Nigerian Journal of Paediatrics

Paper Presentations.pdf

Niger J Paediatr 2016; 43 (2):104 – 159

PANCONF 2016 ANNUAL GENERAL CONFERENCE

Abstracts of Proceedings

CC – BY

47th Annual General and Scientific Conference of the Paediatrics

Association of Nigeria (PANCONF), 19th - 23rd January, 2016

GP 1

GP2

Marfans Syndrome in three consecutive siblings in

Spatial analysis of accessibility to child health care

Sokoto, Northwestern Nigeria

services in Sokoto metropolis

Sani UM, Ahmad MM, Waziri UM, Isezuo KO

Jega MR ¹ , Nakakana UN¹ , Aliyu MN¹ , Muhammad I ² .

Paediatric Cardiology Unit, Paediatric Neurology Unit,

Department of Paediatrics, Usmanu Danfodiyo Univer-

Department of Paediatrics, Usmanu Danfodiyo

sity Teaching Hospital, Sokoto.

University Teaching Hospital, Sokoto, Nigeria

GIS Unit, Department of Geography, Ahmadu Bello

Email: murisbn@yahoo.com

University, Zaria.

Email: jegaridwan@yahoo.com

Background: Marfan syndrome (MS) is an autosomal

dominant multi-systemic connective tissue disorder

Background: Despite the admirable intent of citing ex-

mainly affecting the cardiovascular, skeletal and ocular

isting child health care facilities in resource constraint

systems. We present three cases of MS occurring in con-

settings such as Sokoto, North western Nigeria; limited

secutive siblings from a consanguineous marriage cou-

success has been recorded in reducing child morbidity

ple in Sokoto, Northwestern Nigeria. The aim is to em-

and mortality. This is probably due to geographic inac-

phasize the need for early recognition and genetic coun-

cessibility to such care. Geographic Information Sys-

seling.

tems (GIS) are increasingly being harnessed to help

Case report: An 8-year old girl presented with history of

solve environmental based health problems such as ac-

recurrent cough, weight loss, generalized body weakness

cessibility to health care.

and hypermobility of the joints since 2 years of age.

Objectives: We aimed to assess accessibility to child

Prior to presentation, she was treated for tuberculosis for

health care services in Sokoto metropolis using GIS.

8months with no response. On examination, she had

Methods: Facilities were mapped using handheld Global

classical features of MS including long, thin extremities,

Positioning System. Using network analyst tool in Arc

high arched palate with dental crowding, disproportion-

GIS, cost Origin Destination (OD) matrix was created

ately long arm span, Pes planus, wrist and thumb signs.

using the population weighted centroid of each electoral

Family history revealed similar features in two of her

ward as origins and the health facilities as destinations.

siblings. The first was her elder brother who died sud-

The average nearest neighbourhood analysis was done to

denly at the age of 5yrs while the second was her

determine the spatial randomness of the health care fa-

younger sister aged 5yrs. Echocardiography in the two

cilities. Furthermore shortest route to these facilities was

surviving patients revealed aortic aneurysm. The diagno-

determined. In addition, structured questionnaires were

sis of MS in the patients was made based on revised

administered to determine child health services (i.e.

Ghent nosology (2000). Parents never had any form of

Doctor-patient ratio, patient-bed ratio, facilities for im-

counseling in the past, as this was the first time they

munization, exclusive breast feeding, control of diar-

were informed about the problem. Hence, they were

rheal disease, management of severe acute malnutrition).

counseled accordingly and advised on the need for ge-

Spatial data and non-spatial data were analyzed using

netic testing, prenatal diagnosis and/or family planning.

Arc GIS (version 10) and SPSS (version 20). Statistical

The patients are currently being followed up at the Pedi-

significance was taken as 0.05.

atric Cardiology and Neurology clinics.

Results: Health care facilities in some wards were

Conclusion: Marfan syndrome is a heritable multi sys-

grossly inadequate and three settlements were found to

temic disorder, often complicated by aortic artery aneu-

be deprived child health care facilities. In most areas

rysm and life threatening aortic dissection. Health care

where child health facilities were geographically acces-

providers should be able to recognize the features of this

sible this did not equate with availability of child health

syndrome so that genetic counseling can be offered early

services.

to affected families.

Conclusion: There is need to improve health accessibil-

Key words: Marfan syndrome, consecutive siblings,

ity in certain areas which are underserved in Sokoto

Sokoto, Nigeria.

metropolis.

105

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can result in life threatening respiratory complications.

Childhood poisoning at the Ekiti State University

We report a possible case of this syndrome seen in our

Teaching (EKSUTH) Ado Ekiti, southwest Nigeria

facility in Sokoto

Case report: H.S.B, was a 10-month old female infant

*Oladele SO , Ezra OO , Isaac OO , Oyinkansola TA ,

delivered at term after an uneventful supervised preg-

Odunayo F , Babajide SA

nancy. Apgar scores were 3 and 7 respectively with a

Department of Paediatrics, Ekiti State University

birth weight of 2.54kg. On examination, she had dys-

Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria

morphic features including low set ears, depressed nasal

Email: ladeletunya@yahoo.com

bridge, camptodactyly, hypoplastic nails, talipes equino-

varus and umbilical hernia. She also thrived poorly

Introduction: Poisoning is a preventable cause of child-

weighing 4.2kg at 10 months.

hood morbidity and mortality. Information on childhood

Chest X-ray and contrast study confirmed diaphragmatic

poisoning in the developing world is scanty. This study

(Morgagni hernia) while echocardiography revealed

describes the profile of childhood poisoning at the Ekiti

congenital heart disease (Atrioventricularseptal defect).

State University Teaching Hospital.

Patient had recurrent admissions on account of broncho-

Material and Methods: Children admitted with poison-

pneumonia and heart failure. While being planned for

ing over a 48-months period at the Ekiti State University

surgery, she developed features of severe bronchopneu-

Teaching Hospital Ado-Ekiti, Southwest Nigeria, were

monia with heart failure and died despite treatment.

reviewed.

Conclusion: Fryns syndrome is a rare disorder associ-

Results: It was found that 81 of 5256 admissions repre-

ated with high morbidity and mortality. Early recogni-

senting 1.54% of the total admissions were due to poi-

tion and correction of life threatening anomalies can

soning. Kerosene, Drugs, Alcohol based herbal concoc-

improve prognosis in affected patients.

tion, pesticides, corrosive agents and carbon monoxide

Key words: Congenital diaphragmatic hernia, AVC

were involved in 37.0%, 22.2%, 19.8%, 8.6%, 6.2% and

defect, Fryns syndrome, Sokoto

6.2% respectively. Accidental and non-accidental inten-

tions were involved in 85.2% and 14.8% cases respec-

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tively. Administration of palm oil (oil from Elais

Over-the-counter medication use among under-5

guineensis ), vomiting induction and herbal concoction

children in Gwagwalada Metropolis

were the leading home interventions in 69.1%, 38.3%

and 23.5% respectively. One patient required intensive

Onalo R, Offiong MU, Ochei J, Mamman I

care. There were seven deaths and overall mortality rate

Department of Pediatrics University of Abuja Teaching

was 8.6%.

Hospital Gwagwalada

Conclusion: Poisoning remains a cause of childhood

Email: richardonalo@yahoo.com

morbidity and mortality in Nigeria. The double burden

of both intentional and non-intentional poisonings was

Background: Administration of drugs to children with-

observed alongside higher preponderance of herbal con-

out prescription from physician can lead to unnecessary

coction poisonings compared to previous reports. Estab-

medication use, adverse reactions and drug resistance.

lishment of poisoning information and control centre,

Objective: The aim of the study is to examine the mag-

use of poison score to triage patients and incorporation

nitude of over-the-counter-drug use among under-5 chil-

of routine education on poisoning prevention to parents

dren prior to presentation to physician for consultation.

by health care providers are recommended among other

Methods: A prospective cross sectional study of con-

strategies to combat its scourge in Nigeria.

secutive under-5 children brought to the pediatric outpa-

Key words: Childhood poisoning, Child deaths, South-

tient clinic of University of Abuja Teaching Hospital,

west, Nigeria.

Gwagwalada-Abuja was conducted over a period of

6 months.

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Result: A total of 386 respondents ( mother and child

Fryns syndrome in a child with congenital diaphrag-

pair ) were interviewed. The ages of the mothers ranged

matic hernia and congenital heart disease: a rare

between 18 and 50 years, while those of the children

case seen at Usmanu Danfodiyo University Teaching

were between 1 week and 60 months.

Hospital, Sokoto

176 (45.6%) of the mothers were from the lower socio-

economic class, 124 (32.1%) were from the middle

Ahmad MM, Sani UM, Jiya NM, Isezuo KO

class, and 86 (22.3%) were from the upper class.

Waziri UM.

A total of 306 (79.3%) mothers admitted to have admin-

Department of Pediatrics,Usmanu Danfodiyo University

istered over-the-counter drugs for the treatment of their

Teaching Hospital, Sokoto, Nigeria

children’s symptoms before presenting to the physician

Email: murisbn@yahoo.com

while 80 (20.7%) mothers used none. About one-third

used two or more drugs before consultation.

Background: Fryns syndrome is a rare autosomal reces-

Antipyretic drugs were the most frequently used medica-

sive disorder first described by J.P Fryns in 1979. It is

tions (178), followed by antibiotics (136), antimalaria

characterized by facial abnormalities, distal digit anoma-

(83), antitussives (52), and multivitamins (40).

lies, cardiac defects and congenital diaphragmatic hernia

Discussion and Conclusion: The study demonstrates

(CDH). CDH is the most common associated defect and

widespread use of over-the-counter medications in chil-

106

dren in Gwagwalada Metropolis. There is therefore need

Method: A descriptive cross sectional study was done in

for public enlightenment on the potential harm relating

Port Harcourt, South, south Nigeria were 177 healthy

to the use of over-the-counter drugs in children.

primary students aged 5-13 years were recruited after

consent was obtained from their parents. Their bio data

GP6

was obtained as well as their height, weight, Body mass

A preliminary spatial analysis of an outbreak of

index and body surface area. The spleen was sono-

childhood lead poisoning in Zamfara, Nigeria

graphically evaluated and the splenic length obtained.

Correlational studies were done and results recorded.

Ridwan Jega , Bernard Brabin , Michelle Stanton ,

Result: A total of one hundred and seventy seven chil-

Muhammad Ismail , Hamidu Ahmed .

dren took part in the study. 93 (52.5%) were male, 84

Department of Paediatrics, Usmanu Danfodiyo

(47.5%) were female. The age ranged from 5-14 years

University Teaching Hospital, Sokoto.

with a mean age of 8.40± 1.93years and a median age of

Liverpool School of Tropical Medicine, Pembroke

9years.

Place Liverpool, UK.

The mean length of the spleen for both sexes was found

Department of Geography, Ahmadu Bello University,

to be 8.07cm ± 17.4 with a median length of 8.10cm.

Zaria, Nigeria.

Correlation studies showed a weak non-significant cor-

Email: jegaridwan@yahoo.com

relation between the splenic length, body mass index (P-

.0.73), weight (p=0.27) and body surface area

Objective: To map spatial exposures to lead using blood

(P= 0.142).

lead concentrations in children, soil and water lead lev-

There was a significant positive difference in the mean

els.

between males and females (p=.003) and between the

Design: A descriptive cross-sectional survey.

splenic length and height of the child (p=0.025).

Methods: Primary data consisted of coordinates of min-

Conclusion: The normal value of the splenic length as

ing sites and lead care centers. Secondary data com-

determined will serve as a reference standard in ultra-

prised the study area’s micro -climate, household coordi-

sonographic evaluation of the spleen in Port Harcourt .

nates, age, sex, blood and soil lead values of compounds

Key words: Ultrasound; measurements; spleen length;

where under- fives reside. Spatial and non-spatial ana-

school age children.

lytic techniques were used to map, describe and analyze

spatial patterns.

AP1

Results: Out of 85 children aged between 5 and 54

Abdominal Obesity in Adolescent Girls Attending a

months; males constituted 56% (48/85). Blood lead lev-

Public Secondary School in Port Harcourt, Nigeria:

els above 5 micrograms per deciliter, (mean ± SD) 130.7

prevalence and some factors associated with occur-

± 78.1 were detected in all children. Significant correla-

rence.

tions existed between blood and soil lead concentrations

in the villages of Yargalma (Pearson’s r =0.379, p=0.01)

Tamunopriye Jaja, Balafama Alex Hart, Joyce Okagua

and Dareta (Pearson’s r=0.487, p=0.001).Spatial pattern

Department of Paediatrics, University of Port Harcourt

analysis revealed a random distribution of blood and soil

Teaching Hospital.

leadlevels in both villages. The climatology of the area

Email: tamunopriyej@yahoo.com

showed increase in land surface temperature and de-

crease in rainfall patterns prior to the outbreak.

Background: Deposition of excess fat in the abdominal

Conclusion: Spatial analysis can aid detect and explain

region is strongly associated with the metabolic distur-

the pattern of environmental health problems such as

bances thought to underlie many obesity related compli-

childhood lead poisoning.

cations.

Aim: To determine the prevalence of abdominal obesity

GP7

using waist circumference in adolescents’ girls attending

A pilot study of the sonographic measurements of the

a public secondary school in Port Harcourt, Nigeria and

splenic length in school aged children in Port

to identify some risk factors associated with occurrence

Harcourt

of abdominal obesity in subjects studied.

Methodology: A total of 1330 females aged between 10

Ugboma EW , Agi CE ,Okoh BA .

and 19 years were studied. Data on bio data, dietary

Department of Radiology and Paediatrics , University

habits and measure of physical activity was obtained

of Port Harcourt /University of Port Harcourt Teaching

using a self-administered questionnaire. Anthropometry

Hospital, Rivers State, Nigeria.

was taken and overweight/obesity and abdominal obe-

sity determined using Body mass index percentiles and

Introduction: Ultrasonic evaluation of the solid organs

waist circumference percentiles for age and sex respec-

of the abdomen in children is a common and important

tively. Logistic regression was used to evaluate some

part in the evaluation of various pathologies. Clinical

physical and behavioural factors associated with the

palpitation of the spleen is not very accurate as a means

development of abdominal obesity.

of examination of the spleen. There is a paucity of local

Results: Total of 246(18.12%) were overweight or obese

references for this environment and African as a whole

while 20 (1.5%) subjects had abdominal obesity. Mean

while this is well established in other climes and conti-

age of girls studied was 15.74±1.45 years. Mean waist

nents necessitating this study.

circumference was 72.26±7.17cm. Eighteen (90%) of

107

subjects with abdominal obesity were also overweight

AP3

or obese using BMI percentile estimation. 18(7.5%) of

Prevalence of non-protective immunity against

all subjects with overweight or obesity had abdominal

tetanus and its association with nutritional status of

obesity compared to only 2(0.2%) of those with normal

female adolescents in Ibadan, Nigeria

weight. Physical inactivity, daily fruit consumption and

watching of TV/Internet/Video games for ≥2hours /day

Akinlolu AA, Adebola EO, Temitope AA, Olusegun OA

were significantly associated with development of ab-

Department of Paediatrics, University College Hospital,

dominal obesity.

Ibadan

Conclusion: Prevalence of abdominal obesity was low

Email: dayoadepoju2002@yahoo.com

in this study compared to other studies; reduced physical

activity and sedentary lifestyle identified as significant

Background: The low uptake of tetanus vaccine and its

risk factors in these subjects as reported in other studies.

resultant high burden of tetanus in Nigeria suggest the

Key words: Abdominal obesity, adolescents, girls, risk

need to improve routine and booster vaccination in ado-

factors.

lescents. Targeting such intervention toward the most

vulnerable groups may safe cost and improve effective-

AP2

ness of the disease control. However, information on

Pattern and Determinants of Sleep Problems in

epidemiological factors such as nutritional status needed

school-going Adolescents in Kano, Nigeria

for identification of such groups are not well described

in literature. Therefore, this study was carried to investi-

Peter ID, Adamu H, Asani MO, Aliyu I, Sabo UA,

gate nutritional status as risk factors for non-protective

Umar I

immunity among adolescent girls.

Department of Paediatrics, Aminu Kano Teaching Hos-

Methods: Using a three-stage sampling technique, 851

pital, Kano.

female adolescents were randomly selected from secon-

Email: igopeter@gmail.com

dary schools in Ibadan, Nigeria. A pre-tested question-

naire was used to obtain data on demographic and socio-

Background: Sleep problems especially in the adoles-

economic characteristics, living conditions and history

cent stage of development may be associated with ex-

of tetanus vaccination. An immuno-chromatographic

cessive daytime sleepiness, impaired neurocognitive

rapid test kit, “Tetanos Quick Stick” was used to detect

function and a host of others leading to suboptimal per-

specific tetanus antitoxins protective level (defined as

formance.

concentrations >0.1 IU/L) in venous blood samples.

Objective: To determine the pattern of sleep disorders in

Descriptive and Chi-square statistics were used for data

school-going adolescents based on the BEARS (Bedtime

analysis at p = 0.05.

problems, Excessive daytime sleepiness, Awakenings

Results: Seroprevalence of protective immunity against

during the night and problems falling back asleep, Regu-

tetanus was 38.1% and it significantly decreased with

larity and duration of sleep, Sleep-disordered breathing)

increasing age. More adolescents in public (65.4%) than

sleep screening algorithm.

private (44.7%) schools had non-protective level of im-

Methods: A cross sectional descriptive study involving

munity (OR = 2.34; 95% CI = 1.62, 3.37). When the

353 secondary school-going adolescents in Kano me-

participants were categorised based on their body mass

tropolis. Subjects were selected for the study using mul-

index (BMI), there was no significant difference in the

tistage sampling technique. Study lasted from March

risk of non-protective immunity in the thinness category

2015 to July 2015. Sleep problems were screened for

(OR= 1.07; 95% CI 0.59, 1.91) and overweight category

using the BEARS sleep screening algorithm. The vari-

(OR = 0.92, 95% CI= 0.55, 1.54).

ous BEARS Sleep patterns were assessed with possible

Conclusion: This study showed that protective immunity

risk factors and comparison between stages of adoles-

against tetanus among female adolescents was poor,

cence (early, middle and late) done using the Chi square

more so in public schools and that it has no association

test.

with body mass index. Policy-makers need to consider

Results: Of the 353 adolescents studied, 61.8% were

the inclusion of immunisation against tetanus in the

males while 38.2% were females. Early, middle and late

school health programme.

adolescents constituted 13.9%, 39.9%, 46.2% respec-

Keywords: Tetanus immunity, Schooling adolescents,

tively. BEARS sleep screening revealed awakenings

Vaccination, Body-Mass index

during the night (34.6%) as commonest, then excessive

daytime sleepiness (21.0%). Age-group dependent sleep

AP4

duration was 7.19±1.26, 7.13±1.13, 7.16±1.28, P ˃ 0.05.

Schooling adolescents’ views about feasibility and

Though 62.9% of all the adolescents watch TV/play

funding for school- based immunisation programme

video games till one hour before going to bed and this

in Nigeria

was highest in late adolescence, it was not significantly

associated with any of the sleep problems.

Akinlolu AA, Adebola EO, Temitope AA, Olusegun OA

Conclusion: Both the quality and quantity of sleep in

Department of Paediatrics, University college hospital,

adolescents in Kano is suboptimal. Adolescent and sleep

Ibadan

medicine should receive more attention in our environ-

Email: dayoadepoju2002@yahoo.com

ment.

Key words: Adolescents, Sleep problems, BEARS, Kano.

Introduction: The World Health Organization (WHO)

108

recommends that women of child-bearing age, 15 to 45

and the associated factors among senior secondary

years, should commence a 5-dose regimen of vaccina-

school students in Ilorin metropolis.

tion against tetanus as early as possible, but in Nigeria

Methods: It is a cross sectional study involving 2000

there is no known programme aimed at ensuring early

students selected from twenty schools; using multistage

commencement. The low uptake of tetanus vaccine and

sampling technique. A self-administered questionnaire

the resultant high burden of tetanus in Nigeria suggest

adapted from the Global Youth Tobacco Survey

the need to improve routine and booster vaccination in

(GYTS) was used for data collection and the data

adolescents.

However, epidemiological evidence for

analysed using SPSS software version 16.0.

vaccination, feasibility and acceptability of vaccination

Results: Eighty-two students (4.11%) had ever tried

needed for effective strategy and policy formulation.

cigarette smoking, while the prevalence of current ciga-

This study sought to describe the views of adolescent

rette smoking was 1.95%. Gender, parental cigarette

girls on school-based tetanus immunisation programme.

smoking status, peer influence and student’s engage-

Methods: Using a three-stage sampling technique, 851

ment in vocational training were significantly associated

female adolescents were randomly selected from secon-

with cigarette smoking (p < 0.05). Other factors identi-

dary schools in Ibadan. A pre-tested questionnaire was

fied were wrong perceptions of the effects of cigarette

used to obtain data on demographic, socio-economic

smoking, glorification of cigarette smoking as depicted

characteristics and history of tetanus vaccination. The

by actors and actresses in movies shown on television

participants’ responses to a list of opinion statements on

and the unrestricted access to cigarette.

tetanus vaccination in schools and the possible sources

Conclusion & Recommendations: Although the preva-

of funding were obtained. Descriptive and Chi-square

lence of current cigarette smoking among the students is

statistics were used for data analysis at p = 0.05.

low, the prevailing circumstances have the potential of

Results: Mean age of participants from public (14.4 ±

not only encouraging current smokers to continue smok-

1.9 years) was higher than those from private schools

ing, but may also encourage the initiation of smoking

(13.6 ± 1.6 years); p<0.001. Significantly more adoles-

habits among other students. Hence, there is a need to

cents in private (71.6%) than public (53.6%) schools

take preventive measures to address these identified

disagreed that tetanus immunisation could be given in

factors.

schools. Notably, 68.1% of the adolescents in private

compared with 46.2% in public schools agreed that par-

AP6

ents

will

not

allow

school-based

immunisation

Overweight and Obesity Status of School Adolescents

(p<0.001). About two-third (59.6%) of the adolescents

in Port Harcourt, Southern Nigeria

in private compared with public (46.2%) schools opined

that it would not be possible to give injectable vaccines

Okagua J, Jaja T, Alex-Hart BA.

in schools (p = 0.015). More adolescents in private

Department of Paediatrics, University of Port Harcourt

(80.9%) than public (78.7%) opined that government

Teaching Hospital, Rivers State, Nigeria.

should be solely responsible for funding school-based

Email: joyceokagua@yahoo.com

immunisation in the event it must be introduced.

Conclusion: Adolescents in schools in Ibadan expressed

Background: Adolescent overweight and obesity has

varying opinions on feasibility and funding of school-

been linked to obesity in adult life, with its associated

based immunisation in Nigeria. There is the need to ad-

risks of chronic diseases including cardiovascular dis-

vance knowledge and understanding of adolescents

eases. Thus, prevention aimed at early screening and

through health education in schools.

surveillance should be the key. The aim of this study is

Keywords: Tetanus immunisation, Adolescents, Vacci-

to determine the prevalence of overweight and obesity

nation, Feasibility

among schooling adolescents in Port Harcourt.

Subjects and Methods: A cross sectional study was

AP5

carried out on 2,282 secondary school students aged 10 –

Prevalence and determinants of cigarette smoking

19 years, using a structured questionnaire to obtain data.

among senior secondary school students in Ilorin,

Weights and height were measured using standard meth-

North Central Nigeria

ods. The Body Mass Index (BMI) was calculated from

their weights and heights in kg/m. The nutritional status

Babatunde O

of the students was determined using the BMI percentile

Babcock University Teaching Hospital, Ilishan-remo,

charts for age and gender as recommended by the World

Ogun State.

Health Organization in 2007.

Email: yeluwa2000@yahoo.com

Results: The prevalence of overweight and obesity were

13.2% and 4.6%. The female subjects had a higher

Background/Introduction: Tobacco is the most impor-

prevalence of overweight and obesity (14.6% and 5.2%)

tant preventable cause of premature death in many coun-

than the males (11.4% and 3.8%) and this difference was

tries. Preventing the initiation of tobacco use among

statistically significant (p = 0.041).

adolescents is critical to the control of tobacco use. This

Conclusion: The prevalence of overweight and obese

study assessed cigarette smoking and the associated fac-

adolescents in Port Harcourt is high. We recommend

tors among senior secondary school students in Ilorin

that health education with emphasis on lifestyle changes

metropolis.

and behavioral modification that will promote healthy

Aims/Objectives: This study assessed cigarette smoking

eating and regular physical activities be inculcated into

109

the curiculum of secondary schools in Nigeria.

and school environment. Schools are the only institu-

Key words: Overweight, Obesity, Adolescents, Nigeria.

tions that can nearly reach all youth. They are, therefore,

in a unique position to improve the education and health

CP1

status of young people.

An assessment of school health services in primary

Methods: Thirty three schools were selected through

schools in Enugu East Local Government Area

multistage sampling. Head teachers of the selected

schools and officials of the ministry were interviewed

Bisi-Onyemaechi AI , Nwadiuto AA,

using two separate questionnaires.

Ikefuna AN, Tagbo BN, Chinawa J ,

Results: Eight (24.2%) of the head teachers had heard of

Department of Paediatrics, University of Nigeria

SHP. The commonest reason given for not requesting

Teaching Hospital Enugu.

pre-entrance medical screening was that it was not in the

Department of Paediatrics, University of Port Harcourt

curriculum (nine schools) while seven schools said it

teaching Hospital, Rivers State

was not necessary. Nineteen schools were not aware of

Email: adaobiigbokwe@yahoo.com

periodic medical screening while ten thought it was ex-

pensive. Five public schools gave no treatment in the

Introduction: School health ensures that school children

school because they had neither materials nor personnel.

are in optimal health at all times such that they attain

School meals were not available because it was expen-

their physical and intellectual potential. It is a potential

sive (twelve schools), not necessary (eight schools),

way of achieving a widespread impact on the health of a

against parents wish (four schools). Eighteen schools

large number of children.

felt school-community relations was not necessary.

Aims: to assess school health programme in primary

None of the officials interviewed in the ministries of

schools in Enugu east

education and health was aware of SHP.

Methods: This was a cross sectional descriptive study of

Conclusion: Lack of awareness of the importance of

school health services in thirty three primary schools in

SHP, lack of resources and poor attitude of government

Enugu east. Multistage sampling was used to select par-

are some of the factors responsible for the present state

ticipating schools. Eight wards with both public and

of school health program in Enugu east LGA.

private primary schools were studied using a question-

naire while responses were scored using School Health

NN1

Program (SHP) evaluation scale ranging from 19 to 45.

Implementation of Kangaroo Mother Care among

Results: Four schools (all private) had health personnel.

paediatric health workers in Nigeria

No school required pre-entrance medical examination

Onubogu UC , Okoh BA

before admission and none conducted periodic medical

examination on students and staff. Six schools (all pri-

Braithwaite Memorial Specialist Hospital, Port Har-

vate) had health rooms. Only Twenty four private and

court, River State, Nigeria.

two public schools had functional first aid boxes. Any

University of Port Harcourt Teaching Hospital, Port

child with communicable disease was sent home by all

Harcourt. Rivers State, Nigeria.

the schools. No health records were available in any of

Email: utchayonubogu@yahoo.co.uk

the schools. School lunch was provided in one private

school. Out of a maximum score of 45, public schools

Introduction: Kangaroo Mother Care (KMC) has been

had a mean of 10.30 while private schools had 12.76. (p

proven to significantly improve growth, reduce mortal-

=0.01)

Three private schools attained the minimum

ity and morbidity in low birth weight infants. The

score of 19.

impact of KMC in newborn care is expected to be great-

Conclusion: School Health Services is minimally

est in Africa due to limitations in health care.

existent in Enugu East Local Government area.

Objective: The aim of this study was to determine the

proportion of Nigerian health workers rendering paediat-

CP2

ric care who practice KMC in their institution, and iden-

Factors affecting school health programme (SHP) in

tify some challenges affecting the practice of KMC in

primary schools in Enugu East Local Government

Nigerian health institutions.

Area (LGA)

Method: A cross sectional study of the participants at

45 annual scientific conference of the Paediatric Asso-

Bisi-Onyemaechi AI, Akani NA , Ikefuna AN

ciation of Nigeria was conducted. Information on the

Tagbo BN , Chinawa J

health workers and their facility were collected and ana-

Department of Paediatrics, University of Nigeria

lysed.

Teaching Hospital Enugu.

Result: A total of157 respondents 122 (77.7%) doctors

Department of Paediatrics, University of Port Harcourt

and 35 (22.3%) nurses were studied. 84 (53.5%) prac-

teaching Hospital, Rivers State

ticed KMC. The reasons for not practicing KMC were

Email: adaobiigbokwe@yahoo.com

lack of policy reported by 43 (58.9%) and inadequate

place for the mothers to stay 30(41%). The level of prac-

Introduction: SHP ensures that school children are in

tice was significantly higher among respondents that

optimal health at all times such that they attain their

worked in facilities that care for sick neonates (p =

physical and intellectual potential and receive moral and

0.049), have functional incubators (p = 0.014) and prac-

emotional benefits from their health providers, teachers

tice KMC (p < 0.001).

110

Conclusion: Hospitals should have a written KMC pol-

NN3

icy and provide KMC wards in order to improve imple-

Familial arthrogryposis multiplex congenita at

mentation of KMC practice in Nigeria.

Gusau, Nigeria: Case report and review of the

literature

NN2

Garba BI , Muhammad AS , Musa Abdullahi

Prevalence, risk factors and outcome of preterms at

Onazi SO , Adeniji AO , Ben-Wazieh AA , Yusuf I

a specialist Hospital in Gusau, Nigeria

1 Ahmad Sani Yariman Bakura Specialist Hospital,

Garba BI, Muhammad AS, Musa A, Onazi SO

Gusau

Adelakun MB, Kolawole T

2 Ahmadu Bello University, Zaria

Ahmed Sani Yariman Bakura Specialist Hospital, Gusau

3 Federal Medical Centre, Gusau

Ahmadu Bello University, Zaria

Email: bgilah@yahoo.com

Federal Medical Centre, Gusau

Email: bgilah@yahoo.com

Background/Introduction:

Arthrogryposis

multiplex

congenita (AMC) is characterized by contractions of

Background/Introduction: Prematurity is a significant

multiple joints present at birth with fat or fibrous tissue

cause of neonatal morbidity and mortality with associ-

partially or totally replacing muscles. The aetiology is

ated long term consequences. Several risk factors for

unclear but several factors play a role.

preterm births have been identified, however not all risk

Aims/Objectives: We report a case seen at our hospital.

factors are known.

Methods: A 2 day old male term neonate presented with

Aims/Objectives: We aimed to determine the prevalence,

history of multiple contractures in all limbs since birth,

risk factors and outcome of preterms admitted in our

fever and vomiting of one day duration. Older sibling, a

SCBU

male child had similar multiple contractures in all limbs

Methods: A retrospective descriptive study of all pre-

and died few days after birth. Maternal aunt had a male

term babies admitted into the SCBU who were either

child with multiple contractures of all limbs who also

delivered in the hospital or referred to the hospital over a

died few days after birth. Our case had multiple contrac-

2 year period. Maternal and newborn information were

tures and specific posture involving all the limbs; how-

filled into a questionnaire and data was analysed using

ever no cardiac or neurological abnormality was ob-

SPSS.

served. He was managed as a case of neonatal sepsis

Results: 494 babies were admitted into the SCBU of

with AMC with antibiotics and had POP applied on the

which 56 were premature, with a prevalence of 11.3%.

limbs. He did well and was discharged home to be fol-

Thirty three were males (58.9%) with M:F ratio of 1.4:1.

lowed up at the clinic. He however did not come for

Mean gestational age was 31.79±1.97 weeks with a

follow up and died at home at the age of 10weeks.

range of 28 to 36 weeks while mean birth weight was

Conclusion & Recommendations: Arthrogryposis is a

1.38±0.41kg with a range of 0.50 to 2.40kg. Ecclampsia,

common congenital presentation in many conditions,

PROM, antepartum haemorrhage and maternal sepsis

however aetiology is unclear. Comprehensive muscu-

were the commonest risk factors; while 15(26.8%)

loskeletal evaluation and genetic consultation is

mothers had no identifiable risk factor. Respiratory dis-

required. Early rehabilitation of a child with arthrogry-

tress syndrome, apnoea, jaundice, hypoglycaemia and

posis requires the involvement of the parents/guardians

hypothermia

were

the

commonest

complications.

and multidisciplinary approach to optimise the possibil-

Twenty one (37.5%) were discharged, 26(46.4%) died

ity of making a diagnosis and providing parents with

while 9(16.1%) were discharged against medical advice;

accurate information regarding likelihood of recurrence.

thus 30(53.6%) were discharged alive. Respiratory com-

plications and neonatal jaundice were associated with

NN4

poorer outcome (p=0.000, 0.013 respectively). Male sex

A two-year review of outcome of neonatal admissions

was significantly associated with mortality (p=0.045).

at the Children Emergency Room of the Lagos State

Conclusion & Recommendations: Prematurity still re-

University Teaching Hospital, Ikeja, Lagos

mains a major cause of morbidity and mortality in Nige-

Adeola Barakat Animasahun, Odion Peter Ubuane,

ria. Many premature babies reach the hospitals late in

Olugbenga Gbelee, Fidelis Njokanma.

developing countries due to poverty and poor infrastruc-

tural development; hence when they reach such hospitals

Department of Paediatrics and Child Health, Lagos

the problems of prematurity have already set in leading

State University College of Medicine, Ikeja, Lagos

to poorer outcome.

Nigeria.

Email: deoladebo@yahoo.com

Background: Nigeria has one of the worst health

indicators, including neonatal mortality rate, in the

world. Despite moderate reduction in global infant and

under-five mortality rates neonatal contribution to

childhood deaths has shown minimal decline. With drive

towards intensified scale-up of proven interventions that

will help reverse this trend by all stakeholders involved

111

in neonatal well-being this centre reviews neonatal

usually arises after 1 to 3 weeks of therapy. Generally it

outcome in the Children Emergency Room over a two-

is self limiting, however, on rare occassion can lead to

year period.

vanishing bile duct syndrome.

Methodology: The study is a retrospective review of a

prospectively obtained records of neonates admitted into

NN6

the neonatal section of the Children Emergency Room

Morbidity profile and outcome of newborns admitted

(CHER) of the Lagos State University Teaching

into the neonatal unit of a secondary health care cen-

Hospital (LASUTH), Ikeja, Lagos, South-West Nigeria

tre in Benin City

from January 1 , 2011 to December 31 2012.

Results: 2060 neonates, with total of 2590 diagnoses,

Imuwahen AM, Blessing I, Abhulimhen Iyoha.

were admitted into the CHER over the period in review.

Email: chimus4u@yahoo.com

The male-to-female ratio was 1.4:1. 273 neonates died

in the emergency room giving a mortality rate of 13.3.

Background/Introduction: An important indicator of

The leading causes of morbidity were neonatal infec-

health care is neonatal outcome. Few published data are

tions (41.6%), neonatal jaundice (26.7%), perinatal as-

available concerning neonatal morbidity and mortality

phyxia (23.8%) and prematurity (11.7%). Major causes

from secondary health centres, where a large number of

of death include perinatal asphyxia (41.4%), neonatal

newborns are seen.

infections (38.9%) and neonatal jaundice (28.2%);

Aims/Objectives: To determine the morbidity profile and

preterm /LBW babies accounted for 3.6% of deaths.

outcome of neonates admitted into the neonatal unit of

Severe anaemia and neonatal tetanus had the highest

Stella Obasanjo Hospital, a state owned general hospital

case fatality rate (CFR) of 35.5% and 26.9%

in Benin City, Edo State, Nigeria.

respectively.

Methods: This retrospective study which covered a pe-

Conclusion: the observed mortality rate in this study is

riod of six years (July 2008 – June 2014) involved the

high. Although most of the neonatal illnesses and deaths

extraction of information on patients’ age, sex, diagno-

are preventable. There is a need to scale-up existing

sis, duration of stay and outcome from the medical re-

interventions particularly at the primary healthcare and

cords of the neonatal unit.

community level.

Results: There were 2,302 newborns admitted; out of

which 1,283 (55.7%) being males, while 1,019 (44.3%)

NN5

were females, giving a M: F ratio of 1.3:1. The major

Meropenem associated prolonged cholestasis in the

indications for admissions were presumed neonatal sep-

newborn: A report of two cases

sis 1,425 (61.9%), severe birth asphyxia 942 (40.9%),

neonatal jaundice 565 (24.5%) and prematurity 378

Solarin AU, Olugbade OM

(16.4%) occurring singly or in various combinations.

Babcock University Teaching Hospital, Ilisa-Remo,

Mortality rate was 12.8% with major contributions from

Ogun State

presumed neonatal sepsis, severe birth asphyxia and

Email: adaobisolarin@yahoo.com

prematurity. Most of the deaths occurred in the first

week of life.

Background/Introduction: Meropenem is one of the new

Conclusion & Recommendations: The major causes of

carbapenem antibacterial agent with wide spectrum of

morbidity and mortality among the newborns are pre-

activity against Gram-negative, Gram-positive and an-

ventable. To improve our health indices, we must health

erobic organisms. It has greatest utility in the treatment

educate at the community level while strengthening our

of children hospitalized with serious bacterial infections.

obstetric and perinatal care services.

Despite its usefulness and relative safety, adverse events

have been documented with an overall incidence of 1%.

NN7

We report two cases of cholestasis in neonates of gesta-

The incidence, timing and progression of germinal

tional ages 36weeks and 32 weeks respectively who had

matrix/intraventricular heamorrhage by utlrasono-

septicaemia and received meropenem for 14 days. These

graphy in preterm neonates in Benin City

infants developed cholestasis and deranged liver transa-

minases several days after the discontinuation of therapy

Azubike E Amuabunos, Samuel Ibhanesebhor, Ademola

with meropenem.

A Adeyekun

Aims/Objectives: This report is to create awareness

Email: amua4@yahoo.com

about this uncommon adverse effect of meropenem.

This is also important because of the increasing use of

Background/Introduction:

Germinal

matrix/

drugs such as meropenem as a result of the problem of

intraventricular haemorrhage (GMH/IVH) is the most

increasing resistance of microorganisms to commonly

frequent type of intracranial bleed in the preterm very

used antibiotics.

low birth weight babies. The mild and sometimes mod-

Methods: A descriptive report of two cases in the new-

erately severe GMH/IVH may go unrecognized in the

born

neonatal period with the potential for catastrophic conse-

Results: The two cases had cholestasis with deranged

quences in later life. Routine screening for GMH/IVH

liver function lasting greater than six weeks .

with cranial ultrasonography in extremely low and very

Conclusion & Recommendations: Meropenem has also

low birth weight babies is advocated. There is paucity of

been linked to rare cases of cholestatic jaundice that

data on the time of occurrence, progression of, and the

112

ideal time to perform diagnostic imaging studies for

close correlate of the better known NEC.

GMH/IVH in our own African population.

Conclusion & Recommendations: Idiopathic spontane-

Aims/Objectives: This study aimed at determining the

ous intestinal perforation is a distinct clinical entity from

incidence, timing, severity and progression of GMH/

necrotizing enterocolitis.

IVH in preterm less than 35 completed weeks of gesta-

tion in our population.

NN9

Methods: Babies less 35 completed weeks of gestation

Cost of neonatal care in Federal Medical Centre

admitted in the neonatal unit of the University of Benin

Owerri

Teaching Hospital over a 2 year period from September

2011 to September 2013, were consecutively recruited

Emerenini FC, Ezeofor TC

for the study. A serial cranial ultrasonograhpy was done

Department of Paediatrics, Federal Medical Centre,

using the anterior fontanel as acoustic window for each

Owerri

baby within 12 hr of delivery at the 24th hour and daily

Email: mezydegreat@yahoo.co.uk

until the 7th day. Repeat scans were done on the 14th

day and between 36 and 40 weeks’ post -menstrual age.

Background/Introduction: There is need to know how

Results: A total of 92 preterm babies were with gesta-

much is involved in taking care of newborn in hospital

tional age range from 23 – 34weeks studied. Their birth

Aims/Objectives: The purpose of this study was to esti-

weight ranged from 390gm to 2000gm with a mean of

mate the cost of hospitalization in Special Baby Care

1071gm (±344gm). GMH/IVH was found in 70 (77.7%)

unit of Federal Medical Centre Owerri.

of the neonates, 21.7% had grade 1; 41.3 had grade

Methods: This was a retrospective review of all records

2and3, while 13% had grade 4. While there was an indi-

of all neonates admitted into the hospital from January

rectly relationship between the incidence of grade 1-3

2014 to June 2014. The study group included all admit-

IVH and gestational age, occurrence of intra-cerebral

ted term and preterm newborn infants in SCBU. Vari-

GMH (grade 4) was unrelated to gestational age. 48% of

ables such as presenting complaints, duration of hospital

GMH/IVH occurred within 24hours of life while 75.5%

stay, care and services rendered, fee paid for individual

occurred within 72hours. Low apgar score was associ-

services and total fee paid were extracted. Percentage of

ated risk factors for early GMH/IVH while patent ductus

fee contributed by each of services was calculated. As-

arteriosus and abnormal bleeding were identified risk

sessment of mode of payment was also made. Patients

factors for late GMH/IVH. Thirteen (18.6%) progressed

whose case notes were missing were excluded from the

to varying degree of ventriculomegally and 2 neonates

analysis.

developed hydrocephalus.

Results: A total of 171 neonates were admitted into the

Conclusion & Recommendations: Routine screening for

unit. Preterm babies made 39.2% (n=67) of all admis-

IVH is advocated to reduce the risk of progression and

sions while 60.8% (n=104) were term. The commonest

complications. Monitoring for Identified risk factors and

reason for admission was perinatal asphyxia, 44.3% of

prompt intervention may be of benefit.

all cases, followed by prematurity 41.9%. The major

contributors to the cost hospitalization were fees for

NN8

laboratory (20.09%), drug (18.71%), and Oxygen ther-

Idiopathic spontaneous intestinal perforation; a

apy (8.21%) Total fee paid ranged from N3,400 to

distinct clinical entity from necrotizing enterocolitis:

N77,690 with an average of N27,762.

a case report

About 68% of fathers were self employed. While 30%

are paid employees. Ninety nine percent of the fees were

Ogonor E, Isah II, Ideh RC, Amuabunos A, Okonkwo I,

paid out of pocket.

Omoigberale AI

Conclusion & Recommendations: Cost of newborn hos-

Email: ejibazz@yahoo.com

pitalization is high with laboratory fee being the major

contributors. The main mode of payment was out of

Background/Introduction: Spontaneous intestinal perfo-

pocket.

ration (SIP) is a recognized clinical entity in which there

is a defect in the wall of the gastrointestinal tract of the

NN10

newborn with no demonstrable aetiology and it is com-

Scope of neonatal care services in major Nigerian

monly located in the terminal ileum

Hospitals

Aims/Objectives: We report a case of SIP in a preterm

low birth weight male neonate, noting its similarities

Okonkwo IR, Abhulimhen-Iyoha B, Okolo AA

and differences to the better known Necrotizing Entero-

Email: ikeokonkwo2001@yahoo.com

colitis (NEC) as a cause of abdominal distension and

poor neonatal outcome

Background/Introduction: Neonatal survival bespeaks

Methods: Of particular interest were the rapidity of de-

the quality of neonatal care services available and acces-

velopment of symptoms and the intra-operative findings

sible to the population. Intensive care improves outcome

of multiple large bowel perforations in the absence of

of high-risk infants with serious illness. The tiered level

necrotic intestinal tissue.

of care is yet to be applied to newborn care in Nigeria.

Results: We present this unusual case due to the relative

Classification of care is key to improving neonatal sur-

paucity of similar reports in this locale in order to raise

vival with enhanced referral of high-risk patients to

awareness and increase the index of suspicion of this

higher-level centres.

113

Aims/Objectives: To ascertain the scope of and classify

among respondents. This is shared by patented and im-

available newborn services offered at major Nigerian

provised CPAP due to the high cost of patented devices.

hospitals.

CPAP service and devices should urgently be taken to

Methods: A semi-structured validated questionnaire was

the primary and level health facilities closer to the loca-

administered to attendees during 2015 Pediatric Asso-

tion in the communities where newborn deaths occur.

ciation of Nigeria conference. The information derived

This shift is key to sustainable decline in Neonatal

was used to categorize neonatal care services.

Mortality Rate in Nigeria.

Results: The respondents consisted of doctors 201

(84.8%) and nurses 36 (15.2%) in 54 health facilities

NN12

from all geopolitical regions of Nigeria. Of the 54 facili-

The impact of an initial-set point prediction tool for

ties, 34 (63%) were located in state capitals and 47

prompt attainment of stability during neonatal incu-

(87%) in public hospitals. Half of the evaluated units

bator care – a comparative study

belonged to Class I, 22 (40.7%) Class II, and 5 (9.3%)

Adesina TC , Olateju EK , Okechukwu AA , Alabi P ,

Class III levels of neonatal care. Majority (81.6%) of the

Amadi HO

a,b

doctors have been trained on neonatal resuscitation; with

senior residents being the highest 49 (89%) and Medical

Paediatrics Department, University of Abuja Teaching

officers (MO) the least 4 (40%) trained. Doctors with

Hospital, Gwagwalada FCT

training in mechanical ventilation (MV) were 39.2%;

Bioengineering Department, Imperial College London,

Consultants (51.2%), MO’s the least 1(11.2%) trained

United Kingdom

(p=0.025). Monitoring is usually by pulse oximeters 54

Email: h.amadi@imperial.ac.uk

(100%), multi parameter monitors 23 (42.6%) and rarely

ABGs 6 (11%).

Introduction: Recent studies have identified high inci-

Conclusion & Recommendations: Neonatal care in

dences of abnormal temperatures to be associated with

Nigeria is still developing. Most centres provide basic

recorded high mortality rate in extremely low birth-

neonatal care services. Regionalization of care may be

weight (LBW) neonates that presented at special care

the solution to higher level neonatal care.

baby units (SCBU) of tertiary health institutions in Ni-

geria. The literature has presented an algorithm (the

NN11

handy-approach) which is a set of rules that dynamically

Bubble CPAP use in Nigerian tertiary hospitals; the

guides the manipulation of incubator set-points in nor-

patented and the improvised, how far so far?

malising a neonate’s temperature. This does not how-

ever specify the initial incubator set-point at the com-

Okonkwo IR, Okolo AA

mencement of care to guarantee quick attainment of

Email: ikeokonkwo2001@yahoo.com

normotherm. Hence the aim and objectives of the pre-

sent work was to develop, validate and comparatively

Background/Introduction: CPAP is simple and effective

assess the impact of an ‘initial set -point algorithm

newborn respiratory support. It is used in newborn respi-

(ISA)’ on the overall survival of extremely LBW neo-

ratory and non-respiratory diseases. Early use in preterm

nates at the University of Abuja Teaching Hospital

infants reduces mortality and need for neonatal intensive

(UATH).

care. The patented CPAP machines though effective is

Methods: The ISA prediction tool was developed to op-

expensive for many resource poor countries. This has

erate with inputs of (1) infant’s point -of-admission tem-

led to improvised CPAP devices for administering this

perature (2) prevailing environmental temperature and

intervention.

(3) the air temperature of the expectant incubator. Ethi-

Aims/Objectives: This study ascertains availability of

cal approval was obtained from the UATH Ethical Com-

CPAP services and the types used in Nigerian tertiary

mittee and the developed tool was applied to manage

hospitals.

neonates (BW = 600g to 1200g) presented from June

Methods: The validated questionnaire enquired about

2015 when this study began. The outcome was com-

the availability of the CPAP device, training on the use

pared against a set of ‘control’ comprising all similar

of respiratory support and use of such or similar device.

cases presented between January 2008 and December

The questionnaire was administered to consenting par-

2011 prior to UATH’s adoption of the handy -approach.

ticipants during the 2015 edition of the Paediatric Asso-

Lifetime temperature plots were generated for each case.

ciation of Nigeria conference.

Parameters assessed and compared were (1) time lapse

Results: 237 questionnaires were returned by respon-

before initial thermal stability (2) rate of morbidity and

dents representing 54 health facilities from six geopoliti-

(3) overall survival outcome.

cal regions of the country. CPAP devise was used in

Results: A total of 73 cases were analysed (62 control-

72% of the evaluated facilities. They are mostly public

samples, Mean (±SD), BW: 995g ± 169g, range: 800g –

(87%) tertiary hospitals (76%). Supplemental oxygen

1200g and 11 test-samples BW: 1027g ± 162g, range:

(37.6%) was the commonest mode of respiratory support

800g – 1200g). Average time lapse to initially stabilise

followed distantly by CPAP (3.4%). Improvised CPAP

each patient was CONTROL: 12.1hrs ± 11.7hrs, range:

device is used by 47.7% of the respondents. Only 25.3%

0.3hrs – 47.5hrs; TEST: 0.6hr ± 0.7hr, range: 0.1hr –

of the respondents had patented machines located in

2.0hrs. Overall, 30 of 62 control-cases died (NNMR:

33% of the facilities.

484/1000) as against no mortality for the 11 test-cases

Conclusion & Recommendations: CPAP use is high

so far recruited. Of nine control-cases with BW ≤800g,

114

only 1 survived, while all three for the test-cases have

Aim: To identify risk factors for severe neonatal jaun-

survived.

dice at the national Hospital Abuja to enable appropriate

Conclusions: Our preliminary results of this ongoing

recommendations for the prevention of jaundice related

study clearly show that quick effective intervention of

neonatal death/brain injury.

deviating body temperature has overwhelming positive

Subjects/Methods: Babies admitted into SCBU and

impact on neonatal survival. Hence, the use of the

treated for jaundice from April 2015 to May 2015 were

Handy-approach and ISA tools may be essential in re-

consecutively recruited into the study with parental con-

ducing Nigeria’s corporate NNMR.

sent. Socio-demographic information and history of

NN13

common neonatal jaundice risk factors were obtained for

Burden of Severe Birth Asphyxia at Federal Medical

statistical analysis. Jaundice was classified as mild (10-

Centre Asaba. Lessons and Proposal for Alleviation

14mg/l), moderate (15-24mg/dl) and severe ( ≥ 25mg/dl).

Results: A total of 123 babies were seen, 68(55.3%) of

Nwankwo O , Uche C , Okolo AA

whom were males with an Inborn/Out born ratio of

Federal Medical Centre, Asaba

1:2.3. Eighty two percent were term. Mild, moderate and

Corresponding Author, UBTH, Benin.

severe Jaundice accounted for 44(35.8%), 36(29.3%)

and 43(35%) respectively. The mean serum bilirubin

Background: Globally, birth asphyxia accounts for ap-

level was 21.2(9.3)mg/dl with a range of 10mg/dl-56mg/

proximately 9.4% of all U5 mortality, 27% of neonatal

dl. Although sepsis, ABO/Rh isoimmunization and

mortality; survivors

develop long term neurologic se-

G6PD deficiency were the most common individual risk

quelae. Perinatal factors contribute to 90% of birth as-

factors, over 50% of the babies had multiple risk factors.

phyxia (BA). The incidence, remains high in developing

Being out born (P<0.001), late presentation (P<0.001)

countries.

and Sepsis(P=0.008) were associated with increased risk

For Nigeria, the second highest contributor to Neonatal

of severe jaundice.

While Rh isoimmunization was

mortality, perinatal Asphyxia is the third commonest

most common in the severe group, the difference was

cause of mortality (24%).Available data indicates the

not statistically significant (p=0.07). Thirty two (26%)

incidence of 24 /1000 deliveries. Major causes are peri-

had signs of acute bilirubin encephalopathy and ex-

natal, butthe underlying social factor is lack of antenatal

change blood transfusion was done in 50 (40.7%) ba-

care.

bies.

Objective: To assess the trend of birth asphyxia over a

Recommendation: There is an urgent need for centrally

four year period in an effort to identify a strategy for its

coordinated public enlightenment program on early

reduction so as to impact on reduction of neonatal mor-

identification of neonatal jaundice and implementation

tality.

of infection control measures in all health care facilities.

Methods: We reviewed case records of admission to

SCBU over March 2010 to December 2014 and ex-

NN15

tracted the relevant information as the APGAR and the

Outcome of newborn admissions in the Special Care

HIE scores. All cases with APGAR of < 3 at 1min or < 5

Baby Unit of Federal Medical Centre Owerri

at 5 minute were extracted and all infants with HIE

scores were included.

Emerenini FC, Ezeofor TC

Results: 356 (161.5/1000) were asphyxiated and 204

Federal Medical Centre, Owerri

(92.6/1000) had HIE in a total of 2203 admissions. The

Email: mezydegreat@yahoo.co.uk

asphyxia rates hovered around 16% over the years. Only

22% cases occurred in the booked mothers. The overall

Objective: The purpose of this study was to evaluate the

BA mortality was 26,6%. Major causes of neonatal mor-

immediate outcome of newborns admitted into the Spe-

tality were prematurity, BA, Sepsis and NNJ for an

cial Baby Care Unit (SCBU) of Federal Medical Centre

overall neonatal mortality of (128/1000).

(FMC) Owerri.

Conclusion: BA, the second highest cause of neonatal

Study design/Methods: This was a retrospective study

mortality was an important cause of admission at the

carried out in the Special Baby Care Unit of Federal

FMC Asaba. 22% of BA mothers were booked. Efforts

Medical Centre Owerri from January 2014 to June 2014.

at improving the situation should also target strategies

The subjects included term and preterm newborn infants

for improving ANC utilization.

admitted into the SCBU both those delivered in FMC

(inborn) and those delivered outside the hospital

NN14

(outborn). Using the admission register, case notes of all

Risk factors for severe neonatal hyperbilirubinaemia

neonates admitted into SCBU within the study period

at the National Hospital Abuja

were retrieved. Variables collected were presenting

complaints, diagnosis, care and services rendered and

Audu LI, Mairami AB, Otuneye AT, Muhammed N,

final outcome. Cross tabulation of diagnosis with final

Mshelia LJ Nwatah V, Wey Y.

outcome was made and where necessary Chi Square was

calculated; p<0.05 is considered significant.

Background: Neonatal hyperbilirubinaemia remains an

Results: A total of 171 neonates were admitted in to the

important cause of neonatal admissions in Nigeria.

Special care Baby Unit during the study period, 49.1%

When severe, it causes irreversible neurotoxicity result-

(n=83) were inborn while 50.9% (n=86) were out born,

ing in death or long term neurological deficits.

and place of birth of 2 patient was missing.

115

The mortality was 6.5% of admission (n=15) during the

NN17

reviewed period, 9.4% of out born died, while 2.4% of

Sclerema neonatorum in a term neonate: A case re-

inborn died. Forty seven percent (47%) of deaths was

port

associated with perinatal asphyxia, prematurity 40%,

jaundice 6.7% and sepsis 6.7%.

Farouk ZL, Muhammad A, Ashiru H, Usman F

All babies who died required oxygen at some point in

Peter ID, Lawal NO, Nura L, Gurama K

the course of illness, while none of those who never

Department of Paediatrics, Aminu Kano Teaching Hos-

required oxygen died.

pital, Kano

Conclusion: Asphyxia was the leading cause of death.

Email: faroukzubaida@yahoo.com

Newborn illness requiring oxygen therapy has a poorer

prognosis. Ninety one percent (91.3%) of the admitted

Background: Sclerema neonatorum is a rare inflamma-

preterms survived.

tory disease involving the subcutaneous tissue and mani-

Keywords: Outcome, Newborn, Federal Medical Centre

fests as hardening of skin and subcutaneous adipose

Owerri.

tissue. Untreated, it progresses to interfere with respira-

tion, culminating in death. We present the successful

NN16

management of this rare condition that affects preterm

Evaluation of umbilical cord serum ferritin in appar-

newborns, however in this case, in a term neonate.

ently healthy preterm babies at the University of

Case report: O.E. was referred to the neonatal unit of

the Aminu Kano Teaching hospital, Kano on the 4 day

Nigeria Teaching Hospital (UNTH), Enugu

of life with complaints of fever and hardening of the

Asinobi IN, Ibe BC , Ikefuna AN, Ibeziako SN

buttocks and back all of 2 days duration. Hardening of

Ndu I, Ekwochi U

skin was first noticed on the buttocks and progressed to

Email: isaacasinobi@gmail.com

the back and extending to the right thigh. Baby was irri-

table with excessive cry. Examination revealed an irrita-

Background/Introduction: Iron is essential for neurode-

ble newborn, febrile (T= 38.9 ˚C), not pale, tinge of

velopment. Trans-placental iron accretion occurs maxi-

jaundice, indurations of the gluteal skin, back and right

mally in the third trimester, being directly proportional

thigh which was tender with differential warmth. Fluctu-

to gestational age (GA) and weight. Thus, preterms are

ant swellings developed while on admission which were

at risk for low iron stores. The neurodevelopmental ef-

aspirated. Baby had miniESR of 5mm/hr, full blood

fects of iron deficiency such as reduced cognition cannot

counts done which was suggestive of sepsis, blood cul-

be reversed even with iron supplementation. In neonates,

ture showed a gram negative coccobacilli though no

iron stores are best assayed using serum ferritin. In most

organism was cultured, pus aspirate done twice yielded

centers, iron levels are assessed using haemoglobin and

no growth. Baby had double volume EBT done, oral

iron supplementation is routinely commenced after the

prednisolone 3mg daily for 1 week and antibiotics- IV

second week of life.

unasyn and gentamicine were administered for 3 weeks.

Aims/Objectives: To assess the iron stores of preterms at

There was remarkable improvement.

UNTH by determining the prevalence of low serum fer-

Conclusion: Conventional therapy used in newborn care

ritin, and its relationship with GA, birth weight and gen-

proves successful in the management of this condition

der.

but awareness of this diagnosis is paramount to early

Methods: Seventy preterm and seventy term neonates

initiation of appropriate treatment.

were studied. Preterms were classified as extreme, mod-

Key words: Sclerema neonatorum, sepsis, antibiotics.

erate and very preterm. Umbilical cord blood taken at

delivery was assayed for haemoglobin, ferritin and C-

NN18

reactive protein. The cutoff for low serum ferritin was

Prevalence and risk factors for foetal malnutrition in

35µg/l. Obtained data was analyzed using SPSS 20.

term babies delivered at the University of Port

Results: Serum ferritin had a wide range of 20.6µg/l -

Harcourt Teaching Hospital

296µg/l amongst preterms. Low serum ferritin was more

Josiah AE , Opara PI , Nte AR

prevalent in preterms (35.7%) than term neonates (6%).

There was a significant positive correlation between

Department of Paediatrics, Braithewaite Memorial

serum ferritin and GA (r = 0.513), and birth weight in

Specialist Hospital, Port Harcourt

2,3

preterms (r = 0.512). No such correlation existed be-

Department of Paediatrics, University of Port

tween male and female preterms.

Harcourt Teaching Hospital, Port Harcourt

Conclusion & Recommendations: Serum ferritin should

Email: josiahae@yahoo.com

be assayed routinely in all extreme preterm and extreme

low birth weight newborns. Also, iron supplementation

Background: Foetal malnutrition (FM) is a “clinical

is recommended for all stable extreme preterms after

state of a baby of any birth weight (BW), characterised

CRP levels <10ng/ml have ruled out infection/

by obvious intrauterine loss or failure to acquire normal

inflammation.

amounts of subcutaneous fat and muscle mass,

manifesting as wasting, shortfalls in weight, length and

other anthropometric measurements.” It is associated

with increased morbidity and mortality in the newborn.

Aim: To determine prevalence of, and risk factors asso-

116

ciated with FM in Port Harcourt, Nigeria

babies with FM had lower overall weights.

Method: This was a prospectivehospital-based study,

Conclusion: There is persistence of low weight at six

carried out at the Labour Wards of the University of Port

weeks despite better mean weight gain in babies with

Harcourt Teaching Hospital. Baby-mother pairs who

fetal malnutrition.

met the inclusion criteria for the study were recruited

consecutively.Relevant biodata were recorded, and

NN20

babies' nutritional status were assessed using the

Case Report: Pantoea spp - a rare cause of compli-

Clinical Assessment of Nutritional Status Score

cated neonatal sepsis in the neonatal unit of ESUTH/

(CANScore) chart. Data were entered into a Microsoft

Parklane, Enugu

excel sheet and analysed using standard statistical tools.

Results: Of 300 newborns studied,176(58.7%) were

Asinobi I, Ekwochi U, Ndu I, Amadi O, Orji N

males and 124(41.3%) females with a M:F ratio of 1.4:1.

Email: isaacasinobi@gmail.com

The prevalence of FM was (16.7%). Babies with FM

had significantly lower anthropometric indices (length,

Background/Introduction: Neonatal sepsis is a signifi-

OFC and MUAC) than their counterparts (p=0.00).

cant cause of neonatal mortality and morbidity. Effec-

Being small for gestational age, and non-use of at least

tive management is key to neonatal survival and well-

one dose of intermittent preventive treatment for malaria

being. Blood culture plays a central role in antimicrobial

in pregnancy were significantly associated

with

therapy. With-holding antimicrobial therapy while wait-

occurrence of FM (p<0.005).

ing for culture results can lead to delays in treatment.

Conclusion: The prevalence of FM in Port Harcourt is

Thus, empirical treatment with antimicrobials based on

high and highlights the need for evolving appropriate

local culture sensitivity patterns is often necessary. Rare

interventions and strategies for its prevention

organisms are not usually represented on routine culture

plates and are thus often missed on blood culture.

NN19

Aims/Objectives: We describe a rare organism Pantoea

Pattern of weight gain amongst babies with fetal mal-

spp identified as a cause of an atypical presentation of

nutrition in Port Harcourt, Nigeria

neonatal sepsis.

Case presentation: Baby UO, a male neonate delivered

Josiah AE , Opara PI , Nte AR

at GA 37weeks through emergency c/s on account of

Department of Paediatrics, Braithewaite Memorial

maternal pre-eclampsia. APGAR was 5:1. After vigor-

Specialist Hospital, Port Harcourt

ous resuscitation with PPV, APGAR improved to 7:5.

Department of Paediatrics, University of Port Harcourt

The admitting diagnosis was Moderate Perinatal As-

Teaching Hospital, Port Harcourt

phyxia. He received IVF, steroids and antibiotics. Over

Email: josiahae@yahoo.com

the next few days he developed abdominal distension

progressing to subcutaneous emphysema of the abdo-

Background: Postnatal growth depends on several fac-

men and chest. Chest and abdominal X-ray showed mas-

tors including genetic potential and intrauterine growth.

sive pneumoperitoneum with subcutaneous emphysema.

Follow up of babies with foetal malnutrition (FM) in

Blood culture showed Pantoea spp. sensitive to Mero-

relation to their postnatal growth speed as well as the

ponem and resistant to most other antibiotics. He re-

catch-up and catch-down phenomena is important in to

ceived IV Meronem and metronidazole. On the 10th

allow early intervention.

DOL he had an abdominocentesis during which a large

Aim: To determine pattern of weight gain in term new-

amount of gas was released. By the 21st DOL, abdomi-

borns with FM in comparison with their well nourished

nal distension and vitals had stabilized. He was dis-

counterparts in the first 6 weeks of life.

charged on 29th DOL and is currently stable.

Methods: This was a comparative study of pattern of

Conclusion & Recommendations: Spontaneously occur-

weight gain in term babies with and without FM deliv-

ring Pantoea bacteremia is rare in neonates. A high in-

ered in the UPTH. Apparently well term infants were

dex of suspicion and adequate antimicrobial therapy are

recruited consecutively in the labour wards shortly after

paramount for prompt and effective treatment.

birth for the study. The CANSCORE was used to deter-

mine nutritional status of the babies within the first 24

NN21

hours of life. Birth weights and other anthropometric

Knowledge of Traditional Birth Attendants (TBA’s)

indices were obtained at birth and at 6 weeks. Data were

On detection, Causes, Treatment and complications

analysed using standard statistical methods.

of Neonatal Jaundice in Kano Metropolis

Results: There were 176 males and 124 females (M:F

ratio = 1.4:1). Birth weights ranged from 1550.0g to

Fatima Usman, Binta Jibril Wudil*, Hadia Ashiru, Amal

4700.0g with a mean of 3281.8±505.1g.Fifty babies

Kuliya Gwarzo#

(16.7%) had FM. Mean weight at six weeks of babies

Department of Paediatrics, #Haematology AKTH, Kano

with

was

4512.9±616.7g,

compared

*Department of Paediatrics MMSH Kano

4881.1±749.7g, for babies without FM. Mean weight

gain of babies with FM was 1,746.87±510.0g, compared

Background: Neonatal jaundice and its attendant

with 1,492.67±649.6g for babies without FM. The

complications continue to be a growing concern in

difference was statistically significant ( t =2.46; p=0.02).

Sub-saharan Africa.

However, despite higher mean weight gain at six weeks,

In Northern Nigeria, about 80% of deliveries takes place

117

at home. Due to proximity and cultural practices, the

Objective: To determine the knowledge, attitude and

TBA’s are the first point of contact with mothers at de-

practice of pregnant mothers attending antenatal care on

livery and in the early neonatal period. With the high

neonatal jaundice in Kano metropolitan.

prevalence of NNJ, also accounting for8% of neonatal

Methodology: The study was a cross sectional descrip-

deaths, and the proven effectiveness of health education

tive community based one which involved 424 pregnant

in prevention of kernicterus, there is a need to assess

mothers attending antenatal care across maternity cen-

and improve the knowledge of TBA’s in early identifi-

ters from six metropolitan local governments based on

cation of NNJ and early referral.

convenient sampling. Questionnaire based interview was

Methodology: A cross sectional community-based study

conducted following their consent.

was conducted on 47 TBA’s from 6 metropolitan areas

Results: A total of 424 pregnant mothers were studied of

in Kano. Pre and post test Interviewer administered

which 57.3% were of parity 1 – 3. Many did not know

questionnaires were filled, analyzed and compared. The

their blood and Rhesus groups (52% and59%) respec-

percentage difference of responses between the two tests

tively. Majority of them (95.5%) did not know what

were also obtained. Focused group discussions were

neonatal jaundice is, however99.8% believed that jaun-

done to the TBAs in small groups of 20. The interview

dice is abnormal. Only 14.9% had previous babies with

was recorded in writing as well as wudio

jaundice and many used glucose water. Mode of cord

Results: A total of 47 TBAs were enrolled. Two

care was via heat compress in 70.8%. Majority did not

declined for the test. 1 absconded for the post-test, so 44

use icterogenic substances but most of them (80%) did

were analysed.

not know the causes of jaundice and its complications.

For the pretest, the minimum score obtained was 15

Many mothers start breastfeeding on time and ade-

(2.3%), while the maximum Score was 35 (2.3%). Ma-

quately, however most of them used prelacteal feeds.

jority of the respondents (70%) scored 50% of the points

Conclusion: There is an urgent need for improved

obtainable.

awareness on neonatal jaundice, its risk factors, causes

For the post-test, a minimum score of 25 (2.3%), and a

and complications through health education of women

maximum score of 36 (13.6%)were recorded, with 100%

and potential mothers particularly at the community

scoring over 50%. The focus group discussion result: A

level.

lot of the TBAs believed that the cause is congenital

mostly due ingestion of bitter or oily substances by the

NN23

mother during pregnancy. Others believed that pregnant

Infantile hemangioendothelioma of the liver in a Ni-

woman should take certain herbs during pregnancy fail-

gerian newborn: a case report

ure of which leads to jaundice. For this reason they be-

Nwaogazie U , Ezenwa B , Akintan P , Fajolu I

lieved that less cases of jaundice are seen as the intake

Ezeaka C

of traditional medication increases during pregnancy.

Effect of jaundice. While some participants believed that

Department of Pediatrics, Lagos University Teaching

jaundiced babies who are not treated end up losing their

Hospital, Lagos, Nigeria

lives others believed that a jaundiced baby that is not

treated can survive but the baby will have poor growth

Background: Hepatic hemangioendothelioma though

and development.

rare, is the most common benign vascular tumour of the

Conclusion: The present study showed poor knowledge

liver in infancy and the most common symptomatic

and practices of TBA on neonatal jaundice improvement

hepatic tumour presenting in the first 6 months of life.

in the knowledge of neonatal jaundice amongst TBA’s

Its ability to present with life threatening complications

in pre and post test results.

such as congestive cardiac failure and thrombocytopenia

should heighten clinical suspicion of this condition in

NN22

newborns presenting with an abdominal mass .

Knowledge, attitude and practice of pregnant

Owing to the rarity of the condition, there is no struc-

mothers attending ANC on neonatal jaundice in

tured therapeutic research, but a small number of cases

Kano metropolis

have been reported to respond well to treatment with-

steroid. In a bid to create awareness to the existence of

Abbdulsalam M, Tsiga F*, Muhammad IY#

this rare condition in our environment, we report a case

Adullahi SU

of symptomatic hemangioendothelioma in a newborn

Departments of Paediatrics, *Community Medicine,

and challenges that can be encountered during manage-

#Chemical Pathology, Amino Kano Teaching Hospital,

ment in our environment.

Kano

Case Report: Baby O.A is a 22 day old female neonate

who presented with an abdominal mass noted at birth.

Background: Neonatal jaundice is the visible manifesta-

Diagnosis was made based on clinical findings and re-

tion of unconjugated hyperbilirubinaemia and is a sig-

sults of abdominal ultrasound scan and CT scan which

nificant cause of neonatal morbidity and mortality. It

were in keeping with a hepatic hemangioendothelioma.

accounts for 8% of neonatal deaths in Sub Saharan

She was treated with oral prednisolone, propanolol and

Africa and 20% of hospital admissions in Nigeria. Kano

aggresive supportive treatment with blood and platelet

State has a population of about 10million people and a

concentrates transfusions. Her management was se-

fertility rate of about 7.4 with only 3 hospitals that admit

verely hampered by challenges in obtaining a histologic

neonates in the state.

diagnosis, financial constraints and unavailability of

118

appropriate diagnostic tools. She was discharged and is

Funding: Saving Lives at Birth, FOG Award No AID-

being followed up at the outpatient clinics.

OAA-F-13-00072

Conclusion: Hemangioendothelioma should be consid-

ered in the differential diagnosis of infants presenting

NN25

with an abdominal mass in the newborn period as it

The burden of perinatal asphyxia at University

could be associated with significant morbidity and

college hospital, Ibadan

mortality requiring aggressive treatment and meticulous

supportive care.

Atoba T, Tongo O

Keywords: Haemangioendothelioma, newborn, tumour

Email: tope_lawal@yahoo.com

NN24

Background/Introduction: Perinatal asphyxia accounts

Prevalence and risk factors for kernicterus in

for one-third of neonatal mortality globally especially in

Nigeria

developing countries like Nigeria. It is also associated

with significant neonatal and long term morbidity.

Diala U , Hassan L , Umar S , Omoyibo E , Imam Z

Aims/Objectives: To describe the prevalence of as-

Slusher T

phyxia, its risk factors and complications among admit-

Department of Paediatrics, University of Jos, Jos,

ted neonates in UCH, Ibadan.

Nigeria

Methods: 82 neonates diagnosed as severe perinatal as-

Department of Paediatrics, Ahmadu Bello University,

phyxia admitted over a five month period were recruited

Zaria, Nigeria

and their parameters described. Severe asphyxia was

Department of Paediatrics, Murtala Muhammad

defined as APGAR score of < 3 at 1 minute and <5 at

Specialist Hospital, Kano, Nigeria

5minutes, failure to initiate or sustain breathing at birth

Department of Paediatrics, Federal Medical Center,

and presence of signs of neonatal encephalopathy. In-

Asaba, Nigeria

vestigations include electrolytes, urea and creatinine,

Massey Street Children’s Hospital, Lagos, Nigeria

urinalysis, urine SG, electrocardiogram amongst others.

University of Minnesota, Minneapolis, MN, United

Results: 70% of the babies were out born. Risk factors

states.

identified were male sex, place of ANC, number of

Email: dialaum@yahoo.com

ANC visit, duration of ANC visits and maternal educa-

tional status. Complications were encephalopathy

Background: Kernicterus accounts for about 6% of neo-

52.6%, respiratory distress 87.2%, sepsis 78.2%, AKI

natal deaths in Nigeria. The reasons for the high rate of

37.2%. Mortality rate was 24.3% and 52.6% of these

acute bilirubin encephalopathy (ABE) are not fully un-

deaths occurred within 24 hours of admission. 18.6% of

derstood.

survivors had neurologic deficit on discharge.

Objective: To determine the prevalence and risk factors

Conclusion & Recommendations: Perinatal asphyxia

for ABE in 5 regions in Nigeria.

remains a major contributor to neonatal morbidity and

Design/Methods: A collaborative prospective observa-

mortality in UCH, Ibadan

tional study was performed in 9 major hospitals in Kano

(2), Zaria, Jos (4), Lagos, and Asaba. We gathered

NN26

demographic data, perinatal history and laboratory data

Neonatal Jaundice in University of Port Harcourt

from patients treated for jaundice. We compared data

Teaching Hospital

from neonates with and without ABE to identify the root

causes of ABE in this population.

Uchenwa-Onyenegecha TA, Eneh AU, Opara PI

Results: Collectively, 160/1026 (15.6%) jaundiced neo-

Okagua J

nates had ABE, representing an average 2.8 ABE cases/

Department of Paediatrics University of Port Harcourt

center/month.

Teaching Hospital.

Behavioral factors associated with ABE (P <0.001) in-

Email: tochiuchenwa@yahoo.com

cluded delayed admission >3 days (X 18.24, OR 2.06),

travel distance to hospital >15 km (X 13.28),lack of

Background: Acute bilirubin encephalopathy (ABE) has

maternal knowledge about jaundice (X 25.57, OR 2.96)

remained a common cause of morbidity and mortality in

and home deliveries (X 51.0, OR 3.9).

Nigeria

Clinical factors associated with ABE (P <0.01) included

Aim: This study aimed to determine pattern and risk

LBW, blood type incompatibility, anemia, and sepsis.

factors for NNJ at the University of Port Harcourt

ABE occurred in 35/204neonates with ABO 3/35 with

Teaching Hospital

Rh incompatibility. Thirteen ABE cases had sepsis.

Methods: This was a prospective descriptive study of all

27neonates with severe hemolytic anemia (TSB>20 and

babies with NNJ managed at the SCBU of UPTH from

hematocrit<30%) probably had G6PD deficiency.

March 2014 to October 2015. They were consecutively

Conclusions: Delayed treatment of severe jaundice,

recruited and information on socio demographics, risk

mainly from a lack of knowledge, is a major cause of

factors, treatment and outcome was obtained. Data was

ABE. Increasing public awareness about jaundice and

analysed using SPSS version 20.0.

unsafe practices about G6PD deficiency, closer monitor-

Results: NNJ accounted for 18.4% of all admissions. Of

ing of LBW neonates, and providing jaundice services

149 neonates managed for NNJ, 53.7% were males and

closer home, promise to reduce ABE in Nigeria.

46.3% females (M:F = 1.2:1). Ninety six (64.4%) were

119

inborn, 53(35.6%) out born, and 79 (53%) were term

PC 1

babies. Most 138 (92.6%) were delivered in health fa-

Case report atrial myxoma a rare cause of cerebro

cilities and presented within 72hrs of life. Mother’s level

vascular disease in children

of education did not significantly influence duration of

symptoms before presentation (P=0.996). Sepsis, pre-

Onubogu UC, West BA, Orukpabo BO

maturity and ABO incompatibility were the common

Braithwaite Memorial Specialist Hospital, Port

risk factors. Thirty seven (24.8%) had SB ≥ 340umol/L.

Harcourt, Rivers State, Nigeria

Exchange blood transfusion was done in 46(30.9%),

Email: utchayonubogu@yahoo.co.uk

including 6 babies (4%) with signs of ABE. There was

no statistically significant relationship between risk of

Background: Cardiac myxoma is a rare cause of cere-

developing ABE and gestational age (P=0.439). All ba-

brovascular disease (CVD), especially in African chil-

bies with encephalopathy were discharged home.

dren in which the commonest cause is Sickle cell dis-

Conclusion: NNJ has remained a major cause of neona-

ease. CVD is however the commonest manifestation of

tal morbidity however the incidence of ABE in our unit

cardiac myxoma in paediatric age group.

was low possibly due to early intervention.

Case presentation: 11 year old female presented with a

Key words: Neonates, Jaundice, risk factors, Port

5hrs history of dizziness, headache, inability to walk and

Harcourt

vomiting. On examination, she had a stiff neck, bilater-

ally dilated pupils, a left CN V1, VII palsy, decreased

NN27

power, tone and reflexes in left upper and lower limb.

Morbidity and mortality patterns of admissions into

MRI of the brain showed subacute Rt thalamic infarct,

the Special Care Baby Unit of University of Port

She was managed for complicated Meningitis. 3months,

Harcourt Teaching Hospital, Rivers State, Nigeria

later she collapsed with complaints of heaviness of the

Rt side of the body and inability to walk. Examination

Obikwu U, Okagua J, Opara PI, Eneh AU

revealed cold legs bilaterally with very low volume dor-

Department of Paediatrics, University of Port Harcourt

salis pedis pulsation. ECG showed sinus rhythm, left

Teaching Hospital, Port Harcourt.

atrial hypertrophy, and left ventricular hypertrophy.

Vascular ultra sound of both legs showed deep focal

Background: Neonatal mortality is the highest contribu-

vein clot in Rt common iliac vein. A transthoracic echo-

tor to under-5 mortality in Nigeria and Sub Saharan Af-

cardiography revealed a mobile mass in the left atrium

rica and has greatly impacted on the attainment of mil-

(myxoma) measuring 3.9 by 2.6cm, impinging on the

lennium development goals 4 (MDG 4).

mitral valve, a dilated left atrium and multiple ectopic

Objective: To determine the morbidity and mortality

beats. A diagnosis of Left a trial myxoma with intermit-

patterns of patients admitted into the Special Care Baby

tent arrhythmia and multiple thromboembolic events

Unit (SCBU) of the University of Port Harcourt Teach-

was made. She was placed on anticoagulants, physio-

ing Hospital (UPTH), Rivers State, Nigeria.

therapy and referred for surgical resection of cardiac

Method: A retrospective analysis of records of patients

tumor. She died after 10months while awaiting surgery

admitted into the SCBU of the UPTH over a 12 month

due to financial constraints.

period from September 2014 to August 2014 was carried

Conclusion: Echocardiography should be done early in

out.

children presenting with ischemic thromboembolic dis-

Result: A total of 622 patients were admitted into the

eases in order to reduce morbidity and mortality result-

unit during the period, there were 332 (53.4%) males,

ing from cardiac pathology.

and 290 (46.6%) females giving a male to female ratio

of 1.1:1. Neonatal sepsis (32.2%), neonatal jaundice

PC2

(14.4%), severe birth asphyxia (13%), and prematurity

Blood pressure profile among apparently healthy

(11.1%) were the major indications for admission.

primary school children in Kano Metropolis, Nigeria

54.5% were admitted into the inborn section and 45.5 %

into the out-born section of SCBU. About a third

Umar A, Asani M, Ibrahim M

(31.3%) of babies were admitted in the first week of life,

Department of Paediatrics, Aminu Kano Teaching

while 16.8% were admitted between 8-28days of life.

Hospital, Kano. Currently at: Department of Paediat-

The overall neonatal mortality rate was 14.6% and the

rics, Rasheed Shekoni Specialist Hospital, Dutse, Ji-

discharge against medical advice (DAMA) rate was

gawa state.

17.8%. Severe birth asphyxia was higher amongst out-

Email: umaralso@yahoo.com

borns (p=0.000). Mortality rate was also significantly

higher in outborns (p=0.001). The commonest reason for

Background: In an attempt to study and prevent the

DAMA was lack of funds for continued care.

development of hypertension in adults, there is a grow-

Conclusion: Majority of admissions were preventable

ing interest in measuring blood pressure in children be-

conditions. Enhancement of good antenatal and delivery

cause the nature of essential hypertension may be more

services, and implementation of the National Health

clearly understood if it could be studied early in the

Insurance Scheme for neonatal services will assist in

course of its natural history. Age, sex, family history of

reducing neonatal morbidity andmortality.

hypertension, environmental factors and anthropometric

indices are known to affect arterial blood pressure lev-

els.

120

Objectives: To determine the blood pressure profiles

Keywords: Transposition, great, arteries, children,

among apparently healthy primary school children in

Nigeria.

Kano metropolis.

Methodology: This was a cross sectional prospective

PC4

study of 2000 apparently healthy children aged 6-14

Thoracic ectopic cordis in a Nigerian Child

years carried out between February and October 2013.

Adeola Animasahun, Akpoembele D Madise-Wobo.

Blood pressure was measured with mercury sphygmo-

manometer using standard technique. The first and fifth

Department of Paediatrics and Child Health Lagos

phases of korotk off sounds were taken as indicative of

State University College of Medicine Ikeja. Lagos,

systolic and diastolic blood pressure respectively. The

Nigeria.

data were analyzed using SPSS version 16.0 and a p

Department of Paediatrics Lagos State University

value of <0.05 was regarded as statistically significant.

Teaching Hospital,Ikeja Lagos, Nigeria.

Results: The overall mean systolic blood pressure (SBP)

Email: deoladebo@yahoo.com

and mean diastolic blood pressure (DBP) were

93.8+8.91 and 59.8+6.95 mmHg. Mean SBP among

Introduction: The last documented report of a case of

males and females were 93.17+8.70 and 94.28+9.06

ectopic cordis in Nigeria was over two decades ago. In

mmHg while DBP were 59.1+6.9 and 60.3+6.9 mmHg

view of its rarity, we discuss a case of thoracic ecto-

respectively. The differences were statistically signifi-

piacordis in a Nigerian child.

cant.

Case Report: The patient was a female infant admitted

Body mass index (BMI) was found to correlate signifi-

on the tenth day of life with a history of a defect in the

cantly with systolic and diastolic blood pressure in both

upper third of the anterior chest wall noticed from birth.

genders.

She was delivered to a 24years old primiparous woman.

Mean blood pressures correlate with BMI and were

Examination revealed a female infant who had a defect

found to be higher among females than that of males

on her manubro-sternum with a pulsating heart covered

which is similar to studies done elsewhere.

by the pericardium visible through the defect. Her pulses

Key words: Blood Pressure, Children, Kano

were normal with normal heart rate. Other systemic ex-

ams were normal. An initial diagnosis of thoracic ecto-

PC3

piacordis was made. Echocardiograph revealed a dextro-

Transposition Of The Great Arteries As Seen At The

rotated heart with situs solitus, 2mm Patent Ductus Arte-

Lagos State University Teaching Hospital

riosus and a patent foramen ovale. Surgery was delayed

till after four weeks on admission due to financial con-

Animasahun BA , Madise-wobo AD , Gbelee HO

straint. She had wound breakdown which was well man-

Omokhodion SI

aged and she was discharged. She was readmitted about

Department of Paediatrics, Lagos State University

two months later with three day history of fever and one

Teaching Hospital, Ikeja, Lagos

day history of repeated convulsions. She was febrile

(40.1 C), pale, in respiratory distress. She was also,

Department of Paediatrics, University College

Hospital, Ibadan

tachypneic, tachycardic, and lethargic with a bulging

anterior fontanelle. A presumptive diagnosis of septi-

Background: Palliative and definitive interventions to

caemia with meningitis. Intravenous antibiotics were

manage children with transposition of the great arteries

commenced immediately. Unfortunately she succumbed

are currently not available in Nigeria and there are lim-

within 12 hours of readmission at the age of seven

ited reports on it in Africa and sub-Saharan Africa.

months.

Methods: A prospective and cross sectional study in-

Conclusion: Ectopiacordisis generally uncommon with

volving consecutive patients diagnosed with transposi-

few survivors. Management of ectopiacordis is ex-

tion of the great arteries using clinical evaluation and

tremely challenging.

echocardiography at the Paediatric Department of Lagos

State University Teaching Hospital, Lagos Nigeria as

PC5

part of a large study between January 2007 and Decem-

Cardiomyopathies among Children attending a

ber 2014.

tertiary Hospital in South-WesternNigeria

Results: There were 48 cases of TGA with a male to

Animasahun A, Madise-Wobo AD , Gbelee O,

female ratio of 2:1. Its prevalence amongst children with

congenital heart disease was 4.9% , while it was 15.4%

Lamina MO, Ogunkunle OO, Oke DA

1,3

among those with cyanotic congenital heart disease. The

Department of Paediatrics and Child Health; Lagos

mean age + SD of the subjects was 10.3±21.8 months.

State University College of Medicine, Ikeja Lagos,

Up to 70% of the patients were less than 6 months of

Nigeria

2,4

age at presentation. The most common mode of presen-

Department of Paediatrics Lagos State University

tation was cyanosis. The most common associated in-

Teaching Hospital Ikeja, Lagos, Nigeria.

tracardiac anomaly was ventricular septal defect.

Email: deoladebo@yahoo.com

Conclusion: Transposition of the great arteries is as

common in Nigeria as in the other parts of the world.

Background: Acquired heart diseases (AHD) such as

There is an urgent need to establish Paediatric cardiac

myocarditis, cardiomyopathies and rheumatic heart dis-

centres in Nigeria if these children are to be salvaged.

eases are important non-communicable diseases respon-

121

sible for morbidity and mortality in children. We aim to

with no focal lung lesion. The abdominal ultrasound and

describe the pattern and distribution of cardio-

CT scan showed complete transposition of the abdomi-

myopathies in children less than 13 years in a tertiary

nal viscera. She was managed for bronchial asthma but

hospital in Southwestern Nigeria and compare with pat-

defaulted in follow-up visits.

terns in the sub-region.

Conclusion: A thorough examination of all newborns is

Methods: Prospective and cross sectional, involving

required for early diagnosis and appropriate counseling

consecutive patients diagnosed with cardiomyopathy

is necessary to allay fears and correct misconceptions.

using echocardiography at the Paediatric Department of

Lagos State University Teaching Hospital (LASUTH)

PC7

Lagos Nigeria between January 2007 and December

Blood pressure to height ratio as a screening tool for

2014.

pre-hypertension and hypertension in adolescents

Results: Cardiomyopathy was documented in 31

(2.75%) children with structural heart disease and con-

Ladapo TA, Fajolu IB, Adeniyi FO, Ekanem EE,

stituted 25% of patients with acquired heart disease dur-

Maduako RO, Jaja T, Oduwole AO

ing the study period. The prevalence of cardiomyopathy

Department of Paediatrics, Lagos University Teaching

amongst the children attending the Department of Paedi-

Hospital, Idi-Araba

atrics, LASUTH was 9 in 100,000 children over an 8

Email: drteeladapo@yahoo.com

year period. The mean age of the children was 5.48 ±

4.0 with male to female ratio of 1:1.30. Congestive car-

Background/Introduction: Current methods of detection

diac failure was the commonest indication for echocardi-

of children with hypertension are cumbersome and con-

ography, in 48.38% of all the patients. Dilated cardio-

tribute to under-diagnosis hence the need to generate

myopathy was the most common disease accounting for

simpler diagnostic tools. The blood pressure to height

71% of the cardiomyopathies, followed by Hypertrophic

ratio has recently been proposed as a novel screening

cardiomyopathy (HCM,)(16.1%) and Restrictive Cardio-

tool for pre-hypertension and hypertension in some

myopathy (RCM)(12.9%) respectively. The subjects

populations. We evaluated its applicability in our envi-

with DCM were younger than both HCM and RCM.

ronment.

Conclusion: Cardiomyopathy is an important cause of

Aims/Objectives: To evaluate the BPHR as a screening

congestive cardiac failure in children. DCM is the pre-

tool for high blood pressure in a group of black adoles-

dominant type of cardiomyopathy in our subjects fol-

cents using blood pressures derived by the auscultatory

lowed by HCM and RCM. Children with DCM were

method.

younger than those with HCM and RCM. EMF is the

Methods: The weights, heights and blood pressure meas-

predominant form of RCM in our subjects.

urements of 2,364 apparently healthy adolescents were

Keywords: Cardiomyopathy, Children, Acquired, Con-

determined. Sex-specific systolic and diastolic blood

gestive, Cardiac, Failure , Hypertrophic, Restrictive

pressure to height ratios (SBPHR) and (DBPHR) were

calculated and their ability to detect prehypertension and

PC6

hypertension was determined using Receiver Operating

Dextrocardia with situs inversus totalis in an 8 year

Curves (ROC). Discriminatory ability was measured by

old girl: A case report

the area under the curve (AUC) and optimal cut-off

points along the curve were determined. A p value of

Tunde-Oremodu I, Okosun OE

<0.05 was considered statistically significant.

Department of Paediatrics, Federal Medical Centre,

Results: The SBPHR and DBPHR were similar across

Yenagoa

all age groups and sexes. The AUC of SBPHR and

DBPHR for diagnosing prehypertension and hyperten-

Background: Dextrocardia is a congenital anomaly of

sion by sex was > 0.95 for both diastolic and systolic

the heart characterized by the location of the heart on the

hypertension in both sexes. It ranged between 0.803 and

right side, instead of on the left side in the foetus . It

3,6

0.922 for pre-hypertension and 0.954-0.978 for hyper-

can also be associated with situs inversus totalis which

tension indicating higher accuracy for hypertension.

also is a rare congenital anomaly characterized by a mir-

Sensitivity was higher for systolic and diastolic hyper-

ror image positioning of major abdominal and thoracic

tension (90-98%) compared with pre-hypertension (87-

viscera.

98%). Specificity was lower than sensitivity across all

Case report: We report the occurrence of dextrocardia

categories of hypertension and prehypertension (0.64 to

with situs inversus totalis in an 8 year old female in

0.88%) though higher for hypertension (0.75-0.88) com-

order to highlight the need for appropriate newborn ex-

pared with pre-hypertension (0.64-0.75).

amination and challenges associated with management

Conclusion & Recommendations: BPHR is a useful

in low income settings She presented with recurrent res-

screening tool for prehypertension and hypertension in

piratory symptoms from birth which usually responded

black adolescents. Accuracy increased with higher de-

to bronchodilators. Although she was delivered in a hos-

grees of hypertension.

pital, ano-rectal malformation was detected at 3 weeks

of age. At presentation, the only abnormality noticed

was the apex beat which was palpated at the 5 right

intercostals space, mid clavicular line. Chest x-ray,

Chest CT and echocardiography revealed dextrocardia

122

PC8

echos performed for children undergoing surgery was

Spectrum of structural cardiac diseases in children

done. The requests were categorized according to refer-

in Gwagwalada metropolis and its environs: a

ring specialties, into ophthalmology, dentistry, ENT and

two-year prospective echocardiography review

others. The biodata and echo findings were noted.

Analysis was done with SPSS 20.0.

Onalo R, Ajanaku I, Mada W

Results: A total of 181 children with same number of

Department of Paediatrics, University of Abuja

echos were studied, 100(55.2%) were males. Most 87

Teaching Hospital, Gwagwalada, Abuja

(48.1%) with oro-facial clefts were from Dentistry. Of

Email: richardonalo@yahoo.com

the 181, 39 (21.5%) had cardiac abnormalities. Most 34

(87.2%) were congenital heart disease (CHD). Ophthal-

Background: Cardiac anomaly remains an important

mic requests with suspected congenital Rubella syn-

contributor to childhood morbidity and mortality. Early

drome (CRS) had the highest prevalence 8/12(66.7%)

diagnosis is critical to preventing complications and

while the least was oro-facial clefts 15/87(17.2%). Atrial

mortality. Echocardiographic evaluation is the gold stan-

septal defect was the commonest abnormality in 14

dard for the diagnosis of structural heart diseases.

(35.9%).

Objective: To review the spectrum of structural heart

Conclusion: Pre-anesthetic echo should be performed

diseases prevalent in Gwagwalada metropolis and its

especially for children with suspected CRS and other

environs.

congenital anomalies requiring non cardiac surgery.

Methods: Consecutive children referred to the Paediatric

Keywords: Pre-anesthetic; echocardiography; children;

Cardiology Unit of University of Abuja Teaching Hos-

non cardiac surgery; congenital rubella syndrome; cleft

pital over a 2-year period were recruited and all had

lip and palate; Nigeria

echocardiography performed.

Results: Echocardiograms were performed on 362 chil-

PC10

dren within the study period. The age range was 1 day to

Prevalence of Rheumatic Heart Disease detected by

16 years. There were 185 males and 177 females, giving

echocardiographic screeening: a community-based

a male to female ratio of 1.05:1. Normal scan was re-

study of school children in Port Harcourt Local

corded in 104 (28.7%) children; while 110 (30.4%) chil-

Government Area, Rivers state, Nigeria

dren had congenital malformation and 38 (10.5%) had

Ujuanbi SA , Tabansi PN , Otaigbe BE

***

acquired heart diseases. Myocarditis (11, 28.9%), peri-

carditis (6, 15.8%), rheumatic heart diseases (6, 15.8%)

Department of Paediatrics, University of Port Harcourt

and dilated cardiomyopathy (4, 10.5%) were the pre-

Teaching Hospital, Port Harcourt, Nigeria.

dominant acquired heart diseases, while ventricular sep-

Email: asokoedion@yahoo.com,

tal defect (52, 47.3%), atrial septal defect (43, 39.1%),

asokoedion2015@gmail.com

pulmonary stenosis (27, 24.5%) and patent ductus arteri-

osus (25, 22.7%) predominate in the congenital group.

Background: Rheumatic heart disease (RHD) is an im-

Discussion and Conclusions: The predominance of con-

portant public health problem in developing countries.

genital heart diseases in this locality spells the need for

Community-based studies using portable echocardiogra-

provision of adequate facilities for treatment of children

phy have enhanced detection of RHD for early interven-

with these disorders. A study on factors accounting for

tion.

the high prevalence of congenital heart diseases in this

Objectives: To determine the prevalence of RHD among

environment is highly recommended.

school children in Port Harcourt Local Government

Area (PHALGA), the pattern of valvular involvement

PC9

(s), the relationship of the disease with certain risk fac-

Pre-anesthetic echocardiographic findings in

tors (such as overcrowding and socioeconomic status)

children undergoing non cardiac surgery at the

and to ascertain the sensitivity, specificity and positive

University of Benin Teaching Hospital, Nigeria

predictive value of cardiac auscultation in detecting

RHD.

Ikhurionan P , Imarengiaye C , Sadoh WE

Methods: A total 461 students aged 5-15 years were

Department of Child Health, Department of Anesthesi-

selected by multi-staged sampling from thirteen schools

ology, University of Benin Teaching Hospital, PMB

in PHALGA. Questionnaires were used to obtain rele-

1111Benin City, Edo State Nigeria.

vant information on history suggestive of rheumatic

fever or RHD and parents occupation and level of edu-

’

Email: sadohehi@yahoo.com

cation. Subsequently, all the selected students had car-

Background: Pre-anesthestic echocardiogram (echo) is

diac auscultation and echocardiographic examination.

requested certain non-cardiac surgeries to identify possi-

Result: The study revealed an RHD prevalence rate of

ble structural cardiac anomalies. They are referred be-

4.3 per 1,000 students using cardiac auscultation and 6.5

cause it is the standard of care or because of suspected

per 1,000 students using echocardiography only. All

cardiovascular abnormality on clinical evaluation.

(100%) of the affected students with RHD were within

Objective: To describe the prevalence and spectrum of

the age category of 11-15 years and were females. Mi-

structural cardiac abnormalities seen in various non-

tral regurgitation (66.7%) was the commonest valvular

cardiac conditions referred for echocardiography.

lesion seen. There was significant association between

Methods: A 5 year retrospective review of pre-anesthetic

RHD and overcrowding (p=0.04), while 66.7% be-

123

longed to the middle socioeconomic class (SEC) and

PC12

33.3% to the low SEC. Cardiac auscultation is 66.7%

Comparison of obesity, overweight and elevated

sensitive and 98.7% specific in detecting RHD with a

blood pressure in children attending public and

positive predictive value of 25% when compared with

private primary schools in Benin City, Nigeria

echocardiography.

Israel-Aina YT, Sadoh AE, Uduebor JE, Shaibu M,

Conclusion: Early diagnosis and prompt treatment of

Ogonor E , Enugwuna FC , Sadoh WE,

RHD is recommended.

Key words: Rheumatic Heart Disease, Echocardiogra-

Department of Child Health, University of Benin

phy, School Children

Teaching Hospital, PMB 1111, Benin City, Edo State,

Nigeria

PC11

Department of Paediatrics, Delta State University

Prevalence and interrelationship of over-nutrition

Teaching

Hospital,

Oghara,

Delta

State

and prehypertension/hypertension among primary

Department of Child Health, Kuje General Hospital,

school children in non-urban areas of mid-western

FCTA Abuja, Nigeria

Nigeria

Ibrahim Babangida Government Specialist Hospital,

Minna, Nigeria.

Adetunji AA, Adeniran KA, Alikah SO, Akpede GO

Email: sadohehi@yahoo.com

Department of Paediatrics, Irrua Specialist Teaching

Hospital, PMB 08, Irrua, Edo State, Nigeria

Background: Overweight and obesity in children and

Email: tunjiwale2007@yahoo.com

adolescents is on the rise globally. It is perceived that

children of the affluent who are attending private

Background: There is an emerging problem of over-

schools may be more affected than those in public

nutrition, ON (obesity and overweight) in developing

schools.

countries, which could be associated with the increasing

Objective: To compare the prevalence of overweight,

prevalence of cardiovascular disorders, particularly ele-

obesity and elevated blood pressure (BP) in pupils at-

vated blood pressure, EBP (prehypertension and hyper-

tending public and private primary schools in an urban

tension). However, data are limited on the size of the

community in Benin City.

problems in primary school children, particularly those

Methods: In this cross sectional study, the BMI and BP

in non-urban areas.

of pupils in public and private primary schools, recruited

Aims and Objectives: To determine the prevalence of

by multistage sampling method, were measured. Their

ON and EBP and the relationship between them among

nutritional status was categorized using their BMI per-

non-urban primary school children.

centiles. BP variable were based on Fourth Blood Pres-

Methodology: 1187 children aged 6-11 years were re-

sure report. Analysis was by SPSS.

cruited from schools in Esan West Local Government

Results: A total of 1466 pupils were recruited, 814

Area of Edo State, Nigeria through multistage sampling

(55.5%) were in public schools and 722(49.2%) were

in 2013. Their body mass index and blood pressures

males. The prevalence of overweight and obesity respec-

were determined and classified using standard methods.

tively was higher in private schools 11.8% and 11.7%

The statistical significance of the difference in preva-

compared to public schools 3.3% and 0.9%, p =

lence between groups were determined using Fisher

<0.0001. The mean systolic BP of pupils in public

exact test, with the level of significance set at p <0.05.

schools 96.8 ± 12.5 mmHg was higher than that in pri-

Results: 17 (1.4%) were obese and 41 (3.4%) over-

vate schools 95.5 ± 10.2 mmHg, p = 0.032. The preva-

weight, giving a total prevalence of ON of 4.8%. 44

lence of pre-hypertension and hypertension between

(3.7%) had prehypertension and 35 (2.9%) hypertension,

pupils in public and private schools was not significant,

giving a total prevalence of EBP of 6.7%. 10/58 pupils

p = >0.05.

with ON versus 69/1129 pupils without ON (odds ratio

Conclusion: The prevalence of overweight and obesity

(95% CI) = 3.2 (1.55, 6.60), p = 0.007) had EBP. Only

is higher in pupils attending private schools compared to

10/79 cases of EBP (9/35 cases of prehypertension ver-

those in public school while pre-hypertension and

sus 1/44 cases of hypertension (OR (95% CI) = 14.88

hypertension was not significantly different between the

(1.78, 124.3), p = 0.005) were in children with ON.

school types. Urgent measures are needed to stem the

Conclusion: Both the prevalence of ON and the preva-

tide of overweigh/obesity through education, weight

lence of EBP are within the lower range of the preva-

reduction and physical activity programmes especially

lence in urban areas. However, although the prevalence

in pupils attending private schools.

of EBP is higher in children with ON, using the criterion

Keywords: Blood pressure, body mass index, obesity,

of ON grossly underestimates the risk of EBP.

overweight, private schools

Keywords: Elevated blood pressure; Interrelationship;

Mid-western Nigeria; Over-nutrition; Prevalence; Non-

urban areas.

124

PC13

Methodology: Across-sectional study that involved 156

Prevalence and types of congenital heart disease in

HIV infected children aged 15 years and below. Aspects

children with Down syndrome in the University of

of their cardiovascular function were determined by

Benin Teaching

clinical examination, chest radiograph, electrocardiogra-

phy and echocardiography. They also had laboratory

Eki-Udoko FE, Isah AI, Sadoh WE

estimation of CD4 count, CD4 percentage and HIV viral

Department of Child Health, University of Benin Teach-

load.

ing Hospital, Benin City

Results: Cardiac disorders were detected by echocardi-

Email: sadohehi@yahoo.com

ography in 79 (50.6%), by ECG in 60 (38.5%) and chest

radiograph in 10 (6.4%) of the 156 children studied. The

Introduction: Down syndrome (DS) is the commonest

major cardiac disorders encountered included depressed

chromosomal disorder. Children with DS are prone to

ejection fraction (30.1%), dilated cardiomyopathy

having congenital heart diseases (CHD) and a variety of

(7.1%), pulmonary hypertension (7.1%), sinus tachycar-

CHDs have been described in DS. Most previous Nige-

dia (17.3%), right ventricular hypertrophy (11.5%), car-

rian studies have small numbers

diomegaly (5.1%) and symptomatic congestive heart

Objective: determine the prevalence and types of CHDs

failure (1.3%). The overall prevalence of cardiac disor-

seen in children with DS in UBTH.

ders was 66.7%. Both ECG and ECHO abnormalities

Method: Consecutive child with clinical features of DS

were commoner in males, ART naïve participants, those

seen in the wards or out-patient clinics of the UBTH

with advanced stage of HIV disease and severe immuno-

between July 2012 and December 2013 was referred for

suppression.

echocardiography and prospectively recruited for the

Conclusion: Cardiac disorders in HIV infection are not

study. The bio data of the child and parents were noted.

uncommon and may be asymptomatic. It is therefore

The CHD was confirmed on echocardiography, their

necessary to include baseline and periodic cardiac ex-

number and types were noted. Analysis was done with

aminations in the management protocol for children

SPSS 20.0.

with HIV infection to ensure optimal care and improved

Results: A total of 64 children with DS were recruited,

quality of life.

of which 36(%) were female. Their ages ranged from 2

days to 15 years. Mean paternal and maternal ages were

PC15

42.9 ± 7.3 years (range: 30 - 60 years) and 36.2 ± 5.7

Echocardiographic findings in newborns and post-

years (range: 23 - 50 years) respectively. The prevalence

neonatal infants undergoing preoperative evaluation

of CHD was 51(79.7%). Most 49(96.1%) were

for surgically correctable congenital malformations

acyanotic

CHDs.

Commonest

CHD

was

atrio-

ventricular septal defect (AVSD) in 20(39.2%), fol-

Onalo R, Osagie OE.

lowed by Atrial septal defect 11(21.6%). The least was

Department of Paediatrics and Paediatric surgery

persistent truncusarteriosus (PTA) in 1(2.0%).

University of Abuja Teaching Hospital, Gwagwalada,

Conclusion: The prevalence of CHDs in DS children

Abuja

was high in this study. The commonest is AVSD and the

types included cyanotic CHDs. Children with suspected

Background: Congenital cardiac malformations could co

DS should be evaluated to exclude CHDs.

-exist with surgically correctable non-cardiac congenital

Keywords: Down syndrome; congenital heart disease;

structural abnormalities. The occurrence of the two con-

echocardiography

ditions portends increased anaesthetic risk and pe-

rioperative complications. Early recognition could fa-

PC14

vourably alter the post-operative outcome.

Cardiac disorders in children with HIV/AIDS at the

Objectives: To describe the prevalence and pattern of

University College Hospital, Ibadan, Nigeria

congenital heart defects in young infants with non-

cardiac congenital malformations preparing for surgical

Mbajekwe RO, Ogunkunle OO, Oladokun RE

interventions.

Department of Paediatrics, University College Hospital,

Methods: Consecutive newborns and postneonatal in-

Ibadan, Nigeria.

fants with congenital malformations being prepared for

Email: reubby2003@yahoo.com

surgery were sent to the paediatric cardiology unit of

University of Abuja Teaching Hospital for echocardi-

Background: Cardiovascular abnormalities have been

ography from August 2013 through July 2015. A Vivid

reported as a serious complication of human immunode-

e portable echo machine was used to evaluate the heart

ficiency virus (HIV) infection. They contribute signifi-

using a 6S transducer.

cantly to the morbidity and mortality associated with the

Results: Of the 34 newborns and postneonatal infants

disease, which still has a high burden in sub-Saharan

with congenital non-cardiac malformations, 21(61.8%)

Africa. Routine and periodic cardiovascular evaluation

were males while 14 (41.2%) were females, giving a

have however, not been incorporated into the HIV man-

M:F ratio of 1.5:1. Gastrointestinal malformations con-

agement protocol in most settings in Africa.

stituted 50% of cases. Omphalocoele major and biliary

Objective: To determine the prevalence, pattern and

atresias were the most common malformations seen. Six

associations of cardiac disorders in children with HIV/

babies had completely normal heart, 4 had isolated pat-

AIDS at the University College Hospital (UCH), Ibadan.

ent foramen ovale, thus giving a total of 10 babies with

125

structurally normal hearts. Of the 24 babies with struc-

PC17

tural heart defects, 14 (58.3%) had single defect while

Blood pressure measurements in primary school pu-

10 (41.7%) had two or more defects consisting of 21

pils of Ethiope West Local Government Area of

acyanotic and 3 cyanotic defects, namely truncus arteri-

Delta State using the dinamap Oscillometer

osus, double outlet right ventricle and hemianomalous

Anighoro GU , Okolo AA , Diakparomre MA ,

pulmonary venous return. A total of 34 cardiac defects

Sadoh WI .

were seen. Thirty-one (91.2%) of the heart defects were

simple while 3 (8.8%) were complex heart defects.

Delta State University Teaching Hospital, Oghara

Atrial septal defect (9, 37.5%), patent ductus arteriosus

University of Benin Teaching Hospital, Benin City

(9, 37.5%) and ventricular septal defect (6, 25.0%) were

the commonest simple heart defects.

Background: Adult Hypertensive disorders and resultant

Conclusions: Congenital structural abnormalities are

cardiovascular morbidity is on the increase. Childhood

common indications for surgical interventions in young

blood pressure is the strongest predictor of adult blood

infants. Recognition of co-existing structural cardiac

pressure. It is now understood that elevated BP in chil-

abnormalities is essential in preoperative planning and

dren may represent the onset of essential hypertension in

may be a useful guide in averting untoward anaesthetic

adults. Thus the potential to prevent adult hypertension

accident.

starting in childhood depends on the knowledge of the

determinants of childhood blood pressure. Measure-

PC16

ments with the automated oscillometric device correlate

Left ventricular non-compaction cardiomyopathy in

strongly with intra-arterial readings.

HIV infected Nigerian child

Objective: To assess the oscillometric Blood Pressure

(BP) values in apparently healthy primary school pupils

Adaora A. Okechukwu, Richard Onalo, Eno E. Ekop

of Ethiope West LGA (EWLGA) so as to to determine

Department of Paediatrics, University of Abuja

the prevalence of hypertension and pre hypertension.

Teaching Hospital, Gwagwalada, Abuja.

Methods: Following due ethical process, the Dinamap

oscillometric device was utilised to assess blood pres-

Introduction: Left ventricular non-compaction cardio-

sure (BP) of a cross section of rural primary school pu-

myopathy (LVNC) is a rare congenital heart condition

pils aged 5 years to 12 years in Ethiope West Local

representing an arrest in the normal process of myocar-

Government Area (EWLGA) of Delta State. BP was

dial compaction, resulting in a spongy myocardium,

measured with the Dinamap monitor. Statistical analysis

persistence of prominent ventricular trabeculations and

was with the SPSS version 16, year 2007.

deep intrartrabecular recesses. Clinical presentations

Results: A total of 1200 pupils 632 (52.7%) females and

vary from asymptomatic, to arrhythmias, thromboem-

568 (47.3%) males were recruited; 321(26.8%) pupils

bolism, heart failure, and sudden death.

from private schools and 879 (73.2%) from public.

We report a case of LVNC in an HIV-positive girl

The prevalence of hypertension was 6.7%. Children

whose initial manifestation was acute stroke. To our

from the public schools (7.2%) had higher BP than those

knowledge, this is the first reported case of LVNC in

from the private schools (5.3%) P=0.035.

HIV – infected paediatric patient in Africa.

The prevalence of pre-hypertension was 6%. Children in

Case Report: A 10-year old HIV-infected girl who has

private schools had a significantly higher pre-

been on anti-retroviral therapy for 8 years, presented

hypertensive prevalence of 7.2% than those in public

with 4-day history of deviation of the mouth to the left,

schools 4.8%

inability to use right limbs and loss of speech. Examina-

Conclusion and Recommendation: Pattern of blood pres-

tion revealed left facial nerve palsy, right hemiplegia,

sure changes in the children of this community has

dyspnoea, tachypnoea and displaced apex beat.

shown a higher trend in values for the ages and a high

Imaging showed globular heart, pulmonary plethora and

prevalence of hypertension and prehypertension. There-

cerebral infarct. ECG revealed left ventricular hypertro-

fore it is recommended that BP of children in this age

phy with strain pattern, left atrial enlargement and repo-

cohort in EWLGA be measured using the Dinamap XL

larisation abnormality. Echocardiographic findings in-

device and the developed charts referred to for easy in-

cluded grossly dilated left ventricle with spongy-to-

terpretation and detection of elevated BP at every con-

compact ratio of 4.5, intratrabecular recesses and severe

tact with a health facility.

left ventricular dysfunction.

Keywords: Blood Pressure measurements, Hyperten-

A diagnosis of stroke likely secondary to thromboem-

sion, Prehypertension, Children

bolism from LVNC in WHO clinical stage 2 HIV pa-

PC18

tient was made. She was successfully managed with

The Adolescent with Cardiac Disease in Zaria

antifailure regimen, anticoagulant and physiotherapy.

Discussion: The true prevalence of LVNC is unknown.

Orogade AA, Yakubu O

Diagnosis of LVNC was based on the Jenni criteria. Our

Department of Paediatrics Ahmadu Bello University

patient, prior to this hospitalization had been asympto-

Teaching Hospital Shika Zaria

matic for LVNC disease.

Conclusion: Myocardial non-compaction can present

Introduction: The outcome in adolescents (aged 10-

with dramatic events, thus the need for routine screening

19years) accessing healthcare for cardiac disease is

of HIV infected children for heart diseases.

largely undocumented. The benefits of global techno-

126

logical advancements in cardiac care should accrue to

data and clinical staging of HIV disease were obtained.

this paediatric subset who are link to our future. This

Skin examinations were carried out, clinical photo-

study evaluates outcome of adolescents with chronic

graphs and blood samples for full blood count and CD4

cardiac disease in Zaria.

were obtained. Body Surface Area affected by the infec-

Methods: Adolescents attending paediatric cardiac clinic

tion was estimated using the ‘Rule of nine’. Data was

of ABUTH from Nov - Oct 2015 were studied. Demo-

analysed using SPSS version 21.

graphic details including age at diagnosis, frequency of

Results: There was no statistically significant difference

visits and disease outcome were obtained. Socioeco-

in prevalence of dermatophytosis in the subjects (13.1%)

nomic milieu was profiled in relation to health outcome

and controls (10.2%), p = 0.44. Highest prevalence rate

and Health Related Quality of Life (HRQOL) was as-

was in the 5 – <10 years age range in both groups. Tinea

sessed.

capitis, tinea faciei, tinea corporis, tinea pedis and tinea

Results: Fifty two adolescents(41 early, 8 middle and 3

unguium were seen in the subjects. The latter two were

late) comprising 18% of all cardiac patients were en-

absent in the control group. Multiple sites of infection

rolled. There were 23 with congenital structural cardiac

and atypical lesions were encountered among the sub-

disease (diagnosed since infancy), 26 with rheumatic

jects. There was no significant difference in the sizes of

heart valvular disease and 3 TB pericarditis. Eighty eight

lesions in both groups. There was no statistically signifi-

percent (46/52) were from low/ medium socioeconomic

cant relationship between prevalence rate and degree of

families. Irregular clinic attendance usually unaccompa-

immunosuppression.

nied by parents was recorded in 38%. Only 7 patients

Conclusion: HIV infection in Nigerian children is asso-

had had surgery and self-reported (HRQOL) was mostly

ciated with atypical and multiple distributions of der-

impaired in middle and late adolescents. Ten (19%)were

matophytic infections. The presence of tinea pedis or

lost to follow-up.

tinea unguium may be pointers to possible HIV infection

Discussion: Half of the respondents majorly followed up

since infancy had not had definitive surgery in compari-

PD2

son to prenatal diagnosis and early surgical repair prac-

Giant congenital melanocytic nevus in a 3 week old

ticed in developed countries. Access to surgical repair of

Child

acquired disease is almost nonexistent so there is im-

paired quality of life attributable mainly to chronic car-

Olomukoro CN, Falodun OA, Adesanya OO, Uno M

Department of Paediatrics and Internal Medicine

Conclusion: The adolescent with cardiac disease ismedi-

(Dermatology), National Hospital Abuja, FCT, Nigeria.

cally underserved and in undesirable quality of life. Re-

Email: chikaolomukoro@yahoo.com

newed commitment to cardiac healthcare for this silent

yet vital group is strongly advocated.

Background: Giant congenital melanocytic nevus is a

rare condition with incidence of about 1:50,000 births. It

PD1

increases risk of neurocutaneous melanosis and transfor-

Clinical spectrum of dermatophytosis in HIV sero-

mation into malignant melanoma. Identification and

negative and seropositive Children in Abuja, Nigeria

follow up of affected children is therefore important.

Case report: A 3 week old male neonate presented with

Olomukoro CN, Ogunbiyi AO, Oniyangi O

high grade fever and excessive crying. Examination re-

Audu LI, Iregbu KC

vealed a febrile, irritable child with a bath suit distribu-

Department of Paediatrics and Microbiology, National

tion of hyperpigmentation, multiple noodles, a large tied

Hospital Abuja, FCT

off foul smelling necrotic noodle and satellite lesions.

Department of Internal Medicine (dermatology),

He was managed for Sepsis in a child with giant con-

University College Hospital, Ibadan, Oyo state.

genital melanocytic nevus.

Email: chikaolomukoro@yahoo.com

Conclusion: The psychological impact of Giant Con-

genital Nevus on the family of the affected child and its

Introduction: Human immunodeficiency virus (HIV)

health implication to the child makes it important. Man-

predisposes the infected to infections including fungal

agement of this condition is a huge challenge especially

skin infections especially dermatophytosis. Though der-

in the developing countries where out of pocket health

matophytosis may appear trivial, in the immune defi-

financing almost precludes quality healthcare for the low

cient, there may be risk of atypical, extensive and inva-

socioeconomic class without health insurance.

sive infection.

Aim: This study was aimed at finding out the preva-

PD3

lence, clinical pattern, and the association if any be-

Linear and whorled nevoid hypermelanosis in a

tween the prevalence of dermatophytosis and the immu-

Nigerian Child: a case report and literature review

nological or clinical stages in HIV seropositive children

2months to 15years at the National Hospital Abuja,

Ujuanbi AS*, Eke GK**, Akani NA***

Nigeria.

Department of Paediatrics, . University of Port

Methodology: This was an observational cross-sectional

Harcourt Teaching Hospital, Nigeria.

study of 206 HIV positive children who met the study

Email: asokoedion@yahoo.com

criteria (subjects) and 206 HIV-negative children

matched for age and sex (controls). Sociodemographic

Introduction: Linear and whorled nevoid hypermelano-

127

sis (LWNH) is a rare skin condition characterized by

nomic condition (p=0.523). The psychosocial impact of

linear streaks and swirls of macular hyperpigmentation

tinea capitis was high at 58.2%. The impact was severe

along the lines of Blaschko. The disease may occasion-

in 3.3%, moderate in 23.9%, mild in 31.0% and in

ally have associated extracutaneous manifestations. The

41.8%, there was no impact.

exact pathogenesis is unknown and no satisfactory treat-

Conclusion: The prevalence of tinea capitis infection in

ment modalities for LWNH are currently available.

primary school children is high, with a higher preva-

There are few case reports of the disease in literature

lence in males and a remarkable psychosocial impact on

worldwide and none has been previously reported in

majority of infected children.

Nigeria. We are reporting one such rare case of linear

Key words: Tinea capitis, psychosocial impact.

and whorled nevoid hypermelanosis in a 9 month old

Nigerian child.

PE 1

Case report: A 9 month old female who presented with

Paediatric endocrine disorders in University of Port

abnormal dark skin pigmentation noticed at birth sug-

Harcourt Teaching Hospital.

gestive of LWNH with extracutaneous presentation in-

cluding microcephaly, turricephaly, anisocoria, nystag-

Jaja T, Yarhere IE, Uchenwa-Onyenegecha TA

mus and delayed developmental milestones. This shows

Department of Paediatrics University of Port Harcourt

the existence of this rare disease in Nigeria.

Teaching Hospital, Port Harcourt, Rivers State, Nigeria.

Conclusion: Linear and whorled nevoid hypermelanosis

PMB 6173.

though uncommon, is associated with significant mor-

Email: tamunopriyej@yahoo.com

bidity especially among those with extracutaneous le-

sions. No effective treatment is available for this disor-

Background: Endocrine disorders constitute a major

der.

health problem globally. In developing countries,

low

Key words: Linear, whorled, nevoid, hypermelanosis,

awareness and diagnostic challenges coupled with the

Nigerian

overshadowing effect of the burden of infectious dis-

eases and malnutrition.

PD4

Objectives: To describe the pattern of various endocrine

Prevalence and Psychosocial Impact of Tinea Capitis

disorders seen in children and adolescents in Port Har-

among Primary School Children in Emohua, Rivers

court.

State, Nigeria

Methods: A retrospective review of all endocrine cases

seen at the Paediatric endocrinology unit of the Univer-

Fienemika AE, Opara PI, Alikor EAD

sity of Port Harcourt Teaching Hospital between Janu-

Department of Paediatrics, University of Port Harcourt

ary 2013 and March 2015 was done.

Teaching Hospital.

Results: A total of 122 patients presented with endocrine

Email: tasnengie@yahoo.com

disorders over the 2year study period. There were 61

(50.0%) female and 54(44.3%) males. Seven (5.7%) had

Background: Tinea Capitis also known as ring worm of

genital ambiguity.The ages of patients ranged from

the scalp is the most common fungal infection. It is

12days to 17years with a mean age of 6.9 ± 5.1. The

highly contagious and poses a public health challenge in

commonest endocrine disorders were thyroid disorders,

developing countries

diabetes mellitus (DM), pubertal disorders in 23(18.9%),

Objective: To determine the prevalence and psychoso-

21(17.2%) and 20 (16.4%) respectively. Twenty two

cial Impact of tinea capitis among primary school chil-

(18.0%) of the patients were obese. Other disorders

dren in Emohua, Rivers State.

include rickets in 14(11.5%) and disorders of sex devel-

Study Design: Descriptive cross-sectional study.

opment in 10(8.2%), of these children with disorders of

Setting: School based survey using primary school chil-

sex development, 7(70%) had ambiguous genitalia.

dren in Emohua, Rivers State.

Type 1 DM remained the commonest type of DM. Most

Method: Multi-stage sampling technique was used to

of the patients were of the middle social class (social

recruit pupils aged 6-12 years from 9 primary schools in

class III). Challenges included high cost of investiga-

two school districts. A total of 1,289 pupils consisting of

tions and drugs, high rate of loss to follow up.

698 (54.2%) males and 591 (45.8%) females were stud-

Conclusion: Thyroid disorders, obesity, diabetes melli-

ied. A structured pre-tested questionnaire was used to

tus, disorders of puberty and rickets were the leading

obtain relevant information. Diagnosis of tinea capitis

endocrine disorders in our review. High cost of investi-

was made clinically and scrapings of the hair and scalp

gations and loss to follow up were major challenges to

obtained for microscopy.

care.

Results: Tinea capitis was clinically diagnosed in 184

Keywords: Endocrine disorders, Children, Adolescents,

pupils, giving a prevalence of 14.3% with a male to fe-

Port Harcourt.

male ratio of 2.5:1. Of 184 clinically diagnosed cases,

mycological examination of hair and scalp scrapings

gave positive results in 127 (69.0%) pupils. Tinea capitis

was significantly higher among males than females

(p<0.001). The infection was not significantly associated

with overcrowding (p=0.997), poor personal hygiene

(p=0.998), animal contact (p=0.284) and low socioeco-

128

PE2

painless wrist swelling in an 11months old infant with

Neonatal diabetes treated with oral sulphonyuria- a

radiologic features and biochemical deficiency of Vita-

case report

min D in mother infant pair and marked reduction in

sunlight exposure. Mother manifested features of possi-

Elusiyan JBE, Olorunmoteni OE, Oluwatimilehin JO

ble osteomalacia in pregnancy, did not receive vitamin

Department of Paediatrics, Endocrine and Metabolic

D supplements during pregnancy and after delivery, she

Unit, OAUTHC, Ile-Ife.

also received little or no sunlight due to change in life-

style as she stayed indoors with baby.

Background/Introduction: Diabetes mellitus (DM) is a

Conclusion: This report therefore reveals risks factors

chronic endocrine disorder characterized by hyperglyce-

for vitamin D deficiency in a region with abundant

mia due to absolute or relative insulin deficiency. Neo-

sunlight.

natal diabetes (NDM) is when diagnosis of DM is made

Keywords: Vitamin D, Rickets, Risk factors

within six months of life and it is classified as mono-

genic and caused by specific gene mutations. NDM is

PE4

said to occur in 1 in 100,000-500,000 live birth and

Clinical and Demographic Profile of Children and

there is scanty report of it among Nigerian Children.

Adolescents with Type 1 Diabetes Mellitus at the La-

Aims/Objectives: To report a case of NDM managed

gos University Teaching Hospital (LUTH), Lagos,

successfully with oral hypoglycaemic agent

Nigeria: a 10-year review

Methods: Case file of a child managed for neonatal dia-

betes was reviewed

Oyenusi EE, Nwaogu NTL, Oduwole AO

Results: AF presented at the age of 8 week with fever,

vomiting (2 episodes), fast breathing and loss of con-

Objectives: To describe the demographic and clinical

sciousness. He was noticed to have been urinating fre-

profile of the children and adolescents with Type 1 DM

quently for 2 weeks before presentation as evidenced by

attending the Paediatric Endocrinology Clinic of LUTH

increased frequency of diaper change. There was no

over a 10-year period.

history of diarrhoea nor family history of diabetes. He

Methods: Data extracted from case records of patients

presented severely dehydrated and in respiratory dis-

attending the clinic from September 2005 to October

tress. Initial random blood glucose was 24mmol/l and

2015were collated on an excel spreadsheet and analysed

HbA1c of 12.2%. Urine analysis showed glycosuria and

using SPSS version 20. Ethical approval was obtained.

ketonuria. He was resuscitated with intravenous fluid

Results: Sixty four patients(31 males and 33 females)

and Insulin. A trial of glibenclamide was commenced

with Type 1 DM were seen. They constituted 26.3% of

out of necessity on the 4th day of admission and insulin

endocrine cases. The median age was 15 (range, 2-27)

was discontinued. Blood glucose has remained well con-

years. The median age at presentation was 10.5(range,

trolled and HbA1c ranges between 6.5-7.5%. He is pres-

1.6-16) years. More than half of the patients (54.7%)

ently 11 months old and his growth and development

presented for the first time with diabetic ketoacidosis

has been optimal. Plan is presently underway to do a

(DKA) while the rest presented with varying combina-

genetic testing.

tions of classical symptoms of polyuria, polydipsia and

Conclusion & Recommendations: Neonatal diabetes

weight loss. Median HbA1C at presentation was 12

may not be uncommon in our environment. Clinicians

(range, 9.8-14)%.Major acute metabolic complications

should have a high index of suspicion especially in chil-

include hypoglycaemic episodes and DKA. Further

dren with severe dehydration without evidence of sig-

analysis of 20 patients who have had DM for more than

nificant gastrointestinal fluid loss.

5years revealed microalbuminuria in 20% and diabetic

neuropathy in 5%.Hyperlipidaemia was seen in 18% of

PE3

these patients. Hypertension (either combined systolic

Isolated wrist swelling due to Vitamin D deficiency in

and diastolic, or isolated systolic and diastolic) was re-

a Nigerian Infant: case report and identification of

corded in 45% of these patients. Fourteen patients aged

risk factors

above 18 years are being co-managed with adult endo-

crinologists through a transitional clinic.

Ujuanbi S , Jaja T

Conclusions: Type 1DM constitutes a major proportion

Department of Paediatrics, Paediatric Endocrinology

of the paediatric endocrine disorders encountered. Ma-

Unit, University of Port Harcourt Teaching Hospital.

jority of patients present with DKA at diagnosis. Hence

Email: tamunopriyej@yahoo.com

nationwide health education of the population and train-

ing of health workers is advocated for early recognition

Introduction: Vitamin D deficiency rickets has multiple

of symptoms.

aetiologies in infants in the tropics and regions of abun-

dant sunlight. The reduced intake of vitamin D from

breast milk in mothers with vitamin D deficiency and

absence of Vitamin D supplementation are common

causes. Reports have shown vitamin D deficiency a rare

underlying cause of rickets in Nigerian children a region

with abundant sunlight.

Case Report: Here is a rare presentation of progressive

129

PE 5

children to the Children Outpatient Clinic and

chil-

Penile dimensions in newborns from Port Harcourt,

dren’s wards of the department of Paediatrics from Janu-

South South Nigeria

ary 2012 to December 2013. Data were entered in to a

microcomputer and analyzed using SPSS version 20.0

Elusiyan JBE , Ekut FE , Fajola AO

1,2

Results: Three hundred respondents were studied. Age

Department of Paediatrics and Child Health, Obafemi

range 18 – 55 years, mean age of 31.59 + 6.6 years.

Awolowo University, Ile-Ife

Breastfeeding was initiated within 30 minutes of deliv-

Obio Cottage Hospital, Port Harcourt,

ery in 57’7% of mothers, 8.3% and 6% gave plain water

Community Health Department, SPDC, Port Harcourt

and glucose water respectively on the first day of life.

Only 11.9% of mother’s breastfeed exclusively for the

Background/Introduction: There are documented racial

first six months. Complementary feeds were started at 1

and geographic variations in penile dimensions and only

month by 3.3% of mothers, while only 4% of mothers

few data exists on the subject in Nigeria.

breastfed their children till age two years.

Aims/Objectives: The study set out to document the

Conclusion: Breast feeding practices are still poor in our

stretched penile length and penile diameter of male new-

environment and need to be strength end through educa-

borns in Port Harcourt, South South Nigeria and com-

tion.

pare with two earlier studies from other regions of Nige-

ria.

PGN 2

Methods: Four hundred and eleven consecutively deliv-

Alagille syndrome: a case report

ered male newborns were recruited. SPL and PD were

Ahmed PA, Wey YA, Adesanya O, Uno MG

measured using standard methods and a digital metal

calliper. The mean values were determined and com-

National Hospital Abuja.

pared with other anthropologic parameters and also with

Email: ahmedpatience@yahoo.com

the other earlier studies.

Results: The mean SPL from this study was 3.17±0.5cm

Background: Alagille syndrome (AGS) is a rare cause of

and mean PD was 1.07±0.17cm. There was no signifi-

prolonged jaundice and a high index of suspicion is re-

cant correlation with the any of the anthropologic pa-

quired for diagnosis. It has an autosomal dominant in-

rameters but the PD showed positive correlation with the

heritance pattern, expressed variably. It contributes to

Birth weight, birth length and head circumference. The

the incidence of neonatal jaundice and cholestasis in

mean SPL was however smaller than the other two ear-

older children, with an incidence of 1:100,000 live births

and the 4 most frequently transplanted disease.

lier studies. The 3rd and 10th percentile for the SPL was

2.3cm and 2.5cm.

Case Report: T.O, Female 11 years, presented with re-

Conclusion & Recommendations: It is concluded that

current yellowness of the eyes since birth, progressive

there may exists a regional difference in penile dimen-

loss of sight, recurrent body swelling, reversal of sleep

sions across the southern parts of Nigeria. A penile

and irrational talk. She had pale stools, dark urine, and

length of less than 2.3cm should be taken as represent-

body itching, lately prolonged bleeding with epistaxis.

ing micropenis in the region.

Her pregnancy was associated with polyhydramnios in

the 3 trimester, birth weight 2.4kg, fully immunized.

PGN 1

She had delayed walking and tooth eruption. She is

Knowledge and practice of breast feeding among

second of four children in a monogamous non-

mothers seen at the University of Port Harcourt

consanguineous marriage.

Teaching Hospital

She was small for age, deeply icteric with perculiar

facies. She had thin long limbs, broad wrist, rachitic

Yaguo Ide LE, Tobi N

rosary, genu valgum, pedal oedema. Echocardiograph

Department of Paediatrics and child health, University

findings included 1 and 2 heart sounds with aortic and

of Port Harcourt Teaching Hospital, Port Harcourt,

pulmonary stenosis. Abdomen was tender with moderate

Nigeria. P.M.B. 6173

ascites. Liver functions were deranged. Brain MRI

Email: lucyaguolucy@gmail.com

showed multiple chronic infarcts, chest radiograph mul-

tiple butterfly vertebrae. Genetic evaluation revealed no

Background: Nutritional status of children is determined

mutation in JAG 1 gene, karyotype 46XX. Liver biopsy

by two important factors which are exclusive breastfeed-

was not done. A diagnosis of Allagille syndrome was

ing and introduction of complementary feeds. Exclusive

made. She also had hepatic failure with encephalopathy.

breastfeeding rate in Nigeria has remained low (17%)

Conclusion: Allagille syndrome should be considered

and only 35% of children aged 20-23 months in Nigeria

early in the evaluation of older children with persistent

are still breastfeeding. The aim of this study was to de-

cholestatic jaundice.

termine the knowledge and breastfeeding practices

Key words: Allagille syndrome, cholestatic jaundice

mothers who brought their children to the paediatric

department of University of Port Harcourt Teaching

Hospital (UPTH)

Methods: A Cross-sectional hospital-based study. Self-

administered structured questionnaires were used to re-

trieve information from mothers who brought their

130

PGN 3

adequate growth of children.

Diarrhoeal deaths in under-five Nigerians: clinical

Objective: To determine the status of micronutrients

characteristics of hospitalized children

among stunted malnourished pre-school age children

seen at Usmanu Danfodiyo University Teaching Hospi-

Udoh E, Mkpo-uto A, Ikobah J, Amajor C

tal (UDUTH), Sokoto.

Department of Paediatrics, University of Uyo Teaching

Methodology: Study was descriptive and cross-

Hospital, Uyo, Akwa Ibom State.

sectional, carried out at the Paediatric department of

Department of Paediatrics, University of Calabar

UDUTH, Sokoto. Subjects were 275 malnourished chil-

Teaching Hospital, Calabar, Cross- River State

dren aged 6-60 months. Nutritional status and stunting

was assessed using the WHO classification of malnutri-

Introduction: It is estimated that about 800, 000 under-

tion. Serum vitamin A and zinc were analysed using

fives die annually from diarrhoea disease worldwide.

Basseys colorimetric method and Atomic Absorption

Some of the deaths occur in hospitalized children. The

Spectrophotometric method respectively.

clinical characteristics of these children may be related

Result: The mean age of the malnourished children was

to the fatal outcome.

26.2±14.6 months compared with 28.2±17.0 months in

Objective: To describe the clinical characteristics of

the controls (p= 0.157). 66(24.0%) malnourished chil-

hospitalized under-fives that die from diarrhoea disease.

dren were severely stunted, 52(18.9%) had moderate

Method: This was a retrospective study of under-five

stunting, 63.0(22.9%) had mild stunting, while only 94.0

diarrhoeal deaths in the University of Calabar Teaching

(34.2%) had normal stature. The mean serum levels of

Hospital recorded between 2010 and 2015. Patients’

vitamin A and zinc of malnourished children were

case notes were retrieved and information on their bio-

23.4±13.2µg/dl and 13.5±3.3µmol/L, which were sig-

data, nutritional status, immunization status, clinical

nificantly lower than the controls’ 54.1±22.8µg/dl and

features, investigations, treatment and duration of ad-

15.8±1.9µmol/L respectively (p=<0.05). The mean se-

mission were extracted. Data was entered into Microsoft

rum vitamin A and zinc levels showed a decreasing

Excel and analyzed using the same package.

trend with increasing severity of stunting (p=0.0001).

Result: A total of 98 diarrhoeal deaths occurred within

Conclusion: Children with severe stunting had the sig-

the period under review. The patients were of equal sex

nificantly lower mean serum vitamin A and zinc levels.

distribution with 88 (89.8%) aged 0 -2 years. Forty

Keywords: Micronutrients, Stunted malnourished pre-

seven (48.0%) of them were severely malnourished. The

school children, Sokoto

main symptoms associated with diarrhoea were fever 85

(86.7%), vomiting 53 (54.1%), cough 37 (37.8%) and

PGN5

fast breathing 26 (26.5%) while dehydration 92 (93.8%),

Vitamin A and zinc levels of malnourished preschool

pallor 58 (59.2%), hepatomegaly 50 (51.0%) and dysp-

age children at Usmanu Danfodiyo University

nea 43 (43.9%) were the main signs. Forty eight chil-

Teaching Hospital, Sokoto, Northwestern Nigeria

dren (49.0%) died in the first day of admission. The as-

sociation between time-to-death and nutritional status of

Adamu A, Ahmed H, Jiya NM, Ibitoye PK, UM Sani,

the children was statistically significant ( χ = 23.6; P =

Yusuf T, Ugege MO, Jiya FB, Isezuo KO

0.0001).

Department of Paediatrics, Usmanu Danfodiyo

Conclusion: Most under-five diarrhoeal deaths occur in

University Teaching Hospital, Sokoto.

children less than two years of age and are associated

Email: nanadamu@gmail.com

with febrile illnesses. Severe malnutrition is an underly-

ing factor to these deaths and is associated with time-to-

Background: Micronutrient deficiencies constitute a

death in hospitalized children.

devastating form of malnutrition whose consequences

can be crippling or fatal. In developing countries where

PGN4

malnutrition is prevalent, children usually have multiple

Micronutrients status of stunted Malnourished Pre-

micronutrient deficiencies. There is increasing evidence

school age children at Usmanu Danfodiyo University

that zinc and vitamin A interact in several ways; Zinc is

Teaching Hospital, Sokoto, Nigeria

a component of retinol binding protein (RBP), a protein

necessary for transporting vitamin A in the blood.

Adamu A, Ahmed H, Jiya NM, Ibitoye PK, Sani UM,

Objective: To compare mean serum levels of vitamin A

Yusuf T, Ugege MO, Jiya FB, Isezuo KO

and zinc between preschool age children with malnutri-

Department of Paediatrics, Usmanu Danfodiyo

tion and age matched well-nourished children at

University Teaching Hospital, Sokoto.

Usmanu Danfodiyo University Teaching Hospital

Email: nanadamu@gmail.com

(UDUTH), Sokoto.

Methodology: Study was descriptive and cross-sectional,

Background: Stunting is a major problem worldwide

carried out at the Paediatric department of UDUTH,

affecting more than 178 million children under five.

Sokoto. It was conducted among 275 malnourished chil-

32.5% of children in developing countries are

dren aged 6 -60months and age matched well-nourished

stunted.While the aetiology of stunting is complex, in-

controls. 5mls of venous blood was taken for serum vita-

adequate nutrition and infection are among factors that

min A and zinc analysis.

are thought to play major roles in reducing a child’s

Result: The mean serum levels of vitamin A and zinc in

height-for-age. Several micronutrients are essential for

children with malnutrition were 23.4±13.2µg/dl and

131

13.5±3.3µmol/L, which were significantly lower when

PGN7

compared to those of the controls 54.1±22.8µg/dl and

Comparison of post delivery Hospital practices that

15.8±1.9µmol/L respectively ( p= <0.05). Mean serum

support breastfeeding among centers of delivery in

vitamin A and zinc levels were significantly low across

Jos

all age groups of study subjects compared to age

Adah RO Collins J, Okolo SN

matched controls ( p= <0.05). Similarly, the lowest mean

serum zinc level was observed among children with

Department of Paediatrics, Jos University Teaching

oedematous malnutrition (12.8±3.0µmol/L) when com-

Hospital, Jos Plateau State

pared to that of the controls (15.8±1.9µmol/L). The dif-

ference was significant (p =0.0001).

Background : The goal of establishing the Baby Friendly

Conclusion: Children with malnutrition had signifi-

Hospital initiative (BFHI) was to promote, protect and

cantly lower mean serum vitamin A and zinc levels

support breastfeeding for the optimal mental and physi-

Key words: Vitamin A and zinc levels, malnourished

cal growth of infants. Bearing in mind the overwhelm-

preschool children, Sokoto

ing effect optimal breastfeeding practice has, it is perti-

nent to review the practices of BFHI hospitals.

PGN6

Objectives: To assess post delivery breastfeeding sup-

Influence of maternal and child characteristics on

portive practices and Exclusive Breastfeeding rates

breastfeeding techniques

(EBF) among BFHI designated and Non-BFHI centers

o f

d e l i v e r y

i n

J o s

Adah RO , Collins J , Okolo SN

Methodology: A total of 294 mother-child pairs that

Department of Paediatric, Jos University Teaching

delivered in tertiary and secondary BFHI centers along

Hospital, Jos. Plateau State

with non-BFHI private hospitals were studied. Mothers

were questioned on health care workers actions toward

Background: Optimal breastfeeding is the sole way of

them that support breastfeeding after delivery. Informa-

nurturing the human infant to achieve both mental and

tion collected was analyzed using software SPSS

physical potential. A number of maternal and child fac-

version 21.

tors are associated with breastfeeding practices, conse-

Result: Of the 294 mothers 112(38.4%) delivered in the

quently the knowledge of these characteristics may be

tertiary centre, 66(22.4%) secondary centres and 116

used to ensure best breastfeeding practices

(39.2%) private hospitals. Overall EBF rate was 42.4%,

Objective: Describe characteristics of breastfeeding

EBF rate was significantly higher in the tertiary centre

mothers, breastfed children and assess the correctness of

(56.1%) and the least in Non BFHI hospitals (37.3%) (p

breastfeeding techniques.

-0.015) Prelacteal feeds were given in 19.7% of all ba-

Materials and Methods: Using a pretested questionnaire

bies with private hospital having highest proportion

in a cross sectional study, 500 mother-child diad were

(24.1%).

interviewed and observed for correct techniques during

Only 23.9% of mothers started breastfeeding within 30

breastfeeding session. Information collected was entered

minutes of delivery, the least (15.5%) in the tertiary hos-

into and analyzed using software SPSS 21 version.

pital (p-0.002). 33.6% were assisted to breastfeed by

Results: Of the 500 babies, 14(2.8%) were less than one

health workers and non-medical personnel (57vs 41).

month old, 294(58.8%) aged 1-5 months, 136(27.2%)6-

Poorer breastfeeding techniques was significantly asso-

11 months and 56(11.2%) above 11 months. Of these,

ciated with delivery at secondary BFHI centers

55.2% are male and 44.8% females with M:F ratio of

Conclusion: BFHI hospitals have lax supportive prac-

1.2:1. Mothers age ranged from 16- 45 years. Mothers

tices for Breastfeeding with concomitant poor EBF

with university education were 86(17.2%), 228(45.6%)

rates. Health workers should be retrained to educate and

had secondary and 120(24%) had primary education or

initiate breastfeeding in mothers to increase EBF rates

less. Maternal occupations ranged from housewives to

and improve the health of infants.

top professionals. Primiparas formed 32%(160), women

with 2-3 children 40.4%(202) and 4 or more children

PGN8

23.6%(118).

The Complimentary Feeding Practices and

Correct maternal positioning was associated with moth-

Nutritional Status among Under-five Children in a

ers that practiced Exclusive Breastfeeding (p-0.001), had

Community in Sokoto, North-Western Nigeria

tertiary education (p-0.001), attended Antenatal clinic

Yusuf T , Baba J , Nauzo AM , Jiya NM

(ANC) 4 times and above (p-0.001).Correct child posi-

tion was associated with maternal university education

Department of Paediatrics Usmanu Danfodiyo

(p-0.005), and child ranked 2 -3 (0.002). Appropriate

University Teaching Hospital, PMB 2370, Sokoto.

attachment was associated with women with university

Email: dimeji74@gmail.com

education, (p-0.001), older than 40 years (0.020), babies

6 month and above (p-0.001).

Background: Complimentary feeding is the corner stone

Conclusions: Younger aged, less educated and primi-

of child’s nutrition. Most malnourished children had

para mothers need more support and guidance for appro-

their predicament originating from the period of transi-

priate techniques to breastfeed. It is recommended that

tion breastfeeding to family diet.

mothers should be taught and shown correct breastfeed-

Objectives: To determine the complimentary feeding

ing techniques.

practices and nutritional status of under-5 in Gwiwa

132

community.

rhoea and ARI respectively as compared to 115 (75.2%)

Methods: A cross-sectional study carried out in Gwiwa

and 113 (73.9%) with diarrhoea (p= 0.03) and ARI (p=

community, Wammakko LGA, Sokoto state between

0.04) respectively among non-exclusively breastfed chil-

May and August 2015. One hundred and forty-six Moth-

dren.

ers with children aged 6 – 36 months were interviewed

Conclusion: The incidence rate of exclusive breast feed-

using structured interviewer questionnaire and the nutri-

ing is low in our community and might have impacted

tional status using WHO classification of malnutrition.

negatively on under-5 morbidity in the community. Ef-

Data was analyzed using SPSS version 20.0. A p-value

forts should be geared towards improving exclusive

≤0.05 was taken as significant

breast feeding campaign in our community.

Results: Sixty-eight (45.9%) of the respondents were

Key words: Exclusive, Breastfeeding, Childhood, Mor-

aged 15 – 24years and 81(54.7%) were of low socio-

bidity.

economic class. Twenty-six(17.6%) of the children were

exclusively breast fed for 6months. Sixty-nine (46.62%)

PGN 10

of the children studied commenced complimentary feed-

Infant and young child feeding practices in Okrika

ing at 4 – 6month of age with the mean age of

Town, Rivers State, Nigeria

5.5±2.5months. There were 90 males and 58 females.

Tamunoiyowuna G. Okari, Alice R. Nte, Angela I.

Sixty-nine (46.6%) used plain pap with 41.2% fed more

Frank-Briggs.

than 3 times per day. The mean age of cessation of

breast feeding was 17.7 ±3.5 months. Sixty-five

Department of Paediatrics, Braithwaite Memorial Spe-

(43.9%), 53(35.8%) and 33(22.3%) of the children were

cialist Hospital, Port Harcourt, Rivers State, Nigeria.

underweight, wasted and stunted respectively.

Department of Paediatrics, University of Port Harcourt

Conclusion: The complementary feeding practices are

Teaching Hospital, Alakahia, Rivers State, Nigeria

suboptimal in this community and might explain the

Email: teegokari@yahoo.com

poor nutritional status of the under-5 in this community.

Efforts should be geared towards optimal complemen-

Background: Optimal infant nutrition in the early years

tary feeding practices in our community.

of life promotes appropriate growth and development of

Key words: Complementary, Feeding, Practice, Nutri-

the under five child in addition to reducing childhood

tional, Status, Under-5.

morbidity and mortality. In Nigeria, only 30% of chil-

dren were fed appropriately according to the WHO in-

PGN 9

fant and young child feeding policy.

The Effect of Exclusive Breast Feeding Practices on

Objectives : The objectives were to determine the preva-

Morbidity among Under-five Children in a

lence of breastfeeding, exclusive breastfeeding among

Semi – Urban Community in Sokoto, North-Western

under-fives in Okrika Town, the duration of breastfeed-

Nigeria

ing and the age at commencement of complementary

feeding.

Baba J, Yusuf T, Jega MR, Jiya NM

Materials and Method: A cross sectional descriptive

Department of Paediatrics Usmanu Danfodiyo

study using was carried out in 2012. Using a multistage

University Teaching Hospital, PMB 2370, Sokoto.

random sampling technique, 410 under-fives in 410

Email: dimeji74@gmail.com

households in Okrika Town were selected to participate

in the study. A questionnaire was used to collect data on

Background: An important component of child survival

feeding practices from the caregivers of the under-fives.

strategy is breastfeeding. It protects against infections

Results: The 410 children studied were aged 0-59

especially diarrhoeal and respiratory diseases.

months, comprised of 127 (52.9%) males and 193

Objectives: To determine the incidence of exclusive

(47.1%) females. Of these, 408 (99.5%) were breastfed,

breast feeding and its effect on under-5 morbidity in

154 (37.7%) commenced breastfeeding within 30 min-

Gwiwa community.

utes of delivery and 65 (15.9%) received prelacteal

Methods: A cross-sectional study carried out in Gwiwa

feeds. Seventeen (45.9%) children aged 0-6 months

community, Wammakko LGA, Sokoto state between

were exclusively breastfed and 173 (46.3%) of those

May and August 2015. One hundred and eighty six

aged 6-59 months were exclusively breastfed for 6

Mothers with children aged 6 – 59months were inter-

months. The mean duration of breastfeeding was 13.9 +

viewed using structured interviewer questionnaire. Data

4.06 months. Complementary foods were commenced

was analyzed using SPSS version 20.0.

between 1- 18 (mean 5.9+ 23.) months with 32% start-

Results: Seventy-three (39.2%) of the respondents were

ing at age < 6 months.

aged 15 – 24 years and majority (54.3%) is of low socio-

Conclusion: There is need to improve on the infant and

economic class. Thirty-three (17.7%) of the children

young child feeding practices of under- fives in Okrika

were exclusively breast fed for 6 months. There was

Town.

significant difference in the rate of exclusive breast

Keywords: Under-fives, breastfeeding, prelacteal feeds,

feeding among different socio-economic classes. One

complementary feeding.

(3.5%) and 16 (11.3%) hospitalization were recorded

among exclusively and non-exclusively breast fed chil-

dren respectively (p= 0.4). Eighteen (54.5%) and 23

(69.7%) of the exclusively breastfed children had diar-

133

PGN 11

intestine. However, most cases of gut malrotation are

Prevalence of malnutrition among under-fives in

diagnosed in the first year of life but in minority of cases

Okrika Town, Rivers State

the patient become symptomatic only in adolescence or

adulthood. Presently, there are few reports on malrota-

Okari TG, Nte AR, Frank-Briggs AI

tion in the older children especially in the sub-Saharan

Department of Paediatrics, Braithwaite Memorial Spe-

african continent.

cialist Hospital, Port Harcourt, Rivers State, Nigeria

Methods: The Clinical records of children above the age

Department of Paediatrics, University of Port Harcourt

of 2 years who presented with recurrent abdominal pain

Teaching Hospital, Alakahia, Rivers

State, Nigeria.

± vomiting between January 2013 and October 2015 at

Email: teegokari@yahoo.com

the Lagos University Teaching Hospital were reviewed.

Clinical features, radiological findings and operation

Background: Malnutrition is a public health problem in

findings were documented.

developing countries and an underlying factor in one-

Results: 5 patients with malrotation of the gut were seen

third of the 6.6 million global under-five deaths re-

during the study period. The mean age was 8.8 years

corded in 2012. In 2011, 35.8% and 10% of Nigerian

(range: 5-10 years). The commonest complaint was in-

under-fives were stunted and wasted respectively.

termittent colicky abdominal pain in 5 (100%), and re-

Objective: To determine the prevalence of wasting,

current vomiting in 9 (100%). Other features included

stunting, underweight and overweight malnutrition

failure to thrive in 2 (40.0%). Preoperative diagnosis

among under-fives in Okrika Town.

was possible in 3 patients, with the use of Abdominal

Material and methods: A cross sectional descriptive

computerized tomography scan. Operative findings in-

study was undertaken between April and June 2012. A

cluded obstructing bands of Ladd and volvulus with

multistage random sampling was used to recruit 410

situs inversus. Symptoms were relieved satisfactorily

under-fives from 410 households in Okrika Town. A

and quickly with surgical intervention.

proforma was used to collect data from the caregivers of

Conclusion: There is a need for a high index of suspi-

selected children, who were later weighed and their

cion for intestinal malrotation in children who present

height measured. The WAZ, HAZ and WHZ anthro-

with a prolonged history of recurrent abdominal and

pometric indices were calculated using WHO Anthro3.2

vomiting irrespective of the age. Imaging plays a signifi-

and children with those with WAZ, HAZ and WHZ < -

cant role in the diagnosis of the condition. Prompt surgi-

2SD were classified as underweight, stunted and wasted

cal management remains the most effective treatment.

respectively and overweight if WHZ was > +2SD.

Result: The 410 children studied were aged 0-59

PGN13

months, comprised of 127 (52.9%) males and 193

Paediatric Upper GI endoscopy: A tertiary hospital

(47.1%) females. Forty three (10.5%) children were un-

experience

derweight, 56 (13.6%) stunted, 36 (8.8%) wasted and 6

Adeniyi OF , Lesi OA , Odeghe E , Owoseni O

(1.5%) overweight. Stunting was most prevalent in those

Adekola O , Oduwole AO

aged 48-59 months, while underweight and wasting

Department of Paediatrics, Department of Medicine,

were most prevalent in those aged 36-47 months and 12-

23 months respectively. There were no statistically sig-

Department of Anaesthesia College of Medicine,

nificant differences in the prevalence of underweight,

University of Lagos/ Lagos University Teaching

stunting and wasting among the males and female under

Hospital, Idi Araba , Lagos.

-fives, (p> 0.05).

Conclusion: Stunting was the most prevalent and over-

Background and Objectives: Paediatric endoscopic pro-

weight least prevalent forms of malnutrition among un-

cedures are now standard care in the developed world

der-fives in Okrika Town.

for the management of gastrointestinal disorders. How-

Keywords: Malnutrition, under-fives, underweight,

ever, in the developing countries, upper gastrointestinal

overweight.

(GI) endoscopy remains an underutilized tool in the care

and management of paediatric gastrointestinal disorders.

PGN12

This study was carried out to determine the indications

Recurrent abdominal pain and vomiting in the older

and the spectrum of endoscopic findings in children seen

child: It could be intestinal Malrotation

at the Lagos university teaching hospital (LUTH).

Materials and Methods: The indications for paediatric

Adeniyi OF , Ajayi E, Elebute OA

upper GI endoscopy and endoscopic findings in all

Department of Paediatrics, College of Medicine,

children ≤ 16 years old referred for the procedure from

University of Lagos, Lagos/Lagos University Teaching

July 2013 to October 2015 were documented. The en-

Hospital, Idi Araba, Lagos.

doscopic yield in these children was also determined.

Department of Surgery, Paediatric Surgery Unit, Lagos

Results: 50 children were referred for upper gastrointes-

University Teaching Hospital, Idi Araba Lagos.

tinal endoscopy during the study period. There were 26

Email: layo_funke@yahoo.co.uk

boys and 24 girls. The children were aged 3 months to

16 years and the mean age was 7.98(±4.18) years.

Introduction: Malrotation of the gut refers to abnormal

The indications for upper endoscopy were recurrent ab-

positioning of the intestine within the peritoneal cavity

dominal pain (56.0%), upper GI bleeding(26.0%), re-

and this may involve the small intestine or the large

current vomiting (10.0%), Heartburn (4.0%), dysphagia

134

(2.0%) and ingestion of corrosive(2.0%).

PHO 2

Endoscopic findings were as follows: Hiatus hernia

Thrombocytopenia-absent radius (TAR) syndrome:

(20.0%), Esophageal varices (12.0%), Gastritis (22.0%),

a case report

Duodenitis (4.0%), Gastric ulcer (6.0%), Gastric polyp

and Gastric erosions in (2.0%) of the cases respectively.

Toritseju PO, Shatima DR, Chikodili N Olomukoro,

The overall endoscopic yield was 56.2%.

Samira U Maidama.Department of Paediatrics, National

Conclusion: There is a need to increase the awareness of

Hospital Abuja. FCT.

the role of paediatric endoscopy in diagnosis and treat-

Email: orowopeace@yahoo.com

ment of GI disorders in the developing countries. Re-

current abdominal pain still remains a relevant indica-

Background: Thrombocytopenia-absent radius

tion for the procedure. The need to develop training pro-

syndrome is a rare congenital disorder with autosomal

grams on paediatric endoscopy and paediatric gastroen-

recessive inheritance pattern. It is a multisystemic syn-

terology in general cannot be over emphasized in the

drome comprising of thrombocytopenia, bilateral absent

developing countries.

radii and presence of both thumbs. Incidence is 0.42 in

100,000.

PHO 1

Case: This article describes a two months old boy who

Hydroxyurea improves clinical outcomes in sickle

was brought to the Emergency Paediatric Unit with his-

cell disease in Nigerian children

tory of boils of one week and fever of a day duration. He

had a past history of life threatening haemorrhage fol-

IkeOluwa A. Lagunju, Alexander Oyinlade, Biobele

lowing circumcision. Essential examination findings

Brown, Olugbemiro Sodeinde.

included; pallor, multiple furuncles and bilateral

Department of Paediatrics, College of Medicine,

hemimelia of the upper limbs. Complete blood count

University of Ibadan, Nigeria &

showed low platelets and anaemia while X-ray of the

Department of Paediatrics, University College Hospital,

limbs showed no radial bone.

Ibadan, Nigeria.

Conclusion: This case report seeks to emphasize the

Background: In search for effective therapy for sickle

need for clinicians to promptly diagnose this life threat-

cell disease (SCD), Hydroxyurea (HU) has proved to be

ening condition to avoid mortality from its associated

useful in reducing the frequency of vaso-occlusive cri-

complications especially intracranial haemorrhage.

ses, acute chest syndrome and the need for blood trans-

fusion in SCD. There is little documented on the effec-

PHO 3

tiveness of HU use in Nigerian children with SCD.

Clinical and laboratory predictors of elevated

Aims: To describe the pattern of HU use and its effec-

transcranial doppler velocities in children with sickle

tiveness in ameliorating symptoms in a cohort of Nige-

cell disease and their counterparts with normal

rian children with SCD.

haemoglobin variants

Methods: Children with SCD who were placed on HU

were prospectively followed to document clinical and

Abimbola A, Famosaya, Lagunju I, Akinbami F

haematological response.

Email: phamoh1@yahoo.com

Results: Thirty-eight children (18 boys and 20 girls)

with a mean (SD) age of 8.5 (±3.8) years were studied.

Background/Introduction: Nigeria has the highest bur-

One had haemoglobin SC disease and the others homo-

den of sickle disease (SCD) worldwide and stroke is one

zygous SS. Table 1 shows the indications for HU ther-

of the most devastating complications of the disease.

apy. Follow up lasted 12-62 months; mean (SD) 23.4

Transcranial Doppler (TCD) velocity is a well estab-

±14.4 months. Thirty five (92.1%) children reported

lished predictor of stroke risk in children with SCD.

improved well being while 3 (7.9%) reported no change.

There are no data on the pattern of TCD in Nigerian

Indices of improved general being reported were fewer

children with normal haemoglobin variants. We set out

vaso-occlusive crises (89.5%), improved effort tolerance

to determine the clinical and laboratory predictors of

(89.5%), fewer school absenteeism (84.2%),improved

elevated TCD velocities in a setting of limited resources.

school performance (78.9%) and improved appetite

Aims/Objectives: To determine the clinical and labora-

(76.3%).Need for blood transfusion fell by 66.6%. There

tory parameters that predict elevated Transcranial Dop-

was a significant rise in steady state haematocrit. No

pler velocities in children with SCD and their counter-

major adverse drug reactions was recorded.

parts with normal haemoglobin variants.

Conclusion: HU is beneficial in the management of Ni-

Methods: A comparative cross-sectional study was car-

gerian children with SCD. It ameliorates the symptoms

ried out. Children with SCD confirmed by haemoglobin

of the disease and significantly reduces stroke risk.

electrophoresis were evaluated. Demographic variables,

haemoglobin oxygen saturation (SPO2), full blood count

and glucose-6-phosphate dehydrogenase were analysed

and correlated with TCD velocities.

Results: 120 children with SCD were studied with mean

age of 94.8±41.3 months. Significantly higher mean

TCD velocities was recorded in the SCD group com-

pared with the HbAA/AS group (p=0.01). Nineteen

(15.8%) and 7(5.8%) of children with sickle cell anae-

135

mia had conditional risk and high risk velocities respec-

PHO5

tively. None of the children with HbAA/AS had ele-

Neuroblastoma stage 4s requiring prolonged course

vated velocities and all haemoglobin SC had standard

of chemotherapy

risk. Haemoglobin SS phenotype, female gender and

low haematocrit are predictive of elevated TCD veloci-

Oyesakin AB, Oniyangi O, Oyesegun AR, Akano AO

ties and increased stroke risk in children with SCD.

Hamza N, Emechebe O

Conclusion & Recommendations: In setting of limited

National Hospital Abuja.

resources, children with haemoglobin SS phenotype,

Email: wwunimibade@gmail.com

low steady state haemoglobin, and female gender should

be given priority of TCD screening.

Background: Neuroblastoma stage 4s is a special stage

of neuroblastoma seen in children less than 12 months

PHO4

old. It is characterised by a small primary tumour with

Wilms tumour: experience at a Tertiary centre in the

metastasis limited to the liver, skin and or bone marrow.

Niger Delta region of Nigeria

It accounts for less than 7-10% of all cases of neuroblas-

toma but has an event free survival of >80% even with-

Eke GK , Ujuanbi SA

out treatment. Recent studies have suggested using cyto-

Department of Paediatrics, University of Port Harcourt

genetic analysis to prognosticate neuroblastoma stage 4s

Teaching Hospital, Port Harcourt, Nigeria.

and not age alone.

Email: asokoedion@yahoo.com,

D. U presented to us at 10 weeks of age with complaints

asokoedion2015@gmail.com

of progressive abdominal swelling of 4 weeks and whit-

ening of palms and soles of the feet of 2 weeks duration.

Background: Wilms tumour (WT) is the commonest

Pregnancy, delivery and neonatal period were essentially

primary malignant renal tumour of childhood. Despite

normal. Examination revealed a fairly preserved infant

enormous progress made in its treatment in high income

who was pale and had massive hepatomegaly. She had a

countries, it is still a difficult cancer to treat in the devel-

full blood count, clotting profile, liver function tests,

oping world.

abdominal ultrasound scan and liver biopsy done, details

Objectives: To review the clinical profile and outcome

discussed herein. A diagnosis of neuroblastoma was

of treatment of children with WT at the University of

made following tissue histology and staged as 4s.

Port Harcourt Teaching Hospital (UPTH), Nigeria.

She commenced chemotherapy with carboplatin eto-

Methods: All patients with WT admitted into the Paedi-

poside combination. However after 6 courses of chemo-

atric Oncology unit of the UPTH from January 2011 to

therapy the primary tumour which was in the right adre-

December 2014 were reviewed. Their clinical profile,

nal gland persisted though it had shrunken to less than

management and treatment outcome were analyzed.

half its initial size and she still had residual hepatic me-

Results: Thirty-one children aged 6 months to 13 years

tastasis. Her chemotherapy was hence extended.

were studied, 17(54.8%) males, 14(45.2%) females,

Conclusion: It is pertinent to closely follow up patients

M:F=1.2:1. Average duration of symptoms was 10

with stage 4s neuroblastoma as age alone does not dic-

weeks. All presented with abdominal mass while haema-

tate how the course of this tumour will run.

turia (22.6%) and hypertension (19.4%) were less fre-

quent. Twenty-six (83.8%) children had metastatic dis-

PHO6

ease at diagnosis, 4 (13%) had bilateral disease. Nine-

Priapism in Children with Sickle Cell Disease in Port

teen (61.2%) patients received chemotherapy, 12

Harcourt, Nigeria

(38.7%) had surgery and 13(42%) patients defaulted

George IO, Gbobo I, Aiyedun CN.

with or without commencement of treatment. Mortality

and Surgery ; University

Departments of Paediatrics

was recorded in 8 (25.8%) cases while 3 (10%) were

disease free between 9 and 18 months after completion

of Port Harcourt Teaching Hospital, Port Harcourt,

of treatment.

Nigeria

Conclusion: The rate of completion of treatment of WT

as well as survival from this childhood cancer is very

Background: Priapism is a complication of sickle cell

poor in our environment. Strengthening of palliative

disease (SCD) that if left untreated results in irreversible

care systems, introduction of free health care for all

fibrosis and impotency .The aim of this study was to

childhood cancers and institutional measures to ensure

determine the prevalence, pattern, steady state labora-

completion of therapy are recommended to improve

tory parameters of children with priapism and their treat-

survival.

ment.

Methods: A retrospective study of children with

sickle cell disease who were diagnosed with priapism

at the Sickle Cell Clinic and the Emergency Ward of

the University of Port Harcourt Teaching Hospital

(UPTH), Port Harcourt, Nigeria, from 1

August

2010 to 31

July 2015. Demographic as well as

steady-state clinical and laboratory data were ex-

tracted from the patients' medical records. Data ana-

lysed included age, sex, steady-state packed cell

136

volume, leucocyte and platelet count; and treatment.

very high levels of leukocyte. Received ceftriaxone or

Results: A total of 345 folders of children with SCD

ampicillin +gentamicin ±oral erythromycin), paraceta-

(342, HbSS; 3HbSC) were retrieved during the period

mol 12(100 %), ibuprofen 8(66.7 %),tramadol 3

under review. Five children were found with diagnosis

(25.0 %) , pentazocine 8(66.7%) and blood transfusion 9

of priapism. The mean age was 8.0±4.6 (range 3-

(75%).The average length of stay was 7 days (range 4 –

15years).The mean packed cell volume (PCV), white

14 days). One patient died (8.3%).

blood cell count (WBC) and platelet counts were

Conclusion: ACS is not an uncommon in children with

22±2.7; 8±2.9 and 179.4±25.7 respectively. The mean

SCA in Port Harcourt. Education of parents on the need

PCV of children with priapism was significantly

to recognize early symptoms of the disease is essential.

(P<0.05) higher than the control. Fever 4(80%), dehy-

Clinicians must be trained to correctly diagnose and

dration 2(40%), rigorous physical exercise 1(20%) and

manage it promptly and efficiently to avoid its related

emotional disturbances 1(20%) were associated risks

disastrous consequences.

factors. Stuttering pattern was the commonest 3

Key Words: Acute chesy syndrome; clinical features;

(60%).Most 4(80%) of them were managed conserva-

Treatment; Outcome; Port Harcourt

tively with irrigation of saline and adrenaline. None

of them had exchange blood transfusion. Two (40%)

PHO8

of them had shunt after intumescence of 5 and10 days

Point of care testing for anaemia in children using

respectively. Only 1(20%) had recurrence. None had

portable haematocrit meter: a pilot study from Ekiti

erectile dysfunction.

State University Teaching Hospital and implications

Conclusion: The prevalence of priapism among patients

for health care in resource poor settings

with SCD is low (1.5%) in Port Harcourt. High steady

*Olatunya OS, Ogundare EO, Agaja OT, Omoniyi E,

state haematocrit values were significantly associated

Adeyefa BS, Oluwadiya KS

with priapism .Fever and dehydrated were the common-

Department of Paediatrics and Surgery, Ekiti State

est pre-morbid conditions associated with priapism. The

treatment options for all types of priapism were initially

University Teaching Hospital, Ado Ekiti, Ekiti State,

conservative but surgical therapy must be available

Nigeria

when applicable to circumvent erectile dysfunction.

Background: Prompt and accurate diagnosis is needed

PHO7

to prevent the untoward effects of anaemia on children.

Acute Chest Syndrome in Children with Sickle Cell

Although haematology analysers are the gold standard

Anaemia: An audit in Port Harcourt, Nigeria

for accurate measurement of haemoglobin or haema-

tocrit for anaemia diagnosis, they are often out of the

*George IO, Frank-Briggs AI, Aiyedun CN

reach of most health facilities in resource poor settings

Department of Paediatrics, University of Port Harcourt

thus creating a care gap. We conducted this study to

Teaching Hospital, Port Harcourt, Nigeria

examine the agreement between a point of care device

and haematology analyser in determining the haema-

Background: Acute chest syndrome (ACS) is a leading

tocrit levels in children and to determine its usefulness

cause of death from sickle cell disease worldwide ac-

in diagnosing anaemia in resource poor settings.

counting for about 25% of all deaths. The aim of this

Methods: EDTA blood samples collected from partici-

study was to determine the prevalence, clinical features

pants were processed to estimate their haematocrits us-

and outcome in Port Harcourt, Nigeria.

ing the two devices (Mindray BC-3600 haematology

Materials and Methods: A retrospective cohort study

analyser and Portable Mission Hb/Haemotocrit testing

during a five year period. Records of all patients with

system). The agreement between the two sets of meas-

sickle cell anaemia (SCA) admitted into the Wards were

urements was assessed by the methods of Bland and

examined. Those enrolled for the study satisfied two

Altman.

criteria: (i) lower respiratory tract symptoms and (ii)

Results: The intraclass and concordance correlation co-

new pulmonary infiltrates on the chest radiograph.

efficients were 0.966 and 0.936. Sensitivity and specific-

Socio demographics, genotype, clinical and laboratory

ity were 97.85% and 94.51% respectively while the

features, treatment given and outcome were obtained.

positive predictive and negative predictive values were

Data were analysed by descriptive statistics. Variables

94.79% and 97.73%. The Bland and Altman`s limit of

were compared by students ’t - test. P value ≤ 0.05 was

agreement was -5.5 ̶ 5.1 with the mean difference being

regarded as significant.

-0.20 and a non significant variability between the two

Results: A total of 345 children with sickle cell anaemia

devices measurements (p = 0.506).

were admitted during the 5 year period. Twelve of them

Conclusion: Haematocrit determined by the portable

had acute chest syndrome (3.5%).Majority 7(58.3%) of

testing system is comparable to that determined by the

them under 5 years. There were more males 8(66.7%)

haematology analyser. We recommend further studies

than female 4(33.3) %. The most common clinical fea-

on its use as a point of care device for determining

tures were fever 12(100%), cough 10(83.3%), chest pain

haematocrit in resource poor settings where haematol-

5(41.7%), pulmonary consolidation 12(100 %), and res-

ogy analysers are not available.

piratory distress 12 (100%).The admitting diagnosis

Keywords: Child health, Anaemia, Point of Care

were bronchopneumonia 6(50%), severe malaria 3

devices, Early diagnosis, Nigeria.

(25%) and vaso-occlusive crises 3(25%).There were

137

PHO 9

Objective: To describe the distribution of haemoglobin

Sarcoma Botryoides in Nigerian children- Case

phenotypes in newborns and older children aged

Series

<60 months in the communities of Ethiope West.

Methods: Following due ethical process, subjects within

Udechukwu NP , Ikefuna AN , Ojukwu JO , Ukoh UC

the age cohort 0 to 60 months who were randomly and

1,3,4

Department of Paediatrics FETHA, Ebonyi, Nigeria.

prospectively selected were enrolled from three commu-

Department of Paediatrics UNTH Enugu, Nigeria.

nities of Ethiope West. Their socio demographic pa-

Email: patcy42@yahoo.com

rameters were noted and blood samples collected unto

Whartmans paper and EDTA bottles, were transported

Introduction: Rhabdomyosarcoma-(RMS) is a malignant

to the Laboratory in Cotonou. Analysis was by isoelec-

embryonal tumour arising from the primitive muscle

trofocussing and the Capillaris method for the hemoglo-

cells (rhabdomyoblast) of striated muscles but can also

bin phenotype determination.

develop from virtually all organs including those devoid

Results: Two hundred and eighty eight (288) neonates

of striated muscles like the prostate, urinary and gall

and one thousand, two hundred and sixty three (1,263)

bladders. The embryonal type of this lesion accounts for

older children were recruited from randomly selected

about 60% of all cases and has the botryoid subtype-

homes in three health wards. Results were available for

Sarcoma botryoides-(SB) as a variant. In this variant,

Two hundred and forty six (246) neonates and one thou-

tumor cells and an edematous stroma project into a body

sand,one hundred and ninety four (1,194) older children

cavity like a bunch of grapes, is found most often in the

Five haemoglobin phenotypes consisting of HbAA

vagina, uterus, bladder, nasopharynx, and middle ear.

(73.6%), HbAC (0.4%), HbAD (0.1%),HbAS (23.7%)

Objective: This case series is presented to highlight the

and HbSS (2.2%) were identified.

frequency of this supposedly rare tumour as well as the

Their distribution by age cohorts varied and stabilized

difficulties in the management.

beyond age 24 months. The observed prevalence of

Case Series: SB in three children aged between fifteen

HbSS ranged from 1.9% to 3.2% in the cohorts aged 1

months and four years who presented in our facility is

month to less than 60 months. In the neonates, preva-

described. The three patients presented in advanced

lence was 1.2%, specific distributions for the other hae-

stage. The 1 two had histology confirmation which was

moglobin phenotypes were HbAA (78.5%), HbAC

embryonal RMS while the 3 had urine cytology which

(0.8%) and HbAS (19.5%).

was positive for malignant cells that showed oval/round

86.9% of the children aged 1month to less than

cells with hyper chromatic nuclei. The first (vagina SB)

60months had normal nutritional status, 20.7% were

had three cycles of chemotherapy with Vincristine,

underweight, while 13.8% were stunted. Abnormal

Dactinomycin and Cyclophosphamide, the 2 (oral cav-

clinical signs was significantly higher among HbSS sub-

ity) refused treatment while the 3

(urinary bladder)

jects.

died on the first day of chemotherapy with Dactinomy-

Conclusion: Various phenotypes have been described

cin.

from the communities of Ethiope West. These findings

Conclusion: SB is a rapidly growing malignancy, early

support the case for early diagnosis of sickle cell disease

presentation and prompt initiation of appropriate treat-

that can pave the way for comprehensive care manage-

ment is necessary to improve outcome. These are ham-

ment and follow up of these cases.

pered by financial constraints and ignorance in resource

Key Words: Hemoglobin Phenotypes, SCD, Children

poor settings like ours. Education, poverty alleviation

and committed funds can improve the situation.

PHO11

Morbidity characteristics of children with sickle cell

PHO10

anaemia admitted in children’s ward of ESUTH over

Distribution of Haemoglobin phenotypes in

a 5 year period

neonates and older children less than 60 months

in Ethiope West Local Government Area of

Obuoha E, Odume CU, Oliji C, Nduka U, Nwike C

Delta State

Enugu State Teaching Hospital (ESUTH), Parklane.

Nwajei GA , Okolo AA , Rahimy MC

+++

Method: Retrieval of folders of all sickle cell patients

Diakparomre MA and Odunvbun ME .

admitted within June 2010 and May 2015 and extraction

Delta State University Teaching Hospital, Oghara.

of data.

University of Benin Teaching Hospital, Benin.

Results: Over a 5 year period, there was a total of 99

+++

Centre Hospitalier National, Cotonu, Benin.

patients with genotype HbSS admitted, 47 Male and 52

Female with ratio 1:1.1 respectively.

Background: Globally, Nigeria ranks second highest in

Body pain was the commonest presenting complaint in

U-5 mortality and 8% of infant mortality accrues from

86 patients(80.6%), followed by fever in 82 patients

Sickle Cell Disease (SCD);She alonecontributes 54.54%

(82.5%), pallor in 49 patients(49.4%), cough in 19 pa-

of the annual births of SCD. Over 66% of babies are

tients (19.1%), limping in 5 (5.6%), convulsion in 3

born outside the formal health care system. Community-

(3%).

based studies that would give a more precise picture of

The provisional diagnosis was Vaso occlusive crisis in

the problem are lacking. Comprehensive care and follow

86 patients (80.8%), Anaemic crises in 22 patients

up programs for SCD are scare.

(22.2%). 70 patients had Malaria (70.7%), Sepsis in 33

138

patients (33.3%), Acute Chest Syndrome in 15 patients

Conclusion: Further studies would be required to eluci-

(15.2%), Acute/Chronic Osteomyelitis in 7 patients

date the mechanism of this interaction

(7%), Septic arthritis in 3 patients (3.3%), CVA/TIA in

2 patients (2.7%) and meningitis in 1 patient (1%).

PM 1

Management involved use of oral analgesics only in 28

Pregnancy outcome of ART-experienced and ART-

patients (28.3%) and 71 patients (71.7%) required par-

naïve HIV-infected mothers

enteral analgesics also. 40 patients (40.4%) received

blood transfusion out of which 29 received 1 unit of

Ugwu RO, Eneh AU

blood, 8 patients received 2 units, 1 patient received 3

University of Port Harcourt Teaching Hospital, Port

units and another 1 patient more than 5 units of blood.

Harcourt.

Only one mortality was recorded.

Email: rossaire2003@yahoo.com

Conclusion: Pain is the commonest presenting com-

plaint. Morbidity pattern over the period of study was

Introduction: Untreated maternal Human Immunodefi-

low among these patients.

ciency Virus (HIV) infection is associated with adverse

pregnancy outcome including preterm birth, low birth

PHO12

weight, and mother-to-child transmission of the virus.

Assessment of micro-rna 150 and 221 as prognostic

Aim: To compare the pregnancy outcome between treat-

markers in bcr-abl positive chronic myeloid

ment-experienced and treatment-naïve HIV-infected

leukaemia

mothers.

Methods: A cross-sectional study of HIV-infected moth-

Chinwe, Joe-Akunne ; Ezeanosike OB , Afonne JO ,

ers who brought their infants for follow up between No-

Ezeonu CT , Anyanwu OU , Umeh CCR

vember 2007 and May 2015. Relevant information ob-

Nduka N

tained includes: time of diagnosis, antiretroviral therapy

Department of Paediatrics, Family Medicine, Federal

(ART) regimen and when it was commenced, gesta-

Teaching Hospital, Abakaliki,

tional age at delivery and birthweight of child. Infection

Department

Pharmacology

and

Therapeutics,

status of the infant was determined by DNA PCR at

Nnamdi Azikiwe University Teaching Hospital, Nnewi

6weeks of age. Based on when ART was commenced,

mothers were grouped into three [(HAART experienced

Background: Micro-RNAs control gene expression by

(HE) if ART was started before pregnancy, HAART in

destabilizing targeted transcripts and inhibiting their

pregnancy (HIP) and no HAART (NH)].

translation. In many human cancers including CML,

Result: A total of 1,466 HIV-exposed infants were seen

abnormal expressions of miRNAs have been described.

(616(42%) in HE, 312(21.3%) in HIP and 538(36.7%)

The current treatment for newly diagnosed cases of

in NH groups). There were 735(50.1%) males and 731

CML is imatinib and it produces rapid haematological

(49.9%) females. Zidovudine/Lamivudine/Nevirapine

responses. It is currently impossible to predict whether a

was the most frequently used combined ART in 78%.

patient will develop resistance to imatinib. This makes

The mean birthweight was 3.12±0.38Kg (3.10±0.58Kg

identification of predictors of resistance to imatinib an

in HE; 3.12±0.53Kg in HIP; 3.19±0.74Kg in NH)

important goal in their management.

(p=0.04). A hundred and seventy-five (11.9%) babies

Micro RNA expression patterns can be used to predict

were preterms [73(11.6%) in HE; 25(8.0%) in HIP; 77

outcome (remission or relapse). Here the possible use of

(14.3%) in NH](p=0.02), while 144(9.8%) were LBW

micro RNA 150 and 221 for prognostication was

[64(10.4%) in HE; 15(6.1%) in HIP; 61(11.3%) in NH]

studied.

(p=0.038). Twelve (0.8%) babies had birth defects [8

Methods: Peripheral blood samples of CML patients

(66.7%) in HE; 4(33.3%) in HIP]. The commonest birth

who are being treated with imatinibwas analyzed for the

defects were neural tube defect 6(50%) and congenital

expression of microRNA 150 and 221 (n=50)

heart defect 4(33.3%). Overall transmission rate was

Total RNA was extracted from GITC lysate of the blood

22.6% [3.9% in the HE, 5.1% in HIP and 54.1% in NH

using RN easy mini Spin column. Total RNA was con-

groups](p=0.00001).

verted to complimentary DNA by random hexamerprim-

Conclusion: The benefits of early HAART in reducing

ing using murine moloney leukaemia virus reverse tran-

mother-to-child transmission must be weighed against

scriptase. PCR was used for detecting bcr-abl transcript

the risks of lower birth weight and potential teratogenic

type.

effects of drug exposure on the foetus.

Results: Samples showed expression of miRNA-150 and

Key words: pregnancy outcome, ART naives, ART

miRNA-221. Correlation of BCR-ABL ratio with

experienced, preterm delivery, Low birth weight, birth

miRNA-150 and miRNA-221 was done and the Spear-

defects, MTCT.

man correlation coefficient value between bcr-abl1 and

miRNA-150 was 0.442 (P value = 0.001;CI, 0.18-0.65

showing a fairly strong correlation. Coefficient of deter-

mination=20%,CI: 3-42 %, implying about 20% of bcr-

abl1 ratio could be accounted for bymiRNA-150 values.

The Spearman value between bcr-abl1 and miRNA-221

was 0.26;CI: -0.02-0.51;P=0.0652 showing miRNA-221

had weak correlation.

139

PM 2

who present with fever.

Prevalence of malaria in Paediatric HIV Patients as

Patients and Methods: A 12 month prospective study

seen at the National Hospital, Abuja- Nigeria

was carried out in the neonatal unit of the Braithwaite

Memorial Specialist Hospital in Port Harcourt, Nigeria.

Ahmed PA, Oniyangi O, Oyesakin AB, Adeoye AO,

Neonates 0-28 days old presenting with fever were re-

Ulonnam CC, Mohammed- Nafi’u R.

cruited. Blood film for malaria parasite and full blood

Email: ahmedpatience@yahoo.com

count were done for each recruited patient before the

commencement of medications.

Background: Malaria and HIV accounts for childhood

Results: Of 782 neonates admitted into the neonatal unit,

morbidity and mortality in the sub-Saharan Africa. Ma-

103 (13.2%) were recruited. Forty five (43.7%) had

laria deaths approximate 655,000 /year, of which 86%

positive malaria parasite. Twenty one (46.7%) were

are children, and of about 40 million HIV people,

males and 24 (53.3%) were females with a M:F ratio of

2.6million are under 15years.

1:1.1. Thirty six (80.0%) of the neonates with positive

Aim: To determine the prevalence of malaria parasitemia

malaria parasite were aged 0-7 days while 9 (20%) were

in HIV infected children and determine any associated

between 8-28 days. Other common clinical features of

factors.

malaria in neonates presenting with fever were poor

Method: A prospective descriptive study on HIV sero-

suck (24.4%) and jaundice (15.6%). Thirty eight

positive patients recruited as cases, attending the paedi-

(84.4%) neonates were discharged home while 1 (2.2%)

atrics HIV treatment clinic, National Hospital Abuja-

died.

Nigeria. These were age and sex matched with non- HIV

Conclusion: Malaria is not uncommon in the neonatal

patients as controls. All subjects would not have been on

period. Poor suck and jaundice are the commonest clini-

antimalarial chemoprophylaxis or received antimalarial

cal features of malaria in the neonatal period apart from

in the previous 2weeks. With a questionnaire, subject’s

fever.

biodata and other relevant information were obtained.

Keywords: Malaria, Neonates, Prevalence, Clinical

Laboratory tests included Hb/PCV, MPs and CD4 count.

Features, Port Harcourt

Consent and ethical approval were obtained.

Result: a total of 120 patients were seen, (60, HIV sero-

PM4

positive/ 60 non_HIV), mean age (±SD) 10.08 (±3.68)

Symmetrical peripheral gangrene following severe

years. 29(48.3%) HIV positive versus 26 (43.3%) non-

malaria

HIV patients owns an ITN, (p=0.583); 16(26.7%) HIV

Folayan OS , Katibi OS , Olorunsola BO

positive versus 13(21.7%) non-HIV used the ITN, (p=

Abdulkadir MB

0.522). 8(13.3%) HIV positive versus 15 (25.0%) non

HIV had positive malaria parasitemia, (p= p=0.104).

Department of Paediatrics, Federal Medical Centre,

Bivariate analysis of HIV infected with positive malaria

Bida.

parasitaemia showed no significant difference

with

Department of Paediatrics, University of Ilorin Teach-

ages, sex, WHO staging and CD4 count, ownership and

ing Hospital, Ilorin, Nigeria

usage of ITN; (Fisher’s exact >0.05).

Email: novesec@yahoo.com

Conclusion: positive malaria parasitemia level was not

found significant in HIV positive patients.

Introduction: Symmetrical peripheral gangrene (SPG) is

Key words: paediatrics HIV, Malaria, ITN (insecticide

a well-documented but rare clinical syndrome character-

treated net)

ized by symmetrical distal ischemic damage leading to

gangrene of two or more sites in the absence of large

PM3

vessel obstruction or vasculitis. The aetiologic factors

Prevalence of malaria among Neonates presenting

responsible for SPG are vast and it could follow many

with fever in Port Harcourt, Nigeria

common disease. We present a 9month old child who

developed symmetric peripheral gangrene following

West BA, Opara PI

severe malaria.

Department of Paediatrics, Braithwaite Memorial

Case Summary: M.F is a 9month old infant from Ilorin

Specialist Hospital, Port Harcourt, Rivers State,

East Area of Kwara State who presented with a two day

Nigeria.

history of high grade intermittent fever and a one day

Department of Peadiatrics, University of Port Harcourt

history of progressively worsening paleness of the palms

Teaching Hospital, Rivers State, Nigeria.

and soles. No history of bleeding from any part of the

Email: westboma@yahoo.com

body, jaundice nor passage of coca-cola colour urine.

On examination he was lethargic, severely pale, febrile

(Temperature 38 C) in respiratory distress with Grunt-

◦

Background: Malaria remains one of the most signifi-

cant disease burdens in Africa especially in children and

ing. Pulse rate was 160beats per minute, Blood pressure

pregnant women. Malaria in the newborn once consid-

70/40mmHg, Respiration 40 breaths per minute Rapid

ered rare has now been reported as a common phenome-

diagnostic test for malaria was positive, his packed cell

non. Diagnosis of malaria in the neonatal period is quite

volume (PCV) was 9%. His genotype was AA).

challenging as the clinical features of malaria are non-

Twenty four hours after admission he developed dark

specific, variable and similar to those of sepsis.

discolouration and subsequent gangrene of the tip of the

Aim: To determine the prevalence of malaria in neonates

digits of both feet and the hand which initially pro-

140

gressed up to the distal interphalangeal joint. Investiga-

care and 30 of 35 (85.7%) transferred compared to 60 of

tions done showed no evidence of large vessel vascu-

143 (42%) LTFU or dead were on HAART (p<0.001).

litis, disseminated intravascular coagulopathy nor con-

Forty-eight of 340 (14.1%) still in care and 7 of 35

nective tissue disorder.

(20%) transferred compared 6 of 143 (4.2%) LTFU or

He was managed for severe malaria (Severe anaemia in

dead were on second line regimen (p = 0.003). Mothers’

heart failure and metabolic acidosis) with intravenous

HIV status was unknown in 14 (4.1%) of those still in

Artesunate, transfusion with packed cells, intravenous

care and 2.9% transfers compared to 16.8% among the

fluid Infusion and sodium bicarbonate. There was no

LTFU or dead (p <0.001). Fathers’ HIV status was un-

further progression of the gangrene beyond 48hrs on

known in 36 (10.6%) of those still in care and 2.9% of

conservative management.

transfers compared to 28.7% among the LTFU or dead

Conclusion: The exact pathophysiology of the vascular

(p <0.001). Sixty (17.6%) among those still in care and

occlusion in SPG is uncertain. A low-flow state along

25.7% among the transfers versus 3.5% of LTFU or

with disseminated intravascular coagulation (DIC) is

dead had been disclosed (p <0.001).

usually present. SPG is a cause of significant morbidity

Conclusions: Absence of HIV co-morbidities at presen-

and mortality often requiring multiple limb amputations

tation, being on HAART, known parental HIV status

in the survivors. Early recognition of SPG and its under-

and status disclosure to HIV-infected children improves

lying conditions can have profound impact on the man-

outcome.

agement of the condition and its final outcome.

Key words: Paediatric HIV, children, outcomes, Enugu.

Key words: peripheral, gangrene, malaria, child

PM6

PM5

Babesiosis: a rare cause of recurrent severe anaemia

Outcomes of Paediatrics HIV Care at the University

in a 3 year old girl

of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu

Yetunde T , Israel-Aina , Magdalene EO , Lofor PVO

after ten years of service

Osueni G

Departments of Child Health and Microbiology ,

Iloh KK, Ubesie AC, Emodi, IJ, Obum-Anyim IJ

Ayuk AC, Iloh OO

University of Benin Teaching Hospital, Benin City

Department of Paediatrics, Faculty of Medical Sciences,

College of Medicine

Abstract: Babesiosis is a rare malaria-like disease

Email: keneiloh@yahoo.com

caused by intra-erythrocytic parasite Babesiamicroti .

Humans get infected by bites of ticks commonly found

Background: The use of anti-retroviral therapy has re-

on the body of dogs and other animals. The incidence is

sulted in improved survival among HIV-infected chil-

unknown in our environment. The clinical presentation

dren. Paediatric HIV services formally commenced at

can be silent or benign in majority of cases; and may be

the University of Nigeria Teaching Hospital in 2006.

life-threatening or fatal especially in those who are im-

Aim: To determine the outcomes for HIV infected chil-

munocompromised.

dren at UNTH, Enugu.

We report the case of a 3 year old girl who presented

Methods: This was a review of prospectively collected

with recurrent fever, recurrent severe anaemia and jaun-

data of HIV-infected children seen between July 31st

dice. The family keeps a dog, but no history to suggest

2006 and August 1st 2015 at the Paediatric HIV clinic of

tick bites. She had multiple blood transfusions during

the University of Nigeria Teaching Hospital, Ituku

the illness. An initial diagnosis of malaria and sepsis

Ozalla, Enugu.

was made. She however did not improve with appropri-

Results: Five hundred and eighteen of 555 enrolled chil-

ate treatment for the initial diagnoses. With the need for

dren had complete data and were included in the data

multiple transfusions (up to 10 transfusions at a fre-

analysis. Two hundred and sixty-five (51.2%) were fe-

quency of 4-5 days); further examination of her blood

males. The mean age of the participants was 9.8 ± 4.5

film revealed intra-erythrocytic parasite with maltese

years while the mean age at HIV diagnosis 5.2 ± 3.8

cross. She was treated with intravenous quinine and

years. Two hundred and sixty-two subjects (50.6%) had

clindamycin. She improved on these medications and

one or more co-morbidities at baseline assessment. Four

was discharged home.

hundred and five (78.2%) were on HAART and 61

Babesiosis is rare in our environment. A high index of

(15.1%) have been switched to second line regimen.

suspicion is needed to enhance the diagnosis and to pre-

Two hundred and twenty-nine were orphaned (paternal,

vent potential mortality in affected children.

104; maternal, 63; and double 62). Three hundred and

Keywords: Babesiosis, recurrent severe anaemia,

forty (65.6%) were still in care, 143 (27.6%) had been

multiple blood transfusions.

lost to follow up or dead while 35 (6.8%) were trans-

ferred out or into the adult clinic. Four hundred and

forty eight of the mothers (86.5%) and 319 of fathers

(61.6%) were HIV-infected. Seventy-four children

(14.3%) knew their HIV status. Eighty-three of 143

(58%) LTFU or dead subjects compared to 162 of 340

(47.6%) still in care had baseline co-morbidities (p =

0.01). Three hundred and fifteen of 340 (92.6%) still in

141

PM7

cal studies among HIV infected patients (adults and chil-

Beta-endorphin levels in the cerebrospinal fluid and

dren) showed significantly higher prevalence rate of

plasma of children with cerebral malaria

helminthiasis compared to controls.

Method: This study was done to determine the preva-

Olorunmoteni OE , Adeodu OO , Oseni SBA

lence and intensity of helminthic infection in HIV in-

Obuotor EM

fected children in Abakaliki. It was a cross sectional

Department of Paediatrics and Child Health, Obafemi

study that involved consecutive recruitment of 84 con-

Awolowo University Teaching Hospitals Complex, Ile-

firmed HIV infected children and equal number of age

Ife, Osun State

and gender matched HIV negative children as controls.

Department of Biochemistry, Obafemi Awolowo Uni-

Stool analysis was by Kato-Katz technique.

versity, Ile-Ife, Osun State

Result: A total of 168 participants (84 subjects and 84

controls) were recruited during the study period. Major-

Background: Cerebral malaria (CM) is the most lethal

ity were males (98, 58.3%), male to female ratio was

form of malaria, yet its pathogenesis is not fully re-

1.4:1. The prevalence of soil-transmitted intestinal

solved. Alterations in cytokine expression, local inflam-

helminthiasis in children infected with HIV from the

mation and microvascular obstruction are all hypothe-

two study centers was 28.6% as against 20.2% observed

sized. Beta ( β) -endorphins have also been postulated to

in controls (difference not significant). Mean parasite

be involved in this process although the exact role is

intensity of HIV infected subjects was found to be

unknown. This paper reports on one aspect of a study on

276.35± 55.34, which was significantly higher than the

β -endorphins in CM.

mean parasite intensity observed in controls (162.35±

Objectives: This study set out to determine the levels of

55.29), (p = 0.000).

β -endorphin in cerebrospinal fluid (CSF) and plasma of

Conclusion: this study showed a higher mean parasite

children with CM.

intensity of helminth infection in HIV infected children

Methods: It was a cross-sectional study conducted at the

compared to normal population. Six-monthly de-

OAUTHC, Ile-Ife, Osun State, Nigeria where consecu-

worming for all children, and in particular HIV infected

tive children admitted for CM and who met the study

children, is recommended.

criteria were recruited. Additional to the standard inves-

tigation for CM, CSF and venous blood samples were

PM9

obtained from the subjects for the determination of β -

Effect of immunodeficiency on the prevalence and

endorphin levels.

intensity of helminth infections in HIV infected

Results: Forty children with CM were studied along

children in two hospitals in Abakaliki, Ebonyi state,

with forty age - and sex - matched controls. The mean

Nigeria

CSF β -endorphin (± SD) level for the children with CM

was 1.8±0.9 pmol/ L. The mean plasma β -endorphin

Orji ML, Onyire NB, Ibe BC, Roland RC.

levels at admission (3.1±2.0 pmol/ L) and discharge

Federal Teaching Hospital Abakaliki, (FETHA) Ebonyi

(4.1±3.3 pmol/ L) were higher in children with CM than

state, Nigeria

in the control subjects (2.7±0.7 pmol/ L). However, only

the mean plasma β -endorphin levels at discharge was

Introduction: Chronic helminthiasis cause immune dys-

significantly higher than that of controls ( p = 0.012).

regulation while HIV infection results in immune de-

Conclusion: The findings showed the mean plasma β -

struction. The presence HIV and helminth infection in a

endorphin level was higher in children with CM than in

co-infected host may influence morbidity and /or mortal-

the controls and there was increased production of β -

ity of either disease.

endorphins in children with CM during the course of the

Aims/objectives: This study was aimed at determining

illness.

the effect of immune deficiency on the prevalence and

intensity of helminth infection in HIV infected children

PM8

in two hospitals in Abakaliki.

Prevalence and intensity of soil-transmitted helminth

Methodology: It was a cross sectional study that in-

infection in Human Immunodeficiency Virus (HIV)

volved consecutive recruitment of 84 confirmed HIV

infected children in two hospitals in Abakaliki,

infected children attending the ART clinic. Stool analy-

Ebonyi State, Nigeria

sis for subjects was done, using the Kato-Katz tech-

nique. Blood sample for estimation of CD4 cell count

Orji ML, Ibe BC, Onyire NB, Ibekwe RC.

was carried out using flow cytometer (Cyflow SL,

Federal Teaching Hospital Abakaliki, (FETHA) Ebonyi

Partec, Munster, Germany) from the subjects.

state, Nigeria

Results: A total of 84 subjects were recruited during the

study period, majority were males (58.3%). Male to

Background: Sub-Saharan Africa is a high risk area for

female ratio was 1.4:1. The age range of participants

helminthic infection and as well harbors 68.0% of all

was 2-17 years, while mean age of subjects infected

people living with HIV infection worldwide. Studies

with helminthiasis was 6.10± 3.34 year. Four out of 84

among Ethiopian immigrants with helminthiasis in Israel

subjects (4.8%) had severe immunodeficiency, 10

showed immune dysregulation and a reduction in CD4 T

(11.9%) had advanced immunodeficiency, 18 subjects

-cell count among subjects, which returned to normal

(21.4%) had mild immunodeficiency and 52 out of 84

with the use of antihelminthic. In Nigeria, epidemiologi-

subjects (61.9%) had not significant immunodeficiency.

142

A significant number of subjects in advanced and severe

PM11

immunological stages had helminthiasis ( χ =12.49,

Neonatal malaria complicated by hypoglycaemia and

p=0.001). There was however no significant relationship

hyperparasitaemia: Report of a case successfully

between intensity of helminthiasis and immunologic

treated with intravenous artesunate

stages of subjects.

Onyiriuka AN , Amuabunos AE .

Conclusion: The study showed that immunodeficiency

Endocrine and Metabolic Unit, Neonatology Unit,

state may influence acqusition of helminth infection in

HIV infected children.

Department of Child Health, University of Benin

Recommendation: Six-monthly de-worming of HIV

Teaching Hospital, PMB 1111, Benin City, Nigeria.

infected children is recommended.

Email: alpndiony@yahoo.com

Key words: Immunodeficiency stage, helminth infec-

tion.

Introduction: There is no established and widely ac-

cepted guidelines for clinical management of severe

PM10

neonatal malaria. The aim of this paper is to raise the

The prevalence of Helicobacter pylori infection using

alertness of physicians regarding the occurrence of se-

stool antigen in apparently healthy Nigerian secon-

vere malaria in the neonatal period and to describe the

dary school children in Surulere LGA Lagos state

treatment modality we adopted (in the absence of an

internationally accepted guidelines for chemotherapeutic

Ajayi EO, Adeniyi FO, Renner JK, Esezobor CI

treatment of neonatal malaria).

Case presentation: We report a case of a 26-day-old-

Background: Helicobacter pylori ( H. pylori ) is known to

female infant who presented with fever and poor feeding

cause chronic gastritis, peptic ulcer disease, gastric ade-

of 2 days duration. On examination, she was lethargic

and pyrexial with a temperature of 38.7 C. She was in

nocarcinoma and mucous associated lymphoid tissue

lymphoma and it is acquired in childhood. There is lim-

respiratory distress with a respiratory rate of 72 cycles/

ited knowledge about the prevalence and associations of

minute. The lung fields were clear on auscultation. The

H. pylori using a non-invasive method like the mono-

laboratory findings were falciparum malaria parasitae-

clonal stool antigen test with a high sensitivity, specific-

mia 3+, PCV 32%, and random blood glucose 1.9mmol/

ity and accuracy in Nigeria. This study aimed to deter-

L. Blood culture was sterile and chest radiograph was

mine the current prevalence and associated factors in

normal. A diagnosis of severe neonatal malaria was

apparently healthy Nigeria secondary school children in

made. This case highlights the successful use of intrave-

Surulere L.G.A of Lagos state.

nous artesunate followed by oral artesunate in the treat-

Method: A multistage sampling technique was used to

ment of neonatal malaria complicated by hypoglycaemia

recruit two hundred and fifty nine apparently healthy

and hyperparasitaemia (severe neonatal malaria), with-

children, aged 11 – 18 years (106 males, 153 females).

out apparent adverse effect. The total duration of treat-

They were investigated in a descriptive cross-sectional

ment was 7 days.

study for H. pylori infection using a monoclonal stool

Conclusion: Although intravenous artesunate followed

antigen test. A pretested interviewer administered ques-

by oral artesunate appears safe and effective in the treat-

tionnaire was used to obtain information on their socio-

ment of severe neonatal malaria, further data is required

demographic factors and their nutritional status was de-

in order to develop evidence-based treatment guidelines

termined to assess associated factors.

for such neonates.

Results: The majority (51.7%) were aged 11 – 13 years

Key words: malaria, neonate, hypoglycaemia, hyper-

while about half were from the middle socio-economic

parasitaemia, artesunate.

class. The overall prevalence of H. pylori was 49.0% in

259 secondary school children. The age specific rates

PM12

were 52.0% in children age 11 – 13 years, 43.3% in chil-

Clinical correlates of CD4 cell count in HIV infected

dren age 14 – 16 years and 4.7% in the age group 17 –

children in UITH, Ilorin

18 years. H. pylori was associated with underweight

Adeline A , Ernest K , Ojuawo A

malnutrition (p = 0.003) but no association was found

with age, gender, type of secondary school, Class cate-

Department of Paediatrics, Federal Teaching Hospital,

gory, maternal level of education and socioeconomic

Ido- Ekiti.

2,3

class.

Department of Paediatrics, Unilorin Teaching

Conclusion: The prevalence of H. pylori infection is

Hospital, Ilorin.

high among Nigerian secondary school children particu-

Email: aoadaje@gmail.com

larly in those who are underweight. Routine screening of

underweight secondary school children for H. pylori is

Background: Human Immuno- deficiency Virus (HIV)

infection constitutes a global health crisis. The CD4

recommended. The long term effect of H.pylori on the

health of children needs to be further evaluated.

cell count is essential monitoring tool for disease course

and response to treatment. Studies on CD4 count clini-

cal correlates in Nigeria are few and where available, are

not based on World Health Organization clinical staging

criteria, hence this study.

Objective: To determine the clinical correlates of cd4

143

cell count in HIV infected children in UITH, Ilorin.

patients and relative yield from this activity was

Methodology: A cross-sectional case control study con-

ducted at the Unilorin Teaching Hospital, Ilorin. A total

Results: Contact tracing occurs in a mean of 25% of

of 140 children recruited (70 HIV infected and 70 non-

paediatric index cases. This is carried out by the attend-

infected controls). Parameters obtained were weight,

ing physician in all cases by requesting for Tuberculin

height, OFC, age and sex. All recruited had thorough

Skin tests in all contacts mentioned by the care giver at

clinical examination and WHO Paediatric HIV/AIDS

the point of diagnosis, most commonly during in patient

Clinical Staging criteria used. Whole blood CD4 counts

care. The caregiver, usually parents and close relatives

assessed by flow cytometry. CD4 percent was calculated

are required to bring such contacts to the health facility

using standard formula.

for screening. The relative yield over the last year is

Results: Had 140 children evaluated. Both populations

about 5 new paediatric cases per centre from this method

were similar with 94(67%) males and 46 (33%) females

of contact tracing. Number need to contact trace (index

with a M: F of 2:1 and age range 1.5 -12 yrs. The Mean

case/new cases) is 15 and number needed to screen

CD4/mm ranges for each clinical stage(Stage 1=534-

( c o n t a c t s / n e w

c a s e s )

i s

6 0 .

669/ mm ; Stage 2=500-655/ mm ; Stage 3=141-571/

Conclusion: The practice of contact tracing from the

mm ; Stage 4=34-393/ mm ).The CD4% ranges for each

tertiary institutions needs to be strengthened for maxi-

clinical stage: Stage 1(15-16%); Stage 2 (15-16%);

mum effectiveness desired.

Stage 37-15%); Stage 4(1-10%).The subjects had severe

immune-suppression(< 500/mm ) with majority of the

PM14

subjects 70(50.0%) in stage 3.

Seroprevalence and risk factors of hepatitis B (HBV)

Discussion: Mean CD4 count and CD4% decreased

virus infection among adolescents in Enugu, Nigeria

with increasing WHO Clinical Staging with positive

Eke CB, Ukoha OM, Ibekwe RC, Asinobi IN

correlation between CD4% and clinical staging, but not

Ikefuna AN

with CD4 count.

1,3,5

Conclusion: The CD4 count and percent decreased with

Department of

Paediatrics, College of Medicine,

worsening clinical stage in the HIV infected children.

University of Nigeria/ University of Nigeria Teaching

This study highlights usefulness of clinical correlates of

Hospital Enugu.

CD4 cell count and CD4 percentages in care of HIV

Department of Paediatrics, Federal Medical Centre

infected children in resource poor settings.

Umuahia, Abia State.

Key words: Human Immuno- deficiency Virus (HIV);

Department of Paediatrics, University of Nigeria

World Health Organization (WHO), Clinical Correlates

Teaching Hospital Enugu

CD4 Cell Count.

Email: christopher.eke@unn.edu.ng

PM13

Background: Despite the universal hepatitis B virus

Contact tracing from paediatric TB cases in North-

(HBV) immunization coverage of newborns in Nigeria

ern Nigeria: a neglected strategy?

for over a decade now the prevalence of HBV among

Nigerian children is still in the hyper-endemic range.

Ahmed P , Orogade AA , Onazi SO , Abubakar U

Objectives: To determine the prevalence and risk factors

Isa H .

for hepatitis B virus infection among adolescents in

Department of Paediatrics, National Hospital, Abuja .

Enugu urban.

Department of Paediatrics, Ahmedu Bello University

Methods: A cross-sectional seroprevalence survey was

Teaching Hospital Zaria .

conducted among school children in Enugu urban. Sub-

Department of Paediatrics, Federal Medical Center,

jects were selected using multistage sampling method.

Gusau, Nigeria.

Hepatitis B surface antigenaemia (HBsAg) was assayed

Department of Paediatrics, Federal Medical Center,

for in blood using rapid third generation enzyme-linked

Bida, Nigeria

immunosorbent assay kits. Data was analyzed using

Lyons

Hospital,

Kaduna

State,

Nigeria

Statistical Package for Social Sciences (SPSS) version

20.0 (Chicago, Il. USA) with the level of statistical sig-

Introduction: The ‘Roadmap for Childhood Tuberculo-

nificance set at p = < 0.05.

sis’ was developed by WHO and partners in 2013 to

Results: Four hundred and twenty children aged 10 to

achieve zero deaths from childhood TB with one of its

18years were studied.

key messages being collaboration across the health sys-

Of these, 13 tested positive for HBsAg, giving an over-

tem and community in areas of high TB burden. Contact

all hepatitis B seroprevalence of 3.1%.

tracing using paediatric index cases has not been ade-

The median age for HBsAg positivity was 14 years

quately explored in control of Childhood TB. To maxi-

though age was not statistically associated with HBV

mize this strategy, a survey of current practice in health

infection. Social class, scarifications/tattooing, circumci-

institutions in Northern Nigeria was carried out.

sion and history of surgery were the statistically signifi-

Methods: Practice of specialists responsible for caring

cant modes of transmission.

for child TB care from 5 health institutions in Northern

Conclusion: The seroprevalence of hepatitis B among

Nigeria in the last one year were compared using inter-

children in the study population is high.

view method. Details were obtained with regards to

Its screening in school children should be incorporated

process of contact tracing from index paediatric TB

into school health services in our setting while aware-

144

ness campaigns and health education on its modes of

presentation was14 days (SD12days) and preadmission

transmission and prevention should be promoted and

antibiotics were recorded in 25(41%). The most in-

strengthened.

volved site was the right lower limb, most commonly

Keywords: HBsAg, Prevalence, Risk factors, Children.

pyomyositis (n=16; 26%), osteomyelitis (n=15; 25%)

Funding: ROCHE Pharmaceuticals Nigeria supported

and septic arthritis (n=14; 23%). One in five patients

the study with donation of some of the test kits.

had sickle cellanaemia. Only 26 (42.6%) patients had

cultures. Ten (16%) were gram-negative of which 3

PM15

(30%) were extended spectrum beta- lactamaseproduc-

Buruli Ulcer in a 12 year old girl from an urban

ing strains. The common isolates were Staph. aureus

Setting

(n= 13; 50%)and Klebsiella species (n=4;15.0%). No

mortality was recorded.

Oladokun RE, Ogunbosi BO, Ogun G, Azeez RA

Conclusion: Multidrug resistant gram negative organ-

Paediatric Infectious Diseases Unit, Department of

isms are emerging as important pathogens in soft tissue

Paediatrics, University College Hospital, Ibadan

and bone infections. The importance of obtaining ap-

propriate cultures to guide antibiotic therapy cannot be

Background: Buruli ulcer is a rare disease caused by

overemphasized.

Mycobacterium ulcerans . Although buruli ulcer is en-

demic in Nigeria, it may be overlooked or under-

PM17

diagnosed.

Acceptance of HIV testing among caregivers of chil-

Case: A twelve year old girl from an urban middle class

dren using provider-initiated testing and counselling

setting presented with a 5 day history of ulcer, 12cm by

strategy in Ido-Ekiti, Nigeria

10 cm, on the medial aspect of the left foot. It was pre-

ceded by multiple eruptions over same region. No his-

Oluwaseyi B

tory of fever. She was managed initially for an unspe-

Babcock University Teaching Hospital, Ilishan-remo,

cific ulcer with antibiotics. Her haemoglobin genotype

Ogun State.

is AS and she tested HIV negative. She had no evidence

Email: yeluwa2000@yahoo.com

of diabetes mellitus; her random blood sugar was

102mg/dl. X-Ray of the foot did not show any bony

Background/Introduction: Missed opportunities exist for

involvement. Acid fast bacilli were not seen but histol-

early detection of HIV infection in children visiting

ogy of wound biopsy showed extensive necrotizing epi-

healthcare institutions. Provider Initiated Testing and

dermal ulceration with granulomatous tissues suggestive

Counselling (PITC) Strategy is a strategy for reducing

of buruli ulcer.

She had skin grafting and anti-

missed opportunities for children who are HIV infected

tuberculosis therapy consisting of Rifampicin and

and enhancing their access to HIV preventive measures,

Moxifloxacin.

care interventions and treatment.

Conclusion:

Awareness and knowledge about buruli

Aims/Objectives: The objective of the present study was

ulcer are necessary in order to initiate early treatment

to determine the acceptability of PITC Strategy for HIV

and prevent permanent disfigurement and disability.

testing among caregivers of children seen at Paediatric

Emergency Unit of Federal Medical Centre (FMC), Ido-

PM16

Ekiti, and the factors that influenced acceptability.

Bone and soft tissue infections: need for a review

Methods: This was a prospective, hospital-based cross-

sectional study of acceptability of HIV testing using

1,2

Joy N. Ibeh, Babatunde O. Ogunbosi,

Regina E.

PITC model. Consecutive caregivers of new patients

1,2

Leke Ifesanya, Kike Osi-

Oladokun, DeboAdemola,

1,2

aged 0-15 years were offered HIV testing using WHO

nusi

guideline on PITC. Pre-test and post-test information

University College Hospital Ibadan. Department of

was provided in individual sessions. Those whose HIV

Paediatrics, University of Ibadan. Department of

status was already known were excluded.

Orthopaedic Surgery, University College Hospital

Results: Five hundred and thirty (97.6%) of 543 caregiv-

Ibadan.

ers counselled for HIV testing of their wards gave con-

sent for the test. The age range of the caregivers was 19-

Background: Bone and soft tissue infections are com-

56 with a mean of 30.2 (6.8) years. Acceptability rate

mon in the paediatric age group with increasing reports

was inversely associated with the level of education and

of infection with community acquired resistant strains of

social class of the caregivers. The proportion of uncles/

the usual organisms. Regular review of the bacteriology

aunties among those that declined testing was 7.7%;

of such infections is warranted.

significantly higher than the proportion of 0.6% among

Method: A prospective descriptive study of the presenta-

those that accepted testing (p = 0.02). Three hundred

tion and bacteriology of bone and soft tissue infections

and forty-eight (65.7%) of the caregivers whose wards

was carried out between January 2013 and December

required admission accepted the testing, while only four

2014 among in-patients in a tertiary hospital.

(15.4%) whose wards did not require admission ac-

Results: Sixty-onepatients presented with bone and soft

cepted the test (p = 0.001).

tissue infections during the study period. There were34

Conclusion & Recommendations: Acceptability rate for

(55.7%) males and the median age was 58months (range

HIV testing, using PITC Strategy, was high in all the

2 -168 months). The mean duration of symptoms before

age-groups; acceptability rate was inversely associated

145

with their level of education and social class

PNP1

Bilateral Pelvic Kidneys: A review of 2 cases

PM18

Garba BI , Muhammad AS , Musa A , Onazi SO

The dilemmas of the comorbidity of lassa fever and

Adeniji AO , Ben-Wazieh AA , Yusuf I

acute abdomen in the management of acutely ill

children in lassa fever endemic areas

Ahmad Sani Yariman Bakura Specialist Hospital,

Gusau

Akpede GO , Adetunji AE , Udefiagbon OE

Ahmadu Bello University, Zaria

Omosofe FO , Akerele JM , Oyedeji AO , Mbanefo K ,

Federal Medical Centre, Gusau

Ogbaini EE , Ikponmwosa O

Email: bgilah@yahoo.com

Department of Paediatrics, Irrua Specialist Teaching

Hospital, Irrua. Department of Surgery, ISTH, Irrua.

Background/Introduction: Congenital anomalies of the

Department of Anaesthesia, ISTH, Irrua. Department

urogenital system are common and renal anomalies are

of Community Medicine, ISTH, Irrua, Lassa Institute,

mostly asymptomatic and may be found only during

ISTH, Irrua.

physical or radiological investigations for urological or

Email: tunjiwale2007@yahoo.com

other medical complaints. Ectopic kidneys can be pelvic,

iliac abdominal or anywhere along the path of their as-

Background: The management of febrile children with

cent; with a slight predominance on the left side and

Lassa fever (LF) is made more difficult by the presence

commoner in males.

of comorbidities including malaria, bacterial sepsis and

Aims/Objectives: We report two cases seen in our hospi-

acute abdomen. Among the challenges associated with

tal.

the latter is the problem of delayed or missed diagnosis

Methods: Case 1- A 9 year old girl presented with recur-

of LF. However, the associated problems of over diag-

rent fever, recurrent facial swelling and recurrent ab-

nosis of LF and delayed or missed diagnosis of acute

dominal discomfort. Urinalysis and urine MCS were all

abdomen have not been described.

normal. Ultrasound showed both kidneys were located

Methods: The diagnosis of Lassa fever was confirmed

in the pelvis. Right kidney was posterosuperior to the

using reverse transcriptase polymerase chain reaction,

urinary bladder while the left was in the left iliac fossa

RT-PCR.

extending into the pelvis. Both kidneys were otherwise

Results: A 7 years old girl was admitted with acute onset

normal, she however did not return for IVU. Case 2- A

of vomiting, fever and abdominal pain and typical signs

12 year old boy presented with fever, lower abdominal

of acute appendicitis. The abdominal ultrasound scan

pain, dysuria, haematuria and urethral discharge. Uri-

supported the diagnosis and the child scheduled for sur-

nalysis showed + of blood, urine microscopy showed

gery but this was deferred because the Anaesthetic Team

few red blood cells, but no organism was cultured. Ul-

thought that “high grade fever makes appendicitis

trasound showed both kidneys were located in the pelvis

unlikely”, raised the possibility of LF, and requested for

adjoined over the midline by isthmus giving a horse

Lassa virus RT-PCR. Although the RT-PCR was posi-

shoe kidney; however both were otherwise normal. IVU

tive, and a regimen of intravenous ribavirin and antibiot-

showed both kidneys were located in the midline within

ics was instituted, the child did not improve but deterio-

the pelvic region. Left pelvicalyceal system and ureters

rated until operated upon on the 6 day. The findings

appeared normal in outline and calibre, no calculus was

included “ruptured vermiform appendix, and abscess

seen and right kidney was not excreting contrast. An

walled by omentum to the ileocaecal region and pelvis

assessment of UTI with unilateral functional horse shoe

with approximately 200 ml of pyoperitoneum”.

She

kidneys was made and he was managed with antibiotics

improved rapidly postoperatively and was discharged 8

to be followed up at the nephrology clinic.

days later after completing the course of ribavirin and

Conclusion & Recommendations: Bilateral pelvic ec-

antibiotics.

topic kidneys are not common, may be asymptomatic

Conclusion: The dilemmas illustrated by this case are

and diagnosed following radiological investigations. We

questions of the indications for confirmatory tests in

reported two cases diagnosed by ultrasound and one

VHF endemic areas, and the reality of carrier state ver-

confirmed to have unilateral functional kidney.

sus what constitutes VHF co-infection or comorbidity.

The need for a consensus on these and other related is-

PNP2

sues are discussed.

Treatment of idiopathic steroid resistant nephrotic

syndrome: a single centre experience in

South-Western Nigeria

1,2

Ladapo TA ,

1,2

Esezobor CI

Department of Pediatrics, College of Medicine,

University of Lagos .

Lagos University Teaching Hospital, PMB 12003,

Idi-Araba, Lagos, Nigeria.

Background: Newer immunosuppressives such as

calcineurin inhibitors and mycophenolatemofetil (MMF)

146

have improved the outcome of children with steroid re-

had haemodialysis (HD)

sistant nephrotic syndrome (SRNS). These agents have

The duration of peritoneal dialysis ranged from three to

only recently become available for use in our environ-

seven days. PD was used for 3 infants with AKI. One

ment and their impact on care is not known.

was a neonate with septicaemia and hyperbilirubinae-

Objective: To determine the outcome of children with

mia, 2 had possible haemolytic uraemic syndrome and

SRNS treated with cyclosporineand compare with the

one child with malaria AKI.

outcome following treatment with other drugs.

One (6.2%) of the patients died while undergoing perito-

Methods: Medical records of children managed for idio-

neal dialysis for malarial AKI. Three (19%) of the pa-

pathic nephritic syndrome (iNS) over a six-year period

tients who had peritoneal dialysis had full recovery of

were reviewed.

kidney function and are presently on follow up in the

Results: We reviewed 103children (M:F;1.7:1, 0.6-15.2

nephrology clinic

years, median 8.8) with iNS of whom 25(24.3%) had

All of the patients with CKD had haemodialysis, 4(25%)

SRNS. Follow-up was for 5 months to 6.25years. Of

were discharged against medical advice due to financial

these 25, only 17 received further immunosuppressants.

constraints and 7(43.8%) died.

Seven of 10 children (70%) treated with cyclosporine

Conclusion: Dialysis remains a life saving treatment for

and alternate day prednisolone achieved full remission.

children with renal failure especially AKI. The long

Treatment failure in one child was due to poor compli-

industrial strike during the study period affected the

ance from drug unaffordability. In comparison, cyclo-

number of cases seen. Mortality is very high for patients

phosphamide and alternate day prednisolone achieved

with CKD due to high cost of dialysis.

full remission in 2 of 5 (40%) children while enalapril

and alternate day prednisolone achieved partial remis-

PNP4

sion in 2 of 3 (66%) children. One child with cyclophos-

Visual recovery in a paediatric patient with

phamide resistance subsequently achieved remission

nephrotic syndrome and bilateral optic atrophy?

with cyclosporine. Full or partial remission to all medi-

Babatunde OD, Ademola AD, Ogun OA

1,2

3,4

cations was not related to sex (p=0.96), age (p=0.54),

Asinobi AO

1,2

serum albumin (p=0.37) or hypertension (p=0.43) but

Department of Paediatrics, Ophthalmology University

was positively correlated with serum cholesterol. (p=

0.02). There were 4 deaths (16% mortality). Side effects

of Ibadan.

Department of Paediatrics, Ophthalmology University

of cyclosporine were minimal comprising facial acne

and gingival hyperplasia in one child each and hirsutism

College Hospital Ibadan

in five.

Conclusion: Most children with iSRNS treated with

Background: Posterior reversible encephalopathy syn-

cyclosporine achieved remission of nephrotic syndrome.

drome (PRES) is a recently described disorder and the

clinical symptoms include alterations in mental state,

PNP3

seizures, vomiting, and abnormalities of visual percep-

Review of Paediatric dialysis in the University of

tion such as cortical blindness. Were port possible unex-

Port Harcourt Teaching Hospital (UPTH)

pected visual recovery in the presence of bilateral optic

atrophy in a 5 year old girl with nephrotic syndrome

Anochie I, Eke F, Udegbunam G

(NS), which may be related to PRES.

Department of Paediatrics, University of Port Harcourt

Case Report : A 5 year old girl presented to our hospital

Teaching Hospital, Port Harcourt

with recurrent body swelling of one month duration,

lethargy and breathlessness of a day’s duration. She had

Background: Dialysis is an important treatment for pa-

anasarca and her BP was 124/91mmHg. Herbiochemical

tients with renal disease. It may be in the form of perito-

parameters were consistent with NS, while E/U/Cr were

neal dialysis or hemodialysis. This may be used for pa-

normal. She had intravenous Fresh frozen plasma,

tients with acute kidney injury or chronic kidney dis-

frusemide, mannitol and ceftriaxone. She developed

eases.

focal seizures associated with loss of consciousness on

the 6 day of admission. Her CSF analysis was normal.

Methods: A prospective review of children from 3days

to 16years who had dialysis from November 2014 to

Intravenous calcium gluconate, and oral calcium supple-

2015 in UPTH was done to ascertain the indications,

mentation were added to her medications with resolution

types and outcome.

of symptoms. She was started on oral prednisolone.

Results: A total of 1,640 children including 554 neo-

However by the 20th day on admission, she was noticed

nates were seen during the study period. Out of which

not to be tracking objects. Her visual acuity was no per-

31(1.9%) patients had renal failure, 18(58%) acute kid-

ception of light bilaterally, and fundoscopyshowed bilat-

ney injury (AKI) and 13(42%) chronic kidney disease

eral optic atrophy. However, she appeared to have re-

(CKD).

covered some vision and began reaching out for objects

The patients comprised of 8 (25%) males and 23 females

31st day on admission. She was discharged on day 33,

(75%) with a male: female ratio of 1:3. Dialysis was

having received 22 doses of prednisolone. She however

done in 16 (52%) patients, 3 (19%) females and 13

continued to have proteinuria and is to be followed up

(81%) males. They were 3(18.8%) infants, 4 (25%) >5-

on outpatient basis.

10 years, and 9 (56%) > 10 years of age.

Conclusion: Potential explanation for transient blindness

Four (25%) had peritoneal dialysis (PD) and 12 (75%)

in our patient is PRES, however patient will require fur-

147

ther evaluation.

tality in sub-Saharan Africa (SSA). There are no

reported cases of ESRD in DS in SSA

PNP5

Aim: We reported 2 cases of DS who presented as early

Risk factors for chronic kidney disease in children

teens with CKD to highlight the challenges in the man-

attending paediatric outpatient clinic in Federal

agement

Medical Center Asaba

Methods: A 13year old male and 10year old female with

DS were admitted in University of Port Harcourt Teach-

Ajaegbu O , Ezeonwu BU , Nwafor I , Nnodim I

ing Hospital (UPTH) with features of CKD which pro-

Ayodeji A , Okolo AA

gressed to ESRD. Renal biopsy on the first case showed

Department of Paediatrics, Federal Medical Center

focal segmental glomerulosclerosis. The second case

Asaba, Delta State.

had congenital heart disease as a co-morbidity. The first

Department of Paediatrics and child health, University

case was managed conservatively, while the female had

of Benin Teaching Hospital, Benin, Edo State.

only 2 sessions of haemodialysis due to financial con-

Email: ajaegbuobinna@yahoo.com

straints, until their demise. There was no facility for

chronic peritoneal dialysis, and renal transplantation in

Introduction: In Nigeria, chronic kidney disease (CKD)

children is very expensive in Nigeria.

incidence in children ranges between 2-6 cases per an-

Conclusion: Regular monitoring of renal function early

num. Management of CKD which includes dialysis and

in life and routine echocardiography should be done at

renal transplant (renal replacement therapy) is not easily

birth in all DS to prevent or retard the progression to

obtainable and affordable in our environment. Identify-

ESRD

ing patients with increased risk and prompt treatment

aimed at risk reduction, slow down the progression.

PN1

Consequently, screening for early detection therefore

Hearing impairment and poor school performance

becomes inevitable, even individuals who appear normal

amongst primary school children in Port Harcourt

should be screened for modifiable CKD risk factors such

Aitafo JE, Anochie IC, Onotai LO

as proteinuria, hypertension and obesity.

Objectives: To screen for risk factors for chronic kidney

Department of Paediatrics, Braithwaite Memorial

disease in children attending paediatric outpatient clinic

Specialist Hospital, Port Harcourt, Rivers state,

in Federal Medical Center Asaba.

Nigeria.

Methods: It was a cross sectional descriptive study in

Department of Paediatrics,

which all the children 3-16 years, attending the children

Department of Otorhinolaryngology, University of Port

outpatient clinic, and have satisfied the inclusion criteria

Harcourt Teaching Hospital, Rivers state, Nigeria.

were screened for proteinuria, hypertension and obesity,

Email: enekoleaitafo@yahoo.com

in the month of June 2014.

Results: A total of 298 children: 153 (51.3%) males and

Background: Hearing impairment is the most frequent

145 (48.7%) were screened. Children (3-9 years) com-

sensory deficit in humans with a higher prevalence in

prise 74.2% (221/298) while adolescents (10-16 years)

developing countries. It results in speech and language

were 25.8% (77/298), with a male to female ratio of

delay, difficulties in parent-child, peer-child and child-

1:1.1. The median age of the children was 6 years and a

teacher interactions. Consequently, it may lead to poor

range of 3-16 years. Risk factors for CKD (proteinuria,

school performance, low self-esteem and poor psycho-

hypertension and obesity) were detected in 15.8%

social development.

(47/298) children. The respective proportion of those

Aim: To determine the prevalence of various types of

with proteinuria, hypertension and obesity was 3.0%

hearing impairment in primary school children in Port

(9/298), 3.7% (11/298), 10.1% (30/298) and the pres-

Harcourt and it's relationship with poor school perform-

ence of the risk factors for CKD has no age or gender

ance.

predilection.

Materials and methods: A cross-sectional study using

Conclusion: Risk factors for CKD exist in asymptomatic

multistage random sampling was carried out. Eight hun-

children, obesity being the most common.

dred and two children from 13 primary schools in Port

Harcourt were screened using pure tone audiometry after

an otoscopic examination. The last school year's exami-

PNP 6

nation average score for each child was obtained from

End stage renal disease (ESRD) in Down

the class register. An average score of less than 2 stan-

syndrome – A report of two cases

dard deviation below the class mean score (-2SD) was

considered a fail. A score above this was considered a

Anochie IC, Tabansi PN, Eke FU, Okpere AN

pass.

Institution- Department of Pediatrics and Child Health,

Results: The prevalence of hearing impairment was

University of Port Harcourt

29.4%. It was more common among the older children,

females and those from the lower socioeconomic

Introduction: The incidence of renal and urological

classes. Conductive hearing loss was the most common

involvement in Down’s syndrome (DS) is not very com-

type. Unilateral hearing loss was more common than

mon. End stage kidney disease; a stage 5 Chronic kid-

bilateral hearing loss. Poor school performance was

ney disease is associated with high morbidity and mor-

commoner among those with hearing impairment and

148

more so, amongst those with bilateral hearing impair-

tic evaluation and a high risk of misdiagnosis and inap-

ment.

propriate therapy.

Conclusion: Hearing impairment is common among

Objective: We appraised EEG studies in a cohort of chil-

primary school children in Port Harcourt and may con-

dren with epilepsy in order to evaluate access to and the

tribute to poor school performance.

impact of EEG in the diagnostic evaluation of the cases.

Keywords: Hearing impairment, pure tone audiometry,

Methods: Inter-ictal EEG was requested in all cases of

conductive hearing loss, poor school performance.

pediatric epilepsy seen at the pediatric neurology clinic

of the University College Hospital, Ibadan over a period

PN2

of 18 months. Clinical diagnosis without EEG evalua-

Pattern of Attention Deficit Hyperactivity Disorder

tion was compared with the final diagnosis post- EEG

among primary school pupils in Ile Ife

evaluation.

Results: A total of 329 EEGs were recorded in 329 chil-

Oke OJ, Oseni SBA, Adejuyigbe EA, Mosaku KS

dren, aged 3months to 16 years, median 61.0 months.

Email: oketimilehin@gmail.com

Clinical evaluation pre-EEG classified 69.3% of the

epilepsies as generalized. The a posteriori EEG evalua-

Background/Introduction: Attention Deficit Hyperactiv-

tions showed a considerably higher proportion of local-

ity Disorder (ADHD) is a neurobehavioral developmen-

ization-related epilepsies (33.6%). The final evaluation

tal disorder with onset in early childhood that has vary-

post EEG showed a 21% reduction in the proportion of

ing prevalence across the World. In Nigeria, there is

cases labeled as generalized epilepsy and a 55% increase

paucity of information on ADHD prevalence.

in cases of localization-related epilepsy (p<0.001).

Aims/Objectives: This study determines the pattern of

Conclusion: There is a high risk of misdiagnosis and

ADHD among pupils in Ile- Ife.

therefore the use of inappropriate therapies in children

Methods: This cross-sectional study was conducted be-

with epilepsy in the absence of EEG evaluation. The

tween February and July 2014 among 1,385 pupils in Ile

implications of our findings in the resource-poor country

-Ife. These pupils were selected using the multistage

scenario are key for reducing the burden of care and cost

random sampling technique. The Disruptive Behaviour

of epilepsy treatment on both the caregivers and the al-

Disorder Rating Scale (DBDRS) was used in screening

ready overloaded tertiary care services.

the studied population who had ADHD according to the

Diagnostic Statistical Manual of Mental Disorder fourth

PN4

edition (DSM IV).

Acute Disseminated Encephalomyelitis: a report of

Results: Sixty five (4.7%) out of the 1,385 pupils had

two cases

ADHD. Thirty eight (5.5%) of the 687 males and 27

(3.9%) of the 698 females had ADHD. There was no

Labaeka AA, Oyinlade A, Lagunju IO

statistically significant difference in prevalence and gen-

Department of Paediatrics, University College Hospital

der (?2 = 2.141, p = 0.143). Twenty eight (43%) of the

Ibadan

65 pupils had the inattentive subtype, 25 (38.5%) had

the combined subtype while 12 (18.5%) had hyperac-

Introduction: Acute Disseminated Encephalomyelitis

tive / impulsive subtype. Forty five (6.1%) of 735 pupils

(ADEM) is an immune-mediated inflammatory condi-

aged 5-8 years and 20 (3.1%) of 650 pupils aged 9-12

tion affecting the brain white matter and spinal cord. It

years had ADHD. The prevalence was significantly

usually manifests as an acute-onset encephalopathy as-

higher in the younger age group than the older age

sociated with polyfocal neurologic deficits typically

groups (?2 = 7.153, p = 0.007).

following a bacterial/viral infection or vaccination. It’s a

Conclusion & Recommendations: The prevalence of

monophasic disease of pre-pubertal children with a

ADHD was 4.7% with no gender prevalence. The inat-

mean age incidence of 5-8 years.

tentive subtype was the commonest and the hyperactive

Method: We present the first report of ADEM in Nige-

subtype was the least seen in the study. Hence, early

ria; a 4 year old boy and another 7year old boy, who

screening and prompt treatment of ADHD will promote

presented to our facility with features of acute cerebellar

the pupil’s academic potentials.

dysfunction, speech defects and behavioural changes.

Both were evaluated by cranial CT and cranial MRI

PN3

scans. Diagnosis was based on clinical presentation and

Electroencephalography as a tool for evidence-based

neuroimaging studies. They were treated with high dose

diagnosis and improved outcomes in children with

intravenous methylprednisolone at 20mg/kg/day in two

epilepsy in a resource-poor setting

divided doses for 5 days with remarkable resolution of

symptoms. Both made total recovery without any resid-

Lagunju IO*, Oyinlade A*, Ogbole G+, Atalabi M+

ual neurological sequelae.

Famosaya A*

Conclusion: The diagnosis of ADEM should be consid-

ered in any child presenting with an acute onset of visual

Background: Electroencephalography (EEG) remains

impairment, weakness, numbness and ataxia. Clinical

the most important investigative modality in the diag-

evaluation and cranial MRI aid diagnosis. High dose

nostic evaluation of individuals with epilepsy. Children

Methyl Prednisolone is highly effective in management.

living with epilepsy in the developing world are faced

with challenges of lack of access to appropriate diagnos-

149

PN5

The CD4 cell count is essential monitoring tool for

Suspected helminth- induced eosinophilic meningitis

evaluation of immune status.

in a Nigerian boy: a case report

Methodology: A cross-sectional study conducted on first

visit to the Neurology Clinics of the Unilorin Teaching

Oladele DM, Mohammed SS, Ibraheem RM,

Hospital, Ilorin. A total of 70 children recruited. Pa-

Afolabi JK, Gobir A, Wahab BRJ

rameters obtained were weight, height, OFC, age and

Department of Paediatrics, University of Ilorin

sex. All recruited had thorough clinical examination and

Teaching Hospital, Ilorin, Kwara State, Nigeria

Whole blood CD4 counts assessed by flow cytometry.

CD4 percent was calculated using standard formula.

Background: Eosinophilic meningitis is a rare form of

Results: Had 70 children evaluated with 47(67%) males

meningitis mostly associated with CNS helminthic in-

and 23 (33%) females with a M: F of 2:1 and age range

1.5-12 yrs (mean age of 4.9± 3.4). Mean (SD) CD4/mm

fection with the rat lungworm, Angiostrongylus canto-

nensis acquired by eating raw or undercooked seafoods

for 1.5-2.9yrs was 2112.7 (214.3); for 3-5yrs 1630.4

being the commonest cause . The diagnosis is established

(115.7) and for >5-12 yrs was 1182.8(102.6). Mean

by travel and diet history in the presence of typical clini-

(SD) CD4% for 1.5-2.9yrs was 56.1 (68.3); for 3- 5yrs

cal and laboratory findings which include eosinophilia

was 18.7 (19.4) and for >5- 12yrs was 47.5 (68.9).

Discussion: The mean CD4 cell count and mean CD4%

in CSF with or without peripheral blood eosinophilia.

Though without definitive CSF findings, we present a

was highest for children aged 1.5 to 2.9yrs. The mean

CD4 cell count and mean CD4% decreased with in-

case of a Nigerian boy with suspected helminth-induced

eosinophilic meningitis.

creasing age.

Case Summary: A.A, a 13 year old boy presented with a

Conclusion: The baseline CD4

levels in Neurologic

four day history of severe headache and three day his-

disorders was highest for children aged 1.5 to 2.9yrs and

tory of vomiting. No history of photophobia or neck

simulates the baseline CD4 levels in Normal healthy

pain. Vomiting was effortless and without nausea. No

children population.

history of fever or similar episodes of headache in the

Key Words: Neurologic Abnormalities, Paediatric base-

past.

line data.

Child had ingested poorly cooked snails alongside some

of his colleagues in his boarding school 10days prior to

PN7

presentation with similar symptoms in the other col-

Childhood epilepsy in Nigeria: a systematic review

leagues including hyperaesthesia and coma in some of

them. Child had clinical features of raised ICP at presen-

Oyinlade OA, Busari OO, Lagunju IA

tation and subsequently developed pareasthesia. CT scan

was normal; CSF analysis showed protein of 12mg/dl,

Background: Epilepsy is the most common neurological

WBC: 96cells/mm3 with 70% polymorphs, polymorphs

disorder in childhood worldwide with the greatest bur-

were however not further classified. There was also pe-

den in the developing countries where about two-thirds

ripheral eosinophilia (744cells/ μ L). He was managed

of the affected population are children. It is a significant

with dexamethasone, albendazole, repeated CSF taps

cause of childhood morbidity and mortality in develop-

and analgesics and improved with no CSF sequelae on

ing countries where a wide treatment gap exists.

follow up.

Method: We carried out a systematic review of studies

Conclusion: Helminth-induced meningitis is a cause of

on childhood epilepsy in Nigeria from 1977 to date via

meningitis in this part of the world, though rarely seen.

extensive literature search

on HINARI, Pubmed,

Appropriate diagnosis and management gives a favour-

Google scholar and Mendeley databases using the key-

able outcome.

words: childhood epilepsies, Nigeria and seizures.

Results: Our search revealed36 studies on childhood

PN6

epilepsy in Nigeria,26 were hospital based while 10

Baseline CD4 levels in Children with neurologic ab-

were community based. Average hospital based preva-

normalities in UITH, Ilorin

lence was 38.2% while a significant proportion (40.3%)

of patients had symptomatic epilepsy. Generalisedtonic

Adaje A , Kolade Ernest , Ayo Ojuawo

clonicepilepsy topped the list of seizure semiologies

Department of Paediatrics, Federal Teaching

accounting for 55.5% of cases while perinatal asphyxia

Hospital, Ido- Ekiti.

2,3

and intracranial infections were the leading predisposing

Department of Paediatrics, Unilorin Teaching Hospital,

factors.

Ilorin.

Access to diagnostic aids like electroencephalography

Email: aoadaje@gmail.com

and neuroimaging and enormity of cost of care are major

challenges. A considerable proportion of patients

Background: Paediatric baseline data on CD4

cell

(42.6%) still utilize complementary and alternative

count and CD4 percentage in children are few in Nige-

medicine while a sizeable proportion of patients (44.6%)

ria. Majority of available literatures with regard to CD4

had associated co-morbidities among which cerebral

cell count were done in adults, and are being extrapo-

palsy stands out. Basic knowledge about epilepsy is in-

lated for paediatric use. The study was carried out to

adequate among school teachers and pupils.

determine the CD4 cell levels children with Neurologic

Conclusion: Adequate funding of epilepsy care and re-

disorders (Cerebral Palsy & Seizure disorders) in UITH.

search is required to reduce the burden of childhood

150

epilepsy in Nigeria. Multicentre collaboration will also

PN9

enhance filling of reseach gaps and development of na-

Pattern of dysbiosis in the gastrointestinal system of

tional protocols for the management of epilepsy.

children with Autism Spectrum Disorder

PN8

Izuwah DN, Shatima DR, Alikor AD, Ulonnam C

Leukodystrophy: Report of a rare paediatric

Department of Paediatrics, National Hospital Abuja,

neurodegenerative disorder

Nigeria

Department of Paediatrics, University of Port Harcourt

Murtala MA , Ahmed H , Ali L , Sule MB

Teaching Hospital

Departments of Paediatrics , Neurosurgery and

Radiology, Usmanu Danfodiyo University Teaching

Introduction: Autism Spectrum disorder (ASD) is the

Hospital, Sokoto, Nigeria

most chronic childhood developmental disorder with

severely compromised life style without treatment. It

Background: Leukodystrophy comprises of rare genetic

majorly affects the social interaction of the child with

disorders that cause global neurologic deterioration as a

abnormal repetitive behaviors and various speech im-

result of degeneration of myelin sheath of the cerebral

pairments.

white matter, leading to disorders of movement, speech,

There is no known cause of autism but predisposing

vision, hearing and mental development. Their diagnosis

factor is said to be multifactorial, genetic predisposition

rests mainly on the clinical clues and the MRI patterns.

being influenced by environmental factors that includes

We report this case to remind physicians of these rare

gastrointestinal issues.

neurologic disorders.

Gastrointestinal dysbiosis has been reported in Children

Case presentation: We report HS, a 30months old girl

with ASD and this is said to contribute to leaky gut syn-

who presented with a complaint of progressive loss of

drome via increased intestinal permeability and some of

previously acquired neurodevelopmental milestones

the adverse behavioral issues like increased irritability,

including neck control, worsening speech, swallowing

tantrums, aggressive behaviour, and sleep disturbances.

difficulties and nystagmus, noticed over the previous 8

These include deficient in the normal good flora of the

months. She developed multifocal convulsions a week to

intestines with overgrowth of fungal infection and other

presentation. There was no antecedent febrile illness,

bacteria leading to dysequilibrium in the gut flora.

convulsions or loss of consciousness and no history of

Objectives of the study: This study was aimed to

ingestion of concoctions, toxic substance or head

describe the pattern of dysbiosis in children with ASD

trauma. Nopast history of convulsions or hospital admis-

Methods: This is a prospective descriptive study on chil-

sion. She had normal perinatal history, normal initial

dren with ASD attending Our Lady of Guadalupe Au-

neurodevelopment and is fully immunized. Parents are

tism centre. Ethical approval was obtained from Ethical

first cousins (consanguineous marriage) but no similar

committee of National Hospital, Abuja. Modified

history in siblings.

Checklist for Autism in Toddlers (MCHAT) and Diag-

Examination revealed normal head size with horizontal

nostic and Statistical manual of

nystagmus, head lag and quadriparesis. No involuntary

Mental disorders (DSM IV) were used to identify the

truncal or limb movements were noted. Extremities were

children with ASD. A comprehensive digestive stool

hypotonic and tendon reflexes were diminished. Oph-

analysis was conducted on the subjects recruited and the

thalmologic examination revealed no evidence of optic

results obtained were analyzed. Additional information

atrophy or neuritis. Brain MRI (T2 weighted) showed

on the sociodemographic were obtained and recorded in

extensive and symmetric diffuse areas of high signal

a proforma.

intensity in the deep white matter areas with no post

Results: 24 children with ASD were enrolled from Au-

contrast enhancement, in keeping with aleukodystrophy.

gust 2013 to July 2015. The ages were 2-10 years.

Search for acquired neurodegenerative disorders such as

All the subjects had Bifidobacter in the stool of which

HIV- associated progressive encephalopathy, infantile

15(62.5%) had appropriate maximum level. There were

S S P E a n d

m u l t i - f o c a l /

9(37.5%) with lactobacillus strain in their stool sample.

inflammatoryleukoencephalopathies were negative.

15(62.5%) subjects had zero level of lactobacillus in

Conclusion: Leukodystrophy is a rare but debilitating

their stools.

neuro-genetic disorder whose current care is mainly

The other bacteria cultured in various levels were Alpha

supportive. Molecular genetic studies and biochemical

hemolyticus streptococcus in 20 (83%), Gamma hemo-

enzyme assays help in further characterizing some of the

lyticus in 19 (79.2%), Klebsiella infection 14 (58.3%),

varied forms of the disorder, but thesewere not available

Bacillus specie 7 (29.1%), Proteus spp 3(12.5%), Pseu-

to us.

domonas 2(8.3%), Hemolytic e coli 5(20.8%) and Staph

Key words: Leukodystrophy, neurodegenerative, neuro-

aurous 5(20.8%).

regression, cerebral white matter

The fungal organisms found were Candida spp in 23

subjects (95.8%) and Trichosporon spp 5 (20.8 %)

The different species of Candida were; Candida parapil-

iosis in 13 (54.2%), Candida kruseii 5 (20.8%) and Can-

dida albicans 10 (41.7%).

Conclusion: There is evidence of dysbiosis in Children

with ASD with markedly low level of lactobacillius

151

which is the main beneficial gut flora called probiotics.

An understanding of the characteristics of the prevalent

Empirical treatment with Probiotic might help alleviate

disorders would facilitate capacity development for

some symptoms seen in children with ASD

early diagnosis, adequate management and prevention

Key words: ASD, Dysbiosis.

resulting in better outcomes with these disorders.

Objective: To describe the pattern of childhood neuro-

PN10

logical disorders in the Paediatric Neurology Clinic

Pott’s Puffy tumour with multiple intracerebral

(PNC) of Benue State University Teaching Hospital

abscesses: case report and review of literature

(BSUTH), Makurdi.

Method: A retrospective study of the records of all cases

Frank-briggs AI, Azubogu U

seen in the PNC of BSUTH between January 2013 and

Department of Paediatrics, University of Port-Harcourt

September 2015. Parameters assessed included: age and

Teaching Hospital,Port-Harcourt

sex distribution, mode of referral, type of disorders and

identifiable predisposing conditions.

Background: Pott's puffy tumour, is a rare clinical entity

Results: The 220 cases seen during the study period

characterized by subperiosteal abscess associated with

were reviewed and of these 161(73.2%) were males and

osteomyelitis. It is usually seen as a complication of

59 (26.8%) were females (M:F, 2.7:1). Their age range

frontal

sinusitis

trauma

and

characterized

was from 1 day to 17 years and majority (156, 70.9%)

by osteomyelitis of the frontal bone, either direct or

were under-fives. Most (170, 77.3%) were referrals from

through haematogenic spread. This results in swelling

outside the hospital. The main neurological conditions

on the forehead. The infection can spread inwards, lead-

were seizure disorders (125, 56.8%) and cerebral palsy

ing to intracranial abscess. Although it can affect all

(42, 19.1%). Predisposing conditions were identified in

ages, it is mostly found among teenagers and adolescent.

80(36.4%) of the cases. Meningitis (46, 57.5%), birth

Objective: We present a case of multiple intracranial

asphyxia (11, 13.8%) and neonatal jaundice (10, 12.5%)

abscesses with Potts Puffy tumour.

were the commonest of the identifiable predisposing

Case Report: A 13 year old girl presented with recurrent

conditions.

catarrh of 2 years, fever and headache of three weeks

Conclusion: Seizure disorders, particularly among under

and a week onset of swelling on the forehead and weak-

-fives, was the commonest disorder. The common pre-

ness of the right side of the body. She had a firm tender

disposing conditions identified underscore the need to

mass on the forehead, slurred and incoherent speech and

strengthen perinatal care and improve upon preventive

right cranial nerve VII palsy.

measures against meningitis while developing the capac-

She also had signs of meningeal irritation- positive Ker-

ity for the management of seizure disorders and the

nig’s & Brudzinge’s signs, hypertonia of right upper and

other prevalent conditions.

lower limbs and reduced power same side. Brain com-

puterized tomography (CT) scan showed multiple left

PN12

sided epidural abscesses, right sided frontal lobe ab-

A probable case of Herpes simplex encephalitis with

scess, paranasal abscesses with osteomyelitis of frontal

negative cerebrospinal fluid PCR

bone, meningeal enhancement in keeping with meningi-

tis and a Potts puffy tumour of the scalp.

Ewedemi F, Gbemisola OB, Ladapo TA, Esezobor CI

Patient had mini craniectomy with drainage of the ab-

Lesi FEA

scesses. She received intravenous antibiotics and

Email: temmiefabs@yahoo.com

physiotherapy.

Conclusion: It is pertinent to make an early diagnosis

Background/Introduction: Herpes simplex encephalitis

and institute effective treatment for sinusitis in order to

(HSE) is a rare, life-threatening brain infection caused

prevent this rare clinical entity.

by Herpes simplex virus (HSV). The diagnostic gold

Key Words: Multiple intracranial abscesses, Pott’s

standard is the detection of HSV DNA in the cerebrospi-

puffy tumour, osteomyelitis.

nal fluid (CSF) by Polymerase chain reaction (PCR).

Though PCR is highly sensitive and specific, false nega-

PN11

tives can occur and result should be interpreted in the

Pattern of childhood neurological disorders seen in

context of the patient's clinical presentation and the tim-

the Paediatric Neurology Clinic of Benue State

ing of the CSF sampling.

University Teaching Hospital Makurdi, North Cen-

Aims/Objectives: We present a case of probable Herpes

tral Nigeria

simplex encephalitis with negative CSF and Blood PCR.

Methods: A 4 year old female with fever and seizures

Eseigbe EE, Idoko A, Ochoga M, Abah R, Dabit JO,

being treated at a secondary hospital for suspected men-

Azih KN, Ajeh A, Ijiko BE, Ogiator AB.

ingitis developed “psychiatric symptoms” and progres-

Department of Paediatrics, Benue State University

sive loss of consciousness and was transferred. She had

Teaching Hospital, Makurdi, Nigeria.

few vesicular rashes peri-orally. Cerebrospinal fluid

Email: eeeseigbe@yahoo.com

analysis was normal. CT scan showed cerebral oedema.

She was commenced on intravenous acyclovir. CSF and

Introduction: Neurological disorders are an important

blood for HSV1 and HSV2 DNA PCR were negative.

cause of childhood morbidity with potentially grave

She regained consciousness after 24 hours of acyclovir.

consequences, particularly in resource limited settings.

Aggression and behavioural symptoms persisted but

152

improved with addition of oral carbamazepine. All

PN14

symptoms had completely resolved by the 14th day.

Miller-Dieker lissencephaly syndrome – a case report

Treatment was completed for 21 days.

Results: The clinical response to acyclovir informed

Boyede GO, Onyia NF, Foluso EA Lesi.

decision to complete therapy. Several studies in Litera-

Lagos University Teaching Hospital, Idi-Araba

ture had documented Herpes encephalitis with negative

Email: ojombo@yahoo.com

HSV PCR with early CSF samples. Repeat CSF PCR

may be subsequently positive. The repeat in index cases

Background/Introduction: Miller-Dieker Lissencephaly

was limited by financial constraints and family’s belief

Syndrome is a rare chromosomal genetic disorder char-

Conclusion & Recommendations: Antiviral therapy for

acterized by classical lissencephaly and characteristic

HSE should be initiated early and completed where

facies due to deletions within chromosome band

there is strong clinical evidence and response to therapy.

17p13.3. The condition is often associated with seizures,

severe intellectual disability and high mortality. We pre-

PN13

sent a case of Miller-Dieker Lissencephaly Syndrome in

Acute flaccid paralysis at the Lagos University

a 5 month old male infant to highlight the clinical and

Teaching Hospital

imaging features of this rare genetic syndrome.

Aims/Objectives: A case report of a rare chromosomal

Tokunbo J, Boyede GO, Ladapo TA, Esezobor CI

syndrome

Lesi FEA

Case Report: DM, 5 month old male infant, presented

Email: tbkjoac@yahoo.com

on account of recurrent seizures and suspected intracra-

nial haemorrhage on transfontannelle USS. Significant

Background/Introduction: A key contributor to the re-

history of polyhydramnios; amniocentesis offered was

cent removal of Nigeria from the list of polio-endemic

declined by parents. Child had history of global devel-

countries is the implementation of a highly sensitive

opmental delay, recurrent aspiration of feeds, failure to

acute flaccid paralysis (AFP) surveillance programme.

thrive and 3 episodes of seizures in the last 3 weeks

The Paediatric Neurology Unit, Lagos University Teach-

prior to presentation. Findings on physical examination

ing Hospital (LUTH) is highly involved in the reporting,

were microcephaly, hypertelorism, low set ears, small

evaluation and management of children with AFP in

palpebral fissures, small jaw, left undescended testis,

Lagos, Nigeria.

inability to fix/follow with the eyes and global hyperto-

Aims/Objectives: To describe the causes, course and

nia. Brain CT scan showed lissencephaly (type1). Chest

outcomes of childhood AFP managed at LUTH from

X-ray showed bronchopneumonia. ECG was normal.

January to October 2015

Echocardiography revealed patent foramen ovale.

Methods: A retrospective folder review of all children

Discussion: Our patient has classic features of the rare

with acute flaccid paralysis was undertaken.. AFP was

Miller-Dieker Lissencephaly Syndrome as documented

defined as 'acute onset of flaccid paralysis in one or

in literature. About 25 – 30% of patients with classical

more limbs in any child less than 15 years.’

lissencephaly have the typical dysmorphic facies and

Results: Six cases of AFP were managed. Their age

congenital malformations like cryptorchidism seen in

range was 2 -14 years with M: F of 1:1. All children

our patient. Prenatal diagnosis opportunity was lost by

were hospitalized and 1 required intensive care. All chil-

amniocentesis refusal. Mortality is high with deaths be-

dren had sufficient stool samples collected by the local

fore age of 2 years.

government AFP surveillance team for analysis. No

Conclusion & Recommendations: Miller-Dieker Lissen-

cases of wild or vaccine-associated poliomyelitis were

cephaly Syndrome is a rare but fatal condition. Prenatal

detected. The most common cause of AFP was Guillain-

diagnosis should be offered to mothers with polyhy-

Barré syndrome in 4 out 6 (67%). Other diagnoses were

dramnios. Genetic counseling should be provided for

one each of non-polio enterovirus infection and rickets.

affected family.

Majority (3 out of 5) had recovered fully, two had resid-

ual paralysis and one was still in intensive care. None of

PN15

the children with GBS received intravenous immune

Co-existence of Sturge-Weber and

globulin.

Klippel-Trenaunay-Weber Syndromes in a Nigerian

Conclusion & Recommendations: Our findings support

Child – Case report

the non-endemicity of polio in our environment with

Guillain-Barre Syndrome being the commonest cause of

Boyede GO, Anene-Nzelu U, Lesi FEA

AFP. AFP surveillance should be on-going and

Email: itschay@yahoo.co.uk

resources for management of severe GBS should be

enhanced.

Background/Introduction: The co-existence of Sturge-

Weber Syndrome and Klippel-Trenaunay-Weber Syn-

drome in the same patient is a rare phenomenon with

few cases reported in the literature globally. None has

been reported in an African child. We present a case

report of a 6 year old Nigerian girl with overlapping

presentation of both neurocutaneous syndromes.

Aims/Objectives: Case Report of a rare co-existence of

153

two neurocutaneous syndromes in a Nigerian child

responded well to treatment as evidenced by resolution

Methods: Case Report: GR is a 6 year old girl who pre-

of clinical symptoms and reduction in pulmonary artery

sented to the Paediatric Neurology Clinic of the Lagos

pressure.

University teaching Hospital on account of focal sei-

Conclusion: Idiopathic pulmonary hypertension does

zures since age 1 year and global developmental delay.

occur in children and responds well to dual therapy with

Physical examination revealed port-wine stain of the left

sildenafil and Bosentan. Though echocardiography can

face, upper and lower limbs with hemi-hypertrophy and

help significantly in evaluation of patient with IPH, fa-

hemiparesis of the left side of the body. There was bup-

cilities for right heart catheterization should be made

thalmous and glaucoma of the left eye. She had moder-

readily available to allow for a more accurate diagnosis.

ate intellectual disability on assessment. There were no

Keywords: Idiopathic pulmonary hypertension, paediat-

varicose veins. EEG and Brain CT scan investigations

rics, diagnostic challenge, clinical course

were performed.

Results: Sturge-Weber syndrome is the more commonly

PP2

seen and reported neurocutaneous disorder in Nigeria.

Prevalence and determinants of hypoxaemia in chil-

The extension of the naevus to the trunk and the limbs

dren admitted to the Emergency Unit of the Wesley

and hypertrophy of the affected limbs suggest an over-

Guild Hospital, Ilesa, Nigeria

lapping of Sturge-Weber Syndrome with the Klippel-

Kuti, Bankole P, Adetola HH, Aladekomo TA

Trenaunay Syndrome. The latter is a rarer sporadic neu-

rocutaneous syndrome characterized by a triad of port-

Department of Paediatrics and Child Health Obafemi

wine stain, varicose veins and musculoskeletal hypertro-

Awolowo University, Ile-Ife, Nigeria.

phy (bone and soft tissue).

Department of Paediatrics, Wesley Guild Hospital,

Conclusion & Recommendations: Presence of extensive

Ilesa, Nigeria

port-wine stain to the trunk and limbs with hemihyper-

trophy of the limbs should alert the Clinicians to the rare

Rationale: The demands for oxygen therapy for very ill

possibility of co-existence of Sturge Weber Syndrome

children in resource poor emergency units often out-

and Klippel-Treunauy-Weber Syndrome. Our patient is

weigh supply. Hypoxaemia is often undetected and un-

the first reported case in a Nigerian Child.

treated in these children because of the non-availability

of pulse oximeters and similar facilities to detect it. This

PP1

study sets out to determine the prevalence and determi-

Idiopathic Pulmonary Hypertension in paediatric

nants of hypoxaemia among children admitted to the

practice: a case report of the diagnostic challenges

emergency unit of the Wesley Guild Hospital, Ilesa,

and Clinical course in a Nigerian child

Nigeria

Methods: Children aged one month to 15 years were

Waziri UM, Sani UM, Isezuo KO.

consecutively recruited and prospectively studied over a

Department of Paediatrics, Usmanu Danfodiyo Univer-

ten month period. All the children hadtheir peripheral

sity Teaching Hospital, Sokoto, Nigeria

oxygen saturation (SpO 2 ) measured at presentation using

a portable pulse oximeter (Nellcor

(R)

N-200, USA) and

Background: Idiopathic pulmonary hypertension (IPH)

hypoxaemia was defined as SpO 2 < 90%. Relevant

is an uncommon problem in children that can results to

history, examination findings were compared among

significant morbidity. In resource limited setting, man-

hypoxaemic and non-hypoxaemic children. Multivariate

agement of affected patients can be quite challeng-

analysis was used to predict the presence of hypoxae-

ing..We present a caseof IPH in a 3-yr old girl and high-

mia.

light some of the challenges in the management of the

Results: Four hundred and two (402) children were re-

patient.

cruited during the study period with male to female ratio

Case Report: H.R, a 3 year old girl presented with recur-

of 1.3:1 and 84 (20.9%) were infants. The predominant

rent breathlessness, cough and body swelling since the

presentations were acute complicated malaria (67.7%),

age of 3 months. She was referred for further evaluation

respiratory tract infections (10.0%) and gastroenteritis

on account of persistent symptoms despite treatment for

(8.9%). Eighty three (20.6%) of the children were hy-

bronchopneumonia and 2 months course of anti-

poxaemic at admission. Infancy, heart failure, cyanosis,

tuberculous drugs. Cardiovascular examination revealed

grunting respiration and convulsionat presentation were

left parasternal heave, loud P2 with signs of right sided

associated with hypoxaemia (p < 0.05). Grunting (OR =

heart failure. Screening for tuberculosis, HIV and viral

4.056; 95%CI=1.492-8.123; p = 0.04) and Cyanosis at

hepatitis were negative.

presentation (OR =10.450; 95%CI = 1.647-19,422; p =

Echocardiography revealed supra-systemic pulmonary

0.006) independently predict hypoxaemia.

artery pressure, with pulmonary artery systolic pressure

Conclusion: Hypoxaemia occurred in approximately one

of 127 mmHg (mean pulmonary artery pressure of 42

out of five ill children admitted to the emergency unit of

mmHg) against systolic blood pressure of 90 mmHg.

the WGH, Ilesa. Emergently ill children with cyanosis,

The heart was structurally normal with no other identifi-

grunting, respiratory distress and convulsion especially

able cause for the elevated pulmonary pressure. Facili-

infants should preferentially be placed on oxygen ther-

ties for cardiac catheterization, Cardiac CT and MRI

apy even when hypoxaemia cannot be confirmed.

were not available for further evaluation. Patient was

commenced on oral sildenafil and Bosentan. She

154

PP3

about cooking smoke as a risk factor for childhood

Pulmonary artery hypertension in children: an audit

pneumonia.

of etiologic factors and outcome from a tertiary

Methodology: A questionnaire-based cross-sectional

center in Sokoto, Northwestern Nigeria

study was carried out at a major market in Benin City

prior to a market rally to celebrate World Pneumonia

Sani UM, Waziri UM, Isezuo KO.

Day 2014. Ethical approval was obtained. The respon-

Pediatric Cardiology Unit, Department of Pediatrics,

dents who were traders gave verbal consent. Information

Usmanu Danfodiyo University Teaching Hospital,

on biodata, cooking location, cooking fuel and presence

Sokoto

of under-fives in the cooking area of homes of respon-

dents was sought.

Background: Pulmonary hypertension (PH) is a rela-

Results: There were 1374 respondents with 1192

tively rare and frequently overlooked problem in chil-

(88.5%) being females. Only 67(4.9%) respondents con-

dren. It is diagnosed when the mean pulmonary artery

sidered smoke from cooking fuel a risk factor for pneu-

pressure exceeds 25mmHg at rest or 30mmHg during

monia while 99(7.2%) considered avoidance of smoke

exercise. As there is paucity of data on the subject in

as a method for preventing pneumonia. Firewood

Nigerian children, this study was undertaken to deter-

(biomass fuel) was utilized by 272(19.8%) respondents.

mine the etiologic factors and outcome of PH among

Respondents with no education were significantly more

pediatric patients in Sokoto.

likely to use firewood (p<0.000).

Materials and Methods: A retrospective study con-

All respondents with under-fives reported having them

ducted between 1 August 2013 and 31 July 2015.

in the cooking area. Having a child who had suffered

Case records of all children diagnosed with PH by echo-

pneumonia previously was not significantly associated

cardiography and/or cardiac catheterization over the

with knowing that smoke was a risk factor for childhood

study period were retrieved. Relevant data was entered

pneumonia p>0.05.

into Microsoft excel and analyzed.

Conclusion: There is poor awareness of smoke as a risk

Results: A total of 52 children were diagnosed with PH

factor for childhood pneumonia while the use of unclean

(3 confirmed by cardiac catheterization abroad). Their

fuel is significant. As part of health education on child-

median age was 7 years (mean + SD=7.6 + 4.3), with

hood pneumonia, smoke as a risk factor should be em-

70% of them above 5 years. There are 19 males and 33

phasized. Government should make cleaner fuels more

females, giving a M: F ratio of 1:1.7. Congenital heart

available, accessible and affordable.

diseases (CHD) are the most common causes seen in 30

(57.7%) patients followed by Acquired heart diseases in

PP5

15 (28.9%), sickle cell anemia in 5 (9.6%) and adenoi-

Congenital cystic adenomatoid malformation: case

dal hypertrophy with obstructive sleep apnea in one

report of a rare cause of neonatal respiratory distress

(1.9%) patient. One (1.9%) patient was considered to

and review of literature

have idiopathic PH.

Six patients had surgery (3 for CHD, one for adenoids)

Disu EA, Kehinde O, Falase B, Sanusi MO, Akinola R

while 27 patients were commenced on medical treatment

Ubuane PO

(sildenafil and/or Bosentan in 9 patients and diuretics in

Email: peterubuane@gmail.com

15 patients). Five (9.6%) patients died (4 preoperatively

and 1 post operatively) while 18 (34.6%) were lost to

Background/Introduction: Congenital cystic adenoma-

follow up.

toid malformation (CCAM), now known as congenital

Conclusion: The etiology of PH in children is diverse,

pulmonary adenomatoid malformation (CPAM), is a

but CHDs remain the most common. Early diagnosis

rare developmental harmatomatous (dysplastic) lesion of

and treatment of underlying causes can prevent the de-

the lower airway. It is a rare cause of respiratory distress

velopment of PH and result in better prognosis.

and recurrent chest infections mostly in the neonatal

Keywords: Pulmonary hypertension, etiology, children,

period; however its presentation spans foetal to adult-

sokoto, Nigeria

hood. In the developed world, most cases are diagnosed

prenatally.

PP4

Aims/Objectives: To report a case and review literature

Trader’s Perception of cooking smoke as a risk fac-

Methods: A 13 day old term male neonate was referred

tor for childhood Pneumonia

to LASUTH from a private hospital with increasing res-

piratory distress and an abnormal chest radiograph sug-

Sadoh AE, Nwaneri DU, Famuyiwa O, Ogboghodo BC,

gestive of pneumonic changes. At presentation, he was

Eregie CO, Oviawe O.

2.8kg with severe respiratory distress. All other aspects

Institute of Child Health, University of Benin, Benin City

of general examination were normal and there were no

Nigeria

obvious dysmorphic features. A diagnosis of CCAM of

the right lower lobe was made following a chest CT

Background: Indoor air pollution by smoke from cook-

scan. The neonate subsequently had a successful resec-

ing fuel is a major risk factor for childhood pneumonia.

tion of the lesion with markedly improved clinical

The knowledge of caregivers about risk factors can fa-

course and resolution of respiratory distress. Histology

cilitate the practice of appropriate preventive measures.

revealed lung tissue with multiloculated cystic lesion

This study set out to evaluate the perception of traders

diagnostic of type 3 to type 4 CCAM.

155

Results: Child is now 20-month old, is being followed-

be controlled and pollution indices developed for moni-

up at the out-patient clinic and has remained symptom

toring.

free.

Conclusion & Recommendations: This case highlights

PP7

the need for enhanced prenatal diagnosis; treatment of

Diaphragmatic flutter in a Nigerian adolescent girl: a

antenatally-diagnosed CCAM has better outcome than

case report

symptomatic ones. Neonates with suspicious chest ra-

diographs should be offered superior imaging studies

Onalo R, Offiong MU, Emembolu AI

like CT. Subsequent early surgical intervention in terti-

Department of Paediatrics, University of Abuja Teach-

ary centres with thoracic surgery expertise and intensive

ing Hospital, Gwagwalada, Abuja.

care would yield better chances of survival and reduce

|Email: richardonalo@yahoo.com

the longterm risks of recurrent chest infections and ma-

lignant transformation.

Background: Diaphragmatic flutteris a disorder charac-

terized by rhythmic contractions of the diaphragmatic

PP6

and respiratory muscles. The syndrome is extremely rare

Air pollution and respiratory disease in children in

with varied clinical presentations resulting in late diag-

Kaduna metropolis

nosis and ineffective treatment. Symptoms include in-

voluntary jerky upper trunk movements and pain.

Orogade AA , Orogade SA , Okuofu , Owoade KO

Case Report: We report a 16 year old girl who presented

Hopke PK

to the cardiology clinic with a 2week history of persis-

Department of Paediatrics, ABUTH Shika, Zaria.

tent hiccup, involuntary jerky movements of the head

Department of Water Resources and Environmental

and upper trunk, and chest pain. Movements were said

Engineering, ABU Zaria.

to be absent during sleep, pain is said to be referred to

Center for Air Resources Engineering and Sciences,

the tip of the left shoulder. No previous history of

Clarkson University, Potsdam, New York, USA

trauma, no history of difficulty in breathing, no cough,

no dyspnea on exertion. no past history of sore throat.

Introduction: Environmental air quality, especially in

The patient is not a known epileptic, has not been on any

developing countries is responsible for more than half of

known medications in the recent past.

health related risk posed by pollution. Air pollution has

Examination findings revealed a well preserved adoles-

been identified in Nigeria from 3 main sources: indus-

cent, having intermittent jerky movements of the trunk,

trial, traffic and effects of northeasterly (Harmattan)

each lasting about 2secs, occurring every 2-5minutes.

winds, all of which are identifiable in Kaduna metropo-

She looked anxious, well oriented, with coherent speech,

lis. This study was designed to identify the contribution

intact cranial nerves, and normal tendon reflexes. Her

of pollutants from these sources on respiratory disease in

peripheral pulses were synchronous with other periph-

c h i l d r e n

i n

K a d u n a

m e t r o p o l i s .

eral pulses, with normal volume. The blood pressure

Methods: Air pollutants(gaseous and particulate matter)

was 108/67mmHg and the heart rate-75beats per min-

were sampled over a 12month period (March 2013- Feb-

utes, and there were no murmurs.

ruary 2014) in 3 industrial areas and a major road high-

Other systems examination revealed normal findings.

way in Kaduna metropolisusing Graywolf Advanced-

Laboratory investigations yielded normal results except

Sense Toxic Gas Monitor and PM 2.5 and PM 2.5-10 nu-

for electroencephalograph that showed bilateral poly-

cleopore polycarbonate filters in the low volume Gent

waves and spikes with hyperventilation. Photic stimula-

sampler respectively for gas and particulate matter. Fur-

tion was associated with spike in the left centro-parietal

ther analysis for PM was done using XRF and Optical

region.

Transmissiometer. Structured questionnaires were ad-

The patient was treated with carbamazepine15mg/kg/

ministered to parents of children resident within 100

day, with much improvements in symptoms.

metres radius of pollution sources and others further

Discussion and Conclusion: Diaphragmatic flutter is a

away to determine risk posed by pollutants tocommon

rare disease that requires high index of suspicion to di-

c h i l d h o o d

r e s p i r a t o r y

d i s e a s e s .

agnose. Treatment can be challenging but we achieved

Results: Major gaseous pollutants identified were Car-

symptom control with normal doses of carbamazepine.

bon Monoxide, Sulphur Dioxide, Hydrogen Cyanide and

Ammonia (TVOC). Black Carbon was unacceptably

PP8

high on the roadway and PM 2.5-10 contributed two thirds

Guideline defined asthma management: how compli-

of particulate matter. The pollutants sources were an-

ant are general practitioners

thropogenic in 90% of cases. Respiratory condition-

swere commonly identified in school aged and include

Osarogiagbon OW, Sadoh EW, Osaghae D

upper respiratory tract infection (94% of respondents;

Email: divinewilbel@yahoo.com

recurrence in 56%), exacerbations of asthma (16%) and

pneumonia in 10%.Overall attributable risk percent of

Background/Introduction: Asthma is a chronic debilitat-

pollutants was 85%; gaseous pollutants 72%, particulate

ing illness in children, due mainly to the frequent acute

attacks that may be experienced on exposure to triggers.

Conclusion: Air pollution is an important risk factor

The management of these acute attacks vary from place

forpaediatric respiratory diseases in Kaduna. It should

to place depending on the accepted guideline used in

156

such as area. However, there is a global initiative on

scaphoid abdomen, further review revealed bowel

asthma management that has unified all the local guide-

sounds in the chest, right sided heart sounds. Chest X-

lines such that the management is almost the same

ray confirmed the diagnosis but parents refused referral

worldwide. The presence and the adherence to this

for cardiothoracic surgical repair on financial grounds.

guideline remain questionable among health workers.

Exploratory laparotomy revealed bochdalek hernia with

Aims/Objectives: To determine the awareness of and

herniation of the spleen, transverse colon, descending

adherence to the GINA Guideline in the management of

colon and small intestine into the thorax.

asthma by private practitioners.

Results: The defect was successfully repaired and the

Methods: Semi-structured self-administered question-

baby was discharged home seventeen days after the sur-

naires were given to private practitioners during one of

gery.

their continuous medical education (CME) meetings on

Conclusion & Recommendations: CDH can readily be

asthma given by the authors of the study. The question-

missed because several neonatal problems present in

naires were filled by those present and retrieved before

similar fashion, thus emphasizing the need for thorough

the meeting started. The data so generated were entered

evaluation of neonates with respiratory distress using

in EXCEL and transferred to SPSS and analysed.

both clinical and simple investigational tools to exclude

Results: A total of 50 doctors in private practice took

other differentials. The case also highlights the need for

part in the study. 40 were males and 10 females. Out of

appropriate referral and linkages between health care

the 50 respondents, 48 agreed that they managed

facilities in addition to good antenatal care (ANC) as

asthma. The mean years after graduation was 18.04 yrs,

there was no prenatal suspicion of CDH in this patient.

mode 10 years, and median 13 years. Six of the 50 re-

spondents were aware of the existence and content of the

PS2

GINA Guideline. However, only 2 doctors could cor-

Challenges in management of Oesophageal atresia/

rectly state how to treat children under-5 years accord-

tracheoesophageal fistula at the National Hospital

ing to the GINA Guideline, 18 could not completely list

Abuja (NHA)

the components, while 16 stated the wrong management

of such children. In the case of children above-5 years,

Mairami AB, Nwatah VE, Otuneye AT, Wey Y, Audu

only those who could correctly treat children under-5

LI.

years also could treated children above-5 years with the

Neonatal Unit, Department of Paediatrics, National

GINA Guidelines. No participant could correctly state

Hospital, Abuja

the

Guideline-Defined

long-term

management

asthma.

Background: Although an uncommon major congenital

Conclusion & Recommendations: From the foregoing,

malformation, oesophageal atresia is amenable to surgi-

management of acute asthma by private practitioners

cal treatment. Outcome of surgery is however influenced

does not follow the GINA Guidelines. This is a result of

by associated pre- and post-operative morbidities.

the poor awareness by the doctors of the existence of the

Aim: To document the challenges encountered in the

Guideline. So there is need to intensify continuous

management of oesophageal atresia/ tracheoesophageal

medical education among private practitioners.

fistula at NHA.

Methods: The records of all neonates with a diagnosis of

PS1

Oesophageal atresia/trachea-eosophageal fistula man-

Management of congenital diaphragmatic hernia in a

aged over a period of 5 years (October 2010-October

resource poor setting

2015) were retrieved, reviewed and analyzed.

Results: A total of 22 patients with OA/TEF were man-

Fatunla OA, Ogundare EO, Oluwayemi IO, Ajite AB

aged. The records of 7 could not be traced; therefore

Omoniyi E, Olatunya OS

only 15 (75%) of the cases were analyzed. There were 8

Email: odunayo27@yahoo.com

males and 7 females with a mean age at presentation of

4.4 (3.7) days and mean birth weight of 2940 (638) g.

Background/Introduction:

Congenital

diaphragmatic

All the mothers had obstetric ultrasound examination

hernia (CDH) is the presence of a defect in the dia-

but the findings were limited to polyhydriamnios in 9

phragm that allows herniation of some abdominal vis-

(61%) and were reported as normal in 6 (39%). Fourteen

cera into the thoracic cavity. It is commonly associated

of them were out born and the mean age at presentation

with respiratory distress, pulmonary hypoplasia, and

was 4.4(3.7) days. The most common type was Vogt

persistent pulmonary hypertension at birth and can be

type 3b while67% were associated with one or more

fatal in the absence of timely intervention.

other congenital malformations: cardiac(70%) being the

Aims/Objectives: To highlight challenges in the manage-

most common. The presence of aspiration pneumonitis,

ment of CDH in resource-limited settings using a case

dehydration, sepsis and coexisting congenital malforma-

study.

tions delayed surgery and impacted adversely on the

Methods: A male neonate was diagnosed with CDH and

outcome. Thirteen babies had surgery. Postoperative

managed successfully at the Ekiti State University

anastomotic break down and wound dehiscence were

Teaching Hospital (EKSUTH) after being admitted with

compounded by limitations in providing adequate nutri-

respiratory distress, low arterial O2 saturation following

tional support. Two babies died before their planned

referral from a secondary facility where he was being

surgery and the overall mortality rate was 46%.

managed for congenital pneumonia. Although no

Conclusion: Antenatal and early neonatal diagnosis of

157

this condition rarely occurs in our setting, resulting in

SP1

late surgery, post-operative complications and high mor-

Intimate partner violence in pregancy: effects on the

tality in affected babies.

innocent baby

Keywords:

Challenges,

management, oesophageal

atresia, tracheoesophageal fistula.

Amsa BM, Omotayo OA, Mshelia LJ, Audu LI

Neonatal Unit, Department of Paediatrics, National

PS3

Hospital Abuja

Pattern of Emergency Surgical Cases admitted into

the Emergency Paediatric Unit seen at UDUTH,

Abstract: Baby C was delivered via an emergency lower

Sokoto

segment caesarean section under general anesthesia at a

gestational age of 34weeks. His APGAR scores were 3

4 5 and he weighed 2.35kg at birth.

5 10

Yusuf T, Isezuo KO, Jiya FB, Adamu A, Sanni M,

Onankpa BO, Lukong CS

Baby C’s mother is a 24 year old P 1 lady that was rushed

Department of Paediatrics, Department of Paediatric

to the emergency room with a penetrating abdominal

Surgery, Usmanu Danfodiyo University Teaching

injury of 90mins duration. She gave a history of a brawl

Hospital, Sokoto, Nigeria

with her partner who subsequently stabbed her with a

Email: khadisez@gmail.com

knife multiple times and also kicked her all over the

body. She had eviscerated omentum from her gravid

Background: Children with conditions requiring emer-

abdomen as well as lacerations to her forehead and fin-

gency surgery may initially present to the Paediatrician

gers. She had emergency exploratory laparotomy by the

who should have high index of suspicion as some of

surgeons and gynecologists with the neonatologist at

these conditions are initial medical problems that be-

hand and was delivered of a live preterm baby. The neo-

come complicated.

natologist resuscitated him and he required bag and

Objective: To determine the pattern and outcome emer-

mask ventilation for about 15mins. Post resuscitation, a

gency surgical cases admitted via EPU, UDUTH,

5x3cm laceration on his left gluteus was noticed. This

Sokoto.

was sutured immediately.

Materials and Methods: A prospective study conducted

Baby C was subsequently admitted into NICU and man-

over an18-month period (1 July 2012 to 31 December

aged for perinatal asphyxia with stab wound injury. He

2013). Subjects included all children with initial diagno-

received tetanus toxoid, antibiotics and other supportive

sis of medical conditions who subsequently required

care. Baby was discharged to the mother after 13 days

surgical management seen at the Emergency Paediatric

by which time she had recuperated and was successfully

Unit. Data collected were demographic information,

breastfeeding.

presenting symptoms and signs, initial and eventual sur-

We present this case to sensitize pediatricians towards

gical diagnosis and outcome.

the possible effects of IPV in pregnancy on the unborn

Results: Children admitted during the period were 1738,

child.

39 (2.2%) were diagnosed with surgical conditions re-

Keywords: Intimate partner violence, effects, unborn

quiring urgent consult to the respective specialties.

baby.

Twenty-two (56.4%) were above 5 years old and 23

(60%) were of lower socioeconomic status. Male to fe-

SP2

male ratio was 3.9:1. Peritonitis from typhoid perfora-

The prevalence of female circumcision among

tion was seen in 15 (38.5%) patients. Six (16.4%) pa-

children presenting in a semi-urban tertiary teaching

tients had intussusception, five (12.8%) had upper air-

hospital in south west Nigeria

way obstruction from foreign body and post infective

causes, 4 (10.3%) para-pneumonic effusions, 2 each

Ajite AB, Ogundare E, Oluwayemi O, Oyinkansola A

(5.1%) acute appendicitis and Hirschsprungs disease

Adeniyi B, Oyeku O

while 1 each (2.6%) was diagnosed with congenital hy-

Department of Paediatrics, Ekiti State University

pertrophic pyloric stenosis, injection abscess, posterior

Teaching Hospital, Ado Ekiti

fossa tumor, intestinal malrotation and cholecystitis.

Paediatrician diagnosis was consistent with intra-

Introduction: Female circumcision also referred to as

operative diagnosis in 35(89.7%) cases. Three mortali-

female cutting or female genital mutilation (FGM) is

ties(10.3%) were recorded.

being frowned at globally. It is the total or partial

Conclusion: Typhoid perforation is the commonest

removal of the external female genitalia or injury to the

cause of paediatric surgical emergency in our environ-

female genital organ for non medical reason. This study

ment. Preventive measures against infections will reduce

was to determine the prevalence of FGM among chil-

this burden in our community.

dren and identify the prevailing factors and immediate

Key words: Pattern, Emergency, Paediatric, Surgical,

outcome of this practice with the aim of increasing

Cases, Outcome

social awareness thereby influencing positive behavior.

Methodology: The study was carried out among 200

consecutive new female children with age ≤ 15 years

presenting at the out-patient and children emergency

ward of Ekiti State University Teaching Hospital Ado

Ekiti. Parental informed consent was obtained and a

158

research proforma was administered on each subject for

SP4

their bio data, anthropometric, clinical data and ques-

Maternal empowerment prevents kernicterus in Ni-

tions to determine the contributing factors to FGM.

geria

Results: 200 consecutive female children presenting to

the children emergency and out-patient clinic of the hos-

Imam Z , Farouk Z , Abdulkadir I , Pam V , Okolo AA

pital whose age were ≤ 15 years were recruited. The

Wennberg R

prevalence of female circumcision was 30%. Circumci-

Massey Street Children's Hospital, Lagos

sion was done majorly during infancy (81.6%) and type

Department of Paediatrics, Bayero University, Kano

1 FGM was commonly done (70%). Fever, irritability,

Department of Paediatrics, Ahmadu Bello University,

external genital ulcer and discharge were the immediate

Zaria

complications noted. 10% of them <5 years old had

Department of Obstetrics and Gynaecology, University

blood transfusion. Health workers are involved in 62.3%

of Jos

instances of FGM in this study. High parental level of

Department of Paediatrics, Federal Medical Centre,

formal education did not affect the prevalence posi-

Asaba

tively.

Department of Paediatrics, University of Washington,

Conclusion: FGM is an infringement on the physical

Seattle, WA, United States

and psychosexual integrity of the female child and asso-

Email: drzkay@yahoo.com

ciated with health hazard, it is still practiced irrespective

of parents’ level of education. Some health workers are

Background/Introduction: Acute bilirubin encephalopa-

involved in this act.

thy (ABE) is responsible for 6-10% of neonatal deaths

in Nigeria. Most babies with severe ABE are already

SP3

affected when admitted and therefore benefit little from

Child abuse in Nigeria: Nursing Intervention

treatment.

Aims/Objectives: To determine whether public and ma-

Odita HN

ternal awareness about jaundice will reduce the preva-

School of Post Basic Nursing Studies, Paediatric

lence of ABE.

Nursing Programme, University of Port Harcourt

Methods: This prospective observational study docu-

Teaching Hospital, Port Harcourt

mented the baseline prevalence of ABE in 5 collaborat-

ing centers (phase 1) and then evaluated the impact of

Background: Increasing incidence of Child Abuse has

education on the occurrence of severe hyperbilirubine-

been reported in Nigeria, and indeed most of Africa.

mia and ABE. In phase 2, health providers, including

Although a lot has been written about child abuse in

traditional birth attendants, participated in jaundice

Nigeria, the role of the Nurse its intervention has been

awareness sessions. Educational posters were placed in

under-reported.

antenatal clinics and postpartum wards; mothers were

Objectives: The purpose of this paper is to review the

shown how to assess jaundice, taught to avoid sub-

various forms of Child Abuse and to use this framework

stances known to cause hemolysis in G6PD deficient

to highlight the role of the Nurse in the prevention and

infants and when to seek help.

management of this silent epidemic.

Results: In phase 1, 160 cases of ABE occurred in 1026

Methodology: Information was obtained from the litera-

admissions for jaundice (15.6%). In phase 2, the inci-

ture using online and off line literature search.

dence of ABE decreased to 11.1% and in 4 of 5 centers,

Results: Despite the adoption of child’s right by United

from 13.4% to 6.6%. ABE occurred in 27 babies born to

Nations in 1990 as a strategy to ensure child’s survival,

162 uninstructed mothers. No ABE occurred in 181 ba-

protection and development it is still common to see

bies whose mothers had received postpartum instruction

neglected, abandoned and abused children in the streets

about neonatal jaundice. ?2 43.61

P<.0001. Received

of our country Nigeria. Factors that facilitate child abuse

Jaundice Instruction Postpartum No Jaundice Instruc-

or maltreatment is built upon some ecological and child

tion Postpartum Normal 179 123 Suspect mild ABE 2

developmental theories which in turn are embedded in

12 ABE 0 27 Total Cases 181 162

child rearing styles of our society. The nurse as a change

Conclusion & Recommendations: Providing mothers

agent uses her diverse professional knowledge/skills/

and health providers the skill to detect jaundice and

tool which is the nursing process to identify, assess, di-

guidance to avoid ABE empowered them to make ap-

agnose, plan, implement and evaluate the community,

propriate decisions in their babies' care.

family and child to help in the prevention and treatment

Funding body: Saving Lives at Birth, FOG Award No

of this silent killer of our future generation called child

AID-OAA-F-13-00072

abuse or child maltreatment.

Conclusions/Recommendation: It is concluded that the

nursing profession has a role in the prevention and man-

agement of child abuse in Nigeria with the professional

use of the Nursing Process. It is recommended that

greater emphasis should be placed in the giving the

nurse, especially the paediatric nurse the training and

opportunity to manage this, and similar public health

problems.

159

SP5

recruited. A structured pretested questionnaire was used

Health care workers perception on counselling of

to obtain relevant information.

patients/caregivers

Main outcome results: The subjects comprised of 739

males (47.4%) and 819 females (52.6%). The overall

Asinobi I, Ndu I, Ekwochi U, Osuorah C, Amadi O

prevalence of child sexual abuse was 36.7%. Sexual

Department of Paediatrics, Parklane Hospital, Enugu.

abuse was more likely in girls (OR 2.715; 95% CI,

Email: isaacasinobi@gmail.com

2.188- 3.370). Majority of the victims (69.2%) were

abused within their early and mid-adolescent age group.

Introduction: Counselling of caregivers is an integral

Child sexual abuse is prevalent in all social classes but

but overlooked aspect of patient management. Caregiv-

the prevalent rate is higher among the subjects from

ers are often left groping in the dark becausethey are not

lower social class.

informed about their children’s diagnosis, treatment and

Conclusion: The prevalence of child sexual abuse

prognosis. Various factors limit the ability of healthcare

among Adolescents in secondary school in Obio/Akpor

workers to provide adequate counselling to caregivers.

LGA is high. Females are by far the most vulnerable.

These include forgetfulness, ignorance and communica-

Young age and low social class are contributory factors.

tion problems. Healthcare workers need to be aware of

Key words: Child sexual abuse, Adolescents

these challenges to aid in wholistic patient care.

Aim: To assess the perception of healthcare workers on

the counselling of patients/caregivers.

Methodology: Information was obtained using question-

naires distributed amongst participants of the 46thPaedi-

atric Association of Nigeria conference at Abakaliki.

These were analyzed using SPSS 20.

Results: There were 121 participants in the study. Of

this number, 59.5% were females and 40.5% were

males. All participants had heard about counselling, of

which 8.3% had no formal training, 47.1% had received

informal training and 47.1% had informal training on

counselling. Most participants agreed that caregivers

should be counselled, while only one person had a con-

trary view. The commonest barrier to effective counsel-

ling was lack of time (65.3%). Other reasons included

poor counselling skills and inadequate counselling envi-

ronment. While most participants (90.1%) felt all infor-

mation should be shared, less than 5% felt that informa-

tion given should be just enough to stop the caregiver

from disturbing them with questions.

Conclusion: Counselling as part of patient care is uni-

versally accepted. However, several barriers exist to its

effective practice. Opinions also vary on the quantity

and quality of information to be shared during counsel-

ling.

SP6

Risk factors for child sexual abuse among

adolescents in Rivers State

Gabriel-Job N, Alikor EAD, Akani NA

Department of Paediatrics, University of Port Harcourt

Teaching Hospital

Email: jobnneka@yahoo.com

Objective: To determine the risk factors for child sexual

abuse among adolescents in secondary schools in Obio/

Akpor Local Government Area.

Study design: Descriptive cross-sectional study

Setting: School based survey using junior and senior

secondary schools in Obio/Akpor LGA.

Method: Using a multi-staged sampling technique, 13

secondary schools were selected. One thousand five

hundred and fifty eight students who assented to the

study and whose parents gave a written consent were