1>The high prevalence of AKI in SSA is not solely due to the nature of the condition, but rather a complex interplay of preventable and treatable causes, poor health-seeking behavior, socioeconomic barriers, and systemic healthcare challenges. Addressing these multifaceted issues is crucial to improving the management and outcomes of AKI in the region. To ensure that AKI incidence is greatly reduced, there’s&nbsp;a need for proper awareness of this disease entity in SSA, especially since a good number of her populace ingest herbal concoctions and the prevalence of malaria with HIV, which are the main&nbsp;culprits of AKI.

The Burden Of Acute Kidney Injury (Aki) In Africa

Photo by&nbsp;<a href="https://www.flickr.com/photos/fmsc/">Feed My Starving Children (FMSC)</a>&nbsp;on <a href="https://www.flickr.com/photos/fmsc/">Flickr</a> <a href="https://creativecommons.org/licenses/by/2.0/">(CC BY 2.0).</a>Seeing your child’s first smile, watching their initial wobbly steps, and hearing their child begin to form words are all precious milestones that gladdens the heart. This growth comes from nutrients in&nbsp; foods children eat.&nbsp;Children’s food should be rich in essential nutrients delivered in the right balance. When this balance is not maintained or achieved, it can lead to malnutrition which affects the child’s well-being in several ways.&nbsp;Here are some key facts about malnutrition in Nigerian children:<ul><li>Approximately 37% of children (6 million) experience stunting (a condition whereby the child is too short for the age)&nbsp;</li><li>18% of children are affected by wasting (indicating low weight for height)</li><li>29% of children are underweight (which includes both acute and chronic malnutrition)</li></ul><h2 style="margin-left:0cm;">What is malnutrition?</h2>Malnutrition is an abnormality in nutrition. It occurs when there’s an imbalance in a child’s nutrient intake, either because the child takes too much or too little calories, carbohydrates, vitamins, proteins, or minerals. Malnutrition includes both undernutrition and overnutrition, which are consequences of either deficiencies or excesses of vital nutrients.&nbsp;<h2 style="margin-left:0cm;">Why are some children malnourished?</h2>Children are more likely to have shortages of both macronutrients and micronutrients due to their increased nutritional needs during growth. When they don’t get adequate food or don’t eat as they should, they may become malnourished.&nbsp;The consequences of malnutrition in children under five can include being underweight, stunted, or wasted, with or without edema (previously referred to as marasmus and kwashiorkor, respectively), and in severe cases, it can lead to death.&nbsp;Malnutrition represents a critical outcome of food insecurity among children in this age group. Acute malnutrition can result in illness, death, and long-term disabilities, as well as hinder cognitive and physical development, while also increasing the likelihood of concurrent infections.&nbsp;Each year, around 50 million children globally experience acute malnutrition. Despite the availability of treatment, accessing it can be difficult.&nbsp;<h2 style="margin-left:0cm;">Types of Malnutrition</h2>Malnutrition can be categorised primarily into two groups:<ul><li>Overnutrition</li><li>Undernutrition</li></ul><h2 style="margin-left:0cm;">Overnutrition</h2><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_c82187e67e_b5cbc0a3ab.webp"></figure>Overnutrition occurs when your child consumes more nutrients than their bodies need, resulting in excess body fat and related health risks.&nbsp;Children who are classified as overweight or obese face increased risks for a variety of health issues later in life, including:<ul><li>&nbsp;Heart disease</li><li>Diabetes</li><li>Certain types of cancer</li></ul>The occurrence of overnutrition is rising globally, with reports from unicef indicating that 5.7% of children under five were classified as overweight in 2020, an increase from 5.4% in 2000.<h2 style="margin-left:0cm;">Undernutrition</h2><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_f8dc8eb662_b74f10edd9.webp"></figure>Photo by &nbsp;<a href="https://www.flickr.com/photos/dfid/5977576239">Cate Turton / Department for International Development</a> on <a href="https://www.flickr.com/">Flickr</a><a href="https://creativecommons.org/licenses/by/2.0/">(CC BY 2.0).</a>Undernutrition is when a child is not eating enough food or the right foods to meet their body's needs for energy and good health.Undernutrition poses a serious threat to the health and development of children. It can result in severe outcomes like protein-energy malnutrition, including a greater vulnerability to infections, hindered cognitive and physical growth, and, in extreme cases, death.&nbsp;Undernutrition can be further classified into four categories:&nbsp;<ul><li>Wasting (defined as low weight-for-height)</li><li>Stunting (defined as low height-for-age)</li><li>Underweight (defined as low weight-for-age)</li><li>Deficiencies in essential vitamins and minerals</li></ul>Each of these conditions can have a profound impact on a child's health and development.<h2 style="margin-left:0cm;">Why are children unable to access nutritious food?</h2>Dietary practices&nbsp;Unlike adults that can choose what they want to eat, children often take what they are fed. For the first months of life, most children are on breastmilk. Family food such as pap, rice, and “swallows” like eba, amala, and pounded yam, come much later.&nbsp;However, children may be left malnourished due to practices that undermine adequate nutrition. For instance, some mothers think that breastmilk alone is insufficient for their baby's growth and feel compelled to introduce other traditional foods too early.&nbsp;Additionally, there are misconceptions that colostrum—the first milk produced after childbirth—is not healthy for children, and may even be harmful, which leads some mothers to discard it.&nbsp;Breastmilk, especially colostrum, is one of the most nutritious foods a child can take. It is rich in nutrients and easy to digest. It also contains proteins that protect the child from diseases, plus growth factors to support the child’s maturation.&nbsp;Caregiver Ignorance&nbsp;Caregivers, especially first-time mothers are sometimes unaware of how frequently a child needs to be fed. Children’s meals do not follow adult timetables. They need to eat as soon as they are hungry, which is often many times.&nbsp;Young children grow rapidly in the first years of life,&nbsp; and this consumes their energy. Their energy comes from food. So they use more nutrients than adults, necessitating frequent meals that are balanced&nbsp;However, many first-time mothers mistakenly adhere to the adult routine of three square meals a day, which can result in the child not receiving the necessary nutrients.Illness&nbsp;&nbsp;Frequent or severe illnesses can cause a child to become malnourished. For instance, malaria, pneumonia, and measles causes the child to lose energy, or increase their energy demand, leading to malnutrition.&nbsp;An ill child may have poor appetite such that they don’t eat even when food is available. Such child may vomit their food, or lose all their nutrients through to diarrhoea. Some children with short gut may also not be able to absorb the foods they eat, whether the food is adequate or not.&nbsp;Besides, when their parents are ill and there’s other caregiver to take care of the child, the child may suffer malnutrition. This is often true for children of mothers with chronic illnesses, or mothers that had surgery or complications during delivery.&nbsp;Cost of quality mealThe high cost of nutritious meals is a major reason why many children under five in Nigeria suffer from malnutrition. Families, especially those in poorer areas, often can't afford the balanced diets that young children need.This issue is particularly severe in low income communities where many families don’t have a stable source of income, or the income is too low to provide enough food for the family.&nbsp;Moreover, factors like inflation, climate change, and economic instability are driving up food prices, making it even more difficult for low-income families to secure essential nutrients for their children.Conflict and Drought&nbsp;In northeastern Nigeria, the combination of drought and conflict has led to significant food shortages. Displacement of families means that parents often struggle to secure food, as they no longer have a reliable supply. When livelihoods are compromised, food insecurity becomes a pressing issue.&nbsp;According to a June 2024 report by UNICEF on food insecurity in Nigeria, around 11 million children, or one in every three children under five years of age, in Nigeria are experiencing severe child food poverty, making them up to 50 per cent more likely to experience wasting, a life-threatening form of malnutrition.<h2 style="margin-left:0cm;">Signs and symptoms of malnutrition&nbsp;</h2>Signs of malnutrition can vary but often include:<ul><li>Unintentional weight loss</li><li>Reduced appetite or disinterest in food</li><li>Fatigue and irritability</li><li>Difficulty concentrating</li><li>Dry, pale skin</li><li>Easy bruising or rashes</li><li>Changes in hair texture and growth</li><li>Swollen or cracked tongue</li><li>Increased sensitivity to cold</li><li>Prolonged wounds healing&nbsp;</li><li>Higher likelihood of infections</li><li>Night blindness or sensitivity to light</li></ul>Sometimes, a child is given the right amount of food, but essential micronutrients like Zinc, Vitamin D etc are lacking, which would result in a term known as hidden hunger.<h2 style="margin-left:0cm;">How can you prevent malnutrition?</h2><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_78240af50f_8f9bda4a8e.webp"></figure>&nbsp;The key to preventing malnutrition is to maintain a balanced diet that includes a variety of foods from all major food groups. This should include:<ul><li>An abundance of fruits and vegetables, like oranges, watermelon, pumpkin leaves&nbsp;</li><li>Sufficient starchy foods such as bread, rice, yam flour, wheat flour, cassava flour (aka, garri) and pasta</li><li>Adequate dairy or dairy alternatives</li><li>Protein sources like meat, fish, crayfish, eggs, and legumes</li></ul>If you don’t know what a balance diet looks like in your local diet, discuss with a dietitians or a pediatrician to guide you.<h2 style="margin-left:0cm;">How malnutrition is treated</h2>Malnutrition is a medical condition that requires care of specialists like dietitians and pediatricians. Treatment strategies will differ based on the severity of the condition and any underlying health issues. Approaches may include:<ul><li>Correcting life-threatening deficiencies</li><li>Stabilizing the child’s body temperature and fluid levels</li><li>Continuous monitoring and assessment</li><li>Developing a dietary plan that may include nutritional supplements</li><li>Addressing specific symptoms, such as vomiting and diarrhea&nbsp;</li><li>Treating any existing infections</li><li>Evaluating and managing swallowing difficulties</li><li>Following up on the child’s recovery</li></ul>In severe cases where a child cannot eat through the mouth, tolerate enough food, or absorb nutrients on their own, the physician may resort to feeding the child through intravenous (parenteral) or tube (enteral) methods to ensure adequate nutrient delivery.<h2 style="margin-left:0cm;">Conclusion</h2>The complexities surrounding malnutrition are significant, with its most common causes linked to poor dietary quality, inadequate caregiving practices, and recurrent infections among children.&nbsp;The repercussions of malnutrition can lead to both immediate and long-term health challenges, including slower recovery from illnesses and an increased risk of infections.Therefore, it is vital for parents to priorities prevention strategies and recognize the signs of malnutrition to enable timely interventions and restore health in affected children.

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