ISSN 03 02 4660 AN OFFICIAL JOURNAL OF THE PAEDIATRIC ASSOCIATION OF NIGERIA
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Niger J Paediatr 2018; 45 (1):25 - 73
PANCONF 2018 ANNUAL GENERAL CONFERENCE
Abstracts of Proceedings
49th Annual General and Scientific Conference of the Paediatrics
Association of Nigeria (PANCONF), 24th - 26th January, 2018
AP
1
AP
2
Parent and adolescent reported sleep parameters and
Views and experiences with sexting among
the pattern of sleep disorders among school
post-secondary young people in Ibadan, Nigeria
attending adolescents in Ile-Ife, Nigeria
1 Olatunde OE., 1,2
Balogun FM.
Oluwatosin EO 1 ,
Adesegun OF, 2
Morenikeji AK,
3
1 Institute of Child
Health, College of
Medicine,
Akinlolu O,
4
1
University of Ibadan, Ibadan, Nigeria.
PaediatricNeurology Unit, Department Of Paediatrics
2 University College
Hospital, Ibadan, Nigeria
And Child Health, Obafemi Awolowo University,
Email: folushom@yahoo.com
Ile-Ife, Nigeria.
2
Department of Public Health and Community
Background: Sexting
is the
sharing of
sexually sugges-
Medicine, Obafemi Awolowo University, Ile-Ife,
tive or explicit text messages or videos using mobile
Nigeria. Adult Neurology Unit, Department of Internal
3
phone. It has been associated with contrasting things
Medicine, Obafemi Awolowo University, Ile-Ife,
ranging from risky health behaviours to maintaining
Nigeria. Department Of Community Medicine, Osun
4
romantic relationships. Due to the increase in cell phone
State University, Osogbo, Nigeria.
possession among Nigerian young people, it is important
Email: doc_tosino@yahoo.com
to
know their views and experiences with sexting.
Objectives: This
study explored
the experiences
of post-
Background: Sleep
problems have
been reported
to be
secondary young people attending pre-varsity examina-
very common in adolescents in developed countries.
tion preparatory centers in Ibadan regarding sexting.
However, there is a dearth of studies on the sleep pattern
Methodology: This
was a
qualitative study
in which
four
and the types of sleep problems of adolescents in our
focus group discussions and four in-depth interviews
environment.
were conducted among purposively selected young
Objectives: To
determine the
sleep parameters
of Nige-
people and those who engage in sexting respectively.
rian school-attending adolescents and the pattern of
Content analysis of the data was done after transcription.
sleep problems in the adolescents.
Results: Sexting
was described
as rampant
among young
Methods: This
descriptive cross-sectional survey
was
people and it occurs with peers, adults and international
conducted in selected public and private secondary
partners. Sexting occurs usually between opposite sex
schools in Ile-Ife, Nigeria. The adolescents filled the
and it was mostly sent using social media with videos
Adolescent sleep habits survey while a parent-reported
and photos commoner than texts. Males reported send-
questionnaire, the Sleep Disturbance Scale for Children
ing and receiving sext but are of the opinion that females
designed for children and adolescents was used to deter-
request for them. All the females denied ever sending
mine the type of sleep disorders present in the adoles-
sext. Reasons for sexting include to initiate romantic
cents.
relationship, imitate celebrities, get fame and feel ac-
Results: A
total of
346 adolescents
were studied
with a
ceptable by peers. Experienced and witnessed conse-
male to female ratio of 1: 1.1 and a mean age of
quences of sexting include actual sexual intercourse,
13.5±2.29 years. The mean total sleep duration for the
shame, blackmail and attempted suicide. Only two of the
adolescents was 9 hours (h) 08 minutes (m)±113m and 7
participants would allow their parents to see sext sent to
h
15m±86m for weekends and weekdays respectively
them.
with significantly higher values on weekends when
Conclusion: Sexting
was common
among these
young
compared with weekdays ( p= 0.001).
Disorders of initi-
people and it is sent across borders. The implication of
ating and maintaining sleep (DIMS) which encompasses
sexting should be taught in schools to forestall its health
insomnia and circadian rhythm disorders were the most
and legal consequences.
common type of sleep disorder in the adolescents.
Key words: Sexting,
Young people,
Social media
Conclusion and Recommendation:
Disorder of
initiating
and maintaining sleep (DIMS) and circadian rhythm
disorders occur in Nigerian adolescents. Adolescents
have shorter sleep duration than their subjective sleep
need. Therefore, there is a need to educate the adoles-
cents and their parents on the importance of adequate
sleep. Further studies using objective tools are needed.
26
AP
3
dition is enormous. Early diagnosis and prompt manage-
Exploring health workers’ perspective about cervical
ment is vital.
cancer prevention using human papilloma virus
Objective: To
determine the
prevalence of
hypertension
vaccine for adolescents in Ibadan, Nigeria: a
among secondary school adolescents in Gwagwalada
qualitative study
metropolis
Methods: A
multistage sampling
technique was
used to
1,2
1,2
Balogun FM.,
Omotade OO
select 490 secondary school adolescents (10-17years)
1
Institute of Child Health, College of Medicine, Univer-
from 25 secondary school in Gwagwalada. BP measure-
sity of Ibadan, Ibadan, Nigeria. University College
2
ment was done using mercury sphygmomanometer fol-
Hospital, Ibadan, Nigeria.
lowing standard procedure. Hypertension was defined
using the criteria set by the 4 report of the National
th
Email: folushom@yahoo.com.
High Blood Pressure Education Program working group
Background: There
have been
gradual introduction
of
on
hypertension in children. Data were collected using
human Papilloma virus (HPV) vaccine for adolescents
pretested questionnaire.
in
some African countries with the aim of prevention of
Results: A
total of
490 students,
comprising of
200
cervical cancer. The success of this programme in Nige-
males (40.7%) and 291 females (59.7%), M: F ratio of
ria depends on the health care workers in charge of im-
1.1.5, were studied. The overall prevalence of systolic
munization as they wield great influence on parents’
hypertension
was 8.8% while that of diastolic hyperten-
decision
to vaccinate their adolescents.
sion was 9.2%. There was statistically significant differ-
Objectives: This
study explored
the views
of health
care
ence in the gender rates for diastolic hypertension
(
χ =15.04,p=0.002) but not for systolic hypertension
2
workers in charge of immunization about HPV vaccine
for adolescents in selected communities in Ibadan, Nige-
(p=0.911). The prevalence of hypertension increased
ria.
with age, especially among those with overweight and
Methodology: This
was an
exploratory qualitative study
obesity, from 12.3% in early adolescents (10-13years) to
in
which fourteen key informant interviews were con-
27.8% in late adolescents (17-19years).Children with
BMI greater than the 85 percentile had 4.4 times the
th
ducted with two paediatricians, two family physicians,
eight nurses, one health visitor and one social worker.
risk of having hypertension than those with BMI of <
85
percentile.
th
Recorded interviews were transcribed and content data
analysis was done with the aid of the NVivo software.
Conclusion: Elevated
BP is
not uncommon
in appar-
Results: The
HPV vaccine
for adolescents
was accept-
ently healthy school children, especially among those
able to almost all the health care workers but there were
with high BMI, thus regular BP screening and control of
some misconceptions about cervical cancer. Female
obesity among school children is recommend.
healthcare workers tend to have better knowledge about
cervical cancer and HPV vaccine. The main concern
about the vaccine was the high cost and general poor
AP
5
knowledge about the vaccine.
Apart from cost, the
What is killing our adolescents in North East
other challenges envisaged for future HPV vaccine pro-
Nigeria: a 15 year review from Federal Teaching
gramme in Nigeria include completion of the required
Hospital, Gombe.
course and lack of an adolescent health structure to
Isaac WE , Jalo I , Alkali Y , Ghidazuka Y ,Ajani A ,
1
1
1
1
1
reach the adolescents. Few workers will not freely rec-
Iliya A , Oyeniyi C ,Lano M , Popoola A , Ebisike K ,
1
1
1
1
1
ommend the vaccine because of the poor knowledge
Wariri O , Aliu R , Girbo A ,Raymond M ,Ndubuisi V ,
1
1
1
1
1
they
have about the vaccine.
Bakari H , Umar A , Olatoke L , Burak V , Hassan K ,
1
1
1
1
1
Conclusion: The
HPV vaccine
was acceptable
to the
Richard E , Tukur H ,Rabo Y , Ezra D , Bakura H ,
1
1
1
1
1
health workers but there were some identified potential
Daniel A , Mshelia Y , Apollos M
1
2
2
challenges to a successful HPV vaccination programme
i
n
N
i
g
e
r
i
a
.
1
Department of Paediatrics, Department of Health
2
Key words: Immunization
programme, Human
Papil-
Records, Federal Teaching Hospital, Gombe.
loma virus vaccine, Health care workers, Adolescents
Introduction: Adolescence
is the
transition between
childhood and adulthood and it comprises of children
AP
4
between ages 10-18. The mortality rates are low in ado-
Hypertension in secondary school adolescents in
lescents compared to other age groups. It is a period of
Gwagwalada Metropolis
risk taking, immense biologic, psychologic and social
change
Onalo R, Bawa A, Okechukwu A
Aims: To
determine the
causes of
death in
adolescents in
Paediatric Cardiology Unit, Department of Paediatrics,
a
tertiary health facility.
University of Abuja Teaching Hospital, Gwagwalada,
Methodology: A
Retrospective study
using International
Abuja
classification of Diseases (ICD10) based on case notes
Email: richardonalo@yahoo.com
and death certificates of children who died between
2000- 2015 in the facility.
Background: Hypertension
in children
has been
shown
Results: 2888
children died
within the
time period.
to
be on the increase, morbidity associated with the con-
13.0% (376/2888) were adolescents. 55.6% (209/376)
27
were males and 44.4% (167/376) females. 84.0%
strengthening substance use prevention programmes and
(316/376) and 15.7% (59/376) practiced Islam and
implementing regulatory laws on sale and use of
Christianity respectively. 22.6% (85/376) died within 24
substances. Stiffer penalties for offenders are
hours of admission; 41.5% (156/376) between 24 hours
recommended.
to
7 days. Yearly average death is 25. The leading
causes of death included: Injuries 10.1% (38/378);
Eclampsia 7.7% (29/376); HIV/AIDS 6.4% (24/376);
EP
1
Septicaemia 5.9% (22/376); Rheumatic Heart Diseases
Audit of cardiopulmonary arrests among paediatric
5.3% (20/376); Malaria 4.5% (17/376); Tuberculosis
patients at the University College Hospital Ibadan
4.3% (16/376), Acute Pyogenic Meningitis 4.0%
(15/376); Leukaemia 4.0% (15/376), Neoplasms 3.2%
Adeigbe O, Akindolire AE, Tongo OO
(12/376); Chronic Renal Failure 3.0% (11/376); Viral
Department of Paediatrics, University College Hospital,
Hepatitis 2.7% (10/376); Burns 2.7% (10/376); Pneumo-
Ibadan, Oyo State, Nigeria
nia 2.4% (9/376); Sickle cell Anaemia 2.4% (9/376).
Email: abimbola_12@yahoo.com
Conclusion: Injuries
were found
to be
the leading
cause
of
death which is in keeping with global report. Eclamp-
Introduction: Cardiopulmonary arrests
(CPA) in
chil-
sia
related death is probably related to early marriage in
dren
are often fatal and mostly preceded by warning
the
sub region. HIV/AIDS and other infections still con-
signs. Early recognition of warning signs and prompt
stitute a significant cause of mortality. Adolescents
actions may prevent fatality. In order to the improve
health clinics and paediatrics adolescents sub specialty
effectiveness of resuscitation regular reviews are needed
trainings are therefore urgently recommended.
to
audit the procedure and fill in any existing gaps.
Author declare no conflict of interest.
Aim: To
describe the
incidence, events
preceding and
outcomes of paediatric cardiopulmonary arrests at the
University College Hospital, Ibadan.
AP
5
Subjects and methods: This
was an
observational study
Substance use among secondary school adolescents in
of
all paediatric admissions over a 3-month period.
Gwagwalada Area Council, Abuja, Nigeria
Every patient who had a CPA at any time during admis-
sion had their clinical details entered into a structured
Ekop EE, Anochie IC, Airede KI., Obembe A
1
2
1
3
proforma.
Department of Paediatrics, University of Abuja
1
Results: Of
the 886
paediatric admissions (245
neo-
Teaching Hospital, Abuja, Nigeria.
nates), 48 patients (5.4%) had at least 1 episode of either
2
University of Port Harcourt Teaching Hospital,
respiratory or cardiac arrest. There was no isolated car-
Port Harcourt, Rivers State, Nigeria.
diac arrest. There were 60 episodes of respiratory ar-
3
Psychiatry, Usman Danfodio Teaching Hospital,
rests, 10 of which required only bag and mask ventila-
Sokoto, Nigeria.
tion, while 2 had mechanical ventilation and 48 episodes
had accompanying cardiac arrest and had chest compres-
Introduction/Background:
Adolescent substance
use is
sions and IPPV. Neonates accounted for 33(55.0%) of
a
growing epidemic that is placing heavy burdens on
events and majority 48(80.0%) of events occurred in
individuals, families and communities hence the stimu-
under-5s. There was at least one preceding event in 58
lus for this study.
(96.7%) cases: respiratory distress 40(66.7%), circula-
Aim/Objectives: To
determine the
prevalence and
pat-
tory collapse 18(30.0%), deteriorating level of con-
tern of substance use among secondary school adoles-
sciousness 29(48.3%), tachycardia 20(33.3%). Of the 60
cents in Gwagwalada Area Council, Abuja, Nigeria.
events, 52 were not successfully resuscitated, 8 were
Materials and Methods: A
questionnaire-based,
cross-
alive after 24 hours, 3 survived to discharge. Those who
sectional, descriptive study done over a three-month
had longer than 30 minutes of resuscitation all died.
period among secondary school adolescents aged 10 to
Recommendations: Cardio-pulmonary arrests
in children
18
years old after obtaining appropriate ethical approv-
are not usually sudden therefore prompt identification of
als, consent and assent.
warning signs and effective treatment are likely to im-
Results: A
total of
1,196 questionnaires
were analysed,
prove outcome.
of
which 641 (53.6%) were females and 1,052 (87.96%)
from public schools. The overall prevalence rate for
lifetime use was 72.7%. The substance with the highest
EP
2
prevalence rates for lifetime, annual and current use was
Paediatric critical care training in Nigeria: an urgent
kolanut (44.3%, 24.4 and 11.0%, respectively) and low-
gap to fill
est for heroin (0.7%, 0.6% and 0.5%, respectively).
There was a statistically significant male preponderance
Bello O, Akindolire AE, Tongo OO
for licit substance use and a non-statistically significant
Department of Paediatrics, University College Hospital,
female preponderance for illicit substance use. 507
Ibadan, Oyo State, Nigeria
(42.4%) students were single substance users while 363
Email: abimbola_12@yahoo.com
(30.35%) students were multiple substance users. Age at
first use was at ten years of age or less.
Introduction: Majority
of the
causes of
critical illness
in
Conclusion and recommendations:
There is
need for
developing countries such as Nigeria are treatable.
28
Therefore early recognition of critically ill children as
the most common substance. Palm oil (83.3%) and co-
well as proper triage and institution of supportive and
conut water (16.7%) were the commonest forms of
definitive treatment is required to improve outcomes.
home remedies.
Presenting features ranged from mild
There are however no established formal paediatric criti-
symptoms such as fever and vomiting to near fatal
cal care training in Nigeria at preservice and postgradu-
symptoms such as seizures and coma. One patient was
ate levels and learning about critical care is done pas-
managed in ICU. There was no documented mortality.
sively.
Conclusion: Accidental
poisoning remains
a common
Aim: This
study set
out to
evaluate the
knowledge of
cause of presentation to emergency room with kerosene
residents and house officers on identification and triag-
being the commonest agent. Early presentation and
ing of critically ill children.
prompt management will help to reduce mortality.
Subjects and methods: Information was
obtained from
Key Words: Poisoning,
Accidental, Kerosene, Children
resident doctors and house officers using a structured
questionnaire, specific knowledge sought included signs
of
critical illness children, meaning of triage and triage
EP
4
protocols and if they had had any formal teachings in
Morbidity pattern and outcome among under-fives
paediatric critical care.
at the children’s emergency room of federal medical
Results and conclusions: One hundred-and-fifty-six
doc-
center umuahia
tors (28 interns, 92 registrars and 36 senior registrars)
from 27 centres in Nigeria were interviewed. Sixty-
Ibeneme CA, Ezuruike EO, Korie FC, Chukwudi NK,
seven (42.9%) had been taught about recognition and
Ukpabi IK
triaging of critically ill children, 21.9% in medical
Department of Pediatrics, Federal Medical Center,
school and 21% as residents. Seventy (44.9%) were
Umuahia
aware that their centre had triage protocols, but only14
Email: chik4sco@yahoo.co.uk
(9.0%) knew the protocols. Fifty (32.1%) correctly de-
fined triage and 35(22.4%) had good knowledge of the
Background: The
patterns and
outcome of
under-five
signs of critical illness in children. The mean score was
morbidity in health care facilities are invaluable tools
43.09%±1.8 among those who had been taught and
that reflect the disease burden and health care needs of
36.5%±2.5 in those who had not been taught.
the children in the community. Efforts are being made
Recommendations: There
is a
knowledge gap
in identi-
over the past few years to improve child care services in
fying and triaging of critically ill children. It is expedi-
our centre. A preliminary report therefore will assist in
ent to include basic teachings in paediatric critical care
goal-targeted intervention strategies and serve as a base-
in
both preservice and post graduate curricula in Nigeria.
line
for subsequent reviews.
Aim: To
evaluate the
morbidity pattern
and outcome
of
under- fives at the Children’s Emergency Room of the
EP
3
Federal Medical Center (FMC) Umuahia.
Accidental poisoning among under-five children at
Subjects and methods: A
retrospective review
of post-
the children’s emergency room of federal medical
neonatal under-five cases over five years. Information
centre umuahia
such as age, gender, date of admission, final diagnosis
and outcome were analyzed.
Ibeneme CA, Ogbonna IF, Nwala GC
Results: Of
the 5,884
under-fives admitted
over the
Department of Paediatrics, Federal Medical Centre,
study period, 56% were males with a male to female
Umuahia
ratio of 1.2:1. The month of highest admissions was
Email: chik4sco@yahoo.co.uk
January. The leading causes of morbidity were malaria,
diarrheal diseases and respiratory tract infections ac-
Background: Accidental
poisoning among
under-five
counting for 79.9%. Sepsis was the most common mor-
children remains a recognized cause of morbidity and
bidity noted among infants [p< 0.0]. Mortality rate was
mortality with highest rates in low-income countries. Its
4%. Death rate among infants was significantly higher
prevalence and types vary from place to place with pre-
than those beyond infancy, p < 0.01.
senting features ranging from mild to near fatal symp-
Conclusion: Preventable
infections are
the leading
toms.
causes of post-neonatal under-five morbidity in FMC
Aim: To
document the
frequency and
pattern of
acciden-
Umuahia.
tal poisoning among under- fives at the Children’s Emer-
Key
words: Pattern,
Morbidity, Under-fives, Nigeria
gency Room of the Federal Medical Centre Umuahia.
Subjects and methods: A
retrospective review
of cases
of
under-fives with accidental poisoning over 8 years.
Information such as age, sex, type of poison, presenting
features and others were analyzed.
Results: Of
9492 under-fives,
53 (0.6%)
were cases
of
accidental poisoning. Mean age was 21.2 ± 10.1 months.
Male to female ratio was 1.8:1. Mean duration from
incident to presentation was 2 hours. Most common
route of poisoning was ingestion (94.3%). Kerosene was
29
EP
5
and death certificates of children who died between
Respiratory illnesses presenting to the cher of a
2000- 2015 in the facility using simple hierarchical ap-
tertiary hospital in south-east nigeria: a retrospective
proach in Federal Teaching Hospital, Gombe
study
Results: Children
constituted 31.0%
(2888/9294) of
total
hospital deaths. 55.5% (1602/2888) were males and
Ofiaeli OC*, Ndukwu CI*, Nri-Ezedi C*, Ofiaeli
44.5% (1285/2888) females. Neonates, Infants, Tod-
OAR**
dlers, Pre-school, School age and Adolescents consti-
*Department of Paediatrics, NAUTH, Nnewi.
tuted 49.5% (1431/2888), 13.9% (404/2888), 11.6%
**Department of Microbiology, NAUTH, Nnewi.
(335/2888), 3.7% (106/2888), 7.9% (231/2888) and
Email: ofiaeliogochukwuchioma@gmail.com
13.0% (376/2888) respectively. 26.5% (751/2888) died
within 24hrs on admission; 50.4% (1428/2888) died
Introduction :
Respiratory illnesses are
a major
cause of
within seven days; 10.3% (290/2888) died after 14 days
morbidity and mortality in children worldwide.
of
admission. Birth Asphyxia 15.7% (456/2888), Low
Aim and Objectives: The
aim of
this study
was to
deter-
Birth Weight 8.4% (243), Neonatal Sepsis 6.0% (176),
mine
the respiratory illnesses that had presented to the
Congenital malformations 6.0% (176), Preterm Low
Children Emergency Room (CHER) of Nnamdi Azikiwe
Birth Weight 4.8% (141), Malaria 4.7% (137), HIV/
University Teaching Hospital, Nnewi, a tertiary hospital
AIDS 4.2% (123), Septicaemia 4.0% (118), Protein En-
in
South-East Nigeria, from July 2011 to June 2016.
ergy Malnutrition 3.4%(99), Pneumonia 3.2% (93), Bac-
Age
and gender distribution of these presentations as
terial meningitis 2.7% (79), Injuries 2.1% (61), Neonatal
well as out come of admission within 72hrs in the
Jaundice 2.1% (61), Rheumatic Heart Disease 1.8%
CHER were also sought for.
(54), Tuberculosis 1.6% (49), Tetanus 1.5% (42), Diar-
Methods :
Health records
of all
children presenting
over
rhoea disease 1.4% (41), Meconium Aspiration Syn-
a
60 month period were accessed and analyzed.
drome 1.3% (38), Intestinal Obstruction 1.3% (38),
Results :
A total
of 4622
children had
been admitted
into
Burns 1.2% (35)
the CHER OF NAUTH, Nnewi over the specified pe-
Conclusion: Infections
and Newborn
related deaths
ac-
riod. Six hundred and sixty-eight (14.45%) had an Acute
counted for two-third of total child hood deaths. Highly
Respiratory Illness. Age range of the children was I
impactful interventions in maternal and child health
month to 16 years, mean age was 2.33 years (SD 3.56
should be implemented.
years), median age was 1 year and the most frequent age
Author declares no conflict of interest.
among the children who had presented with a respiratory
illness was 1 year. The most common diagnosis was
Bronchopnuemonia - 273 cases (40.87%); followed by
Factors Influencing Health Care Seeking Behaviour
Bronchiolitis, Aspiration pnuemonit is and Acute
in Caregivers of Children Who Present in an
Asthma (11.68 %, 6.59% and 3.44% respectively).
Out-Patient Clinic of a South-East Tertiary Center
There was equal gender distribution among the modal
in Nigeria
age of presentation. Majority of the cases were trans-
ferred to the ward for continued care within 72hrs of
Nri-Ezedi CA*, Ndukwu CI*, Ofiaeli OC*, Ulasi AE*
admission - 367 (54.94%) while 54 (8.08%) died. Both
*Department of Paediatrics, Nnamdi Azikiwe University
age and gender had no significant relationship with out-
Teaching Hospital, Nnewi.
come of 72hours of admission in CHER (P>0.05).
Email: chisomnriezedi@gmail.com
Conclusion :
Prevalence of
ARIs among
toddlers is
still
unacceptably high. Efforts have to be re-enforced in
Introduction: An
optimal health
seeking behaviour
of a
order to reduce the negative impact of respiratory illness
caregiver is essential in the preservation of good health
on
child health and survival in the sub region.
in
any child.
Key Words: Respiratory
illness, CHER
Objectives: To
determine the
factors influencing
health
seeking patterns among caregivers who present with
their wards to the Children’s Out -Patient clinic of
Top 20 causes of death in children of all ages in a
Nnamdi Azikiwe University Teaching Hospital, Nnewi.
tertiary health facility in North East Nigeria: a 15
Methods: A
cross-sectional study that
investigated the
year review
demographic and socioeconomic factors influencing
health seeking behaviour among caregivers using a pre-
Isaac WE , Jalo I , Alkali Y , Ghidazuka Y ,Ajani A ,
1
1
1
1
1
tested modified study questionnaire.
Iliya A , Ndubuisi V ,Oyeniyi C ,Lano M , Popoola A ,
1
1
1
1
1
Results: 116
subjects were
recruited, of
which 32
Ebisike K , Wariri O , Aliu R , Girbo A ,Raymond M ,
1
1
1
1
1
(27.6%)
were
males
and
84
(72.4%)
females
(p<0.0001). The age range was 24-51 years with a mean
Bakari mortality in children in Nigeria. The North-East
age of 38.6 years, SD ±9.7 years. In event of ill health in
geopolitical zone of the country has the worst child
their wards, 50% of participants reported seeking treat-
survival figures
ment first in a formal health care facility while 48% did
Aim: To
determine the
causes of
death in
children of
all
not (24.7% opting for self treatment and 23.6% the pat-
ages in a tertiary health facility.
ent medicine dealer). Multivariate analysis revealed sig-
Methodology: A
Retrospective study
using International
nificant predictors influencing visits to a formal health
classification of Diseases (ICD10) based on case notes
care
to include being a Christian of the Anglican sect,
30
tertiary education of the father and owing a private
tions during our study, 52 who were clinically suspected
means of transport. In contrast, age, gender, distance to
of
rubella benefited (all except two) from the rapid ru-
the nearest health facility and use of media played no
bella serum testing with five positive results. In the five
role.
cases, a congenital rubella syndrome was found with the
Conclusion: Religion,
educational status
of the
father
following epidemiological and clinical profile: 24 years
and means of transport are the leading predictors influ-
old as mean mother age, incomplete or absent follow up
encing appropriate health seeking behaviours. This calls
of
the pregnancy (100%), no history of rubella vaccina-
for a need to re-strategize in other to enhance compli-
tion (100%), all newborns were female and had cataract,
ance in formal health care facilities among caregivers.
either hypotrophy or microcephalia and/or cardiac mal-
Keywords:
Health
seeking
behaviour,
caregiver,
formation was present in three out of five cases. None of
NAUTH
our
patients has done antenatal diagnosis of rubella.
Conclusion: La
rubéole est
associée ŕ
6% des
malforma-
tions congénitales dans notre contexte. D’autres études
Neonatology
de
plus grande envergure devraient confirmer cette si-
Congenital rubella: a reality in Mali
tuation et suggérer l’introduction du vaccin anti -
rubéolique
dans le programme élargi de vaccination.
Dicko-Traoré F, Diakité AA, Ouattara A, Diall H, Cou-
Conclusion: Rubella
is associated
with 6%
of the
con-
libaly O, Koné I, Maďga L, Sidibé L, Konaté D, Belco M,
genital malformations in our context. Large studies are
Sacko K, Diakité FL, Traoré F, Hamadou I, Sylla M
needed to elucidate and to confirm our findings to sup-
Department of Paediatrics, CHU Gabriel Touré,
port a policy introducing rubella vaccination into the
Email: fatdickoped@gmail.com
vaccination schedule National immunization
programme.
Introduction: La
vaccination contre
la rubéole
n’est pas
Mots clés : Rubéole congénitale, Programme élargi de
incluse dans le programme élargi de vaccination au Mali
vaccination, Mali
et
le dépistage pendant la grossesse n’est pas systémati-
Keywords: Congenital
rubella, vaccination schedule
que. Notre travail avait pour but de déterminer la place
National immunization programme, Mali
de
la rubéole congénitale chez les nouveau-nés hospitali-
sés
pour malformations.
Neither is the rubella vaccine included in the vaccination
Prevalence of congenital malaria in newborns of
schedule
National
immunization
programme
mothers with HIV/ malaria co-infection in Benin
( Programme
elargi de
vaccination, PEV ) nor its
screen-
City
ing during pregnancy is systematic in Mali. The goal of
this study was to determine the frequency of congenital
Eki-udoko FE, Sadoh A, Ibadin MO, Omoigberale AI
rubella among inpatient newborn admitted in the depart-
ment of pediatrics for malformations.
Background: HIV
infection and Plasmodium
falciparum
Méthodologie: Il
s’est agi
d’une étude
transversale, des-
malaria co-infection complicate about one million preg-
criptive qui s’est déroulée du 1 octobre 2015 au 31
er
nancies in sub-Saharan Africa yearly. Congenital ma-
janvier 2016 dans le service de néonatologie du CHU
laria is known to have deleterious effects on newborns.
Gabriel Touré de Bamako. Tous les nouveau-nés chez
Little is known about the effects of this co-infection on
qui l’hypothčse clinique de rubéole congénitale a été
the prevalence of congenital malaria in infants delivered
évoquée ont été inclus et ont bénéficié d’un test sérolo-
to
this group of women. This study was carried out to
gique rapide de rubéole.
determine the prevalence of congenital malaria in new-
We
conducted a descriptive, cross sectional study from
borns of mothers with HIV/malaria co-infection in Be-
October 1 , 2015 to January 31 , 2016 in the department
st
st
nin-City.
of
neonatology at the University hospital Gabriel Touré
Methods: Subjects
were 162
newborns of
HIV/malaria
in
Bamako, Mali. All newborns suspected of congenital
co-infected mothers
Controls were 162 newborns of
rubella clinically were recruited to our study and bene-
HIV negative malaria infected mothers. Blood film for
fited from a rapid rubella serum testing.
malaria parasites was done on cord blood and peripheral
Résultats: Quatre
vingt trois
nouveau-nés ont
été admis
blood on days 1, 3 and 7 in the newborns. Maternal pe-
pour malformations pendant la période de l’étude. Chez
ripheral blood film for malaria parasite was done at de-
52, l’hypothčse clinique de rubéole a été évoquée et 50
livery and placental tissue was obtained for confirmation
ont
bénéficié d’un test sérologique. Cinq tests sont reve-
of
placental malaria by histology. Diagnosis of malaria
nus positifs soit 6% des malformations.
in
blood films was by light microscopy.
Dans les cinq cas, un syndrome de rubéole congénital a
Results: The
prevalence of
congenital malaria
in
été retrouvé avec le profil épidémio-clinique suivant :
subjects (34.6%) was significantly higher than the
âge maternel moyen de 24 ans, grossesse non ou mal
22.2% noted among controls (p=0.014). Profound im-
suivie (100%), absence de vaccination anti-rubéolique
munosuppressive state (maternal CD4 cell count < 200
cell/mm ) was significantly associated with prevalence
3
(100%), nouveau-né de sexe féminin (100%), hypotro-
phie
(3cas), microcéphalie (3cas), cataracte (100%),
of
congenital malaria (p=0.006)
malformation cardiaque (3cas). Le diagnostic anténatal
The major predictors of the occurrence of congenital
n’avait été fait chez aucun des patients.
malaria among the subjects were maternal CD4 cell
count < 200 cell/mm and placental malaria while for the
3
Results :Among
83 newborns
admitted for
malforma-
31
controls it was maternal placental only.
Survival of Extreme Preterm Neonates in a Tertiary
Conclusion: Babies
born to
HIV/malaria co-infected
Hospital in South West Nigeria
mothers are at increased risk for congenital malaria
Fajolu IB,* Akintan PN, Ezenwa BN,* Ezeaka VC*
+
+
+
+
therefore all babies born to HIV positive mothers should
be
screened for congenital malaria and managed as
*Department of Paediatrics, College of Medicine, Uni-
appropriate.
versity of Lagos, Idi-Araba, Lagos.
+
Department of Paediatrics, Lagos University Teaching
Hospital, Idi-Araba, Lagos.
Improvement of preterm survival in Lagos Univer-
Email: iretifaj@yahoo.co.uk
sity Teaching Hospital post review of unit protocol
Background: Guidelines
regarding resuscitation of
Uche Anene-Nzelu, Fajolu IB, Akintan PE, Ezeaka VC,
extreme preterm neonates (delivered before 28 weeks
Ezenwa BE
gestational age (G.A) and their survival vary from coun-
Neonatology/Perinatology Unit, Department of
try to country. This group of babies also contributes sig-
Paediatrics
nificantly to neonatal, infant and overall under-five mor-
Lagos University Teaching Hospital, Idi-Araba, Lagos
tality. Age of viability is still regarded by many health-
care providers in Nigeria as 28 weeks G.A and deliver-
Introduction: Preterm
deaths directly
contribute 28%
to
ies before this are considered as abortions. Improved
neonatal deaths globally. Use of prenatal steroids, sur-
survival of these babies has been documented over the
factant and bubble continuous positive airway pressure
years in more developed countries. Documentation of
(CPAP) has significantly improved preterm outcome.
the current survival rate of this group of babies is thus
Other factors like early feeding, use of amino acids has
important to help develop guidelines for their manage-
contributed to their improved survival.
ment and revisit the age of viability.
Objective: To
compare the
outcome of
preterm neonates
Objective: To
document survival
and factors
associated
admitted in the inborn neonatal unit of Lagos University
with mortality in extreme preterm infants admitted in a
Teaching Hospital pre and post revision of unit protocol
tertiary hospital in south West Nigeria.
for the management of preterm neonates with gestational
Subject and Methods: A
retrospective review
of delivery
age <34weeks.
and admissions records of extreme preterm neonates
Method: A
retrospective comparative study.
Data was
delivered at 24 weeks to 27 weeks+6 days G.A and ad-
obtained from hospital records from January 2010 to
mitted in the neonatal unit of the hospital. Data obtained
June 2013 (previous protocol) and August 2013 -June
included G.A, mode of delivery, birth-weight, outcome
2017 (new protocol). The protocol review added use of
and duration of admission.
improvised bubble CPAP, use of intravenous amino
Results: Eighty
six (2.75%)
of the
3125 admissions
dur-
acids and early enteral feeding with expressed breast
ing the study period were extreme preterm neonates;
milk to existing practice such as provision of extra
twenty six (30.2%) of extreme preterm neonates sur-
warmth with Kangaroo mother care and treatment of
vived. Forty seven of these deaths (78.4%) were early
infections.
neonatal deaths. Factors significantly associated with
Results: There
were 286
and 376
preterm admissions
mortality were low birth weight, booking status, low
with gestational age <34 weeks pre (January 2010 to
G.A and short duration of admission.
June 2013) and post protocol review (August 2013 –
Conclusion: Extreme
preterm neonates
have a
moderate
June 2017) respectively. Twenty-one babies were ex-
chance of survival in Nigeria and age of viability should
cluded for incomplete data. There was a significantly
be
revisited.
lower preterm mortality in the post protocol review pe-
Keywords: Extreme
preterm; survival,
age of
viability.
riod compared to the preceding period -32.4% and
42.4% respectively (p=0.01). Early neonatal deaths in
the pre-and post-revision periods were 90.8% and 67.2%
Neonatal deaths in north east Nigeria: 15 years tale
respectively (p=0.00). Majority of the deaths were in
from a tertiary hospital
extreme preterm neonates.
Isaac WE , Jalo I , Alkali Y , Ghidazuka Y , Ajani A ,
1
1
1
1
1
Conclusion: In
resource-poor countries like
Nigeria,
Girbo A , Iliya A , Oyeniyi C , Lano M , Popoola A ,
1
1
1
1
1
adapting protocols and using appropriate technology can
Ebisike K , Wariri O , Aliu R , ,Raymond M , Ndubuisi
1
1
1
1
tremendously improve the outcome of preterm neonates.
V , Bakari H , Umar A , Olatoke L , Burak V , Hassan
1
1
1
1
1
Keywords: Preterm
survival; management protocol
K , Richard E , Tukur H , Rabo Y , Ezra D , Bakura H ,
1
1
1
1
1
1
Daniel A , Mshelia YS , Apollos M
1
2
2
1
Department of Paediatrics, Department of Health
2
Records, Federal Teaching Hospital, Gombe
Introduction: Nigeria’s
neonatal mortality
rate is
one of
the highest in the world. More than a quarter of the
estimated 1 million children who die under the age of 5
years annually in Nigeria die during the first 28 days of
life.
32
Aim: To
determine the
causes of
neonatal death
in a
ter-
weight, length, Apgar score, and type of birth injury.
tiary health facility
The treatment administered to the patients were either
Methodology: A
Retrospective study
using International
medical management such exchange blood transfusion
classification of Diseases (ICD10) based on case notes
in
case of severe Jaundice complicating cephalhaema-
and death certificates of children who died between
toma and/or simple transfusion for anaemia without
2000- 2015 in the facility using simple hierarchical ap-
complication, phototherapy, antibiotics, among others,
proach in Federal Teaching Hospital, Gombe
or
surgical/orthopaedic treatment in the presence of sur-
Results: 49.5%
(1431/2888) of
childhood deaths
oc-
gical injury. Statistical analysis was done using SPSS
curred in newborns. Males were 55.6% (797/1431) and
version 16 (SPSS Inc., Illinois, Chicago USA). A P-
44.3% (634/1431) females. 24.5% (351/1431), 63.0%
value <0.05 was considered statistically significant.
(902/1431), 7.5% (108/1431), 4.8%(70/1431) died in the
Results: Sixty
one out
of 1078
admitted to
SCBU during
first 24 hours, within 1 - 7 days, 7 - 14 and 14-28 days
the 12 months period of the study had different types of
of
life
respectively.
26.3%
(371/1406),
56.1%
birth injuries giving an incidence of 5.7/1000 live births,
(790/1406), 11.9% (168/1406), 4.3% (61/1406) and
p
< 0.0001. Soft tissue injury constituted the majority
1.1% (16/1406) died within 24 hours of admission, 1-7
accounting for 37/61 (60.7%), closely followed by sub-
days, 7-14 days,14-28 days and >28 days of admission.
conjunctival haemorrhages 25/61 (41.0%). Severe peri-
Leading primary causes of death include; Birth asphyxia
natal asphyxia also constituted significant proportion of
31.8%
(456/1431),
Low
Birth
Weight
16.8%
the birth injury 24/61 (39.3%). Other central nervous
(241/1431), Neonatal sepsis 11.9% (170/1431), Preterm
system (CNS) birth injuries includes facial nerve palsy
Low Birth Weight 9.5% (136/1431), Neonatal Jaun-
and Erb’s palsy 13.1% each. The commonest of the frac-
dice3.9%
(56/1431),
Multiple Congenital Malforma-
tures was femoral bone fracture 9/61 (14.8%), followed
tion3.6% ( 52/1431), Meconium Aspiration Syndrome
by
clavicular fracture 5/61 (8.2%). It was revealed that
2.5% (36/1431), Gastrochisis 2.0% (28/1431), Myelo-
urea 2.5 mmol/L, total serum bilirubin (TSB) 12.4 μ mol/
meningocoele
1.7%(25/1431),
Intestinal
Obstruc-
L
and random blood sugar 2.6mmol/L were deranged in
tion1.6% (24/1431), Neonatal Tetanus 1.5% (21/1431),
those neonates with three or more birth injuries and all
Imperforate Anus 1.1% (16/1431), Vitamin K deficiency
the three parameters were statistically significant
bleeding 1.1% (16/1431), Meningitis 1.0% (14/1431),
p<0.05. The common complications encountered in
Omphalocele 0.8% (12/1431).
these patients were jaundice, anaemia and sepsis though
Conclusion: Coordinated
efforts and
provision of
afford-
were
not statistically significant P >0.05. Four patients
able
and quality health care for every mother and child
died, two with internal organ injury were, of which one
are top priorities in Nigeria.
with splenic rupture and the other one with liver damage
in
addition to severe perinatal asphyxia died while the
remaining two patients with severe perinatal asphyxia
Incidence and characteristics of neonatal birth
also died with mortality rate of 6.6%.
injuries in Maiduguri, north-eastern Nigeria
Conclusion: The
incidence of
birth injury
has decreased
overtime especially in the affluent economy where ob-
Simon P , Ibrahim HA , Bello AI , Abubakar GF
1*
1
1
1
stetric and perinatal diagnosis has remarkably improved,
1
Machoko Y , Mustapha B
1
but in the developing economy like ours as demon-
1
Department of Paediatrics University of Maiduguri
strated in this study such an improvement is yet to be
Teaching Hospital, Maiduguri, Nigeria
achieved. However, education of the general populace
*Email: simonpius2000@yahoo.co.uk
especially the pregnant women so that they attend ante-
natal care and deliver at health facility with skilled
Background: Birth
injury is
defined as
impairment of
health personnel will remarkably reduce birth injury.
neonate’s body function that occur due to mechanical
forces during the process of delivery. Incidence of birth
injury varies from place to place, with place of delivery,
Perinatal Asphyxia in University of Abuja Teaching
experience of birth attendants, and mode of delivery.
Hospital: A 3-year Retrospective study
Objective: To
determine the
incidence, characteristics of
birth injury in the Special Care Baby Unit of the Univer-
Olateju K, Onalo R
sity of Maiduguri Teaching Hospital (UMTH).
Neonatal Unit, Department of Paediatric, University of
Subjects and methods: This
is a
prospective observa-
Abuja Teaching Hospital, Gwagwalada, Abuja
tional study that was conducted in a Special Care Baby
Email: oeyinade@yahoo.com
Unit (SCBU) of the University of Maiduguri Teaching
Hospital. The subjects were recruited between 1st Janu-
Background: Perinatal
asphyxia, a
common neonatal
ary, 2016 and 31st December, 2016. Neonatal birth in-
condition in resource-constrained countries, contributes
jury was diagnosed based on paediatrician or senior reg-
significantly to neonatal morbidity and mortality.
istrar examination. Demographic variables: maternal
Objective: To
determine the
prevalence and
outcome of
age, maternal weight, and height, reproductive and la-
babies admitted with perinatal asphyxia.
bour variables: prenatal care, parity, gestational age,
Methods: Medical
records of
babies admitted
with Ap-
presence and duration of PROM, duration of labour,
gar scores of 6 and below or inability to cry at birth be-
type of delivery, and skill of delivery attendance, while
tween 2011 and 2013 were retrieved. Relevant informa-
neonatal variables, includes: neonatal age, sex, birth
tion extracted included age at presentation, gender, place
33
of
birth, gestational age, obstetric complications and
Knowledge of health professionals on newborns’
outcome
of management at discharge, at 3 months and at
intensive care in health district centers in Bamako,
6
months of life.
Mali
Results: There
were 191
babies with
documented evi-
Dicko-Traoré F , Sylla M , Diakité AA , Traoré Y ,
1
1
1
2
dence of moderate to severe asphyxia over the study
Diall H, Coulibaly O , Sidibé L , Hamadou I , Maďga L ,
1
1
1
1
period, 110(57.6%) were males, 81(42.4%) were fe-
Sacko M , Traoré K , Sagara S , Sidibé T , Keita MM
1
1
1
1
1
males, 134 were inborn and 57 were out born. 152 pre-
1
sented within 24 hours of life, 80 of whom were admit-
Département de pédiatrie, CHU Gabriel Touré,
ted within 1hour. Total hospital delivery was 6,036, giv-
Bamako
2
ing a hospital prevalence of 22 per 1000 live births.
Département de gynécologie-obstétrique, CHU Gabriel
Complications while on admission were metabolic aci-
Touré, Bamako
dosis (72), anaemia (18), acute kidney injury (1) and
Email: fatdickoped@gmail.com,
asphyxia cardiomyopathy (1). At discharge, 123 were
normal, 29 had residual hypotonia while 34(17.8%)
Objective: In
this study,
we aimed
to evaluate
the
died. At 3months of life, 10 had evolving cerebral palsy
knowledge level of the health professionals on new
while at 6months, 8 had cerebral palsy, 2 were deaf and
borns’ intensive care.
1
had visual impairment.
Material and Methods: We
interviewed 474
health pro-
Conclusion: Perinatal
asphyxia remains
a significant
fessionals about newborns’ intensive care at the six
cause of neonatal morbidity and mortality in this envi-
health district centers and the university hospital Gabriel
Touré from March 20 to April 20 , 2016.
th
th
ronment. Neurologic deficit is the most common long-
term sequelae. Measures at limiting these complications
Among 474 interviewees, the sex ratio was 0.52; about
are recommended.
70% were from a department of gynecology and obstet-
rics in Bamako and 41.4% had no training on newborns’
intensive
care. Eighty nine percent (89%) of the inter-
Correlation
between transcutaneous bilirubin (TcB)
viewees regardless of their background considered a low
and total serum bilirubin (TSB) in term Nigerian
APGAR score as an indication of intensive care
neonates with jaundice.
(p=0.1583). Among 54% of those who had a good aspi-
ration technique, nurses and mid-wifes at the district
health centers were the best (p=10 ). The indication and
-4
Lawan MT, Audu LI, Mukhtar-Yola M, Shatima DR
rhythm of assisted respiration were known to 30.2% and
Background: Total
serum bilirubin
(TSB) measurement
16% of the interviewees, respectively; About assisted
is
the objective means of assessing severity of neonatal
respiration, 34% thought oxygen should be delivered
jaundice, however, it involves bloodletting. Transcuta-
systematically and the lowest level of knowledge on was
neous bilirubin (TcB) measurement is a non-invasive
among the general physicians (p=0.0063 for the indica-
tion of oxygen and p=10 for its technique). Among the
-4
reliable alternative. There is paucity of data on the per-
formance of TcB, measured with JM-103, in term Nige-
28.5% who knew best the indication of adrenaline, pe-
ria neonates.
diatricians and OBG specialists had the best scores
(p=10 ).
-4
Objectives: To
determine the
correlation between
TcB
and TSB in term Nigerian neonates.
Conclusion: The
knowdelge level
of the
health profes-
Methodology: Consecutive
jaundiced babies
were re-
sionnals on newborns’ intensive care is low in Bamako.
cruited at the National Hospital, Abuja. Using JM-103,
Additional studies are necessary to determine the causes
TcB levels were measured within 5 minutes of blood
to
guide the training strategy on the care to newborns.
sampling for TSB. The TSB was measured by diazo
Keywords: Intensive
care, newborn,
knowledge, Ba-
method.
mako
Results: Four
hundred and
sixty pairs
of TSB
and TcB
were obtained from 297 neonates, aged 1-14 days. The
mean age, gestational age and birth weight were 4.2
Audit of the documentation of admission clerkings
(2.1) days, 38.3 (1.1) weeks and 3.2 (0.5) Kg respec-
into special care baby unit of Usmanu Danfodiyo
tively. There were 169 (56.9%) males and 126 (43.1%)
Universty Teaching Hospital, Sokoto
females. The mean of TcB of 205.2 (53.4) µmol/L was
Adamu A , Isezuo KO , Onankpa BO , Mohammad A ,
1
1
1
2
higher than the mean of TSB of 201.0 (55.9) µmol/L,
Ibitoye PK , Ugege MO , Jiya FB
1
1
1
although the difference was not statistically significant
(p
= 0.244). The correlation coefficient (r) between TcB
Department of Paediatrics, Usmanu Danfodiyo
and TSB was 0.89.
University Teaching Hospital, Sokoto.
Conclusion: Transcutaneous
bilirubin strongly
corre-
Department of pharmacology, Usmanu Danfodiyo
lated with total serum bilirubin in term Nigerian neo-
University, Sokoto.
nates.
Email: nanadamu@gmail.com
Background: Medical
record is
valuable for
research,
audit and medico legal purpose but its primary function
is
for patient care. Omissions in doctors clerking can
lead to multiple errors. Majority of hospitals in Nigeria
34
have limited resources and cannot afford electronic
ables were tested using Chi – Square and Fisher’s exact
medical recording, therefore there is need to maintain
tests.
the quality of existing hand written records.
Results: Two
hundred and
ten babies
were recruited,
this
Objective: To
assess the
omissions in
doctors clerking
of
comprised 117 (55.7%) males and 93 (44.3%) females,
neonates admitted into Special Care Baby Unit (SCBU)
giving male to female ratio of 1.3:1. In-born babies were
of
Usmanu Danfodiyo University Teaching Hospital,
69
(32.9%), while 141 (67.1%) were out-born. There
Sokoto.
were 79 (37.6%) preterms, 124 (59.1%) term and 7
Method: This4-month
prospective study
reviewed ad-
(3.3%) post-term babies. Out of the 210 blood cultures
mission records by different cadre of doctors into the
studied, 102 yielded positive growth of bacterial agents
SCBU from 1 February to 31 May 2015. A preformed
st
st
giving an overall isolation rate of culture proven sepsis
checklist was used to assess the clerkings. The type and
as
48.6%.
percentages of missing data were noted. Data was
The
predominant bacteria isolates were Staphylococcus
analysed using SPSS version 20.
aureus in 48 (47.1%) and Klebsiella pneumoniae 25
Result: One
hundred and
sixty clerkings
were reviewed.
(25.5%). Others included, Pseudomonas aeruginosa 13
There was no identity of the admitting doctor seen in 35
(12.7%), Escherichia coli 8 (7.8%) and Enterococcus
(21.9%). Date of consultation was documented in 150
faecalis 4 (3.9%). The frequently isolated bacteria in
(93.7%) but no time of consultation in 37(23.1%). one
both
early onset and late onset neonatal sepsis were
hundred and forty two (88.8%) had the patients name
Staphylococcus aureus and Klebsiella pneumonia.
written in full on the first page, but no patients name and
Staphylococcus aureus was highly sensitive to mero-
page
numbering on subsequent pages in 110(68.8%) and
penem and cefuroxime, while Klebsiella pneumonia to
135(84.4%) of clerkings. Address and age of patients
amikacin as well as meropenem.
were not documented in 95(54.4%) and 55(34.4%) of
Conclusion: Commonest
bacteria isolates
in neonatal
the medical notes respectively. Omitted examination
sepsis at NHA were Staphylococcus aureus and Kleb-
findings included weight 16(10.0%), length 30(17.5%),
siella pneumonia and a combination therapy with cefu-
gestational age 77(48.1%), respiratory rate 18(11.3%)
roxime and amikacin or monotherapy with meropenem
and heart rate 16(10.0%).
are recommended for the treatment of neonatal sepsis at
Conclusions/ Recommendation: The study
revealed
the National Hospital Abuja.
suboptimal clerking and documentation by doctors, we
Key words: Neonates,
sepsis, bacteria
isolates, antibi-
recommend the introduction of a standard clerking tem-
otic sensitivities, national hospital Abuja.
plate, electronic clerking template and recording device
to
minimise clerking omissions.
Key Words: clerking,
documentation, doctors, omis-
Comparative outcome of intervention in severe
sions, SCBU, Sokoto.
neonatal jaundice using total body phototherapy
application
1,3,5
R ,
3
IL ,
2
Bacteria isolates and respective antibiotic sensitivities
Amadi
HO
,
Mohammed
Abdullahi
Ezeanosike O , Olateju EK , Ibekwe MU , Umar S ,
4
5
4
3
in neonatal sepsis at the national hospital Abuja
3
Okechukwu AA , Bello A
5
1
2
Kefas JG, Audu LI, Ogala WN, Iregbu KC, Otuneye AT,
Imperial College London United Kingdom,
FMC
Nguru Nigeria, Maternal & Neonatal Hospital Minna
3
Mairami AB, Mukhtar MY, Obaro SK.
4
FETH
Abakaliki,
5
Email: daujibir@gmail.com
UATH
Gwagwalada
FCT
Email: h.amadi@imperial.ac.uk
Background: Neonatal
sepsis remains
prevalent, and
currently causes 30 – 50% of neonatal deaths. Correct and
Background: Neonatal
jaundice is
very common
among
timely identification of infectious agents of neonatal
term and preterm babies in Nigeria. This constitutes a
sepsis, as well as their respective antibiotic sensitivity
significant portion of morbidity especially amongst Afri-
patterns are essential to guide empirical and definitive
can neonates. Jaundice is commonly treated with the
antibiotics therapy.
application of phototherapy whilst neonates lay supine,
Aim: To
identify bacterial
pathogens causing
neonatal
often with effective exposure of less than one half of the
sepsis at the National Hospital, Abuja (NHA) as well as
body surface. A more invasive EBT procedure is addi-
determine their respective antibiotic sensitivities.
tionally executed in cases of severe jaundice. Total body
Methods: Two
hundred and
ten babies
were recruited
exposure in phototherapy intervention is uncommon in
consecutively over a six-month period at the neonatal
Nigeria.
unit of NHA, blood samples taken for blood culture, as
Aim: The
aim of
this study
was to
compare the
effective-
well as full blood count and micro Erythrocyte Sedimen-
ness of a total body exposure technique against the con-
tation Rates. Blood culture samples were analyzed using
ventional technique of partial exposure plus EBT.
the BACTEC – 9050 automated blood culture system,
Methods: Twenty
available recent
severe neonatal
jaun-
microbiological study to identify the organisms as well
dice cases from two tertiary SCBUs across Nigeria;
as
determining their respective antibiotic sensitivities
namely Northern-FMC. Nguru (C1) and Southern-
were performed. In addition, where indicated, other
FEHT. Abakaliki (C2), were extracted from Records and
body fluids were taken for microbiological analysis.
studied as Control-groups. Eleven other cases were ex-
The data was analyzed using SPSS version 18, and vari-
tracted from the SCBU of Maternal-&-Neonatal Hospi-
35
tal Minna (T) as Test-group. The method of Control-
An Uncommon Neonatal Exanthem: Disseminated
group intervention was by conventional phototherapy
Neonatal Varicella (Chickenpox)
while that of the Test-group was by total body exposure
using the Firefly phototherapy system (MTTS Asia, Ha-
Hassan L, Adewumi OA, Abdullahi FL, Abdulkadir I,
noi Vietnam). Any additional EBT intervention was
Ogala WN.
noted in the two groups. Total serum bilirubin (TSB)
Neonatal unit, Department of Paediatrics, Ahmadu
above 12.5 mg/dL was treated as severe. Efficiency of
Bello University Teaching Hospital, Zaria, Kaduna
intervention was considered on the basis of the duration
State.
of
time taken for a severe case to downgrade to mild at
Email: elteehassan@yahoo.com.
below 12.5 mg/dL.
Results: Averages
were: Neonate’s
postnatal age
in days
Introduction: Active
maternal varicella
infection with
for T-group was 5±1 (C1=5±4, C2=7±5); GA in weeks
Varicella Zoster virus during the last 3 weeks of preg-
(T=36, C1=37±1, C2=36±4); BW in kg (T=2.6±0.5,
nancy or within the first few days postpartum may result
C1=2.9±0.4,
C2=2.8±0.9).
Pre-intervention
TSB
in
severe congenital neonatal chickenpox. Although not
(T=19±4, range 13-25; C1=24±11, range 14-35;
a
common cause of perinatal infections with an inci-
C2=18±3, range 13-21). Intervention duration in days
dence of 0.7/100,000 live births, outcome could be poor
(T=3±1, C1=6±4, C2=4±2). Fraction given EBT-
with
a case fatality of 30-50%.
intervention (T=0%, C1=100%, C2=71%).
Objective: To
highlight this
rare condition
in the
new
Conclusion/Recommendation: Total body
exposure was
born, the first of such in our centre and bring to the fore
quicker and safer and rarely required the extreme inva-
the management challenges.
sive measure of EBT. This technique is recommended
Case report: A.M
was a
12 day
old male
neonate re-
for rapid reduction of neonatal morbidity in Nigeria due
ferred from a peripheral hospital on account of a 3 day
to
jaundice.
history of fever, 2 days of generalized body rash, fast
breathing, cough, abdominal distension and inability to
suckle of a day’s duration. Pregnancy was essentially
.
Bilateral Congenital Anopthalmia And Congenital
uneventful up until 3 days prior to delivery when mother
Heart Disease in a Child with Family History of
developed a high grade fever and intrapartum, a rash
Consanguinity and Anopthalmia Seen at a Tertiary
manifested
a
few
hours
to
delivery.
Hospital in Sokoto, North western Nigeria
On
examination, he was acutely critically ill, with gener-
alized macula, papulovesicular, some crusted rashes in
Isezuo KO, Sani UM, Waziri UM, Garba BI, Hano IJ
various stages of eruption and crusting, hypothermic
(30 C), and features of severe bronchopneumonia. A
o
Department of Paediatrics, Usmanu Danfodiyo
University Teaching Hospital, Sokoto, Nigeria
clinical diagnosis of Congenital neonatal varicella infec-
tion was made and he was managed supportively whilst
Background: Congenital
anophthalmia is
unilateral or
efforts were made to procure varicella zoster immu-
bilateral absence of the eyeball. It is rare with a preva-
noglobulin (VariZIG) or intravenous immune globulin
lence of 3 per 100,000 births. It is associated with con-
(IVIG) and Acyclovir. Full blood count showed - PCV =
43.6 L/L, leucocytosis of 25 x 10 /L. with differentials
9
genital heart disease (CHD) and consanguinity. This
report highlights a case of anopthalmia and CHD, with
of
neutrophils 53.9%, lymphocytes of 37.5% and normal
significant family history of consanguinity and multiple
platelet count. Blood film showed features of haemoly-
cases of anopthalmia in first degree relatives.
sis. No organism was isolated on blood culture. Viral
Case report: A
5-year old
boy presented
to the
cardiac
cultures could not be done. He developed bleeding from
clinic with history of recurrent cough and fast breathing
orifices and petechia which was considered due to dis-
since infancy. He also had absence of the eyes since
seminated intravascular coagulopathy and persisting
birth which was confirmed by computed tomography
hypothermia despite adequate rewarming methods and
(CT) scan. Family history revealed there were 6 cases of
succumbed to his illness nine hours into the course of
anopthalmia amongst his first cousins who were all
admission before the recommended medications could
products of second degree consanguineous unions. He
be
procured and commenced.
also had bilaterally undescended testes and micro-
Conclusion and Recommendations:
Disseminated con-
cephaly. Echocardiography revealed a large size patent
genital varicella infection can be uniformly fatal espe-
ductus arteriosus. He had surgery in a referral centre and
cially in the presence of active maternal chickenpox five
has done well since discharge. Family was counselled
days before to 2 days after delivery as occurred in this
on
the problems and the risk of recurrence of these de-
case. This highlights the need adequate measure to expe-
fects in other children with practice of consanguinity.
dite clinical and laboratory diagnosis and the availability
Conclusion: This
report highlights
the importance
of
of
VariZIG, IVIG and parenteral acyclovir.
genetic counselling and discouraging consanguinity in
such
families and the community to prevent a devastat-
ing
problem such as anopthalmia which may occur with
other defects.
Key words: Anopthalmia,
consanguinity, CHD,
Sokoto,
Nigeria
36
Morbidity and mortality pattern among preterm
in
10,000 live births, this is the first case in literature
babies admitted into the Special Care Baby Unit of
reported from Sokoto, North western Nigeria.
University of Port Harcourt Teaching Hospital,
Case report: ZM
a female
neonate delivered
by a
21-
Rivers State: A 5-year Review
year-old P 3+0 mother who
received ante-natal care at a
secondary health center. Pregnancy was uneventful and
Eneh A, Opara P, Briggs D, Okpani M
a
normal obstetric scan was seen in the third trimester.
She presented to our facility at 16 hours of life on ac-
Background: About
45% of
deaths among
under-fives
count of absence of skin on both lower limbs noticed at
occur during the neonatal period with a high contribu-
b
i
r
t
h
.
tion from preterm deaths. Regular evaluation of preterm
She appeared pink, a febrile, with bilaterally symmetric
deaths is important as patterns and therefore intervention
absence of skin tissue on the antero-medial surface of
may vary at different times and places.
both lower extremities extending from the knees to the
Objectives: To
determine the
morbidity and
mortality
feet. She had no scalp lesion or bullae, nor any dysmor-
pattern of preterm babies admitted into the Special Care
phic features. Other examination findings were normal.
Baby Unit (SCBU) of the University of Port Harcourt
Blood culture, swab MCS of the skin defect yielded no
Teaching Hospital (UPTH), over a 5-year period.
bacterial growth and hematological investigations were
Methods: This
was a
retrospective review
of data
of
n
o
r
m
a
l
.
preterm babies admitted into the SCBU from 2012 –
A
diagnosis of Frieden type VII aplasia cutis congenita
2016. Information obtained included biodata, morbid-
was made and followed up with multidisciplinary man-
ities, duration of admission and outcomes. Data were
agement using eusol, povidone-iodine dressing, and par-
collated and analyzed using SPSS v20 for windows.
enteral antibiotics. Restoration of skin tissue was noticed
Results: 3,071
babies were
admitted in
SCBU over
the
2
weeks later. However, in the subsequent weeks ZM
period, of which 683 (22.2%) were preterms. Of these,
was lost to follow up.
421 (61.6%) were inborn while 262 (38.4%) were out-
Conclusion: ACC
though rare,
needs proper
diagnosis
born. The male: female ratio was 0.9:1. Morbidity pat-
and multidisciplinary approach in management.
terns varied with birth asphyxia (20%) ranking highest
Keywords: Aplasia
Cutis Congenita,
Newborn, Frieden
among inborns while sepsis (21%) and neonatal jaun-
classification
dice (15%) were more prominent in outborns. The over-
all preterm mortality rate was 24.6 % with rates being
significantly higher in outborns 30.5% versus inborns
Higher order multiple births in Nigeria: The experi-
20.9% (p=0.0059). Mortality was highest among low
ence, challenges and neonatal outcome as seen at a
birth weight preterms. Admission rates decreased stead-
private health facility in Nigeria
ily over the period.
Ezenwa B , Oseni Olatokunbo , Akintan Patricia ,
1
1
2
Conclusion: Birth
asphyxia and
sepsis were
the main
Aliqwekwe Patricia , Chukwukelu Blessing , Fashola
1
4
morbidities recorded. Mortality rates were higher among
Olayinka , Ogunmokun Adegbite ,Odukoya Olusegun
3
3
3
outborns. Low birth weight preterms were most affected
1
because they were in the majority. There was a steady
Department of Paediatrics, The Eko Hospital
2
decline in admission rates. Improving obstetric care,
Department of Paediatrics, LUTH
3
neonatal resuscitation, infrastructure and subsidizing
Department of Obstetrics & Gynaecology, The Eko
healthcare services for preterms is needful.
Hospital
4
Department of Family Medicine, The Eko Hospital
Aplasia Cutis congenita in a newborn seen at Usman
Objectives: This
study aims
to describe
the experience
Danfodiyo University Teaching Hospital, Sokoto
and outcome of higher order multiple (HOM) births in a
private tertiary health facility in Nigeria
Onankpa B , Adamu A ,Jega MR , Mohammed J ,
1
1
1
2
Methodology: This
was a
retrospective review
of records
Tahir AA , Yusuf A , Mohammed H
1
1
1
of
HOM over a period of 3 years in a private tertiary
Department of Pediatrics, Usmanu Danfodiyo
health facility in Nigeria. Relevant data on HOM births
University Teaching Hospital, Sokoto
were extracted from both the patients’ case notes, admis-
Dermatology
Unit, Department of internal medicine,
sion registers and maternity ward and delivery records
Usmanu Danfodiyo University Teaching Hospital,
of
the hospital using a predesigned proforma. Data was
Sokoto.
analyzed using Statistical Package for Social Sciences
Email: nanadamu@gmail.com
(SPSS) version 22.0.
Results: The
prevalence of
HOM births
was 0.72%
of
Introduction: Aplasia
cutis congenital
(ACC) is
rare
1950 births over the 3 year study period; while for Trip-
dermatological condition characterized by the absence
lets, Quadruplets and Quintuplets was 0.56%, 0.1% and
of
skin at birth. The lesion may affect the epidermis,
0.05% respectively. The mean gestational age was 32
dermis and subcutaneous tissue and can progress to in-
±3weeks
and all except 3 sets of triplets were by As-
volve
the muscle, bone and other structures such as the
sisted Reproductive Technology (ART). Respiratory
dura. The scalp is most frequently affected in approxi-
distress syndrome, neonatal jaundice and neonatal sepsis
mately 90 percent of cases, but can be found in other
accounted for more than 80% of the neonatal complica-
parts of the body. Though it has a global incidence of 1
tions noted in HOM births. However, there was no sig-
37
nificant difference between neonatal survival of HOM as
Measurement of Photo Irradiance: Comparative
compared to twin deliveries, p = 0.08.
Analysis of Radiometer Readings of various Photo-
Conclusion: HOM
is becoming
increasingly common
in
therapy units in a Tertiary Centre in Lagos Nigeria.
Nigeria. The strongest risk factor is ART and neonatal
Akintan P , Fajolu Iretiola , Ezenwa B , Ezeaka C
1
2
2
2
complications are common reinforcing the need to
1
streamline ART protocols in Nigeria.
Department of Paediatrics Lagos University Teaching
Key words: Higher
Order Multiple
births; Private
Hospital Idi araba, Lagos Nigeria
2
Health Facility; Neonatal Outcome;
Department of Paediatrics, University of Lagos
Nigeria
Nigeria.
Email: akintanpatricia@yahoo.com
Invasive Candidiasis in a Neonatal Intensive Care
Background: Neonatal
jaundice is
a common
problem in
Unit in Lagos Nigeria
the new-born with devastating consequence if not prop-
erly treated. Early and effective Phototherapy is impor-
Ezenwa BN , Oladele RO , Akintan PE , Fajolu IB ,
a
b
a
a
tant to prevent progression to severe disease. One of the
Oshun PO , Oduyebo OO , Ezeaka VC
b
b
a
key factors of effective phototherapy is the irradiance of
Department of Paediatrics, Lagos University Teaching
the unit which is affected by many factors. The objective
Hospital, Lagos, Nigeria
of
this study was to determine the irradiance of photo-
b
Department of Medical Microbiology and Parasitology,
therapy units used in a Nigerian hospital and factors
Lagos University Teaching Hospital, Lagos, Nigeria
affecting it.
Email: beatriceezenwa@yahoo.com
Method: Irradiance
of the
phototherapy units
were meas-
ured at various distance and at different parts of the
Background: Invasive
candidiasis has
been identified
baby’s body. The included lamps were the convectional
globally as a major cause of morbidity and mortality in
and locally fabricated units with blue and white fluores-
neonatal intensive care units (NICU). Systemic candidi-
cents bulbs, fabricated, fibre optic pad and the light
asis presents like bacterial sepsis and can involve multi-
emitting diode (LED). The mean irradiance of the differ-
ple
organs.
ent
lamps were compared at different distance from the
Objective: To
determine the
prevalence of candida in-
location of the baby. Student T test and the person cor-
fection in a NICU in a tertiary hospital in Nigeria and to
relation coefficient were used to test for significance and
identify its associated risk factor.
association between various factor affecting irradiance.
Methodology: The
study was
a retrospective
descriptive
Result: The
irradiance at
the baby’s
position was
at least
10
uW/ cm /nm for 79% of the phototherapy units,
2
study of all cases of culture-proven invasive
candida
infection in neonates admitted to the NICU over a four-
while 37.5% delivered irradiance in the intensive photo-
therapy range( 30 uW/ cm /nm). The irradiance was
2
year period. Study participants were identified from mi-
crobiology records of all neonates with a positive
can-
highest in the LED and lowest in the locally fabricated
dida culture.
Medical records
of identified
neonates
units. The irradiance increases with the reduction in the
were also reviewed, and relevant information obtained.
distance from the lamps and at the centre compared to
Results: Over
the four
years, 2,712
newborns were
ad-
the periphery.
mitted into the NICU. From these, 1182 various clinical
Conclusion: The
type of
light source,
position and
dis-
samples were collected from babies with features of
tance from the light are are important factors to consider
sepsis and processed in the Medical microbiology labo-
for
improving irradiance during phototherapy in neona-
ratory. Twenty-seven (2.3%) of the cultures yielded
tal
jaundice.
Candida organisms;
fifteen of
the candida cultures
were
Keywords: Jaundice,
New-born. Phototherapy, Light
from male infants with a male: female ratio of 1.3: 1.
emitting diode, Irradiance.
Blood stream infection was the most frequent ICI seen
in
preterm babies (seven [58.3%] out of 12 babies with
ICI). Nearly all (91.7%) affected preterm infants with
Features of Locally Fabricated Phototherapy Devices
ICI were less than 1500g in weight. All were exposed to
Abdulkadir I, Lawal S Adebiyi NM, Slusher TM
1
2
invasive procedures, and broad-spectrum antibiotics.
Vreman HJ , Ogala WN
3
The
case fatality rate among those with ICI was 18.5%.
Conclusion: There
is a
significant prevalence of
invasive
Neonatal Unit, Department of Paediatrics, Ahmadu
candidiasis in high risk newborns and the incidence in-
Bello University/ Teaching Hospital Zaria, Kaduna
creases with increased practices in risk factors such as
State, Nigeria.
1
invasive procedures and antibiotic use and in lower ges-
Department of Chemical Engineering Kaduna Poly-
tational age babies with VLBW
technic, Kaduna State Nigeria
2
Key words: Invasive
candida infection;
neonates; risk
Department of Pediatrics, University of Minnesota &
factors; NICU, Nigeria
Hennepin County Medical Center, Minneapolis, MN
55415, USA
3
Neonatal & Developmental Medicine Laboratory, Divi-
sion
of Neonatology, Department of Pediatrics, Stanford
University Medical Center, Stanford, CA94305-5208,
USA
38
Email: isaburamla@yahoo.com; isaabdul-
natal admissions, are almost invariably accompanied by
kadir@abu.edu.ng
the need for some form of blood transfusion. Blood
transfusion, thus, remains a key day-to-day practice of
neonatology, the audit of which is necessary for plan-
Background: Efficient
phototherapy (PT)
continues to
ning and improved practice and outcome. The study
elude most health facilities in low- and medium income
sought to, for the first time, find the prevalence, pattern,
countries (LMICs) due to the cost of PT devices and
and characteristics of the neonates receiving blood trans-
lack of reliable electricity. In Nigeria pockets of isolated
fusion either as top up or exchange at the neonatal care
efforts have gone into local fabrication of devices for
u n
i t
o
f
A
B U T H ,
S
h i k a -
Z
a r i a .
use.
Methods: This
was a
prospective study
of neonates
Objective: To
highlight features
of locally
fabricated PT
receiving transfusion from September 2016 to February
( F
P T )
d e
v i c e s
i
n
N
i g e r i a .
2
0
1
7
.
Materials and Methods:
Phototherapy devices
in use
in
Results: A
total of
309 neonates
were admitted
during
Kaduna state were surveyed. The structural as well as
the six months study period out of which 101 received at
clinically important features of each PT device were
least one form of blood transfusion, giving a 33% preva-
documented including mobility/ portability, adjustabil-
lence rate of blood transfusion. There were more simple
ity, types, number and colour of lamps used. Irradiance
blood transfusions (61.4%), compared with exchange
was measured using Olympic BiliMeter
TM.
model 22.
blood transfusions (38.6%). Majority (79.2%) of the
Results: Thirty-two
(59.3%) of
the 54
PT devices
in use
transfused neonates received transfusion within the first
were locally fabricated while the remaining were com-
week of life (0-7 days). More males (M:F ratio 2:1) and
mercial, imported devices. Of the 32 FPT devices, 14
slightly higher proportions of term (T) neonates (Term
(43.8%) were immobile wall mounted and non-portable.
vs
Preterm : 50.5% vs 46.5%) received transfusion. Ma-
Twenty two {22/32 (68.8%)} were fixed and non- ad-
jority were of normal birth weight (51.5%), with 1%
justable. Only 5/32 (15.6%) of the FPT devices used
being macrosomic, the remaining 47.5% belonged to
special blue fluorescent lights. None of the devices used
one or the other category of low birth weight. Blood
group O
+ve
light emitting diodes (LED) as light source. Only 3 fab-
was the most common (46.5%) blood group
ricated devices offered irradiance (9.4, 13.6 and 33 µW/
a m
o n g
t h
e
t r
a n s f u s e d
b
a b i e s .
cm
/ nm) at least sufficient for conventional PT at the
2
Conclusion/ Recommendations: The high
rate of
blood
facilities’ traditional distances for PT which ranged from
transfusion in the neonatal unit underscores the need for
4
0
–
7
0
c
m
.
efficient blood banking and other transfusion services.
Conclusions: Fabricated
PT devices
in use
in Kaduna,
Key word: blood
transfusions, neonates, prevalence,
Nigeria, have features which make them deliver clini-
pattern, characteristics.
cally sub optimal PT. The devices will need redesign
and modifications specifically in areas of adjustability to
vary distance and the use of lamps which emit light with
Levels of Neonatal Care in Kaduna State
i
n c r e a s e d
i
r r a d i a n c e .
Recommendation: Local
fabrication of
PT devices
Abdulkadir I, Adebiyi NM, Adeoye G, Ogala WN
should be encouraged however; qualities which enhance
Neonatal Unit, Department of Paediatrics, Ahmadu
optimal performance of PT devices should be incorpo-
Bello University Teaching Hospital Zaria, Kaduna
rated into the fabrication designs.
State, Nigeria.
Keywords: Phototherapy,
neonatal jaundice,
newborn
Email: isaburamla@yahoo.com,
care, kernicterus, devices.
isaabdulkadir@abu.edu.ng
Background: Neonatal
medicine is
a specialized
aspect
of
paediatrics. Availability of newborn units which pro-
Neonatal blood transfusions: Prevalence, pattern and
vide comprehensive neonatal services are an essential
recipient’s characteristics as seen at Ahmadu Bello
integral component of hospital services which guaran-
University Teaching Hospital, Northwest, Nigeria
tees/ assures improved newborn health and survival. In
the structure of our health care system in Nigeria, neona-
Abdulkadir I, Musa S, Onadiran MA, Hassan L
tal units are meant to be component units of secondary
Abdullahi FL, Aminu SM , Ogala WN
1
and tertiary health facilities.
Neonatal Unit, Department of Paediatrics, Ahmadu
Objective: The
study aimed
at determining
the availabil-
Bello University Teaching Hospital Zaria, Kaduna
ity of neonatal units and level of care services in Kaduna
State, Nigeria.
1
state, Northwestern Nigeria.
Department of haematology, Ahmadu Bello University
Materials and Methods: The
study was
a survey
of all
Teaching Hospital Zaria, Kaduna State, Nigeria.
hospitals in Kaduna state including public and non- gov-
Email: isaburamla@yahoo.com,
ernment facilities. Information on availability of new-
isaabdulkadir@abu.edu.ng
born unit, staffing, and equipment were obtained and
units were categorized into levels of care.
Background/ Introduction: Blood transfusion is
a proce-
Results: A
total of
33 public
non –
primary health
care
dure of replacing blood volume and or specific blood
facilities and 25 non- government specialist facilities
components. In Nigeria, prematurity, neonatal jaundice
operated in the state. Only 2 (one each state and federal
and neonatal sepsis, the most common reasons for neo-
39
owned) of the 33 public facilities, both of which were
The frugal politeheart bubble CPAP machine – De-
tertiary
health care facilities had operational neonatal
sign, characterisation and comparisons
units while 15 of the 25 specialist non- government fa-
1,3,4
, Okonkwo IR , Abioye IO , Olateju EK ,
2
3
4
cilities operated neonatal units. All the neonatal units
Amadi HO
Bello
A
3
AA ,
4
Umar
S ,
3
were of level I category except for the federal owned
Okechukwu
1
Imperial College London United Kingdom, UBTH
2
public facility which was of level III category and the
3
state owned public facility which was of level II cate-
Benin-city,
Maternal & Neonatal Hospital Minna,
4
gory.
UATH Gwagwalada FCT.
Conclusions: to
improve neonatal
care, more
effort
Email: h.amadi@imperial.ac.uk
needs to go into improving the quality of our neonatal
units and this should begin with having a national policy
Background: Bubble
continuous positive
airway pres-
on
minimal standards for neonatal care units.
sure (bCPAP) is a widely applied technique in Nigeria
Keywords: Neonatal
unit, neonatal
intensive care,
for sustainable neonatal respiratory support. Few com-
special care baby unit, neonatal medicine.
mercial grade bCPAP systems are available but rarely in
use across Nigerian health facilities because of their
exorbitant cost. Over 90% of Nigerian SCBUs resort to
Physical Injuries in the neonatal period - An after-
the use of an Improvised-bCPAP (IbCPAP) technique,
math of harmful traditional practices
notably deficient of some vital technical capabilities;
hence, this may be associated some morbidities such as
Mokwenyei O, Ezenwa B, Fajolu I, Akintan P,
retinopathy of prematurity, induced neonatal hypother-
Ezeaka C
mia complications and poor surfactant retention among
extreme preterm neonates.
Harmful traditional practices in the newborn period are
Aim: The
aim of
this project
was to
devise and
charac-
those practices and customs that have bad effects on a
terise a low-cost bCPAP system that is functionally akin
newborn’s health and may prevent the newborn from
to
the commercial grade system and, to compare its in-
achieving its normal growth potential and development.
tervention outcomes with those from the Nigerian Ib-
The practices are usually well intentioned, but mis-
CPAP.
guided and misinformed. We present two neonatal vic-
Methods: Frugal
design approach
involving the
deploy-
tims of unintentional physical injuries inflicted by care-
ment of generic components and assemblies was ap-
givers resulting in severe morbidities and highlight the
plied. The resulting system (PbCPAP), with inbuilt air
need to eradicate these deleterious practices and replace
compressor could blend a controllable maximum of 5L/
them with evidence-based newborn care practices.
M
air flow rate with up to 5L/M oxygen flow rate for
Baby OM an 11-day old term female neonate presented
any desired Fio2. The blended gas was filtered, humidi-
on
account of a spreading cellulitis of the left breast area
fied and supplied through a controllable warming inspi-
and fever which started following the traditional practice
ratory channel and via appropriately sized nasal cannula
of
hot water massaging of newborn breasts and expres-
to
the neonate. Neonate’s Spo2 was easily controllable
sion of witches milk which the mother’s aunty had been
via altering its (1) air & oxygen flow rates for new Fi02,
practicing on the baby since the fourth day of life. A
(2) total flow rate for new inspiratory volume flow or (3)
diagnosis of necrotizing fascitis of the left hemithorax
PEEP-straw depth (in cmH20) for new expiratory pres-
secondary to neonatal mastitis of the left breast was
sure. Clinical trials were carried out using three proto-
m a
d e
a n
d
c h
i l d
a
d m i t t e d
types at UBTH Benin (5 cases), UATH Abuja (7 cases)
for intravenous antibiotics Baby NB was a 6-week-old
and Neonatal Hospital Minna (6 cases). Six interven-
term female infant who presented on account of huge
tions with the IbCPAP were applied as control for com-
ulcers on both buttocks. Baby was noticed to have de-
parison.
veloped progressively increasing swellings on both but-
Results: Neonate’s
BW in
kg for
the PbCPAP
was
tocks on the 8th day of life which subsequently ruptured
2.6±1.2, range 0.9-3.6; IbCPAP: 2.6±0.7, range 1.2-3.3.
and drained purulent discharge. There was no history of
Average
Fi02
for
intervention
duration:
fever but there was a positive history of spanking of
PbCPAP=44.6%; IbCPAP=90% . The PbCPAP was
buttocks with bruises at birth during resuscitation, as
efficiently controllable and took average of 6 minutes to
patient did not cry at birth. An assessment of bilateral
fully achieve safe Spo2 stabilisation at 90-95%. No neo-
gluteal ulcers secondary to gluteal subcutaneous fat ne-
nates on PbCPAP experienced thermal instability while
crosis was made. She was admitted and co-managed
100%
of IbCPAP neonates remained hypothermic and
with
the Burns and Plastic Surgical unit.
needed extra intervention. There were better outcomes
Traditional practices inflicting injuries on the newborns
for
the PbCPAP neonates from the three SCBUs, includ-
are
prevalent in our environment. There is need to ex-
ing
a particular case of twins, each supported on either
pose
and eradicate these deleterious practices. All hands
of
the bCPAPs at UBTH, and followed until successful
need
to be on deck to promote, educate and empower
discharge from SCBU. The PbCPAP costs less than
mothers and caregivers on the best newborn practices to
17% of the commercial grade system.
imbibe so that together we can decrease the alarming
Conclusion: Results
suggest that
the PbCPAP
has got
neonatal mortality and morbidity in Nigeria.
the choice combinations of capability, efficiency and
Key words: Harmful
traditional practices, newborn,
low-cost to enable proper bCPAP intervention in Nige-
Nigeria
ria.
40
Case series and review of literature: Uncommon bac-
Subjects and Methods: A
comparative
cross-sectional
terial isolate causing early neonatal septicemia
study of 266 children with symptomatic Plasmodium
falciparum parasitaemia
and 132
apparently healthy
Olateju EK , Airede A , Tahir I , Adebayo I .
1
1 2
1 2
1
children recruited consecutively. They had physical ex-
1
Department of Paediatrics University of Abuja
amination and electrocardiography at presentation. Fre-
Teaching Hospital, Gwagwalada, Department of
2
quencies of electrocardiographic features were described
Paediatrics, Faculty of Clinical Sciences, College of
and compared among the study participants.
Medicine, University of Abuja, Gwagwalada, Nigeria.
Results: Two
hundred and
nine males
and 189
females
Email: oeyinade@yahoo.com
were studied. There were 133 cases of severe malaria,
133 with acute uncomplicated malaria and 132 controls.
Introduction: Neonatal
sepsis is
a life-threatening
condi-
Prevalence of ECG abnormalities was 79.7% in severe
tion, and any delay in diagnosis and treatment may fol-
malaria and 63.2% in acute uncomplicated malaria.
low a fulminant course. The pathogens commonly impli-
There was no significant difference in ECG abnormality
cated in NNS differ significantly between countries, and
between genders or the socioeconomic status of study
within the same country, regional variation in prevailing
participants. Three quarters of the mortality had electro-
organisms causing NNS exists.
cardiographic abnormalities.
Objective: To
report an
uncommon causative
organism
Conclusions and Recommendations:
Severe malaria
of
NNS and highlight challenges in management.
patients had significant ECG abnormalities. These find-
Method: The
case notes
of all
the patients
were reviewed
ings underscore the need for a thorough cardiovascular
and relevant information extracted.
examination, including an electrocardiogram for all chil-
Results: The
four neonates
consist of
1 term
and 3
pre-
dren with severe malaria.
terms with GA of 27, 29 and 34weeks respectively. The
Keywords: Severe
Malaria,
Electrocardiography
presenting signs and symptoms were tachypnea, respira-
tory distress, jaundice, temperature instability, poor oxy-
gen saturation and bilateral eye discharge in two of
Infective endocarditis in five years: A case series
them. Three of the mothers came from a rural settle-
from federal medical centre, Abeokuta
ment, and two of them delivered at home. Baseline labo-
Uzodimma C , Musa Y , Olasunkanmi O
1
1
1
ratory investigations revealed deranged electrolytes in
two patients, severe anemia warranting transfusion in
Paediatric Cardiology unit, Department of Paediatrics,
one patient and blood culture yielded PANTOEA SPP in
Federal Medical Centre, Abeokuta.
all of them. Three patients recovered following treat-
ment with antibiotics and one died.
Introduction: Diagnosis
of infective
endocarditis could
Conclusion: Pantoea
spp is
a rare
pathogen in
the aetiol-
be
delayed if clinicians are not maintaining a high index
ogy of NNS. Early detection and proper antibiotic ther-
of
suspicion for this condition. Its relative rarity does not
apy may cause a favorable outcome.
make it easier and neither do certain atypical presenta-
Key words :
Neonate, Sepsis,
Pantoea spp.
tions. Vegetations in the main pulmonary artery is rare.
We
report three of five cases of infective endocarditis
seen at the Federal medical Centre, Abeokuta from 2013
PC
-2017.
Electrocardiographic features in children with severe
Aims and objectives: To
underscore the
variations in
the
falciparum malaria at the University college hospital,
presentation of infective endocarditis and to sensitize
Ibadan
clinicians to maintain a high level of vigilance for this
differential diagnosis in febrile children.
Akinkunmi F , Ogunkunle O , Akinbami F ,
1
2
3
Methods: Three
cases of
infective endocarditis are
pre-
Orimadegun A
2
sented. The age ranges from eight to fourteen years old.
1
Department of Paediatrics Mother and Child Hospital
The sizes of the vegetations ranged from 10mm-18mm.
Ondo
One case occurred in a child with underlying patent duc-
2
Department of Paediatrics University College Hospital
tus
arteriosus who reported fever of two days duration.
Ibadan
A
large vegetation was seen in the main pulmonary ar-
3
Department of Paediatrics, Niger Delta University
tery near the entrance of the duct. The second case had
Teaching Hospital Okolobiri
no
underlying heart defect, but was being treated for
Email akinkunmifrancis@gmail.com
sepsis. The diagnosis of infective endocarditis was de-
layed for over one month, making way for other differ-
Introduction: Malaria
accounts for
30% of
childhood
entials including juvenile rheumatoid arthritis. The
mortality in Nigeria. This high burden is partly due to its
vegetation was seen on the tricuspid valve. The third
potential to cause multi-organ dysfunction. Cardiac in-
case was referred to our Centre after two weeks of a
volvement in malaria has been reported, but data on spe-
febrile illness, echocardiography revealed vegetations on
cific electrocardiographic features in children with ma-
the mitral valves.
laria is rare.
Conclusion: Infective
endocarditis still
occurs. High
Aims/Objectives: To
investigate
electrocardiographic
index of suspicion is necessary to reduce delayed or
features in children with severe
falciparum malaria at
missed diagnosis.
the University College Hospital Ibadan.
Keywords: Infective
endocarditis, children, vegetations
41
Pattern of presentation and surgical outcomes of
was recommended.
children presenting with vascular ring and pulmo-
Conclusion: UHL’s
anomaly of
the right
ventricle is
a
nary sling in Fortis Hospital Mumbai
very rare anomaly which defies all surgical option ex-
cept transplant. Early recognition institution of drugs
Chinawa JM, Agarwal V, Garekar S, Gaikwad S,
that improves cardiac function may improve the quality
Trivedi B
of
life of the child.
Key Words: UHL
anomaly; child;
Mumbai; rare
Background: Vascular
anomalies are
rare abnormalities
which present with inspiratory stridor and recurrent res-
piratory tract infection. The commonest of these anoma-
PE
lies were vascular ring and pulmonary sling.
The Travails of Nigerian children requiring Growth
Objectives: The
objective of
this study
was to
determine
Hormone Therapy
the prevalence, pattern of presentation and surgical out-
comes of children presenting with vascular ring and pul-
Idris HW, Mado SM, Abdullahi SM
monary sling.
Department of Paediatrics, Ahmadu Bello University/
Methods: A
cross-sectional
retrospective study
in which
Ahmadu Bello University Teaching Hospital Zaria,
a
review of the records of all children attending Fortis
Nigeria
hospital over a 3-year period (2012- and 2015) was un-
dertaken.
Introduction: Since
1958 growth
hormone (GH)
has
Data were analyzed using SPSS 20. Frequencies, rates
been used as substitution treatment for children with GH
and
proportions
were
represented
in
tables.
deficiency.
Result: A
total of
1200 children
had open
heart surgery
Objective: To
describe the
difficulties patient
with GHD
in
the hospital over a three-year period. Of these, 2 had
and their families faced from diagnosis to treatment.
vascular ring and 3 had pulmonary sling giving a preva-
Case Report: 6
children (4males,
2females) aged
be-
lence of 0.4%. Out of the 5 cases, 3 (60 %) were male
tween 3 and 16 years were noticed to have stopped
and 2 (40%) female. Male to female ratio was 1.5:1. The
growing between the ages of 2 and 4years. Their preg-
mean age of presentation was 2.46± 3.52 months. There
nancies were uneventful and birth weight was normal.
were three neonates and two infants. All presented with
No
history of neonatal seizures, delayed passage of me-
stridor. The mean number of days spent postoperatively
conium or jaundice and no family history of short stat-
was 8±3 days and tracheal stenosis was
the only compli-
ure. They were seen in many tertiary hospitals, private
cation noted.
clinics and spiritual homes.
Computerized axial tomography (CT) scan of one of the
Their heights were < - 5SDS. Other findings includes
subjects with vascular ring showed a dilated Kom-
patent fontanel (2), high pitched voice (3), microphallus/
merells diverticulum (KD).
cryptorchidism(1) and dental carries (3). Investigations
Conclusion: Vascular
ring and
pulmonary sling
are rare
revealed very low GH levels, delayed bone age, low
congenital abnormalities seen in our center, early identi-
FT4 , normal TSH, thyroid USS and brain CT. Stimula-
fication and repair will help avert numerous complica-
tion tests and genetic studies were not carried out. A
tions that follow it .
diagnosis of MPHD was made in 3 and SCA with GHD
Key Words: Pulmonary
sling; vascular
ring; tracheal
(2) and isolated GHD (1).
stenosis; Kommerells diverticulum.
Four were started on GHT between 6 months to 4yrs
after diagnosis (sourcing for money, procurement of
GH).
UHL’S anomaly of the right ventricle in one -year-old
Two children (10 & 13yrs old ) are on regular GHT, had
child requiring a transplant: A case report
gained 7 & 16cm in height, had exfoliated 6 teeth, the
fontanel has closed and her self-esteem and school per-
Chinawa JM, Swati G, Trivedi B
formance had improved. Four of the children couldn’t
sustain the therapy.
Background: UHL’s
anomaly of
the right
ventricle is
a
Conclusions: GHT
in Nigeria
is possible,
but the
family
rare anomaly. At present only about 84 cases have been
and physician have to bear with a lot of challenges in
reported in over a century.
order to succeed.
Case presentation: We
report a
case of
one-year old
male, who presented to our out-patient pediatric cardiol-
ogy clinic with a history of recurrent cough and diffi-
Congenital hypothyroidism: A report of two isolated
culty in breathing and failure to gain weight in the pre-
cases at National Hospital Abuja
ceding two months. Chest X ray showed cardiomegaly
Babaniyi IB , Papka NY , Hamza N
1
1
2
while ECG showed a normal sinus rhythm with poor
right ventricular forces. Echocardiography showed se-
National Hospital Abuja
verely dilated right ventricle with thinned out right ven-
Email: nubwayusufu@yahoo.com
tricle wall, poor right ventricular function with severe
tricuspid regurgitation. He has been placed on Aspirin,
Background: Congenital
hypothyroidism is
a disorder
of
Lasilactone and Clexin. However, there were no satis-
thyroid gland morphognesis. It is the commonest endo-
factory surgical option available and heart transplant
crine disorder in newborns occuring in 1:4000 to 1:3000
42
live births. The incidence in Nigeria has not been well
the 418 recruited initiated breastfeeding early. The
documented probably due to lack of neonatal screening.
prevalence of exclusive breastfeeding was 36.6%. Ma-
Aim/ objectives: To
raise awareness
of physicians
to
ternal education was significantly associated with the
have a high index of suspicion for this treatable cause of
practice of EBF while maternal age and delivery facility
mental retardation in children presenting with unusual
were significantly associated with early initiation of
symptoms.
breastfeeding. The median duration of breastfeeding was
Case presentation: Case
1 presented
to our
hospital at
15.1 ± 2.3months.
18
months of age with a respiratory tract infection. She
Conclusion: The
breastfeeding practices of
mothers of
had delayed developmental milestones and coarse facies
children aged 1 – 24months in Egor LGA are below
among other features. This prompted a work up for hy-
a
v
e
r
a
g
e
.
pothyroidism. Thyroid function tests done showed a
Recommendation: Health
Education at
the community
profoundly hypothyroid picture and she was commenced
l e
v e l
o
n
b
r e a s t f e e d i n g
p
r a c t i c e s
on
levothyroxine.
Keywords: Breastfeeding
, practices,
Egor LGA
Case 2 was referred to our facility at nine weeks of age
on
suspicion of a congenital heart disease. The parents
had
complained of dry skin to the referring physician.
Survival and Nutritional Status of Severe Acute
She had a hypothyroid profile on laboratory evaluation.
Malnutrition, Six Months Post-Discharge from Out-
Conclusion: Congenital
hypothyroidism should be
sus-
patient Treatment in Jigawa State, Nigeria
pected in children with unusual symptoms as it is a treat-
1
John C, Diala U, Adah R, Lar L, Envuladu EA, Ad-
1
1
2
2
3
able cause of short stature and mental retardation. The
edeji I, Lasisi KE, Olusunde O, James F Abdu H.
4
5
6
1
introduction of newborn screening will go a long way in
1
identifying the children in need of urgent thyroid re-
Department of Paediatrics, Jos University Teaching
placement to prevent the negative consequences of un-
Hospital, Jos, Nigeria
2
treated hypothyroidism.
Department of Community Medicine, Jos University
Keywords :
Congenital
hypothyroidism,
neonatal
Teaching Hospital, Jos, Nigeria
screening, mental retardation.
3
Department of Paediatrics, Department of Mathemati-
4
cal Sciences, Abubakar Tafawa Balewa University
Teacing Hospital Bauchi, Bauchi, Nigeria
5
Breastfeeding practices among mothers of children
National Primary Health Care Development Agency,
aged 1 – 24months in Egor local government area of
North Central Zonal Office, Abuja
6
Edo state, Nigeria.
Federal Ministry of Health, Maternal, Newborn and
Child Health Unit, Abuja
Adam
Y
2
AO ,
1
Anthony
OA,
Vincent
Email: cchibunkem@yahoo.com
1
Department of Child Health, University of Benin
Teaching
Hospital,
Benin
City,
Edo
State.
Background: The
Outpatient Therapeutic Program
2
Department of Community Health, University of Benin
(OTP) brings the management of Severe Acute Malnu-
Teaching
Hospital,
Benin
City,
Edo
State.
trition (SAM) closer to the community. Many lives have
Email: tonyatimati@yahoo.com
been saved through this approach however little data
exists about the outcome of the children discharged from
Background: Under
nutrition contributes to
about half
of
such programmes. This study was aimed to determine
all the causes of child mortality in developing countries.
the outcome of children with SAM six months post dis-
Optimal feeding during the first 2years of life is essen-
charge.
tial for growth and development. Adequate breastfeed-
Methodology: This
was a
prospective study
of SAM
ing of children under two years of age has the potential
patients admitted into 10 OTPs in two local government
to
prevent 1.4 million deaths in under-five children in
areas of Jigawa state from June 2016 to July 2016.
the developing world annually. Breastfeeding practices
Data from Consenting caregivers were captured using
in
Nigeria are poor with regional variation due to diverse
mobile android device. The general demographic char-
socio-cultural factors. Keeping trend of the breastfeed-
acteristics, infant and young child feeding practices,
ing practices and the associated factors at the commu-
medical history and anthropometric measurements were
nity level is essential in promoting breastfeeding.
captured at recruitment, discharge and at 6months post-
Objective: To
determine the
breastfeeding practices of
discharge.
mothers of children 2years and below in Egor LGA of
Data collected was analysed using Stata MP 14 and an-
Edo State.
thropometric measurements were computed using the
Methods: It
is a
descriptive cross-sectional study
carried
2006 World Health Organization (WHO) growth stan-
out in Egor LGA of Edo State. The participants were
dard.
children aged 1 – 24months and mother pair. Multi-
The
primary outcome measures were nutritional status at
staged sampling technique was utilized in the selection
follow-up (Mid upper arm circumference and weight-for
of
subjects. A semi-structured interviewer administered
-height z-score, mortalities and relationship between
questionnaire was used for data collection. The data
recruitment and post-discharge indices.
obtained were analysed using IBM SPSS version 20
Result: Among
383 subjects
followed up,
93.2& were
s
t a t i s t i c a l
s
o f t w a r e .
alive at 6months while 6.8% were mortalities.
Results: One
hundred and
eighty-six mothers
(44.5%) of
Of
the living subjects, 94.1% had MUAC >12.5cm, sig-
43
nificantly higher than recruitment levels. Prevalence of
in
healthy Nigerian infants.
wasting (WHZ<-3) dropped from 68.9% to 17.6% at
follow-up.
Number of children with complete immunization im-
Helicobacter pylori infection in Malnourished Chil-
proved (35.8% vs 27.9%) and a decrease in number of
dren seen in Lagos
unimmunized children (34.5% vs 20.5%) but an increase
in
number of incomplete immunization (37.6% vs
* Adeniyi
OF, **Temiye
EO, *Fajolu
IB,
43.7%) at discharge, p<0.001.
***Ogbenna AA, ****Lawal M
Mortalities were commoner among the 12-23months
*Department of Paediatrics, College of Medicine, Uni-
old. Most deaths (61.5%) occurred within the first
versity of Lag os/Lagos University Teaching Hospital,
3months post-discharge; mortalities were significantly
Idi – Araba, Lagos
short statured at recruitment, p=0.016; had a smaller
**Department of Paediatrics, College of Medicine, Uni-
head circumference, p=0.005 and appeared more wasted
versity of Lagos/Lagos University Teaching Hospital,
(CI -6.9/-9.3 vs -3.7/-2.55) p=0.005.
Idi – Araba, Lagos
Conclusion: Significant
outcome in
nutritional and
im-
***Department of Haematology, College of Medicine,
munization status is demonstrated. Mortalities are com-
University of Lagos/Lagos University Teaching Hospi-
moner within first three months and among young age-
tal, Idi – Araba, Lagos
groups. Severely deranged anthropometry maybe
****Department of Paediatrics, LUTH
responsible for post-discharge mortalities.
Email: layo_funke@yahoo.co.uk
Introduction: Helicobacter
pylori (Hpylori)
a
gram
Adequacy of bristol stool form scale in the assess-
negative bacterium has been identified as a culprit for
ment of stools by mothers of healthy infants in
diseases like gastritis, peptic ulcer disease and is be-
Ibadan, Nigeria
lieved to be acquired in childhood. However, there re-
mains conflicting reports on malnutrition and Hpylori
An
important complaint of mothers of infants is their
infection with paucity of data in Nigerian children. The
stool form. In the evaluation of stool forms, healthcare
study documents the prevalence of H pylori infection in
workers usually depend on mothers’ reports which are
malnourished children and healthy controls and high-
subjective and influenced by interpretation bias by
lights the observed peculiarities.
health care personnel. There is therefore the need for an
Methods: 130
malnourished children aged
5months-8
objective method of describing stool forms. In the pre-
years and 120 age, sex and socioeconomic matched
sent study, we evaluated the utility of the Bristol Stool
healthy controls were recruited into the study. Anthro-
Form Scale (BSFS) when used by mothers of healthy
pometry was done for all the children and the Hpylori
Nigerian infants.
status was determined with the use of monoclonal stool
Materials and Methods: The
mothers of
122 healthy
antigen test in all the participants. Logistic regression
infants delivered at term and less than six months of age
analysis was used to determine the factors that could
attending the Infant Welfare Clinics of the Institute of
predict the occurrence of the infection in the children.
Child Health, University College Hospital and Adeoyo
Results: The
prevalence of
h pylori
in the
malnourished
Maternity Teaching Hospital, both in Ibadan, Nigeria for
children was 25.8% compared to the 36.1% in the con-
routine immunisation were enrolled.
Mothers were
trols (p=0.127) . 53.1% of the malnourished children
requested to identify their child’s most recent stool using
had moderate malnutrition while 29.2% were severely
the 7-point BSFS.
malnourished. The prevalence of Hpylori infection in
Results: The
mean (standard
deviation) age
of the
122
the stunted (35.5%) and wasted children (35.9%) were
study infants was 80 ±41.6 days (range 4-180 days).
comparable. The infection was also more prevalent in
Eighty-eight (72.1%) infants were exclusively breastfed
the 1-5 year age group (81.4%) and least prevalent in the
and 34 (27.9%) were on mixed feeding. Almost all (120;
children above 5 years.. Multivariate analysis showed
98.4%) mothers felt that the BSFS adequately described
that only stunting and religion were significantly related
their infants’ stools. The most commonly reported types
to
the infection. (p=0.042)
were Type 6 (56.7%) and Type 7 (33.3%). There was
Conclusion: Malnourished
children are
still predisposed
no
association between reported stool consistency and
to
Hypylori infection and more so in those that stunted.
infant feeding, level of maternal education and number
There is need for further studies to determine the rela-
of
previous babies nursed.
tionship between malnutrition and Hpylori infection in
Discussion: The
BSFS chart
may be
a reliable
tool for
African children.
describing stool consistency in healthy infants, notwith-
standing infant feeding, the mothers’ level of education
and her previous experience of childcare. Further re-
search is needed to evaluate the agreement between
mothers and healthcare workers in describing stool con-
sistency using the BSFS in this setting and also its utility
in
children with gastrointestinal disorders.
Conclusion: This
study indicated
that the
BSFS may
be
a
reliable tool for mothers to describe stool consistency
44
Knowledge attitude and practices of mothers regard-
associated with knowledge and prescription of Zn +
ing diarrhoea in children in Abakaliki LGA of
LoORS amongst PHCWs in Ibadan.
Ebonyi State, South East Nigeria
Subjects and Methods: A
cross-sectional study was
con-
ducted in five local government areas of Ibadan Infor-
Asiegbu UV , Asiegbu OG , Ezeonu CT
1
2
1
mation from 200 nonmedical PHCWs, selected via a
3
Ezeanosike OB , Odoh NA
1
three-stage sampling technique, was obtained using a
1
Department of Paediatrics, Department of Obstetrics
2
self-administered questionnaire. Key informant inter-
and
Gynaecology,
Federal
Teaching
Hospital,
views (KII) of 10 matrons were also done. Descriptive
Abakaliki, Ebonyi State
statistics and Chi-square were utilised in analysing the
3
Department of Paediatrics, State House Hospital,
data with level of significance set at p < 0.05.
Abuja
Results: The
PHCWs were
from 7
cadres, mean
age
Email: uzomavivianasiegbu@gmail.com
40.59 ± 9.90 years, 191 (95.5%) females, and 85
(42.5%) had been on the job for 16-20 years. Of all, 136
Background: Diarrhoeal
disease has
significantly led
to
(68%) prescribed Zn +LoORS. Only 57 (28.5%) and
infant morbidity and mortality. Infection is spread as a
result of poor hygiene. Death from diarrhoea is mainly
102 (51%) knew the correct doses of LoORS and zinc
due to loss of water and essential minerals. Oral rehy-
respectively. Factors associated with correct prescription
of
Zn +LoORS included male gender (p= 0.100, 2.70),
2
dration solution (ORS) is most useful in its treatment.
Prevention is basically through adequate sanitation and
16
– 20 years’ experience (p= 0.387, ƛ2 3.03) and being
hygiene. This study is therefore aimed at determining
in
the Senior CHEW cadre. ( ƛ 16.38, p= 0.012). KII
2
mother’s knowledge, attitude and practice about diar-
revealed
that many matrons could not differentiate be-
rhoea
in children in Abakaliki LGA of Ebonyi State.
Methods: A
cross sectional
questionnaire-based study
tween the old and new forms of ORS.
was conducted on 33 women who brought their babies
to
the well-baby/immunization clinics at a primary
health care centre in Abakaliki LGA. The questionnaire
Infant feeding practice and nutritional status: A
consisted of three sections designed for assessing the
rural- urban comparison in Kano
knowledge, attitude and practice and a section for demo-
1
Umma AI, Taiwo GA, Zubairu I
2
2
graphic characteristics. Likert’s scale was used to assess
1
Department of Paediatrics, Department of Community
2
their response. Data was analyzed using Epi Info 7. 1. 3.
10
of CDC, Atlanta.
Medicine, Bayero University/Aminu Kano Teaching
Results: Majority
(81.8%) had
good knowledge
about
Hospital Kano
diarrhoea illness, these were seen mainly among moth-
Email: aummaibraheem@gmail.com
ers who reside in urban areas and who also had higher
level of education. Majority 69.70% strongly believe
Background: Appropriate
infant feeding
practice re-
that witchcraft cause diarrhoea, these were mainly from
mains one of the cost-effective ways of reducing under
the rural areas with low or no formal education. 42.4%
five morbidity and mortality. However, infant feeding
of
these women use anti-diarrhoeal in treatment. Al-
practice has remained poor in this environment.
though many mothers had adequate knowledge about
Objectives: To
determine and
compare the
mother’s
diarrhoea illnesses,
nutritional knowledge, infant feeding practices and the
Conclusion: There
is still
need to
fill up
gaps in
their
nutritional status of their infant in urban and rural com-
attitudes and practice especially in the rural areas to re-
munities in Kano state.
duce the mortalities associated with diarrhoea illnesses.
Methods: A
comparative cross-sectional study
was con-
Keywords: Diarrhoea, Oral rehydration solution, knowl-
ducted in one urban (Kano municipal council) and one
edge, attitude and practice.
rural (Madobi) local Government Areas in Kano. A semi
-structured questionnaire was administered to 440 urban
and 440 rural caregivers and their infants.
Prescription of zinc and low-osmolarity ors for under
Anthropometric indices were used to determine the chil-
-five children with diarrhoea by primary healthcare
dren’s nutritional status. Data was analyzed using SPSS
workers in Ibadan, Nigeria
version 21.
Results: Majority
of the
urban caregivers
(n=273;
Bamidele SO, Adediran KI
62.1%) had good knowledge on infant feeding practices,
Institute of Child Health, College of Medicine,
while majority of the rural caregivers (n=314; 71.4%)
University of Ibadan, Nigeria
had fair knowledge. There was statistically significant
Email: rolaadedgoog@gmail.com
difference in the urban and rural infant feeding practices
(302; 68.6% vs 388; 88.2%; p= 0.001). Few of the urban
Introduction/Background: Zinc plus
Low osmolarity
(16.8%) and rural (8.9%) mothers breastfed exclusively.
Oral Rehydration Salt solution (Zn +LoORS) is the cur-
Many (85.7% vs 91.4%) of the urban mothers and rural
rent recommendation for management of childhood diar-
mothers introduced complementary foods before 6
months of age. Wasting (49.6% vs 38.9%; χ = 10.19, p=
2
rhoea. Primary healthcare workers (PHCWs) are usually
0.006) and stunting ((43.9% vs 35.4%; χ =5.4,p=0.143)
2
the first line of contact for these children.
Aims/Objectives: To
determine the
levels of
and factors
was more prevalent among rural infants.
Conclusion: Although
many of
the caregivers
had good
45
knowledge, this has not translated to good practice and
non-communicable diseases seen in children. It is also
the nutritional status remains poor. Sustainable strate-
the most neglected.
gies are required to improve feeding practices and nutri-
Objectives: To
determine the
pattern of
oral diseases
tional status of children.
among children who presented in the dental clinic of
Keywords: Infant
feeding practice,
Nutritional status,
NAUTH from February 2012 to December 2016.
Rural, Urban
Methods: A
retrospective study
that assessed
for oral
diseases among children using the dental health records
of
NAUTH over 58 months.
Demographics of children with severe acute malnu-
Results: 1105
cases presented
in the
dental clinic
during
trition in Usmanu Danfodiyo University Teaching
the study period, out of which 546 were males and 558
Hospital, Sokoto, North-Western Nigeria
females with a ratio of 1:1.01. The age range of subjects
was 1 month to 17 years (Mean age of 11 years, SD ±4.2
Jiya NM, Adamu A, Yusuf T, Baba J, Ibitoye PK, Ugege
years). 97.8% of cases were symptomatic. Across all age
MO, Jiya FB, Isezuo KO, Hassan MA.
groups, periodontitis was the prevalent disease seen in
Department of Paediatrics, Usmanu Danfodiyo Univer-
32.6% of cases followed by retained deciduous teeth,
sity Teaching Hospital,
gingivitis and caries seen in 9.9%,9.4% and 9.0% re-
PMB 2370, Sokoto, Nigeria
spectively (p<0.0001).
Email: nmajiya2013@gmail.com
Conclusion: An
increasing trend
in of
oral diseases
was
observed during the study period with periodontitis as
Background: Under
nutrition underlies
half of
all deaths
the leading diagnosis. There is need for increased aware-
of
under-five children globally, especially in resource
ness particularly among paediatric health care providers
poor countries Nigeria inclusive. Under nutrition re-
with effective strategies tailored to prevent and control
mains one of the health challenges that Nigeria has to
this trend.
deal with to remain on course to achieve the health-
Keywords: Oral
diseases, children,
NAUTH
related Sustainable Development Goals.
Objectives: To
determine the
prevalence, demographic
factors, sub-types and outcome of Severe Acute Malnu-
Glanzmann thrombasthenia: a rare bleeding
trition (SAM) among children aged 6 - 60 months as
disorder in a Nigerian girl
seen in UDUTH, Sokoto.
Methods: This
descriptive observational study
was con-
Ezenwosu OU, Chukwu BF, Ikefuna AN, Emodi IJ
ducted from 1 January to 31 December 2015 among
st
st
Department of Paediatrics, University of Nigeria
children aged 6-60 months admitted into Emergency
Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
Paediatric Unit (EPU) of UDUTH, Sokoto with SAM.
Email: osita.ezenwosu@unn.edu.ng
Relevant information was entered into a proforma. Data
analysis was done with SPSS version 20.
Introduction: Glanzmann
Thrombasthenia (GT)
is an
Results: One
hundred and
twenty-four (11.0%)
of total
extremely rare autosomal recessive bleeding disorder
admission of 1,127 had SAM during the period. Males
due to defective platelet membrane glycoprotein GP IIb/
were 68(54.8%) with M: F of 1.2:1 and mean age (±SD)
IIIa (integrin α IIb β3). The prevalence is estimated at
was 17.8(±8.5) months. Ninety-seven(78.2%) were of
1:1,000,000 and it is commonly seen in areas where
lower socioeconomic status with maternal illiteracy in
consanguinity is high with epistaxis, gingival bleeding
79(63.7%), large family size 77(62.1%) and no immuni-
and menorrhagia as common presentations.
zation in 99(79.8%). One hundred and six (85.5%) were
Case Presentation: The
authors report
a 15
year old
not exclusively breastfed with delayed initiation of com-
Nigerian girl, born of non-consanguineous parents, who
plementary feed in 53(42.7%).Ninety-four (75.8%)
had
presented with prolonged heavy menstrual bleeding
non-oedematous, 30(24.2%) oedematous SAM. Eighty-
since menarche 3 months earlier, weakness and dizzi-
nine (71.8%) were discharged, 9(7.3%) signed against
ness. She had past history of recurrent episodes of pro-
medical advice while 26 died giving case-fatality rate
longed epistaxis, gastrointestinal and gum bleeding at
(CFR) of 21.0%.
early childhood. Her mother and aunt had repeated epis-
Key Words: Severe
Acute Malnutrition,
children,
taxis during their childhood. On examination, she was
prevalence, Sokoto
severely pale with a haemic murmur. The initial diagno-
sis was Menorrhagia secondary to Bleeding Diathesis
probably von Willebrand disease. Her relevant investi-
Pattern of Oral Diseases in Children that Presented
gation results showed anaemia, normal WBC count,
in the Dental Clinic of Nnamdi Azikiwe University
platelet count, Factor VIII, Factor IX, von Willebrand
Teaching Hospital (NAUTH) Nnewi
assays but raised PT and APTT. She was on supportive
treatment with fresh whole blood, fresh frozen plasma
Nri-Ezedi CA*, Ofiaeli OC*, Nwaneli EI*
and
platelets until diagnosis of GT was made in the
*Department of Paediatrics, Nnamdi Azikiwe
USA.
Currently, she is on 3 monthly intramuscular depo
University Teaching Hospital, Nnewi.
-provera with remarkable improvement.
Email: chisomnriezedi@gmail.com
Conclusion: To
the best
of our
knowledge, this
is the
first documented report of GT in our environment where
Introduction: Oral
diseases are
one of
the most
common
consanguinity is very rare. Our health facilities require
46
adequate diagnostic and treatment facilities for rare dis-
sickle cell disease (SCD). Chronic blood transfusion, the
eases like GT. Meanwhile, there is need for collabora-
gold standard for primary stroke prevention is faced
tion with centres in resource-rich countries where sam-
with numerous challenges in resource-poor countries.
ples can be promptly analysed for diagnosis.
Hydroxyurea (HU) has been shown to reduce elevated
Key words: Glanzmann
thrombasthenia,
Consaguinity,
TCD velocities in children with SCD.
Menorrhagia, Nigerian girl
Aim: To
determine the
effectiveness of
HU in
reducing
the risk of primary stroke in a cohort of Nigerian chil-
dren with SCD and elevated velocities treated with HU.
Pattern and outcome of paediatric oncologic cases in
Methods: Children
with SCD
and elevated
TCD veloci-
Lagos University Teaching Hospital, a 7yr
ties ≥ 170cm/sec treated with HU were prospectively
experience
followed for a minimum period of 12 months to deter-
mine annual incidence of primary stroke in the cohort.
Akere ZA, Akinsete AM, Renner A
Results: One
hundred and
four children,
53 males
and
Lagos University Teaching Hospital, Idi Araba, zaira
51
females were enrolled into the study. Their ages
Email: mide01@yahoo.com
ranged from 2 to 16 years with a mean of 7 years. At
first TCD examination, velocities ranged from 173 to
Background: The
number of
children with
cancer is
on
260 cm/sec and were in the conditional and high-risk
the increase and there is no corresponding increase in
range in 43 (41.3%) and 61 (58.7%) children respec-
the resources available to manage these children.
tively. Follow up ranged from 1 to 8 years with a mean
Despite numerous challenges, some of these children
of
3.6 years. Mean TCD velocities showed a significant
survive this difficult experience.
decline from 197.6 (SD=15.9) cm/sec to 168.7
Aims and objectives: this
paper aims
to provide
informa-
(SD=21.3) cm/sec (P<0.001). One stroke event occurred
tion concerning the pattern, demographic distribution,
in
the cohort, giving a stroke incidence of 0.27/100 per-
and outcome of Paediatric oncologic cases admitted in
son
year.
Lagos University Teaching Hospital over the last 7years.
Conclusion: Hydroxyurea
significantly reduces TCD
Methods: it
is a
retrospective study.
Demographic and
velocities in Nigerian children with SCD and elevated
clinical data of patients who were admitted in the last 7
TCD velocities with a corresponding reduction in the
years (September 2010- September 2017) were extracted
incidence of primary stroke. Hydroxyurea may represent
from admission registers in the wards. Additional infor-
a
potential alternative for primary stroke prevention in
mation was retrieved from patients’ clinical notes.
resource-poor countries where the burden of SCD re-
Results: a
total of
367 children
with cancer
were admit-
sides.
ted within that period. The males were more affected.
Keywords: Stroke,
Sickle cell,
Hydroxyurea
Age distribution was from 2 weeks to 16years. Acute
lymphoblastic leukemia made up the highest number of
admissions; however 85% of them died compared to
Effect of acute painful crisis on the blood pressures
85% survival in developed countries. Survival rate was
of children with sickle cell vaso-occlussive crisis
highest in nephroblastoma which represented the third
most common case admitted in that period.
*Onalo R, *Nnebe-Agumadu U, #Oniyangi OO,
&
Antoinette C, Cooper P
&
Conclusion/ recommendations: this study
shows that
many children are diagnosed with cancer die even in
*Department of Paediatrics, University of Abuja Teach-
those who have cancers with good survival rates. This is
ing Hospital, Gwagwalada, Abuja
due to late presentation, financial constraints during
#Department of Paediatrics, National Hospital, Abuja
&
management and availability of blood support services.
Department of Paediatrics, University of the Wit-
This study will help to advocate supporting children
watersrand, Johanesburg
with cancer by providing a foundation to assist with the
Email: richardonalo@yahoo.com
financial burden of the disease. In addition, structures
should be put in place for blood support services and
Background: Acute
painfull crisis
in sickle
cell patients
current important diagnostic techniques.
is
often associated with transient elevation in blood pres-
Keywords: Admission,
survival, cancer
sure. There is an association between cerebrospinal acci-
dents and higher blood pressures in sickle cell patients.
Objective: To
determine the
prevalence and
severity of
Annual stroke incidence in children with sickle cell
blood pressure increase in children with acute painful
disease and elevated TCD velocities treated with
episodes.
hydroxyurea therapy
Methodology: A
two site,
age and
sex matched
case –
control
study, involving 30 sickle cell anaemia patients
Lagunju IA, Brown BJ, Esione A, Oyinlade AO, Adeniyi
in
steady state and 30 patients with severe vaso-
T, Sodeinde OO
occlussive crisis was conducted over a six month period.
Department of Paediatrics, College of Medicine,
Study adhered to Helsinki declaration and good clinical
University of Ibadan
practice. Blood pressure measurements were done ac-
cording to standard protocol while the severity of pain
Background: Elevated
transcranial Doppler
(TCD) ve-
was assessed by Numerical Visual Pain Scale.
locities accurately predict stroke risk in children with
Results: A
total of
60 patients
(30 in
steady state,
30 in
47
crisis) were recruited. Their mean age was 11.1±3.7year
Acute chest syndrome, higher serum levels of
for those in crisis and 10.6±3.0years for those in steady
interleukin-8 and highly-sensitive C-reactive proteins
state. Pain was rated at 8.6±1.2 and the mean number of
are associated with spirometric lung dysfunction in
pain sites was 2.5±1.0.The mean systolic blood pressure
children with sickle cell anaemia
was 122.5±11.7 and 103.2±10.6mmHg respectively for
Samuel AA , Bankole PK , Kehinde OO , Olufemi OS ,
1
1
2
3
crisis and steady states while the mean diastolic pres-
1
Oyeku AO , Oluwagbemiga OA
1
sures was 74.6±14.6mmHg for crisis state and
65.7±10.5mmHg for steady state. Seventeen patients
Department of Paediatrics and Child Health, Obafemi
with crisis had both systolic and diastolic hypertension
Awolowo University (OAU), Ile-Ife.
compared to only two in those in steady state. Blood
Department of Paediatrics, Wesley Guild Hospital Ilesa
pressure percentile was greater than 99+5 in 8 patients.
Unit, OAU Teaching Hospitals Complex, Ile-Ife.
Isolated systolic or diastolic hypertension was not com-
Department of Chemical Pathology, OAUTHC, Ile-Ife.
mon.
Email: adegoke2samade@yahoo.com
Conclusion: Acute
elevation in
systolic and
diastolic
blood pressures is common in child with vaso-
Introduction/Background: Sickle cell
anaemia (SCA)
is
occlussive crisis. Therefore meticulous attention to
a
chronic inflammatory disorder with multiple organ
blood pressures of patients with sickle cell crisis is rec-
manifestations including acute and long term pulmonary
ommended.
dysfunctions.
Aims/Objectives: To
assess lung
functions of
children
with SCA and determine the role of acute chest
Purpura fulminans with peripheral gangrene in se-
syndrome (ACS) and immunological factors (serum
vere falciparum malaria - a case series
proinflammatory cytokines; highly-sensitive C-reactive
protein(hs-CRP); leucocytes and 25-hydroxyvitamin D
Oladokun RE , Fowotade AA , Lawal TA
1
2
1
(25-OHD) in the development of lung dysfunction.
Department of Paediatrics, Department of Medical
Subjects and Methods: This
cross-sectional study
Microbiology, University College Hospital, Ibadan
included 76 children aged 4 – 15years with SCA in steady
Email: tope_lawal@yahoo.com
state. They were classified into normal or abnormal lung
function(ALF) using spirometric data (forced expiratory
Background: Purpura
fulminans is
an acute
fatal illness
volume at 1second (FEV1), forced vital capacity(FVC)
consisting of septicaemia, shock, and disseminated in-
and FEV1/FVC ratio. Their clinical and immunological
travascular coagulation, often manifesting with gangrene
data were compared by bivariate and regression
of
the distal extremities and necrosis of skin. Purpura
analyses.
fulminans associated with severe malaria has rarely been
Results: Fifty(65.8%)
had ALF,
comprising 23(30.3%),
reported among children.
3(3.9%) and 24(31.6%) with restrictive, obstructive and
Case reports: Two
cases of
purpura fulminans
with dis-
mixed patterns respectively. Twenty-eight(36.8%) had
seminated intravascular coagulation probably due to
history of ACS. Children with ACS were 3.6 times more
severe Falciparum malaria, are presented from a tertiary
likely to have ALF than those without ACS, 82.1% vs.
health facility in Nigeria. Both cases were males, and
56.3%, p=0.022, OR=3.6, 95%CI=1.2-10.8. Interleukin
were infants aged 6 and 7 months respectively. They
(IL)-8 and hs-CRP were significantly higher among
presented with fever, seizures, loss of consciousness and
patients with ALF, 6.01±1.61pg/ml vs. 4.87±2.62pg/ml,
features of shock and had associated peripheral gangrene
p=0.021 and 11.30±1.69µg/ml vs. 2.26±2.42µg/ml,
which developed hours into admission. Investigations
p<0.001 respectively. Although leucocyte counts and IL
showed P.
Falciparum hyperparasitaemia and evidence
-17 were also higher and 25-OHD levels were lower, the
of
disseminated intravascular coagulation. No focus for
differences were not statistically significant, P>0.05.
sepsis was identified and there were no bacterial isolates
Using logistic regression, ACS (p=0.034) and IL-8
from blood culture. Treatment consisted of parentheral
(p=0.02) independently predicted presence of ALF.
artesunate and broad spectrum cephalosporin as well as
Conclusions/Recommendations: Lung dysfunction of
vasopressor agent dopamine , mannitol for raised intrac-
predominantly restrictive pattern is common in this
rainial pressure and phenobarbitone for seizures.
The
cohort and is associated with previous ACS and altered
second child survived but was left with residual gan-
immune markers. Prevention of ACS and inflammation
grene of all the digits which was awaiting surgical am-
may retard development of lung dysfunction in children
putation at the time of the report. .
with SCA.
Conclusion: The
cases presented
demonstrate that
pur-
Keywords: Acute
chest syndrome,
Interleukins, Lung
pura fulminans can occur with severe malaria even in
P.
function, Sickle cell anaemia.
falciparum endemic
settings.
Key Words: Purpura
fulminans, peripheral gangrene,
Severe Falciparum malaria, children
48
Common aetiologic agents of bacteraemia in febrile
descriptive study involved 182 health-care workers in
children with sickle cell disease admitted at national
the 46 PHC centres in four Local Government Areas in
hospital, Abuja
Ilesa. The participants who were selected by simple
random
sampling
completed
self-administered
Okon E J, Oniyangi O, Akinbami FO
questionnaire.
Results:
Their
average
length
of
service
was
Background: Bacterial
infections is
a leading
cause of
12.9±6.6years. Majority, 167(91.8%) knew that SCD is
morbidity and mortality in children with sickle cell dis-
an
inheritable blood disorder. Knowledge on clinical
ease (SCD). The data on the common aetiologic agents
features was also good. However, only 59(32.4%) knew
of
bacteraemia in children with SCD in Africa including
about
prenatal/neonatal
diagnosis,
68(37.4%),
90
Nigeria is limited. This has affected the development of
(49.5%) and 123(67.6%) respectively knew about the
specific interventions required to reduce the burden of
role of chemoprophylaxis, adequate fluids and malaria
this complication in children with the disease.
prevention in SCD care. Only two(4.3%) PHC centres
Objectives: This
study aims
to determine
the prevalence
treat patients with SCD. In one, a visiting doctor runs a
and the common aetiologic agents of bacteraemia in
weekly clinic where children with SCD also attend. One
febrile children with SCD seen at the NHA.
routinely check haematocrit. SCD-targetted nutritional
Methods: This
was a
comparative study
of children
with
counselling and referral to secondary/tertiary hospitals
SCD aged 6 months to 15 years and their age and sex
were poor. None offer SCD screening, home visit,
matched counterparts with haemoglobin A and axillary
record keeping, hydroxyurea therapy, intravenous fluids
temperature ≥380C admitted at NHA as subjects and
or
blood transfusion.
controls. Blood culture was performed with BACTEC
Conclusions/Recommendations:
Knowledge of
Ilesa
Peds/F plus culture medium on each study participants.
PHC workers about early SCD diagnosis and crisis
Results: A
total of
147 children
with SCD
aged between
prevention is poor. The level of SCD care is also poor.
6
months and 15 years and their age and sex matched
PHC workers should be regularly trained and equipped
counterparts with
haemoglobin A were recruited as
on
basic SCD management including early detection,
subjects and controls respectively. The mean age (SD)
crisis prevention and provision of basic genetic
of
the children was 5.0 ± 3.6 years. The prevalence of
counselling to dispel associated myths and stigma.
bacteraemia in SCD was 49 (33.3%) versus 24 (16. 3%)
Keywords: Ilesa,
Primary Health
Care, Sickle
cell
in
the controls. Staphylococcus aureus was the most
disease.
common cause of bacteraemia in both groups, SCD 25
(51.0%) and controls17 (70.8%), followed by Strept.
pneumoniae 12 (24.5%), controls 2 (8.3%) and Salmo-
Cerebral Blood Flow Velocities of Children and
nella spp 5(10.2%) vs 2(8.3%) in controls.
Adolescents with Sickle cell Disease: correlation with
Conclusion: Bacteraemia
is an
important cause
of mor-
clinical and hematological profiles
bidity in febrile children with SCD presenting at the
, Lyra IM , Thiago F , Jamary
3
4
Bartholomew FC
1, 2, 3
NHA. Staph. aureus, Strept. pneumoniae and Salmonella
OF , Uche SN , Marilda de Souza Gonçalves
4
2,5
2,6
spp. are the common cause.
1.Hematology/Oncology Unit, Department of Pediatrics,
University of Nigeria, Nsukka
The Care of Patients with Sickle Cell Disease at
2.Centro de Pesquisas Gonçalo Moniz, Fundaçăo
Primary Health Centres in Ilesa, Southwestern,
Oswaldo Cruz, Bahia, Brazil.
Nigeria
3.Departamento de hematologia, Hospital Universitário
Professor Edgard Santos (HUPES), Universidade Fed-
Samuel AA , Morenike AA , Oyeku AO , Oluwagbemiga
1
2
1
eral da Bahia, Bahia, Brazil
3
OA , Adekunle DA
1
4.Ambulatório Pediatrico de Doença cerebrovascular,
Department of Paediatrics and Child Health, Obafemi
Hospital Universitário Professor Edgard Santos, Uni-
Awolowo
University (OAU), Ile-Ife.
versidade Federal da Bahia, Bahia, Brazil
Department of Paediatrics, Wesley Guild Hospital Ilesa
5.Department of Biochemistry, Ahmadu Bello Univer-
Unit, OAU Teaching Hospitals Complex, Ile-Ife.
sity, Zaria, Nigeria
Department of Paediatrics, Faculty of Medicine, Kuwait
6.Departamento de Análises Clinicas e Toxicológicas,
University, Kuwait.
Faculdade de Farmacia, Universidade Federal da Ba-
Email: adegoke2samade@yahoo.com
hia, Brazil
Email: chizzy_bath@yahoo.com.
Introduction/Background: In
Nigeria, involvement
of
Primary Health Care (PHC) centres in the early
Background: Stroke
is a
devastating complication of
identification and management of individuals with sickle
sickle cell disease (SCD). Abnormal transcranial Dop-
cell disease (SCD) is largely unknown.
pler (TCD) result is the most important risk factor.
Aims/Objectives: To
assess knowledge
of PHC
workers
Objectives: The study aimed at evaluating TCD of chil-
about SCD and evaluate the available facilities and
dren and adolescents with SCD in Salvador, Brazil, and
management practices for SCD care at PHC centres in
correlating the flow velocities with clinical and hemato-
Ilesa, Southwestern Nigeria.
logical profiles of the patients.
Subjects
and
Methods:
This
community-based
Methods: TCD
was performed
on subjects
aged 2-16
49
years, using a 2 MHz probe placed over the transtempo-
rapeutic and the long-term follow-up.
ral windows. The oxygen saturation (SpO 2 ) and anthro-
Key words: Immune
ThromboPenia (ITP),
autoimmu-
pometric parameters were measured, and clinical and
ne, petechiae, purpura, hematuria, children.
hematological profiles retrieved from their medical re-
cords.
Results: One
hundred and
thirty-five patients
were re-
Diagnostic dilemma in a case of childhood tumour in
cruited. The time averaged maximum mean velocity
a resource limited setting: differentiating between
(TAMMV) was 125cm/s. Patients with SCA had a sig-
acute myeloid leukaemia and rhabdomyosarcoma; a
nificantly higher CBFV (131cm/s) than those with
case report
HbSC disease (107cm/s). Only one (0.74%) patient had
1
Garba BI, Sani UM, Isezuo KO, Waziri UM, Abdul-
1
1
1
2
abnormal TCD. CBFV correlated inversely with age,
lahi K, Musa AU, Hano IJ, Abubakar M, Inoh II.
3
1
1
1
SpO2, Hb, and positively with WBC and platelet counts.
1
2
Previous history of ACS and recurrent painful crises was
Department of Paediatrics,
Department of Histopa-
thology, Department of Haematology, Usmanu Danfo-
3
associated with abnormal or conditional velocity.
Conclusion: Frequency
of abnormal
CBFV in
SCD was
diyo University Teaching Hospital (UDUTH) Sokoto.
low. Young age, low SpO 2 , Hb,
and high WBC and
platelet counts were associated with high TCD veloci-
Background: Multiple
primary childhood
cancers can
be
ties. Previous history of ACS and recurrent painful epi-
synchronous or metachronous. With aggressive treat-
sodes were associated with abnormal or conditional
ment of first cancer, the incidence of metachronous tu-
TCD velocity.
mours is increasing; however synchronous tumours are
Key words: sickle
cell disease,
cerebral blood
flow ve-
rare. Acute myeloid leukaemia (AML) occurring in pa-
locity, Transcranial Doppler, children, adolescents, Sal-
tients treated for rhabdomyosarcoma with cyclophos-
vador.
phamide and low-dose etoposide have been reported.
Objective: To
highlight the
challenges in
a resource
lim-
ited setting during management of a childhood tumour
Immune thrombopenic Purpura in a twin girl revea-
Case report: A
10 year
old boy
referred with
a 4
weeks
led by a traumatic injury in Parakou (North Benin)
history of bilateral protrusion of the eyes with fever, but
n
o
b o
n e
p a
i n s
o
r
b
l e e d i n g .
Adedemy JD, Agossou J, Noudamadjo A, Agbeille
Results: Cranial
computer tomography
(CT) scan
re-
Mohamed F.
vealed hyperdense enhancing mass lesion in the superior
Service de Pédiatrie, Département Mčre Enfant, Faculté
and lateral aspect of the right orbit. Initial full blood
de Médecine, Université de Parakou, Bénin.
count (FBC) showed anaemia, thrombocytopenia with
Pédiatre, MCA, Faculty of Medicine, University of
normal white blood cell count (WBC). Fine needle aspi-
Parakou, Benin. BP 123 Parakou,
ration cytology showed features consistent with a small
Email: kofadier@yahoo.fr
round blue cell tumour of childhood, favouring embryo-
nal rhabdomyosarcoma. Chemotherapy was com-
menced, but was changed to 2
nd
Introduction : Idiopathic
or autoimmune
thrombocyto-
line cytotoxics due to
penic purpura (ITP) is a benign blood disease associated
lack of significant improvement. Four months later, he
with an abnormal decrease in platelet count due to a
developed generalized bone pains and repeat FBC
disorder of the immu-ne system resulting in the destruc-
showed marked leucocytosis and thrombocytopenia.
tion of the platelets of the patient by the production of
Bone marrow aspiration (BMA) revealed myeloid hy-
a
n t i - b o d i e s
d
i r e c t e d
a
g a i n s t
t h
e m .
perplasia with maturation arrest and suppression of other
Objective : The
authors report
a case
of autoimmune
lineage consistent with Acute Myelomonocytic Leukae-
thrombocytopenic purpura in a twin 6-year-old girl.
mia FAB M4. He subsequently deteriorated and died
From this clinical case, a review of the literature was
following hematemesis after commencing chemotherapy
made.
f
o
r
A
M
L
.
Clinical case : Persistent
cutaneous signs
at different
Conclusion: Our
patient was
initially treated
for rhabdo-
sites, mucocutaneous endobuccal bubbles and occurren-
myosarcoma but later diagnosed with AML. Lack of
ce
of hematuria were the main reasons for admission to
further investigations limited confirmation of either a
the pediatric emergency room at Parakou University
late diagnosis of AML or a synchronous tumour.
Hospital. This case poses three problems to solve :is ITP
Key words: Acute
myelomonocytic leukamia, Rhabdo-
real ? for ITP is diagnosed by elimination. Is ITP isola-
myosarcoma, synchronous
ted ? It could be associated to other auto-immune disea-
ses or immunodeficiency. What are the tools and tips
helping to undergo an optimal management ie treatment
and ordinary life recommandations, both on the thera-
peutic side and on the recommendations for everyday
life. The apparently healthy clinical condition of the
twin sister of the subject also raised concerns of authors.
Conclusion : This
clinical case
allowed retaining
the
diagnosis by elimination and after treatment. The severe
acute form poses the problem of its urgent care, the the-
50
Generalized lymphadenopathy: an unusual presenta-
of
9.6 years were started on HU from Dec 2016 to Octo-
tion of burkitt lymphoma in a 6-year-old child
ber 2017 but only patients on therapy for more than
3months were analysed (n=32) All were homozygous
Ezenwosu OU , Chukwu BF , Okafor OC , Ikefuna AN ,
1
1
2
1
HbSS. Mean duration of Hydroxyurea therapy was 4.3
Emodi IJ
1
months (range 3 to 10 months) with a mean HU dose of
Department of Paediatrics, Department of Morbid Anat-
15.9mg/kg (range 15mg/kg to 22mg/kg). Mean HbF
omy, University of Nigeria Teaching Hospital, Ituku/
level in patients was 6.9%(range 1.9% to 22.5%).
Ozalla, Enugu, Nigeria
Six or more months duration of HU resulted in signifi-
Email: docsita31@yahoo.com
cant increase in mean Hb levels and a reduction in mean
WBC. There was significant reduction in vaso-occlusive
Intoduction: Burkitt
Lymphoma is
the fastest
growing
crises, frequency of hospitalization and blood transfu-
tumor in human and the commonest of the childhood
sion. One child discontinued HU due to side effects.
malignancies. Generalized lymphadenopathy is a com-
Two others had mild side effects. Challenges included
mon feature of immunodeficiency associated Burkitt
initiation and sustainability of therapy
lymphoma but an uncommon presentation of the en-
Conclusion: HU
is beneficial
in the
management of
chil-
demic type in Human Immunodeficiency Virus (HIV)
dren with SCD in UATH. Acceptability is high among
negative children.
patients and families, but sustainability of therapy re-
Case Presentation: The
authors report
a 6
year old
HIV
mains a challenge.
negative boy who presented with generalized lymphade-
nopathy, cough, weight loss, fever and drenching night
sweat and had received native medication as well as
Serum Ferritin Levels In Patients with Sickle Cell
treatment in private hospitals. His examination revealed
Anaemia on Chronic Transfusion Therapy in
hepatosplenomegaly, bull neck with generalized signifi-
National Hospital Abuja
cant massive lymphadenopathy. Diagnosis was missed
Hamza N , Oniyangi O , Ezeh GO , Okon EJ
1
2
1
1
initially until a lymphnode biopsy for histology con-
1
Ogbe OP , Kure HI
3
firmed Burkitt lymphoma. He was managed on combi-
nation chemotherapy with complete resolution and now
1:Department of Paediatrics, National Hospital Abuja
on
follow up.
2:Department of Paediatrics, Department of
Conclusion: Burkitt
lymphoma involving
lymphnode
Haematology, National Hospital Abuja
generally as the primary site is unusual. High index of
Email: hamzanajaatu@gmail.com
suspicion and early biopsy are the key in this uncommon
presentation.
Background: Central
to the
prevention of
stroke in
Key words: Burkitt
lymphoma, generalized lymphade-
sickle cell anaemia (SCA) is chronic blood transfusion
nopathy, child
therapy (CTT). A major complication of CTT is iron
overload, with its attendant morbidities including liver
and cardiac toxicity. .
Heamatologic and clinical responses to hydroxyurea
Aim: This
is to
describe our
experience with
iron over-
in children with sickle cell disease at the University
load (measured by serum ferritin) in children with SCA
of Abuja Teaching Hospital, Abuja Our experience
on
CTT. This is to raise awareness among clinicians of
the occurrence of iron overload as a complication of
*Nnebe – Agumadu U, ⁺ Adebayo IA
CTT in children with SCA.
Materials and methods: It
is a
retrospective study
of the
University of Abuja , Abuja.
serum ferritin levels of children with SCD on CTT, at-
⁺
*Department
of Paediatrics,
College
of Health Sciences,
Department of Paediatrics, University of Abuja
tending the sickle cell clinic of National Hospital Abuja
Teaching Hospital, Gwagwalada, Abuja
over a 10 year period 2007 – 2017. Data extracted from
the folders of patients with SCD on CTT was analysed
Background: Effectiveness
of hydroxyurea
in sickle
cell
using Microsoft Excel 2010, and are presented as fre-
disease (SCD) is well documented yet there is paucity of
quencies. Means were compared using ANOVA.
its use in Nigeria owning to parental and societal factors.
Results: A
total of
19 children
(M:F of
2:1) aged
5 to
17
Currently, few Nigerian children with SCD are using
years, on CTT for 1 - 11 years, mean 41.57 months were
hydroxyurea.
enrolled in the study. All (100%) had markedly elevated
Aim and objectives: To
determine the
laboratory and
values of serum ferritin, ranged between 850.5ng/ml to
clinical response of children with SCD to hydroxyurea
9324ng/ml, and mean of 2995.5ng/ml. One patient had
therapy and determine barriers to effective treatment.
greater than ten times pre-CTT elevation of serum fer-
Methods: A
retrospective review
of fifty
children with
ritin after 10 months on CTT. There is a significant as-
SCD aged 1 – 17years who are on hydroxyurea therapy
sociation between serum ferritin levels and CTT dura-
in
the paediatric sickle cell unit was done.
tion (p = 0.008).
Outcome measures:
Conclusions: Despite
the importance
of CTT
for stroke
Laboratory response
prevention in SCA, it exposes the child to iron overload
Clinical response
and its attendant morbidities hence the need for screen-
Side effects
ing, risk benefit assessment and prompt treatment when
Results: Fifty
Children (29
M and
21 F)
with a
mean age
present. Other treatment modalities of stroke prevention
51
in
SCA such as Hydroxyurea should be explored.
lation, accounting for 2-3% of all childhood leukaemia.
Keywords: Sickle
cell anaemia,
chronic transfusion
In
FETHA, we recorded 2 cases of CML between 2013
and 2016 and the diagnosis of the 2 case was delayed.
nd
therapy, hydroxyurea, serum ferritin
Objective: To
increase the
awareness of
physicians on
this seemingly rare form of childhood leukaemia to en-
Myxoid liposarcoma in a 2 year old boy: a case
courage early diagnosis and prompts treatment.
report
Case reports: We
present a
10-year-old boy
and a
16-
year-old girl who presented in our facility with features
Babalola TE , Adefehinti O , Aderibigbe AS
1
1
2
of
CML chronic phase. Both cases had leucocytosis.
Adeodu OO .
1
Cytogenetic assessment was positive for BCR-ABL in
1
Department of paediatrics, Obafemi Awolowo
both cases confirming chronic CML. The first case had
University teaching hospitals complex, Ile-Ife
Hydroxyurea before referral to Obafemi Awolowo Uni-
2
Department of Radiology, Obafemi Awolowo
versity Teaching Hospital (OAUTH) for Imatinib ther-
University Teaching hospitals complex, Ile-Ife.
apy. The 2
nd
case was also referred to OAUTH Ile-Ife
Email: tolugifty@gmail.com
where she received Imatinib, however due to disease
progression to blastic phase; she was referred back to
Introduction: Liposarcoma
is a
rather uncommon
soft-
our centre for treatment. She is currently on treatment
tissue tumor. The finding of a myxoid subtype has been
for AML with appreciable response.
shown to correlate with a poor prognosis. Although sur-
Conclusion: CML,
although one
of the
rare childhood
gical treatment is relevant for resectable disease, radia-
leukaemias is becoming more common, probably due to
tion therapy and chemotherapy are also recognized
availability of diagnostic facilities. There is therefore
forms of treatment, especially for more advanced dis-
need for increased awareness of the disease among phy-
ease.
sicians to minimize delays in the diagnosis with im-
Case presentation: We
report the
case of
a 2year
old
proved care and better outcome.
boy who presented with a right gluteal mass and right
lower abdominal swelling of 8 months duration, inabil-
ity to walk, and progressive difficulty with urination. An
Management and Outcome of Patients with Nephro-
irregular abdominopelvic mass involving the right
blastoma at the University of Abuja Teaching Hospi-
gluteal region was seen. Computed tomography showed
tal, Gwagwalada
the
mass to have the density of muscle, compressing the
urinary bladder, with bilateral dilatation of the pelvi-
Offiong UM, Fashie AP
calyceal systems. Biopsy histo-pathology revealed ma-
Department of Paediatrics, University of Abuja
lignant cells with lipogenic differentiation as well as
Teaching Hospital, Gwagwalada, FCT
lipoblasts. He had chemotherapy and concurrent radio-
Email: andrewfashie@yahoo.co.uk
therapy from weeks 9-12 of chemotherapy; following
which a complete response was reported both clinically
Background: Nephroblastoma
is one
of the
commonest
and radiologically. After a 49-week symptom-free pe-
paediatric tumours in Nigeria. It accounts for more than
riod, he had a recurrence of right gluteal swelling and
95% of kidney tumours in children. The tumour demon-
newer masses in the posterior neck and upper back. He
strates rapid response to multi disciplinary treatment
had salvage chemotherapy; but his clinical condition
which includes surgery, chemotherapy with or without
deteriorated with altered sensorium and convulsions. He
radiotherapy, with good survival rates even in resource
eventually succumbed to the disease 31 months after the
poor
settings.
initial diagnosis.
Objective: To
evaluate the
management and
outcome of
Conclusion: Myxoid
liposarcoma is
a rare
tumour in
the
patients with nephroblastoma attended to at the Univer-
paediatric age group. Improvements in facilities for
sity
of Abuja Teaching Hospital, Gwagwalada from
multi-modal treatment will help to improve outcomes in
20012-2016
a
limited-resource setting like ours.
Design: Retrospective
study
Key word: Liposarcoma,
Myxoid, Chemotherapy, Ra-
Setting: Paediatric
oncology unit
of the
University of
diation, Paediatrics
Abuja Teaching Hospital, Gwagwalada.
Results: Fifteen
children aged
12 months
– 12
years
were studied. Eight (53%) were males and 7 (47%) were
Chronic Myeloid Leukaemia in Federal Teaching
females. Six children (40%) were aged less than 24
Hospital Abakaliki (FETHA): A Report of two cases
months, 6 (40%) were 2-5 years, and 3 (20%) were
above 5 years. The patients were treated using SIOP
Udechukwu NP , Oyim-Elechi OC and Okike C
1
2
3
protocol. All the children had pre-operative chemother-
Department of Paediatricks, FETHA, Ebonyi State.
apy. They all had nephrectomy and histological diagno-
Email: patcy42@yahoo.com
sis. Nine (60%) completed treatment while 6 (40%)
were lost to follow up. Four (27%) of the patients died,
Background: Chronic
myeloid leukaemia
(CML) is
a
while 7 (46%) of the patients were disease free and alive
myeloproliferative disorder characterized by prolifera-
12
– 36 months after treatment.
tion of granulocytic cell lines at varying stages of devel-
Conclusion: Loss
to follow
up and
cost of
treatment had
opment. It is predominantly a disease of the adult popu-
a
negative impact on the outcome of the treatment. In-
52
creasing awareness for early recognition and introduc-
against tuberculosis but protection varies from 0 to 80%.
tion of free healthcare for all childhood cancers are some
Aims: To
determine the
tuberculin conversion rates
of
the measures that can significantly improve the sur-
among BCG vaccinated infants
vival of these children.
Subjects/Methods: A
cross sectional
study of
infants
aged 13 to 15 weeks carried out at the Institute of Child
Health, University of Nigeria Teaching Hospital Enugu.
The relationship between age at BCG vaccination
Ethical approval was obtained from the Institution. Pres-
and scar formation
ence of BCG scars were ascertained and measured. 5TU
of
the PPD was implanted and read after 48 hours. Di-
1
1, 2
Ubesie AC, Okafor HU,
1, 2
1, 2
Enemuo EJ,
Ikefuna AN
ameters of Mantoux induration were classified as nega-
1
Department of Paediatrics, University of Nigeria
tive (<10mm) and positive ( ≥10mm). Data analysis was
Teaching Hospital, Ituku Ozalla, Enugu
with Statistical Package for Social Sciences (SPSS) ver-
2
Department of Paediatrics, University of Nigeria
sion 20.0 (SPSS Inc. Chicago, Illinois, USA).
Email: agozie.ubesie@unn.edu.ng
Results: Two
hundred and
twenty-six (80.7%)
of 280
infants received BCG vaccination within first week of
Introduction: The
absence of
BCG scar
may be
an indi-
life, of which 90 (39.8%) were vaccinated within 48
cation of failure of immune response or an unsuccessful
hours of birth. One hundred and eighty (64%) infants
vaccination.
had tuberculin conversion as evidenced by a positive
Aims: This
study sought
to evaluate
the relationship
be-
Mantoux test response with an induration diameter of at
tween age at BCG vaccination and scar formation
least 10mm. Among males, 104 of 143 (72.7%) had a
Subjects/Methods: This
study was
conducted at
the In-
positive Mantoux response compared to 76 of the 137
stitute of Child Health, University of Nigeria Teaching
females (55.5%) (p = 0.003, OR = 2.140, 95% C.I =
Hospital, Enugu. Ethical approval was obtained from the
1.300 to 3.525). There was a significant positive asso-
Institution. Infants aged 13 to 15 weeks were examined
ciation between the presence of BCG scar and tuberculin
conversion ( χ = 40.273, p < 0.001).
2
for the presence of a BCG scar and the transverse di-
ameter of scar measured. 5TU of PPD was implanted
Conclusion: The
tuberculin conversion rate
among BCG
and read after 48 hours. Data analysis was with Statisti-
vaccinated infants was 64%. Males were twice more
cal Package for Social Sciences (SPSS) version 20.0
likely than females to have tuberculin conversion.
(SPSS Inc. Chicago, Illinois, USA).
Key Words: Bacillus
Calmette Guerin,
Infants, Immune
Results: Two
hundred and
twenty-six (80.7%)
of 280
Response, Mantoux.
infants received BCG vaccination within the first week
of
life, of which 90 (39.8%) were vaccinated within 48
hours of birth. One hundred and ninety-nine infants
Childhood allergic rhinitis at usmanu danfodiyo
university teaching hospital, sokoto: a preliminary
(71.1%) developed BCG scars. Among them, 143
report
(71.9%) and 56 (28.1%) had scars ≥ 3 mm and < 3 mm
in
diameters respectively. BCG scar was present in 58
Garba BI, Sani UM, Isezuo KO, Waziri UM, Hano IJ,
(64.4%) of the 90 infants vaccinated within the first two
Falaye AM, Mada IL, Abubakar FI
days of birth compared to 141 of 190 infants (74.2%)
Department of Paediatrics, Usmanu Danfodiyo
University Teaching Hospital, Sokoto
vaccinated at ≥ third day of life (
2
=
2.833, p = 0.092).
Email: bgilah@yahoo.com
The
mean ages at BCG vaccination among infants with
and without a BCG scar were 5.9 ± 5.9 days and 4.8 ±
Background :
Allergic rhinitis
(AR) is
common with
a
worldwide prevalence of 14.6% in children aged 13 and
4.8 days respectively (p = 0.079).
14
years. It is characterized by sneezing, rhinorrhoea,
Conclusion: There
was no
relationship between
postna-
nasal congestion, itchy nose, nasal obstruction and post-
tal
age at BCG vaccination and scar formation/ tubercu-
nasal drip. Antihistamines are safe and effective for
l
i
n
r
e
s
p
o
n
s
e
.
treatment of allergic rhinitis and ocular symptoms in
Key Words: Age,
Bacillus Calmette
Guerin, Scar.
rhinoconjunctivitis.
Objective: To
describe the
socio-demographic and clini-
cal pattern of childhood AR seen at Usmanu Danfodiyo
Tuberculin conversion rates as an indicator of im-
University Teaching Hospital (UDUTH), Sokoto
mune response among BCG vaccinated infants in
Methodology: Descriptive,
prospective study
of children
Enugu
clinically diagnosed with AR attending the Paediatric
1
1, 2
1, 2
1, 2
Pulmonology and Allergy clinic of UDUTH, Sokoto
Enemuo EJ,
Ubesie AC,
Okafor HU,
Ikefuna AN
1
from March 2017 to September 2017. A questionnaire
Department of Paediatrics, University of Nigeria
was used to obtain relevant information and data was
Teaching Hospital, Ituku Ozalla, Enugu
2
analysed accordingly.
Department of Paediatrics, University of Nigeria
Results: Of
the 44
children enrolled,
23(52.3%) were
Email: agozie.ubesie@unn.edu.ng
males, with a M:F ratio of 1.1:1. Age range was 7
months to 13 years, with mean±SD of 5.34±3.25 years.
Introduction: Vaccination
with the
Bacillus Calmette
Majority 26(59.1%) were between 1 to 5 years, followed
Guerin (BCG) remains an effective preventive measure
53
by
6-10 years group 12(27.3%). There were more males,
about them especially in Primary Health Care facilities.
however no statistical significance (p=0.438, Fischer’s
They should also be included in the National Routine
exact). Most of the children belonged to the high socio-
Immunization
Program
and
subsidized.
economic class 26(59.1%) and have concomitant asthma
Keywords:
Immunization,
Non-Routine Vaccines,
42(95.5%), however no statistical significance (p=0.162,
Caregivers,
Fisher’s exact). Rhinorrhoea was the commonest symp-
tom
32(72.7%), followed by recurrent sneezing 26
(72.7%) and nasal blockage 19(43.2%). Thirty one
Prevalence and causes of missed opportunities for
(70.5%) have intermittent AR and mild symptoms 30
immunisation in children aged 0 to 23 months at the
(68.2%). Seasonal AR was seen in 32(72.7%) while 12
federal medical centre Umuahia
(27.3%) had perennial AR. All the children were treated
Okafor AF, Korie FC , Ukegbu AU, Ibe BC,
1
1
2
3
with antihistamine and 27(61.4%) are on intranasal ster-
Ughasoro M, Ojinnaka NC
3
3
oid.
Conclusion: AR
is common
in our
clinic with
majority
1Department of Paediatrics, 2Department of
having co-morbidities, particularly asthma. It is common
Community Medicine Federal Medical Centre Umuahia
in
preschool age; majority are symptomatic and have
3Department of Paediatrics, University of Nigeria
mild intermittent AR.
Teaching Hospital Enugu.
Key words :
Childhood, allergic
rhinitis, asthma,
Sokoto
Email: amarafan@yahoo.co.uk
Background: Missed
Opportunities for
Immunisation
Awareness and use of non-routine immunization op-
(MOI) is a significant cause of low immunisation cover-
portunities by caregivers in selected communities in
age
and resurgence of vaccine preventable diseases.
Ibadan, Nigeria
Hence, identifying the causes of MOI in our health fa-
cilities and eliminating them will help improve immuni-
Onifade, TD, Adediran KI
sation coverage in the area.
Institute of Child Health, College of Medicine,
Objective: To
determine the
prevalence and
causes of
University of Ibadan, Nigeria
Missed Opportunities for Immunisation in children aged
Email: rolaadedgoog@gmail.com
0
to 23 months at the Federal Medical Centre Umuahia,
Abia State.
Introduction/Background:
Immunization with
Non-
Methods: Exit
interviews were
conducted for
300
Routine vaccines (NRV)
contributes to reduction of
mother/child pairs of children aged 0 to 23 months con-
mortality in under-five and school aged children. Few
secutively as they exited the preventive and the curative
studies have explored the level of awareness and use of
sections of Federal Medical Centre Umuahia.
NRV.
Results: Of
the 300
children recruited,
142 (47.3%)
were
Aims/Objectives: This
study was
conducted to
assess the
females and 158 (52.7%) were males with a F: M ratio
knowledge and use of NRV among caregivers in Ibadan,
of
1:1.1.Thirty six (12%) of all the children had missed
Nigeria.
opportunities for immunisation. The causes of
MOI
Subjects and Methods: Two
low density
communities in
noted were; presentation of the children on the ‘wrong’
2
LGAs were purposively selected. A household com-
immunisation
days (72.2%), false contraindications to
munity survey was then carried out amongst 200 care-
immunisation by the health workers (13.9%), unavail-
givers selected by systematic sampling. A self-
ability of vaccines (8.3%) and refusal to open a new vial
administered questionnaire was used to obtain informa-
(5.6%). The commonest reason why the children who
tion on socio- demographic characteristics, child’s health
presented on the ‘wrong’ immunisation days missed
history
knowledge of NRV (Rotavirus, MMR, Pneu-
their previous immunisation appointments was because
mococcal, Meningitis, HPV, Typhoid and Chicken pox)
of
non- availability of the mothers due to illness, parent’s
and
their use. Descriptive statistics and Chi square were
travel and farm work.
utilised in to analysing
data and level of significance
Conclusion: The
commonest reason
why MOI
occurred
set at p < 0.05.
at
the Federal Medical Centre Umuahia was because the
Results: Only
37% of
the caregivers
knew about
any of
children presented on the ‘wrong’ immunisation days.
the NRV. Of these, 54.1% obtained information from
Hence, all the vaccines should be made available to
Secondary and Tertiary Health Care immunization cen-
every eligible child that visits our health facilities on any
ters. Few (10%) of households had used any of the
day of the week in order to effectively eliminate MOI.
NRV, (mainly Rotavirus vaccine 8.5%, MMR 5% and
Keywords: Missed
Opportunities for
Immunisation,
Pneumococcal vaccine 4%).. Significant reasons associ-
Children, Umuahia.
ated with receiving the NRV included caregivers knowl-
edge ( x =37.838, p=.000) and higher
monthly income
2
( x =18.980, p= 0.01). Main reason for
not receiving any
2
was lack of knowledge of the NRV (63%), and amongst
those who knew, the cost of the vaccines (51.9%)
Conclusions/Recommendations:
Awareness about
the
Non-routine Vaccines is poor and a major factor affect-
ing
their use. There is need for increasing awareness
54
Pattern of Childhood Allergic Diseases at Usmanu
country but more so in the Northern part of the country.
Danfodiyo University Teaching Hospital, Sokoto
Several factors have been shown to affect vaccine up-
take and consequently vaccine coverage. One of the
Garba BI, Sani UM, Isezuo KO, Waziri UM, Hano IJ,
factors that contribute to completion of immunisation
Falaye AM, Mada LI, Abubakar FI
series is the satisfaction of the clients with the services
Department of Paediatrics, Usmanu Danfodiyo
rendered at immunisation centres. Therefore, it is impor-
University Teaching Hospital, Sokoto
tant to assess the level of clients’ satisfaction with im-
Email:
bgilah@yahoo.com
munisation services at health facilities.
Aim: To
assess clients’
satisfaction with
immunisation
Background: The
burden of
allergic disease
is extensive;
services at the immunisation clinic of Nyanya General
with an estimate of more than 47 million hospital pres-
Hospital Federal Capital Territory Abuja
entations annually where allergy needs to be considered
Methods: A
mixed method
study comprising
of a
cross-
in
the United Kingdom. Co-morbidity (different expres-
sectional observational quantitative and qualitative as-
sions of allergy in the same individual) occurs in allergic
pect. The data collection tools were a structured inter-
diseases. Asthma and allergic rhinitis (AR) are common
viewer administered questionnaire and Focus Group
causes of illness and disability worldwide; which can co
Discussions. Both descriptive and inferential statistics
-exist or manifest separately.
were carried out on the quantitative data and signifi-
Few existing allergy services are available and there is
cance level was set at p < 0.05 at 95% confidence inter-
paucity of data on pattern of childhood allergic diseases
val
in
Nigeria.
Results: A
total of
79 clients
were recruited
during the
Objective: To
describe the
pattern of
childhood allergic
study and 97.5% of them were the female mothers of the
diseases seen at Usmanu Danfodiyo University Teach-
children. Average age of index child was 5.29± 5.23
ing Hospital (UDUTH), Sokoto
months. About 90% of the participants were very much
Methodology: A
descriptive prospective study
of chil-
satisfied with the services they received while 9% were
dren attending the Pulmonology and Allergy clinic of
just satisfied and only 1 person (1%) was not satisfied.
UDUTH, Sokoto. Information regarding age, gender and
The FGDs revealed poor health worker attitude as the
allergic disease were obtained from August 2016 to Sep-
most important factor that leads to dissatisfaction with
tember 2017; data was analysed accordingly.
services
Results: Of
the 82
children enrolled,
44(53.7%) are
Conclusion and Recommendations:
There was
a high
males, with a M:F ratio of 1.2:1. Age range was 3
level of satisfaction with immunisation services at
months to 15 years, with mean±SD of 6.08±3.99 years.
Nyanya General Hospital despite some short comings in
Majority 39(47.6%) were under fives, 28(34.1%) be-
the services. Staff training at Nyanya General Hospital
tween 5.0-9.9 years, while 15(18.3%) were between 10-
on
appropriate attitude towards their clients is recom-
15
years. There were more males, however no statistical
mended.
significance ( χ2=0.331, p=0.847). The commonest aller-
gic
disease was Asthma 75(91.5%), followed by AR 60
(73.2%), conjunctivitis 21(25.1%) and least was eczema
Predictors of Reliability of Oral History of BCG
2(2.4%). AR was seen in 54(66.0%) asthmatics. Co-
Immunization of Under-Fives Among Caregivers in A
morbidities were seen in 59(72.0%) of children.
Rural Community in Northern Nigeria
Conclusion: Allergic
diseases are
common in
children,
Ibrahim MS , Olawepo, OA , Esekhaigbe, C , Babandi,
1
2
2
more in under fives and males. Asthma was the com-
ZS , Umar, MU ,
2
2
monest, followed by AR. AR was a common co-
1
morbidity in asthmatics.
Department of Community Medicine, Ahmadu Bello
Key words: Childhood,
allergy, asthma,
conjunctivitis,
University, Zaria.
2
rhinitis
Department of Community Medicine, Ahmadu Bello
University Teaching Hospital, Zaria.
Assessment of clients’ satisfaction with immunisation
Background :
Though oral
history of
BCG immunization
services at Nyanya General Hospital Federal Capital
is
commonly used in assessing immunization coverage
Territory Abuja
and making clinical decisions, its reliability may not
always be objective.
Okoli, CV
Objectives: The
study identified
predictors of
reliability
Nyanya General Hospital FCT Abuja
of
oral history of BCG immunization of under-fives
Email: chinyeluokoli@yahoo.com
among caregivers in a rural community in northern Ni-
geria.
Introduction: Immunisation
has been
shown to
be an
Method: It
was a
cross-sectional study of
357 caregivers
invaluable public health intervention that has saved
in
Turunku, Igabi Local Government Area, Kaduna
many
lives Millions of under five deaths are still attrib-
State. Background information of caregiver and child
utable to vaccine preventable diseases especially in low
pair
was obtained using an interviewer-administered
income/developing countries. Despite the proven bene-
questionnaire deployed on Open Data Kit (ODK). Rapid
fits
of vaccination, the vaccine coverage in Nigeria for
assessment of BCG immunization status of the child was
all
vaccines remain abysmally low in all states of the
done
through oral history, followed by verification from
55
either immunization card or presence of BCG scar on
gested how it can be
improved: harmonized prescription,
right upper arm of the child. Reliability was defined as
billing and unit-dose
dispensing for the first 72 hours
concordance between oral history and presence of BCG
antibiotic
treatment.
scar or record of BCG vaccination on immunization
Conclusions:
In
conclusion,
adoption
of
harmonized
card.
prescription pattern and billing as well as unit-dose dis-
Result: Median
age of
caregivers was
25.5±5.0 years
pensing for the first 72 hours antibiotic treatment will
and mean age of children was 21.2 ± 13.6 months. Posi-
enhance
antibiotic availability, sustainability and easy
tive BCG immunization status was obtained by oral his-
change or discontinuation when such need arises. It will
tory [294 (82.4%)], immunization card [136 (46.3%)],
also be reduced waste and improve time-out policy.
and presence of scar [279 (94.8%)]. Oral history was
Key words: Antibiotic
stewardship; Drug
pooling, Time
reliable in only 133 (45.2%) cases. Predictors of reliabil-
-out; Cost sharing
ity
of oral history included history obtained from mother
as
caregiver (aOR=5.3, 95%CI=1.1-25.6); care-giver
below 18 years (aOR=2.90, 95% CI=1.2-7.2); and child
Mothers’ and caregivers’ perceptions of causes and
below 12 months (aOR=2.9, 95% CI=1.7-4.9).
treatment of fever and diarrhea among under-fives
Conclusion: Oral
history of
BCG immunization
is most
in Ile Ife
reliable if obtained from the mother, if caregiver is be-
Babalola TE , Oyetoke TT , Oyeniyi KO , Shittu AA ,
1
1
3
4
low 18 years and if the child is less than 12 months.
Ijadunola KT , Salawu SA .
2
5
Keywords: Reliability,
Oral history,
BCG, Immuniza-
1
Department of Paediatrics, Department of Community
2
tion.
Health, Obafemi Awolowo University Teaching
Hospitals , Ile-Ife.
3
Feasibility and cost analysis of antibiotics pooling as
Department of Paediatrics, State Specialist Hospital,
a financing strategy to enhance drug availability for
Asubiaaro, Osogbo
4
children in resource poor hospitals in Nigeria
Department of Surgery, University of Ilorin Teaching
Hospital ,Ilorin
5
Maduka DU , Nwakoby IC , Onwujekwe OE
1,3
2
3
Department of psychiatry, Lagos University Teaching
Odike AI
4
Hospital, Idi-Araba
1. Department of Paediatrics, University of Nigeria
Email: tolugifty@gmail.com
Enugu Campus, Enugu, Nigeria. P.O. Box 1093 Enugu
Nigeria.
Introduction: Fever
and diarrhoea
account for
a signifi-
2. Department of Banking & Finance, 3Department of
cant portion of infant and under-five mortality in Nige-
Health Administration and Management,
ria; despite child survival programs instituted to reduce
University of Nigeria Enugu Campus, Enugu, Nigeria
this trend. This might be related to the perceptions of
4. Department of Paediatrics, Irrua Specialist Teaching
mothers and caregivers on the causes of these conditions
Hospital, Irrua, Edo State
in
children, which could influence the treatment modali-
Email: maduka.ughasoro@unn.edu.ng
ties that caregivers proffer.
Objective: To
assess the
perception of
caregivers on
the
Background: Antibiotic
use is
common but
has a
lot of
causes and treatment modalities of fever and diarrhoea
challenges.
Implementation of an efficient and cost-
in
under-fives.
effective policy that
can improve availability, sustain-
Methodology: The
study was
conducted among
caregiv-
ability, as well as
discontinuation of antibiotic is lack-
ers with under-fives in Ife central Local Government.
ing. In this study we
explore the concept of antibiotic
Four wards were selected from the 11 wards in the Local
drug pooling as a means
to reduce these challenges.
Government.
Methods: The
mixed-methods study
was undertaken
in
Results: Most
mothers perceived
that fever
could be
three public tertiary
hospitals in Southeast Nigeria. Data
caused by malaria, teething, hot weather, cough, with
was collected using
three Focus Group Discussions
malaria the leading cause (29%). They perceived that
(FGDs) with the
children’s caregivers and 16 In -depth
diarrhea could be caused by teething, eating contami-
interviews (IDIs) with
physicians, nurses and pharma-
nated food, drink and water, dirty environment and feed-
cists. In addition, the
medical records of patients on ad-
ing bottles with the commonest cause being teething
mission were examined.
Information on antibiotic use
(51.8%). The illness behavior of the caregivers was
and challenges, their
impression about pooling antibiot-
however poor, as most of them waited at least one day
ics and possible ways
to improve on antibiotic availabil-
after the onset of fever and diarrhea before taking any
ity and
sustenance.
action. The most frequent factor that influenced the
Results: Antibiotics
were prescribed
to 84.2%
of the
choice of treatment modality was health education mes-
children. Amongst these
prescriptions, 40% of the initial
sages caregivers got from health workers and the mass
antibiotics were
changed to another antibiotic. The ma-
media.
jor challenges that
were encountered by all the caregiv-
Conclusion: Caregivers
had a
fairly correct
perception
ers was the cost of the
antibiotics (85%). None of the
of
the causes of fever, but had incorrect perceptions of
caregivers were willing
to submit their purchased drugs
the causes of diarrhea. Efforts should be directed at edu-
for pooled use by all
the inpatients while the healthcare
cating caregivers on the causes of diarrhea, as well as
providers lauded the
concept of drug pooling but sug-
t h
e
a
p p r o p r i a t e
t
r e a t me n t
m
e a s u r e s .
56
Keywords: Perceptions,
Caregiver, Fever,
diarrhea
Subjects and Methods: Through a
prospective, descripti-
ve
and analytical study covering the period of march to
august 2017, children aged 6 months to 15 years with
Exposed to HIV infection’s children survival: a five
severe neurological forms of malaria and admitted to the
year cohort study in the tertiary pediatric ward of
pediatric emergency ward of Parakou Teaching Hospital
Parakou Teaching Hospital in the North of Benin
has been followed up. Sociodemographic, clinical and
evolving data were registered. Odds ratio was used to
Adedemy JD, Agbeille MF, Agossou J, Noudamadjo A,
identify factors associated with cerebral malaria and its
Aďsso UI, Chabi OA.
outcome. Significant threshold was set up at p value of
Mother and Child Department, Faculty of Medicine,
0.05.
University of Parakou, Benin. PO Box : 02 Parakou
Results: A
total of
604 children
were admitted
for severe
Benin Republic
malaria among which 28.5% presented cerebral malaria.
Email : kofadier@yahoo.fr
The mean age was 33± 25months. Sex ratio was 1.1.
Convulsion and altered consciousness were the main
Introduction : PMTCT
has been
implemented since
reasons of admission (50.6 and 44.8%). Coma scales
2004 in Parakou teaching Hospital. Prevalence of HIV
were severe in 68%. Raised intracranial pressure was
infection among general population is estimated at 1.2%
found in 68.6% of cases. Hemiplegia was found sequae-
in
Benin. With 4.5% rate of HIV mother to child trans-
la
in 2.3%. 15.7% of children died. Cerebral malaria
mission, authors are analysing five year survival rate
was associated with lack of bednet usage (p= 0.000) and
among these children followed up through PMTCT pro-
was most frequent in case of direct admission (p=0.007).
gram in that setting.
Letality was associated to gender (p=0.004), severe ane-
Subjects and Methods: Through a
cross-sectionnal des-
mia (p=0.002) and to raised intracranial pressure.
criptive and analyticalstudy, which ran from may to sep-
Conclusion: This
work gives
clinicians better
understan-
tember 2017, authors collected data from children aged
ding of factors associated with cerebral malaria and its
0
to 5 years followed up between 2010 and 2016. Socio-
outcome.
demographic, clinical, and immunological data were
Key words: Cerebral
malaria, Children,
associated fac-
collected. Kaplan-Meier survival trend was used to as-
tors, coma, raised intracranial pressure.
sess 5 years survival trend and Relative Risk ratio was
used
to search for factors associated with death.
Results: A
total of
121children has
been followed
up.
Human Immunodeficiency Virus Status in Malnour-
The mean age was 12 days of life and sex ratio 1.58.
ished Children seen at Lagos.
Among them, 93.81% were breastfed and 51.24% were
weaned between 6-12 months. ARV prophylaxis was
* Adeniyi
OF, *Temiye
EO, *Fajolu
IB, ⃰
Ladapo TA,
available for 87.60% of children and negative PCR1
*Akinsulie AO, *Ogbenna AA , ***Mabogunje CA,
found in 85.12%. At 18 months, 82.64% f children were
*Akinyode B
alive and HIV serology was positive for 3% of them.
*Department of Paediatrics, **Department of Haema-
Survival rate was stablized around 0.80 at 38th till the
tology, College of Medicine, University of Lagos/Lagos
60th month. Death predictors among exposed to HIV
University Teaching Hospital, Idi – Araba, Lagos.
children were children’s age, mothers’ profession and
***Massey street Children’s Hospital, Lagos
age, mothers’ CD4 count, regularity in follow up and
Email: layo_funke@yahoo.co.uk
ARV prophylaxis. Conclusion : These resultswill help-
cliniciansto monitor a better follow up plan of HIV ex-
Introduction: Human
immunodeficiency virus and
pro-
posed children.
tein energy malnutrition are still prevalent in Nigeria
Key words: PMTCT,
exposed to
HIV, Children,
survi-
and
the occurrence of the two conditions together con-
val
rate, survival trend.
fers
a poor prognosis. The aim of this study was to de-
termine the current categories of malnutrition amongst
under 5 children in Lagos document their HIV status
Epidemilogy, clinic and outcome of children presen-
and describe any peculiarities in the clinical features,
ting with cerebral malaria in children in a tertiary
haematological and biochemical profile in these chil-
hospital in Parakou (Benin)
dren.
Methods: The
study was
a prospective
crossectional
Adedemy JD, Agbeille Mohamed F, Agossou J, Nouda-
study conducted at the Paediatric department of the La-
madjo A, Ngoume JJ.
gos University Teaching Hospital and the Massey Street
Mother and Child Department, Faculty of Medicine,
Children’s Hospital over a 6 month period. All the sub-
University
of Parakou, PO Box : 02 Parakou, Benin
jects had anthropometry, HIV testing, full blood count
Republic
and
serum proteins done. The factors associated with
HIV
status were determined with the logistic regression
Introduction: Cerebral
malaria is
the worst
form of
seve-
analysis.
re
malaria in children and known to be caused by
P.
Results: 214
malnourished children ≤5
years were
re-
falciparum .
Authors are
reporting epidemiological, cli-
cruited into the study. 105(49.1%) of the participants
nical profile and outcome of cerebral malaria in hospita-
had moderate malnutrition while 25.2% had severe
lized children in Parakou.
forms of malnutrition. Fever, cough and diarrhea were
57
the commonest symptoms. Severe wasting, oral thrush,
Conclusion: The
factors that
enable retention
of children
dermatoses and splenomegaly were seen more com-
in
care are multidimensional and intricately connected.
monly in the HIV positive subjects. The haematological
Programme improvement initiatives should include
indices were comparable in the two groups, however,
regular assessment of clients’ perspectives to inform
the total protein was significantly higher in the HIV
implementation of strategies that could reinforce care-
positive subjects compared to the negative group
giver confidence in the health system.
(p=0.042). Multivariate analysis showed that the total
Key words: HIV,
Exposed, Infected,
Children, Adher-
protein (p=0.001) and platelet count (p=0.016) could
ence, Enablers Antiretroviral, Clinic care, Perspectives,
significantly predict the occurrence of HIV in the chil-
Caregivers, Care providers ,
dren
Conclusion: The
presence of
severe wasting,
oral thrush,
diarrhea, splenomegaly, thrombocytopenia and high
Complementary Feeding Practices among HIV-
total proteins in malnourished children should heighten
Positive Mothers in Usmanu Danfodiyo University
the suspicion of possible underlying associated HIV
Teaching Hospital, Sokoto Nigeria
infection. Mandatory screening of malnourished chil-
1
Yusuf T, Jega MR, Sanni AM, Jibrin B, Ibrahim ST,
1
1
1
2
dren for HIV infection is advocated.
1
Onankpa BO, Ugege MO, Omar M.
1
1
Department of Paediatrics, Usmanu Danfodiyo Univer-
1
Enablers of Adherence to Clinic Appointments for
sity Teaching Hospital, Sokoto, Nigeria
2
Children attending an Antiretroviral Clinic in North-
NManagement Science for Health, Sokoto State Team
ern Nigeria: Perspectives of Caregivers and Care
Office, Sokoto, Nigeria.
Providers
Email: dimeji74@yahoo.com
Musa S, Umar LW, Abdullahi FL, Abdullahi SM
Background: Appropriate
complementary feeding is
an
Olorukooba AA, Taegtemeyer M , Alfa AM,
*
effective lifesaving and child survival strategies for HIV
Usman NH
-exposed infants. HIV-exposed children, especially in
Department of Paediatrics, Ahmadu Bello University
the developing world, face the challenge of appropriate
Teaching Hospital (ABUTH), Shika, Zaria, Nigeria
and adequate nutrition during early childhood.
*Liverpool School of Tropical Medicine (LSTM),
Objective: Determine
the complementary
feeding prac-
Pembroke Place, Merseyside, Liverpool, L35QA, United
tices of HIV-positive mothers in UDUTH, Sokoto.
Kingdom
Methods: This
descriptive observational study
was con-
Email: asmaummama@gmail.com
ducted among HIV-positive mother-infant pairs attend-
ing Paediatric ART (PMTCT) clinic, UDUTH, Sokoto.
Background: Nigeria
has the
highest burden
of paediat-
A
structured questionnaire was used to obtain data such
ric
HIV infection and the success of control efforts in
as
demographics and components of complementary
the
country is crucial to the global control of the HIV
feeding practices from randomly selected mother-infant
epidemic. However, defaults from schedules of care
pairs attending the clinic. The data were analysed using
poses a threat to paediatric HIV control in Nigeria. This
SPSS
version 24.0. A p-value of ≤0.05 was taken as
study was conducted in a pioneer facility for the imple-
significant.
mentation of the National HIV Prevention and Treat-
Results: One
hundred and
twenty-two (63.9%)
of the
ment Programmes.
respondents were aged 25-34years and 119(62.3%) were
Objective: To
explore factors
that facilitate
adherence to
of
low socio-economic class. One hundred and fifty-
clinic appointments from perspectives of child caregiv-
three (80.1%) of the children were exclusively breast-
ers and service providers.
fed for 6months. One hundred and thirty-nine (72.8%)
Methods: This
is a
qualitative study
using in-depth
face-
of
the children studied commenced complimentary feed-
to-face interviews conducted in 2016. Thirty-five par-
ing at 6month of age with the mean of 6.2(±1.3) months.
ticipants were purposely sampled to comprise types of
One hundred and fourteen (59.7%) used plain pap with
caregivers of HIV exposed/infected children receiving
125(65.4%) fed more than 3 times per day. The mean
care and from categories of service providers. The inter-
age of cessation of breast feeding was 13.1(±3.5)
views were audio recorded, transcribed, thematically
months. The quality of complementary food is influ-
analysed and presented using a socio-ecological model.
enced by maternal educational (p=0.0001) and socio-
Results: The
themes that
emerged from
participants’
economic
(p=0.0001) statuses. The timing of comple-
narratives
included advanced education, affluence and
mentary feeding is influenced by maternal educational
residing close to the clinic at the intrapersonal level.
status(p= 0.04).
Stable family dynamics and support, HIV status disclo-
Conclusion: Introduction
of complementary
feeding was
sure and being a biologic parent or grandparent as care-
timely in the majority of the HIV-positive mothers but
giver emerged at the interpersonal level. At the commu-
not optima. Efforts should be geared towards improving
nity level, disclosure and support were identified, while
the complementary feeding practices among HIV-
at
the health facility level positive staff attitude, quality
positive mothers in order to enhance the survival of HIV
of
healthcare as well as peer support group influence
-exposed infants.
were factors identified to facilitate regular clinic atten-
Key words: Complementary,
Practice, HIV-Exposed.
dance.
58
Duration of Breast Feeding and Outcome of HIV-
Five years survival rate among HIV infected children
Exposed Infants attending Paediatric ART Clinic in
followed up in a tertiary pediatric ward of Parakou
Usmanu Danfodiyo University Teaching Hospital,
Teaching Hospital in the North of Benin
Sokoto. Nigeria
Agbeille MF, Adedemy JD, Agossou J,
1
Yusuf T, Jega MR, Sanni AM, Jibrin B, Ugege MO,
1
1
1
1
Noudamadjo A, Aďsso UI, Chabi OA.
2
Ibrahim ST, Onankpa BO
1
Mother and Child Department, Faculty of Medicine,
1
Department of Paediatrics, Usmanu Danfodiyo
University of Parakou, PO Box : 02 Parakou Bénin
University Teaching Hospital, Sokoto, Nigeria
Republic
2
Management Science for Health, Sokoto State Team
Office, Sokoto, Nigeria.
Introduction: African
continent is
the most
affected with
Email: dimeji74@yahoo.com.
HIV pandemia. The prevalence of the infection is
(1.2%) in Benin. Children remain the hidden side of the
Background: Appropriate
infant feeding
is still
a chal-
pandemia. The authors are reporting assessment of five
lenge to HIV-positive mothers especially in the develop-
years survival rate among HIV infected children in ter-
ing world despite their desire to breast feeding beyond
tiary pediatric ward of Parakou Teaching Hospital in
the WHO recommended 12 months duration.
Benin.
Objective: Determine
the duration
of breast
feeding and
Methodology: Through
a cross-sectionnal
descriptive
correlate with outcome of HIV-exposed infants in
and analytical study, which ran from may to september
UDUTH, Sokoto.
2017, authors collected data from children aged 2 to 19
Methods: This
descriptive observational study
was con-
years followed up in a tertiary hospital. Sociodemogra-
ducted among HIV-exposed infants attending Paediatric
phic, clinical, and immunological data were gathered.
ART (PMTCT) clinic, UDUTH, Sokoto. The demo-
Kaplan-Meier survival trend was used to assess 5 years
graphics, infant post-exposure prophylaxis, duration of
survival trend and Relative Risk ratio used to search for
breast feeding and results of early infant diagnosis (EID)
factors associated with death.
of
the infants using HIV-DNA PCR machine; and ma-
Results: A
total of
89 children
has been
followed up.
ternal HAART history were documented. The data were
The average age was 3 years and sex ratio 1.28. WHO
analysed using SPSS version 24.0. A p-value of ≤0.05
stage 3 and 4 of HIV infection was found in 19.10% of
was taken as significant.
cases. Diarrhoea (23.60%) and pneumonia (23.60%)
Results: One
hundred and
sixty-three HIV-positive
were the most encoutered opportunistic infections. CD4
mother-infant pairs were studied, 103(61.7%) of the
count raised progressively under TARV (46.07 to
HIV-positive mothers were aged 25-34 years, 105
76.47%). Survival rate was about 74.16% from 2005 to
(62.9%) were of low socio-economic class and 94
the end of 2016. Survival trend varies from 0.96 (first
(56.3%) had informal education. One hundred and fif-
month of follow up) to a stabilization trend of 0.74 on
teen (62.5%) were on TDR/3TC/EFV and 143 (85.6%)
the
64th month. Factors associated with children’s death
were on HAARTs prior to the index pregnancy. All the
were WHO clinical stage 4 (p=0.001), poor follow up
HIV-exposed infants studied were breast-fed and 165
(p=0.007) and poor nutritional status (p=0.003).
(98.8%) had nevirapine as infant PEP. The mean dura-
Conclusion: These
results will
helpclinicians to
monitor
tion of breast feeding among HIV-exposed infants was
data for a better follow up of infected children.
13.2(±3.5) months with 98 (58.7%) beyond 12months.
Key words: HIV
infection, Children, survival
rate, sur-
Maternal age (p=0.03) and socio-economic class
vival trend.
(p=0.03) were associated with prolonged breast feeding
among HIV-positive mothers. All the HIV-exposed in-
fants were uninfected.
Knowledge of Fever in Children and its Management
Conclusion: Majority
of the
HIV-positive mothers
among Health Workers in a Tertiary Hospital in
breastfed beyond WHO recommended 12 months and
South-East Nigeria
their infants were uninfected. This may support the up-
ward review of the duration of breast feeding of HIV-
Nwaneli EI*, Ofiaeli OC*,Nri-Ezedi CA*,
exposed infants in our community.
*Department of Paediatrics Nnamdi Azikiwe University
Key words: Duration,
Outcome, Breastfeeding, HIV-
Teaching Hospital, Nnewi
Exposed.
Email: chisomnriezedi@gmail.com
Introduction: Fever
is an
adaptive response
in humans.
It
is a common symptom in children with parents relying
largely on health care workers for its management.
Objectives: To
determine the
knowledge of
fever in
chil-
dren and practice of its management among health care
workers in Nnamdi Azikiwe University Teaching Hospi-
tal (NAUTH), Nnewi.
Methods: A
self-administered
questionnaire was
used
for
this descriptive cross-sectional study.
Results: A
total number
of 165
health care
providers
59
were accessed: 20 lab scientists (12%), 21 pharmacists
The effect of HIV status non-disclosure on the family
(12.8%), 56 nurses (34%) and 68 doctors (41.2%); with
functionality of HIV infected children
a
mean age and work experience of 37 years and 9.6
*
Jega MR, Yusuf T, Falaki F , Singh S , Adayi S
*
+
+ *
years respectively. 58% of health care providers consid-
*
ered fever to be in the range of 37.8 C-38 C. In the diag-
o
o
Department of Paediatrics, Usmanu Danfodiyo
nosis of fever, 58% of subjects use the thermometer
University Teaching Hospital,
while 42% prefer their hands. Majority of the partici-
PMB 2370, Sokoto, Nigeria
+
pants (95.8%) preferred the axillary area in accessing for
Department of Family Medicine, Usmanu Danfodiyo
fever. To manage fever, 46.8% of workers use anti-
University Teaching Hospital,
pyretics with most preferred anti-pyretic as acetamino-
PMB 2370, Sokoto, Nigeria.
phen (66%): Syrup (33.9%), Tablet (32.2%). The lead-
Email: dimeji74@gmail.com
ing complications of fever were seizures (32.6%) and
dehydration (32.1%).
Background: A
consensus view
shared by
most clini-
Conclusion/Recommendation: The knowledge
of and
cians is that non-disclosure of HIV status to children
management of fever in children among health care pro-
may
result in undesirable consequences like poor adher-
viders were inconsistent in this study. A positive out-
ence
to care and a disruption of family functions. De-
come
can be achieved through regular re-training pro-
spite the probable occurrence of these negative effects,
grams and focused research.
the
prevalence of HIV non- disclosure to infected chil-
Keywords: knowledge,
practice, management, fever,
dren and its effect on perceived family functionality is
children, health, workers, NAUTH
yet to be determined in Sokoto, north western Nigeria.
Methods: The
study cohort
was a
random sample
of
HIV infected children aged between 7 and 16 years who
Clinical presentation of childhood tuberculosis in a
receive paediatric HIV care at the Usmanu Danfodiyo
nigerian hospital: what are the implications?
University Teaching Hospital, Sokoto. Semi-structured
questionnaires were independently administered to HIV
Gobir AA, Ibraheem RM, Johnson WBR
infected children and their care givers to assess socio-
Muhammed SS, Oladele DM, Ojuola AO
demographic characteristics, disclosure status, drug ad-
Department of Paediatrics and Child Health, University
herence and perceived family functionality. Statistical
of Ilorin Teaching Hospital, Ilorin
analysis was carried out using SPSS version 20 and a p-
Email: aishaakarim@yahoo.com
value of < 0.05 was taken to indicate statistical
s
i
g
n
i
f
i
c
a
n
c
e
.
Introduction: Estimates
point to
many undetected
child-
Results: Seventy-three
children-caregiver pairs were
hood TB cases. With advancement in diagnostics, the
interviewed. The mean child age was 10.9 ± 2.2 years,
hope for improved case detection rests on patients pre-
and majority were males. Less than a third of children
senting at appropriate points for care.
had been informed of their status. Children with non-
Objectives: This
study was
therefore designed
to de-
disclosure status were more likely to have poor drug
scribe the symptoms of TB in children to document the
adherence (p = 0.03) and they perceived their family as
point (s) of presentation before our centre and to deter-
b e
i n g
d
y s f u n c t i o n a l
( p
=
0
. 0 1 ) .
mine the methods of diagnosis in children with TB.
Conclusion: A
worrying trend
of non-disclosure
among
Materials and Methods: This
was a
prospective cross-
children attending paediatric HIV care in Sokoto, north
sectional study among all patients with TB managed in
western Nigeria exists and this may have a detrimental
the paediatric clinic of UITH, Ilorin between January 1 ,
st
effect on how these children perceive the functional
2014 and December 31 , 2015. The centre has a DOTS
st
status of their family. Of equal concern is the poor ad-
facility. Diagnosis of tuberculosis was based on one or
herence observed in children with non-disclosure status.
more of the following: identification of acid fast bacilli
Thus, guiding care givers through developmentally ap-
(AFB); other bacteriologic identification of mycobacte-
propriate disclosure process should be a key component
rium tuberculosis; evidence of caseous necrosis and
of
paediatric HIV care in Sokoto.
granulomatous changes on histology; clinical features
suggestive of TB and response to anti-TB. All patients
were screened for HIV. Data analysis was done using
The prevalence and spatial distribution of urogenital
SPSS version 20.0.
schistosomiasis among primary school pupils in
Results: Seventy
patients were
seen. Cough,
61.4%,
argungu lga, Kebbi state, north western Nigeria
fever, 44.3% and weight loss/failure to thrive in 41.4%
*
Jega MR, *Hamid A, *Jiya NM, Mungadi I
+
were the major symptoms. Chest X-ray showed abnor-
†
Yahaya M, Shuaib U, Falaki M, Ahmad M, Falaki F
†
o
♣
malities in 85.7%, 31.4% had reactive Mantoux, and 13
*Departments of Paediatrics, Department of Urology,
+
had Acid-Fast Bacilli seen; 88.6%) presented to a patent
†
Department of Medical Microbiology and Department
♣
medicine vendor or shop owner, and 40 (57.1%) went to
private health facilities.
of Family Medicine, Usmanu Danfodiyo University
Conclusion/Recommendation:
Widening the
net of
those
Teaching Hospital, PMB 2370, Sokoto, Nigeria.
involved in TB care to include patent medicine stores
Center for spatial information science, Ahmadu Bello
and more private facilities will be important if more
University, Zaria, Nigeria.
cases are to be detected.
Email: jegaridwan@yahoo.com
60
Background and aims: Knowledge of
the distribution
of
veaux nés admis soit une fréquence hospitaličre de
urogenital schistosomiasis among pupils is required for
19,5%. Le sex ratio était 1,19. L’âge moyen était
targeted chemotherapy. Despite the presence of expo-
de
1jour. Le paludisme était associé l’infection bacté-
sure
risks in Argungu, North-western Nigeria, preva-
rienne
dans 49 cas (34,7%) et ŕ d’autres comorbidités
lence maps that aid disease control are non-existent. In
dans 21 cas (14,8%). Parmi les 71 cas de goutte-épaisse
this study, we aim to determine the prevalence and spa-
positive pris isolément, les principaux motifs d’admis-
tial
distribution of urogenital schistosomiasis among
sion étaient : la souffrance néonatale immédiate
pupils in Argungu.
(32,4%), la prématurité 18,1%), la fičvre (16,9%) et le
Methods: A
prospective descriptive study
among 840
faible poids de naissance (12,6%). De męme, les princi-
pupils,
aged 5-15 years. Information on pupils' socio-
paux
signes retrouvés ŕ l’examen physique étaient: les
demographic characteristics, exposure risks and micro-
anomalies neurologiques (40,8%), la détresse respiratoi-
scopic
examination of their urine samples were under-
re
(35,2%),
l’hyperthermie
(21,1%)
et
l’ictčre
taken to determine the existence
Schistosoma haemato-
(11,2%).La parasitémie moyenne était de 499p/µl. Le
bium infection.
Pupils' found
to be
infected were
treated
traitement était basé sur les dérivés de l’artémisinine.
with praziquantel, had a urine microscopy repeated six
L’évolution était favorable dans 87,1% des cas. La mor-
weeks
later and the geographic co-ordinates of their
talité globale était 12,9% et la létalité spécifique de 8,4%
schools, residence and the location of the nearest surface
(6/71).
water body spatially analyzed.
Conclusion: Le
paludisme congénital
est une
réalité au
Results: Of
the 840
pupils studied,
23.3% had
urogenital
CHUB/A. Il devient impérieux de reconnaître cet état et
schistosomiasis. Infection was highly associated with
d’envisager des moyens novateurs et efficients de pré-
gender,
socio-economic status and the absence of a func-
vention.
tional school latrine (p < 0.05). Surface water contact
Mots clés: Nouveau-né,
paludisme congénital, préven-
related
activities by pupils' increased the odds of infec-
tion,
Parakou, Bénin.
tion (p < 0.05). Logistic regression found that gender (p
=0.04; 95% CI 0.491, 0.984) and the absence of a func-
tional school latrine (p = 0.008) increased the odds for
Congenital malaria in the CHUDB/A in 2017: myth
infection. Post-treatment, of the 95.4% pupils re-
or reality?
examined, 91.4% were cured. Spatial analysis revealed
the disease to be non-randomly distributed and more
Agossou J*, Noudamadjo A*, Agbeille Mohamed F*,
prevalent among pupils living close to a river.
Adedemy JD*, Houffon R*
Conclusion: Urogenital
schistosomiasis is
endemic
*Department mother-child of the Faculty of Medicine of
among pupils in Argungu and this warrants its inclusion
the University of Parakou and Service of Paediatrics of
as
a disease of public health importance in the area.
Centre Hospital University departmental of Borgou/
Alibori BP 02 Parakou-Benin
Email:agossoujoseph@gmail.com
Paludisme congénital au CHUDB/A en 2017 : Mythe
ou réalité ?
Introduction: The
occurrence of
malaria is
described
classically as rare or exceptional in the neonatal period.
Agossou J*, Noudamadjo A*, Agbeille MF*,
The objective of this work was to describe the aspects of
Adedemy JD*, Houffon R*
epidemiological, diagnostic, therapeutic and outcome of
*Département Mčre-Enfant de la Faculté de Médecine
congenital malaria at the Centre Hospital University
de l’Université de Parakou et Service de Pédiatrie du
departmental of Borgou/Alibori (CHUD (B/A) to Para-
Centre Hospitalier Universitaire Départemental du
kou.
Borgou/Alibori BP 02 Parakou-Benin
Materials and methods: It
is a
cross-sectional and
des-
Email: agossoujoseph@gmail.com
criptive study conducted in the unit of Neonatology of
the B/A CHUD from January to August 2017. Elle has
Introduction: La
survenue du
paludisme est
décrite clas-
included all newborns of less than eight days having a
siquement comme rare ou exceptionnelle en période
drop thick positive. Comorbidities was taken into ac-
néonatale. L’objectif de ce travail était de décrire les
count to establish with precision the diagnosis of conge-
aspects épidémiologiques, diagnostiques, thérapeutiques
nital malaria.
et
évolutifs du paludisme congénital au Centre Hospita-
Results: In
total, 141
newborns had
a drop-thick
positive
lier Universitaire Départemental du Borgou/Alibori
Plasmodium falciparum on
723 newborns
admitted to
a
(CHUD B/A) ŕ Parakou.
hospital rate of 19.5%. The sex ratio was 1.19. The ave-
Patients et Méthodes: Il
s’agissait d’une
étude transver-
rage age was 1 day. Malaria was associated with bacte-
sale et descriptive menée dans l’unité de néonatologie
rial infection in 49 cases (34.7%) and other Comorbidi-
du
CHUD B/A de Janvier ŕ Aoűt 2017.Elle a inclu tous
ties in 21 cases (14.8%). Among the 71 cases of drop-
les nouveaux nés de moins de huit jours ayant une gout-
thick
positive isolation, were the main reasons for ad-
te
épaisse positive. Les comorbidités ont été prises en
mission: immediate neonatal pain (32.4%), prematurity
compte pour établir avec précision le diagnostic de pa-
18.1%),
fever (16.9%) and low birth weight (12.6%).
ludisme congénital.
Similarly, the main signs found on physical examination
Résultats: Au
total, 141
nouveau-nés avaient
une goutte-
were: neurologic abnormalities (40.8%), respiratory
épaisse positive ŕ Plasmodium falciparum sur 723 nou-
distress (35.2%), hyperthermia (21.1%) and jaundice
61
(11.2%). The average parasitaemia was 499p/µl. The
HIV Antibody Reversion following Post Exposure
treatment was based on artemisinin derivatives. The
Prophylaxis in a Child Transfused with Infected
outcome was favourable in 87.1% of the cases. The ove-
Blood
rall mortality was 12.9% and specific lethality of 8.4%
Ibeh JN , Oladokun R , Ademola AD , Asinobi A
1
1,2
1,2
1,2
(6/71).
Conclusion: Congenital
malaria is
a reality
in the
Univesity College Hospital, Ibadan, Nigeria
CHUB/A. It becomes imperative to recognize this and
College of Medicine, University of Ibadan, Ibadan,
consider innovative and efficient prevention ways.
Nigeria
Key words: Newborn,
congenital malaria,
prevention,
Email: joyzmail2002@yahoo.com
Parakou, Benin.
Background: Guidelines
are clear
on post
exposure pro-
phylaxis (PEP) after occupational and non-occupational
A study of group -A streptococcal pharyngitis among
exposure to HIV but very little is documented on pre-
3 – 15year old children attending clinics for an acute
ventive modalities following transfusion with HIV in-
sore throat\
fected blood. We report the case of a toddler with reac-
tive HIV antibody test following blood transfusion, who
Uzodimma CC , Dedeke F , Nwadike V , Owolabi O ,
1
1
1
1
received PEP with subsequent sero-reversion.
Arifalo G , Oduwole O ,
2
3
Case review
FMC, Abeokuta, Ogun state
A
22-month-old boy with severe malaria and sepsis had
State General Hospital, Ijaiye, Abeokuta, Ogun state
received blood transfusion in private health facility two
Sacred Heart Hospital, Lantoro, Abeokuta, Ogun state
days
before presentation. He had fever, seizures, coke
coloured urine and oliguria. There were no previous
Background: Group
A beta-hemolytic
Streptococcus
admissions, surgeries, blood transfusions, scarification
(GABHS) is the only causative organism of pharyngitis
marks or sexual abuse. HIV antibody test at our facility
that
is linked to the aetiopathogenesis of acute rheumatic
was
positive. Both parents tested negative. PEP was
fever and rheumatic heart disease.
commenced
using
Zidovudine,
Lamivudine
and
Aim and Objectives: The
objectives of
the study
were to
Efavirenz. Baseline HIV DNA PCR was negative. He
determine the proportion of GABHS-related pharyngitis,
underwent multiple cycles of peritoneal dialysis.
In
the relationship of clinical symptoms and signs with
addition to the acute kidney injury from the primary
positive culture outcome, and the antibiotic sensitivity
illness, he developed ear discharge and anterior abdomi-
pattern of GABHS among children aged 3-15years, pre-
nal wall abscess. He made a remarkable recovery. A
senting with symptoms of sore throat in three public
repeat antibody test after 6 weeks of PEP was non-
Hospital settings across Abeokuta.
reactive, DNA PCR remained negative and viral load
Methods: Consecutive
children aged
3-15 years
who
was undetectable. His CD4 count improved from 209/
present with sore throat or drooling of saliva and any
mm3 (16.75%) to 1198/mm3 (27%). PEP was discon-
one of these following signs and symptoms were consid-
tinued thereafter.
ered eligible; fever >37.5C, cervical lymphadenopathy,
Conclusions: Blood
transfusions are
lifesaving but
ac-
inflamed tonsils, and exudative tonsils. All bacitracin
cess to safe blood remains a major problem in the devel-
susceptible Gram-positive, catalase-negative cocci were
oping world particularly in regions with a high preva-
classified as Streptococcus
pyogenes
lence of HIV infection. In the event of unsafe transfu-
Results: Of
3,386 children
that were
seen, thirty
(30)
sion, guidelines are required and may be instrumental in
children met the eligibility criteria. Sixteen (53.3%)
preventing established HIV infection.
were males while 14 (46.7%) were females. The mean
Keywords: HIV,
Post exposure
prophylaxis, blood
age of the subjects was 7.37years ± 3.146. Cough was
transfusion, sero-reversion
the most sensitive symptom (65%) while the presence of
exudate was the most specific sign (70%) for GABHS
acute sore throat. Group A beta- haemolytic streptococ-
Enablers of adherence to clinic appointments for
cus (GABHS) was isolated in 66.7% of the children.
children attending an antiretroviral clinic in North-
Streptococcus Viridans was
found in
4 (13.3%)
while
ern Nigeria: Perspectives of Caregivers and Care
the remaining 6 (20%) were sterile. The highest sensitiv-
Providers
ity was shown to gentamicin and chloramphenicol while
amoxicillin-clavulanic acid had the highest resistance
Musa S, Umar LW, Abdullahi FL, Abdullahi SM,
Olorukooba AA, Taegtemeyer M , Alfa AM
*
(94%).
Conclusion: The
proportion of
GABHS throat
infection
Usman NH
is
high in this environment. The current findings under-
Department of Paediatrics, Ahmadu Bello University
score the need to increase awareness about appropriate
Teaching Hospital (ABUTH), Shika, Zaria, Nigeria
throat examination and treatment of sore throat among
*Liverpool School of Tropical Medicine (LSTM),
primary care physicians.
Pembroke Place, Merseyside, Liverpool, L35QA, United
Key word: Sore
throat, Group
A- beta-haemolytic
strep-
Kingdom
tococcus, children, rheumatic heart disease
Email: asmaummama@gmail.com
Background: Nigeria
has the
highest burden
of paediat-
62
ric HIV infection and the success of control efforts in
response.
the country is crucial to the global control of the HIV
Aims: To
determine the
first viral
load result
in children
epidemic. However, defaults from schedules of care
on
ART
poses a threat to paediatric HIV control in Nigeria. This
Methods: Results
of first
viral load
tests in
320 CLHIV
study was conducted in a pioneer facility for the imple-
aged 0-18 on ART were analyzed.
mentation of the National HIV Prevention and Treat-
Results: Males
were 42.5%
(136/320) and
56.3%
ment Programmes.
(180/320) females. Reason for viral load request was
Objective: To
explore factors
that facilitate
adherence to
routine in 90.0% (288/320); Suspected clinical and im-
clinic appointments from perspectives of child caregiv-
munological failure in 5.3% (17/320) and 3.8% (12/320)
ers and service providers.
respectively. 84.1% (269/320) were on first line ART.
Methods: This
is a
qualitative study
using in-depth
face-
First line combinations were AZT/3TC/NVP 60.0%
to-face interviews conducted in 2016. Thirty-five par-
(192/320) and TDF/3TC/EFV 16.6% (53/320). 320 HIV
ticipants were purposely sampled to comprise types of
positive children had received ART; 8.4% (27/320) for
caregivers of HIV exposed/infected children receiving
>1 year; 51.9% (166/320) between 1 and 5 years; 24.1%
care and from categories of service providers. The inter-
(77/320) between 6 and 10 years; 2.2% (7/320) for >10
views were audio recorded, transcribed, thematically
years and 13.4% not indicated. Viral load was undetect-
analysed and presented using a socio-ecological model.
able in 22.5% (72/320) of HIV positive patients;
Results: The
themes that
emerged from
participants’
<1000c/ml
in 27.8% (89/320) and >1000c/ml in 48.8%
narratives included advanced education, affluence and
(156/320). 52% (14/27) of children on ART for > 6
residing close to the clinic at the intrapersonal level.
months but <1 year had VL of >1000c/ml; 44.5%
Stable family dynamics and support, HIV status disclo-
(74/166); 54.5% (42/77); and 42.8% (3/7) had VL
sure and being a biologic parent or grandparent as care-
>1000c/ml after 1 to 5 years, 6 to 10 years and >10
giver emerged at the interpersonal level. At the commu-
years of ART respectively.
nity level, disclosure and support were identified, while
49% (94/192) of children on AZT/3TC/NVP and 43.3%
at
the health facility level positive staff attitude, quality
(23/53) on TDF/3TC/EFV had VL >1000c/ml after at
of
healthcare as well as peer support group influence
least 6months of these ART combinations.
were factors identified to facilitate regular clinic atten-
Conclusion: Almost
half of
children on
HAART are
not
dance.
virally suppressed. Key
Conclusion: The
factors that
enable retention
of children
considerations are poor adherence and/or primary viral
in
care are multidimensional and intricately connected.
resistance.
Programme improvement initiatives should include
regular assessment of clients’ perspectives to inform
implementation of strategies that could reinforce care-
Prevalence of antiretroviral treatment failure and
giver confidence in the health system.
associated factors in HIV infected children on first
Key words: HIV,
Exposed, Infected,
Children, Adher-
line antiretroviral therapy in National Hospital
ence, Enablers Antiretroviral, Clinic care, Perspectives,
Abuja
Caregivers, Care providers ,
Oyesakin AB, Ulonnam CC, Olaniyan FO
Maidamma S
Children are not virally suppressed 6 months and
beyond on HAART: any implications for
Background: Human
Immunodeficiency Virus (HIV)
the ART programme in Nigeria?
and Acquired Immunodeficiency syndrome (AIDS) is a
global pandemic affecting about 2.1 million children by
Isaac WE , Jalo I , Alkali Y , Ghidazuka Y , Ajani A ,
1
1
1
1
1
the end of 2016. Following the introduction of antiretro-
Oyeniyi C , Lano M , Popoola A ,
1
1
1
viral therapy (ART), there has been a significant de-
Ebisike K , Wariri O , Aliu R , Girbo A , Raymond M ,
1
1
1
1
1
crease of HIV-related illness and death. The success
Ndubuisi V , Bakari H , Umar A , Olatoke
1
1
1
achieve with ARV usage has been compromised by sev-
L , Burak V , Hassan K , Richard E , Tukur H ,
1
1
1
1
1
eral factors leading to treatment failure in HIV infected
Rabo Y , Ezra D , Bakura H , Daniel A , Massa A
1
1
1
1
2
children on treatment.
El-nafaty A , Yahaya UR , Yahaya MD , Melah GS ,
2
2
2
2
Aims: This
studies aim
to describe
the prevalence
of
Manga M ,Kudi A , Danlami H , Charanchi M
3
3
3
3
treatment (clinical, virology and immunological) failure
Medina E
4
and
describe some factors that may be associated with
1
Department of Paediatrics, Department of Obstetrics
2
treatment failure in HIV infected children at the Na-
and Gynaecology Department of Microbiology, Federal
3
tional Hospital Abuja.
4
Teaching Hospital, Gombe,
Centre for integrated
Methods: A
retrospective study
carried out
at the
Anti-
health
Retroviral Therapy Clinic of the Department of Paediat-
Programme, Gombe.
rics, National Hospital, Abuja. The study was conducted
from October to December 2017. Case files of HIV in-
Introduction: The
National implementation plan
for the
fected children were obtained after ethical approval was
scale up of viral load testing in Nigeria and ART treat-
given for the study. Inclusion Criteria were; age below
ment guidelines were launched in 2016. Viral load de-
sixteen years, History of First line ARV usage for at
termination is the most important indicator of ART
least 12 months and a minimum of two CD4 count and
63
viral load result within twelve months after commence
outcome with overall reduction in morbidity and devel-
of
ARVs. A proformal was used to obtain information
o
p me n t
o
f
m
u l t i d r u g
r e
s i s t a n t
T B
.
on
biodata- age, social class, mother’s education status,
Objective: To
determine the
pattern and
outcome of
CD4
count and Viral Load at base line and at 12 months
childhood tuberculosis managed at the DOTS clinic in
after initiation of treatment, WHO stage of the disease,
G u
s a u ,
Z
a m f a r a
S
t a t e .
presence of tuberculosis (TB) coinfection within the past
Methodology: A
retrospective study
of children
man-
12
months and adherence record. Data obtained was
aged for TB at the DOTS clinic of ASYBSH, Gusau,
analyzed with SPSS.
Zamfara State, over a 30 months period (January 2015
Results: The
HIV infected
children who
were analyzed
to
June 2017). The clinic serves both children and
were 135.
The mean age (±SD) was 11.50 (±3.31)
adults. All children (<18years) treated for tuberculosis
years. There were 74 males (54.8%) with a male to fe-
over the study period were included. Relevant informa-
male ratio of 1.2:1. The children who were of social
tion from the register were retrieved and analysed ac-
class 1, 2 & 3 were 41(30.4%), 40(29.6%) and 43
cordingly. Treatment outcomes were assessed according
(31.9%) and social class 4 and 5 were 7(5.2%) and 4
to
WHO and NTLCP guidelines. “Cured’’ and
(3.0) respectively. The mothers with tertiary education
“treatment
completed’’ outcomes are classified as
were 67(49.6%) while 7(5.2%) had no formal education.
t
r e a t m e n t
s
u c c e s s f u l .
There were 13(9.6%) with TB opportunist infection
Results: Of
the 415
patients managed,
76(18.3%) were
within the last twelve months. Adherence was good in
children; males were 30(39.5.2%), with a M: F ratio of
86
(63.7%) of the subjects. The subjects in stage 3 and 4
1:1.5. Mean±SD age was 8.89±5.38 years, with 29
were 51(37.8%) and 15(11.1%). The mean CD4 count
(38.2%) being in the 0-5 years age group. Pulmonary
(±SD) of the subjects was 972.19 (±1872.71) cell/mm
3
TB
was seen in 58(76.3%), more females had pulmo-
and the mean Viral load (±SD) was 24469.58
nary TB than males, which was not significant
(±83189.86) copies/ml. The prevalence of clinical, im-
(
χ2=1.350, p=0.245). Seventy five (98.7) were new
munological and virology treatment failure were 25
cases, with (1.3%) treatment after failure. Acid fast ba-
(18.5%), 9 (6.7%) and 89 (65.9%) respectively. Clinical
cilli were positive in 12(15.8%) while Xpert MTB/RIF
treatment failure was significantly associated with TB co
Sensitivity was detected in 7(9.2%). Majority 51(67.1%)
-infection ( χ2= 7.281, df 1, p=0.016) and poor adherence
completed treatment, 12(15.8%) were cured, 9(11.8%)
record ( χ2=18.670, df=2, p=0.000), immunological
were transferred out, 3(3.9%) died, while 1(1.3%) was
treatment failure was significantly associated with gen-
lost to follow up; with successful outcome of 82.9%.
der( χ2=4.520, df 1 p=0.033) and poor adherence record
Conclusion: Treatment
outcome using
DOTS strategy
(
χ2=7.835, df =2, p=0.020) while virology failure was
was good, with a success rate close to 85% of WHO
significantly associated with TB co-infection ( χ2=
benchmark. However, as compared to the adult cases,
7.915, df=1, p=0.005) and poor adherence record
the proportion of childhood TB appears low which may
(
χ2=37.947, df=2, p=0.000).
be
attributable to under diagnosis and under treatment in
Conclusion: There
is a
high prevalence
of clinical
and
o
u
r
c
e
n
t
r
e
.
virology treatment failure in HIV infected children.
Key words: childhood,
DOTS, Gusau,
tuberculosis,
Gender, presence of TB- co-infection, and poor adher-
outcome
ence record are determinant of treatment failure in HIV
infection.
Keyword: HIV
infected children,
treatment failure,
op-
Extracranial and Intracranial Abscesses in Children
portunist infection, adherence.
at Ile-Ife: A Case Series
Oluwatosin EO , Onyia C , Elusiyan JBE
1
2
1
Paediatric Tuberculosis May Still Be Under
Saheed BAO , Ugowe O , Babalola T, Ibitoye S ,
1
3
3
4
1
Diagnosed and Under Treated
Department of Paediatrics and Child Health, Obafemi
Awolowo University (OAU), Ile-Ife Nigeria.
2
Garba BI, Muhammad AS, Yusuf I, Ibrahim TM, Ahmad
Neurosurgery Unit, Lagoon Hospital, Lagos, Nigeria.
3
MM, Yusuf T, Onazi SO
Department of Paediatrics, Obafemi Awolowo
1
Department of Paediatrics, Department of Medicine,
2
University Teaching Hospital Complex (OAUTHC),
Usmanu Danfodiyo University Teaching Hospital,
Ile-Ife, Nigeria.
3
4
Sokoto, Sokoto State.
Department of Paediatrics,
Department of Paediatrics, Federal Medical Centre,
Ahmad Sani Yariman Bakura Specialist Hospital
Owo, Nigeria.
(ASYBSH), Gusau, Zamfara State. Directly Observed
4
Email: doc_tosino@yahoo.com
Treatment Short course (DOTS) clinic, ASYBSH, Gusau,
Zamfara State. Federal Medical Centre, Gusau, Zam-
5
Background:
Central Nervous System Infections are
fara State
significant causes of morbidities and mortalities in chil-
dren with some being prone to the development of ab-
Background: Tuberculosis
(TB) is
a chronic
infectious
scesses which can either be within the brain parenchyma
disease that is preventable and curable, yet a major
or
located in extracranial structures.
cause of childhood morbidity and mortality. Tuberculo-
Objectives: To
describe the
profile and
outcome of
chil-
sis prevalence and mortality are under-estimated in
dren with extracranial and intracranial abscesses at the
many high burden countries. DOTS enhance treatment
OAUTHC.
64
Methods: Consecutive
cases presenting
at the
Children
males) were still on ART as at December 2016. There
Emergency Ward of OAUTHC Ile-Ife were recruited.
were
no records of those successfully tracked but four
The
pattern of presentation, predisposing factors and
mortalities were reported and six clients transferred to
outcome of these children were studied.
other facilities. Those who have transited to the adult
Result: Among
the 641
children admitted
during the
six-
clinic were among those retained.
month period of the study, only six children were diag-
Conclusion: The
rate of
LTFU is
abysmally high.
This
nosed with cranial abscess giving an hospital prevalence
preliminary finding informs a dire need for qualitative
of
0.9% The mean age of the subjects was 8.3±3.4years
studies to explore the reasons for LTFU in ART care
with an equal male to female ratio. Fever, headache and
facilities.
altered sensorium were the most common symptoms,
Key words: Children;
ART care;
Loss-to-follow-up;
with the mean duration of symptom prior to presentation
Magnitude; HIV infected, HIV exposed; Nigeria.
being 12.7±13.4 days. Five (83.3%) of the patients had
intracranial abscesses which were multiple in two
(33.3%) children. The only patient with extracranial
An unusual pathogen in humans – Edwardsiella
abscess had Pott’s Puffy tumour following frontal si-
ictaluri
nusitis. Route of infection was haematogenous in half of
them; by direct spread (Otitis Media and Sinusitis) in
Adepoju AA, Adelaja AO
University College Hospital Ibadan , College of
1
two
(33.3%) and via head trauma in one of the patients.
Medicine University of Ibadan
2
Two
of the patients died with a case fatality rate of
33.3%.
Conclusion/ recommendation: Though uncommon,
ex-
Background: Dysentery
is a
diarrhoeal episode
in which
tracranial and intracranial abscesses remain life threaten-
the
loose or watery stool contains visible blood. It is
ing
in children. Early presentation, early treatment of
often caused by infectious agents ranging from bacteria
infections involving contiguous structures and prompt
to
protozoa. Causes include Shigella species, Salmonella
management with good access to neuroimaging and neu-
species or enterohemorrhagic
Escherichia coli and
En-
rosurgical facilities will improve outcome.
tamoeba histolytica .
Edwardsiella ictaluri belongs to
the Enterobacteriaceae
family, a gram negative short pleomorphic bacilli which
Trends in loss-to-follow-up at a Tertiary Paediatric
affects fish species only and causes enteric septicaemia
HIV Treatment Centre in Northern Nigeria
of
catfish and other species of fish, therefore it is not
zoonotic.
Umar LW, Musa S, Abdullahi FL, Garba MA, Gebi UI*
Case review: A
5 year
old boy
who presented
with fe-
Department of Paediatrics ABU Teaching Hospital
ver, vomiting, passage of bloody stool of 6 days and
Zaria, Nigeria
abdominal pain of a day duration.
*Friends for Global Health, Abuja, Nigeria
Family eats catfish occasionally and last consumption of
Corresponding Author: Dr. Sani Musa,
catfish was about 3 weeks before the illness. No history
Department of Paediatrics, ABUTH Shika
of
similar symptoms in other members of the family.
Email: asmaummama@gmail.com
On
examination,
He
was
acutely
ill,
febrile
(Temperature 38.1 ◦C), not pale with generalised ab-
Background: Loss-to-follow-up
(LTFU) is
a serious
dominal tenderness and guarding but no rebound tender-
challenge to the success of HIV control worldwide and
ness. Hepatomegaly 4cm, bowel sound normoactive.
threatens to reverse the gains of increased access to HIV
Other systems were normal.
care in Nigeria. Knowledge of the extent of LTFU could
Initial diagnosis of acute dysentery R/O typhoid fever
help inform evidence-based strategies for improved re-
was
made.
tention in care.
Blood culture grew Edwardsiella ictaluri, sensitive to
Objective: To
evaluate the
magnitude of
LTFU at
a pio-
gentamycin, levofloxacin, ceftriaxone, cefuroxime, aug-
neer Paediatric Antiretroviral therapy (ART) Clinic.
mentin.
Subjects and Methods: This
was a
retrospective analysis
He
had 1 week of IV ceftriaxone 100mg/kg/day, symp-
toms resolved on the 5 day of treatment.
th
of
clinic attendance records for HIV infected and ex-
posed Children 0-14 years from January 2008 to Decem-
Repeat blood culture was sterile after 5 days of incuba-
ber 2016. Results were presented as aggregate figures
tion.
and
proportions.
Conclusion: Although, Edwardsiella
ictaluri has
not
Results :
The total
number of
children enrolled
into the
been reported in humans, could this be the first case? A
Clinic care was 454, consisting of 254 males and 200
closely related species
Edwardsiella tarda which is
rare
females, with a ratio of 1.27:1. By the end of December
but fatal has been identified as a cause of severe food
2016, 239 were lost to-follow-up, out of which 128 were
and water borne infection in humans.
males and 111 females, giving a cumulative LTFU rate
Key words: Dysentery,
Zoonotic, Septicaemia,
of
52.6%. The annual rates of LTFU were 7%, 16%,
Pleomorphic
9%, 36%, 53%, 48%, 15%, 44% and 36% for successive
years from 2016 to 2008 respectively. The total number
of
clients initiated on ART was 391, with 200 males and
191 females, out of which 187 (96 males and 91 fe-
65
Severe Necrotising Pneumonia in a Toddler: A Rare
Introduction: Renal
size is
an important
parameter in
Presentation with Dual Bacterial Aetiology
evaluation and management of a child with kidney dis-
ease. Establishing the normal limits of renal sizes stan-
Garba MA, Umar LW, Akeredolu F, Mayaki S
dardized against somatometric parameters will be a use-
Makarfi HU
ful tool in detecting probable renal diseases in children.
Infectious Disease Unit, Department of Paediatrics,
Aim: To
determine renal
sizes in
relation to
BMI in
ap-
Ahmadu Bello University Teaching Hospital, Zaria,
parently healthy primary school children in Port Har-
Nigeria.
court.
Email: drkaita@yahoo.com
Methods: The
study design
was cross
sectional and
a
multistage sampling technique was used to recruit 455
Introduction: Necrotizing
pneumonia is
a rare
entity
children aged 6-12 years. Renal ultrasonography was
associated with severe morbidity and mortality but re-
carried out using a portable DP 1100 PLUS real time
ported consistently with single bacterial aetiology. Mul-
ultrasound machine fitted with 3.5MHz probe. The
tiple bacterial aetiology predicts worse pathology with
length, width and anteroposterior diameter of the kid-
fulminating clinical course. Reports of necrotizing pneu-
neys were measured and renal volume calculated. The
monia from multiple bacterial infections are scanty in
BMI percentile for age and sex were obtained. The renal
published literature.
sizes were correlated with somatometric parameters and
Objective: To
report a
case of
severe necrotizing
pneu-
regression equations derived.
monia with dual bacterial aetiology
.
Results: The
overall mean
renal length
of the
right and
Case report: A.M,
a three-year
old toddler
presented
left kidneys were81.5±7.4mm and 80.9±7.6mm while
the mean renal volume were52.1±15.4 cm
3
with ear discharge for three weeks, fever, breathlessness,
and
52.2±15.4 cm respectively. The renal length and vol-
3
cough and haemoptysis for ten days. He was referred
ume increased at a rate of 1.372mm and 1.951cm per
3
from a private facility where he received antibiotics and
year and at a rate of 0.067mm and 0.176cm per one
3
blood transfusion. He was found to be underweight,
tachypnoeic, tachycardic, with bilateral crepitations and
percentile increase in BMI respectively. The regression
tender hepatomegaly. With a diagnosis of severe bron-
model derived for predicting renal length in mm
chopneumonia antibiotics, oxygen and supportive care
=65.731 + (1.372 Age X ) + (0.067 BMI
percentile X )
while that for renal volume in cm =26.386 + (1.951
3
were commenced, to which he responded poorly with
persistent symptoms over the first week. Specimen cul-
Age X ) + (0.176 BMI percentile X ), (Where X is the
ture results obtained later yielded
Klebsiella pneumoniae
independent variables: age in years and BMI in percen-
and Staphylococcus
aureus , while tests for HIV and
tile).
tuberculosis were negative. Antibiotics were changed
Conclusion: BMI
has a
significant positive
linear rela-
from the 2 week but he remained persistently hypoxic
nd
tionship with renal length and volume. The renal length
with progressive lung parenchymal destruction on imag-
and volume increased at a rate of 0.067mm and
0.176cm respectively for every one percentile increase
3
ing. Subsequently, his condition began to gradually im-
prove and by the 5 week cough and haemoptysis sub-
th
in
BMI.
sided with sustained symptoms resolution till discharge.
Key words: Ultrasonography, renal
sizes, body
mass
He
maintained improvement thereafter with progressive
index, children
lung re-expansion over four weeks.
Conclusion: Necrotizing
pneumonia should
be consid-
ered in children with recurrent haemoptysis, fulminant
Impact of socioeconomic status on access to dialysis
course and poor response to standard treatment. The
in a paediatric nephrology unit, in south western
turbulent clinical course requiring prolonged hospital
Nigeria
care and the isolation of dual organisms documented to
1,2
Ademola AD
1,2
Lawal TA, Asinobi AO,
1
independently cause lung parenchymal damage strongly
suggests concomitant pathology by both organisms.
Department of Paediatrics, University College Hospital,
Ibadan, College of Medicine, University of Ibadan.
1
2
Key words: K.
pneumoniae, S.
aureus, Child,
Necrotis-
ing pneumonia
Email: tope_lawal@yahoo.com
Introduction: Payment
for services
remains out
of
Relationship between renal size as determined by
pocket in most patients presenting to health facilities as
ultrasonography and body mass index in apparently
health insurance schemes are not available and accessi-
healthy primary school children in Port Harcourt
ble to all. Hence, in children who require dialysis there
is
a delay in commencement of dialysis as caregivers’
Uchenwa
TA , Anochie IC , Okafor HU
1
1
2
ability to provide materials needed for dialysis is ham-
Maduforo OC , Department of Paediatrics, University
3 1
pered by financial constraints.
of Port Harcourt Teaching Hospital, Port Harcourt.
Objectives: To
describe the
socio-economic status of
2
Department of Paediatrics, University of Nigeria
parents of patients requiring dialysis. To document time
Teaching Hospital, Enugu, Department of Radiology,
3
to
access of dialysis.
University of Port Harcourt Teaching Hospital, Port
Methods: This
is a
retrospective
cross-sectional study,
Harcourt.
the records of 37 patients who had dialysis over a10
Email: tochiuchenwa@yahoo.com
month period (January – October 2016) was reviewed.
66
The Ogunlesi classification of socio-economic status
(53.8%) were lost to follow up at 3 months.
was used. The class of the children was assigned from I-
Conclusion and Recommendation:
Acute glomeru-
V
based on the score of parents’ educational status and
lonephritis is the commonest cause of AKI seen in this
occupation.
study. Preventive strategies at all levels of care still re-
Results: Of
the 37
patients who
had dialysis,
eleven chil-
mains paramount. The high occurrence of patients being
dren had peritoneal dialysis (PD). About 39% of fathers’
lost
to follow up could be minimized by counseling and
had bachelor’s degree or its equivalent, while based on
reduction of poverty.
occupational status, 60% of mothers’ were in Class III.
Keywords: AKI,
Children, Presentation, Sokoto,
Out-
Half of the children belonged to class III, 41% were in
come.
class IV and none in class I.
Dialysis was commenced on the same day as need was
established in 27% of children and 59.5% commenced
Malformative uropathy revealed by severe sepsis In
dialysis between day 2 and 4.
a three years old girl at a tertiary hospital in
For patients who required PD, all had improvised cathe-
Parakou (Benin): A Case Report
ter used as appropriate catheters are not readily avail-
Agbeille F , Agossou J , Adedemy JD , Noudamadjo A ,
*
*
*
*
able.
Gandaho I .
**
Conclusion: A
major determinant
of timely
and appro-
priate access to renal care in low income settings is so-
*Mother and Child Department, **Département of
cioeconomic status of the caregiver.
surgery, Faculty of Medicine, University of Parakou,
Keywords: socioeconomic
status, parents,
dialysis, chil-
Benin
dren.
Introduction: Upper
urinary tract
abnormalities are
rela-
tively frequent and could be diagnosed at birth or before
Community acquired acute kidney injury among
birth. Some of them are seen mostly after obstructive
children at Usmanu Danfodiyo University Teaching
complications. Authors are reporting a right ureteric
Hospital, Sokoto
duplicity revealed by severe sepsis.
Observation : A
3years old
girl, without
known particu-
Jiya FB, Ibitoye PK, Jiya NM, Jibrin B, Adamu A
lar history, was refered from a peripheric center for
Isezuo KO, Obasi I
septic choc with hyperthermia (40°C). The physical exa-
Department
of Paediatrics, Usmanu Danfodiyo
mination found a right flank mass with lumbar contact
University Teaching Hospital, Sokoto
and kidney slip, and a pain to the shaking of the right
Email: fatimabellojiya@gmail.com
flank. The complementary explorations led to the dia-
gnosis of ureteric duplicity with destruction of the upper
Background: Acute
kidney injury
(AKI) remains
an
pyelon,
complicated
with
pyonephrosis.
important cause of morbidity and mortality particularly
She had undergone a double antibiotic therapy combi-
in
developing countries. Community acquired forms are
ned with a partial superior nephrectomy. The operative
more prevalent in our setting, due perhaps to high occur-
sequences were simple.
rence of infectious diseases of relevance to the develop-
Conclusion: Infectious
complications are
severe in
up-
ment of AKI.
per urinary tract obstacles leading at the end to kidney
Objectives: To
determine the
prevalence, pattern
and
destruction, needing early diagnosis.
outcome of AKI among children at Usmanu Danfodiyo
Key words: Ureteric
duplicity, pyonephrosis, sepsis,
University Teaching Hospital (UDUTH) Sokoto.
partial nephrectomy, children.
Methods: This
was a
2- year
retrospective descriptive
study from September 2015 to August 2017. Cases were
children aged below 15 years admitted into Emergency
Childhood Acute Glomerulonephritis In Umuahia,
Paediatric Unit (EPU) with diagnosis of AKI using kid-
Abia State, Nigeria
ney disease improving global outcome criteria. Relevant
information from their case folders were extracted into a
Ibeneme CA, Onuh EF, Ezuruike EO
profoma sheet and data was analyzed using SPSS ver-
Department of Paediatrics, Federal Medical Centre,
sion 20.
Umuahia
Results: Thirty-six
(1.0%) of
the 3493
admissions had
Email: chik4sco@yahoo.co.uk
diagnosis of AKI. Males were 22(61.1%) and females
were 14(38.9%), with M:F ratio 1.5:1. Mean age at pres-
Background: Despite
the declining
incidence of
acute
entation was 2.47 ± 1.4 years. Majority 20(55.6%) were
glomerulonephritis (AGN) in the developed part of the
of
low socioeconomic class. Commonest clinical presen-
world, the disease remains fairly common in low income
tations were body swelling 22 (61.1%) and anuria 14
countries with varied presentations leading to childhood
(38.9%). Majority 21(58.3) had AKI stage 3. Common-
mortality. Establishing the local pattern of the disease
est diagnoses were Acute glomerulonephritis 10(27.8%),
and its complications may assist in planning intervention
Obstructive uropathy 7(19.4%) and Septicaemia 6
strategies to improve disease outcome.
(16.7%). Twenty-six (72.2%) of the 36 patients were
Objectives: To
document the
prevalence among
paediat-
discharged, 6(16.7%) died and 4 (11.1%) left against
ric admissions, the sociodemographic characteristics,
medical advice. Of the 26 that were discharged, 14
common presenting features, complications, and out-
67
come of acute glomerulonephritis in Federal Medical
Attention deficit hyperactivity diorder among
Centre Umuahia.
primary school children with poor academic
Subjects and Methods: Review of
cases of
AGN seen
performance in the FCT
over
a period of six years. Patients’ biodata, clinical and
Offiong UM , Ali I , Mairiga F
1
2
1
laboratory features and outcome were analyzed.
1
Results: AGN
accounted for
0.9% of
paediatric admis-
Department of Paediatrics, University of Abuja
sions with a male to female ratio of 2:1. Peak age inci-
Teaching
2
dence was 5 to 10years with a mean of 7.32±3.59. Ma-
Department
of Medicine, Clinical Psychology Unit
jority (52.6%) were of the low socioeconomic class.
Proteinuria and haematuria were constant features. Other
Introduction: Poor
academic performance
can be
de-
common features included oedema of varying degrees
fined as a school achievement below the expected for a
(94.7%), anemia (68.4%), hypertension (57.9%), fever
given age, cognitive skill and schooling. At least 15-
(57.9%), oliguria (52.6%) and cola-coloured urine
20% of school children will fall below the expected aca-
(36.8%). UTI was the notable co-morbidity. Complica-
demic score. Attention Deficit Hyperactivity Disorder
tions were acute kidney injury, hypertensive encephalo-
(ADHD) is a cause of poor school performance. It af-
pathy and pulmonary edema. Mortality rate was 5.3%.
fects 8-12% of school aged children worldwide. While
Conclusion:
AGN remains a cause of childhood mor-
ADHD if treated can improve school outcomes, there is
bidity with varied complications leading to death. How-
limited data on its occurrence in children failing in
ever, where facilities for intervention are available out-
school, thus the indication for the study.
come
is generally good.
Materials and Methods: This
study was
carried out
Key words: Acute
glomerulonephritis,
Childhood,
among primary school children with poor school per-
Umuahia, Nigeria
formance who were assessed to have symptoms of
ADHD using the DSM-IV school version adapted by Du
-Paul.
Typhoid Glomerulonephritis and Pneumonia ina
Results: A
total of
103 forms
were returned
giving a
Female Nigerian Child: A Rare Co-Complication
response rate of 82.4%, one form had no student biodata
thus was discarded. The male: female a ratio was 1:1.3.
Ibeneme CA, Ogba EI, Iwegbulam CC, Ezuruike EO
The mean age was11.9 years. Fifty (48.5%) children
Department of Pediatrics, Federal Medical Center,
assessed to have 6 items or more scoring 2-3 in either
Umuahia
the subsets of hyperactivity-impulsivity or inattentive-
Email: chik4sco@yahoo.co.uk
ness; 17(34%) were females and 33(66%) were males.
The ADHD subset distribution showed 16 (32%) had
Background: Typhoid
fever is
a severe
multi-systemic
combined, 3(6%) had hyperactivity-impulsivity while 31
disease caused by Salmonella organisms and remains
(62%) had inattentiveness.
endemic in many developing countries. Renal
complica-
Discussion: Poor
school performance
is regarded
as a
tions due to typhoid
occur in 2% - 3% of cases and are
symptom not a diagnosis as it may be a reflection of a
considered to be rare
in children. We
report a
case of
larger problem thus it requires careful investigation. A
acute glomerulonephritis and bronchopneumonia in a
prevalence of 43% was seen in this study.
female Nigerian child with typhoid sepsis.
Conclusion: There
is need
for further
studies to
develop
Case report: N.N,
a 9
year old
female presented
with
policies for intervention to improve education for these
fever, headache, abdominal pain and poor appetite of 2
children.
weeks, reduced urine output, cola colored urine, fast
Keywords: ADHD,
School failure
breathing and weakness of 6 days. Findings included
dyspnea, pallor, temperature of 38.5 , grade III bilateral
0
pitting leg oedema, ascites, hypertension, dull percus-
Profile of Cases of Autism Spectrum Disorder seen in
sion notes with reduced breath sounds on the right mid
Sokoto over a Decade
and lower lung zones as well as crepitations on both
lung fields. Laboratory findings were proteinuria,
Ahmad MM, Ahmed H, Jiya NM, Baba J, Legbo JF,
haematuria, azotemia (urea of 279mg/dl), creatinine of
Omar M, Tahir AA
4.2mg/dl, PCV of 18%, leukocytosis.
Widal test
Departments of Paediatrics, Usmanu Danfodiyo
showed the O agglutinin titre for salmonella typhi and
University Teaching Hospital, Sokoto, Nigeria
paratyphi to be 1:160 and 1:320 respectively. Renal
Email: murisbn@yahoo.com
scan showed raised cortical echogenicity and some loss
of
corticomedullary differentiation. CXR revealed bilat-
Introduction: Autism
Spectrum Disorder
(ASD) is
a
eral patchy opacities. She was managed with intrave-
group of lifelong neuro developmental disorders charac-
nous antibiotics with resolution of symptoms.
terized by poor social skills: impairments in communi-
Conclusion: Awareness
about rare
presentations of
ty-
cation, social interaction and stereotypic or restrictive
phoid fever as well as
prompt diagnosis and treatment
interests/behaviours.
can help to decrease
morbidity and mortality.
Aim: To
determine the
profile of
ASD cases
seen in
Key Words: Typhoid
sepsis,
Glomerulonephritis,
Sokoto over a decade
Pneumonia, Nigeria
Methodology: A
retrospective observational study
of the
clinical presentation and neuro imaging findings in chil-
68
dren with ASD seen in UDUTH Sokoto was done, using
11.18%. Management varied depending on tumour type
the hospital records (from July 2007 to June 2017).
ranging from interval follow up , VP shunt insertion for
Result: Out
of 1267
cases seen
in Paediatric
Neurology
hydrocephalus ,tumour biopsy and excision for others.
clinic over the period, ASD accounted for 18 cases
Some patients had radiosurgery, radiation therapy and
(1.4%). The mean age of the cases was 5.6 ±2.5 (range 2
chemotherapy.
to
13) years, with a male to female ratio of 1:1.6. All the
Conclusion: MRI
is invaluable
in management
of
cases had the 3 core symptoms of impaired communica-
peadiatric brain tumours. It was very useful in diagno-
tion,
socio-emotional
interactions
and
restricted/
sis, follow up post treatment, imaging of complications,
stereotypic behaviours that all started within first 2-3
and it affected management and outcome.
years of age. Identified co-morbidities among the cases
Keywords: MRI,
Paediatric ,
Brain tumours.
include motor delays (27.8%), seizures (33.3%) and
hyperactivity (55.6%). Only 7 out of 18 patients (38.9%)
had a brain CT scan, which was normal in 5 out of 7
Prevalence and factors associated with malnutrition
(71.4%) and features of cerebral atrophy in 2 out of the
among children with chronic neurologic disorders in
7
(28.6%) cases.
paediatric neurology clinic in IHU, OAUTH, Ile-Ife
Conclusion: Autism
spectrum Disorder
is not
uncom-
mon among children with Neurologic disorders in our
Anyabolu CH#, Olorunmoteni O#, Elusiyan JB#
setting and is associated with multiple neurodevelop-
Adebayo SO*, Kareem AJ^
mental co-morbidities. There is need to create more
#Department of Paediatrics and Child Health, Obafemi
awareness so as to enhance early presentation and ap-
Awolowo University, Ile-ife
propriate intervention measures.
*Department of Demography and Social Statistics,
Key words: Autism,
Development, Sokoto, UDUTH
^Department of Paediatrics, Obafemi Awolowo
University, Ile-ife
Magnetic Resonance Imaging of Paediatric Brain
Introduction: Malnutrition
is a
potential co-morbidity
Tumours in Nigerians: A five year review
among children with diverse chronic diseases. However
the burden, pattern and determinants among children
Umar AA*, Aimua H*, Nwafor A*, Onuh J*,
with chronic neurologic disorders in pediatric neurol-
Ike-ugwoke O*, Shetimma DR**
ogy clinic in Ile-ife remains undetermined.
*Department of Radiology, **Department of
Aim: To
determine the
prevalence, pattern
and factors
Peadiatrics, National hospital Abuja.
associated with malnutrition among children attending
Email: draaumar@yahoo.com
the pediatric neurology clinic in OAUTHC, Ile-ife.
Method: This
was a
cross sectional
study over
3 months
Introduction:
Magnetic Resonance Imaging (MRI)
in
the paediatric neurology clinic. Fifty six consecutive
commenced in Nigeria 18 years ago, at the National
consenting children who were between ages 1 and 12
Hospital Abuja (NHA). MRI is the imaging modality of
and their caregivers participated in the study. Malnutri-
choice in the evaluation of brain tumours, due to the
tion was assessed using the WHO 2007 Reference.
multi planar capability and use of non- ionizing radia-
Sociodemographic factors, caregiver knowledge and
tion with superior soft tissue differentiation.
dietary patterns were also assessed.
Aim: To
evaluate the
radiological features of
paediatric
Results: The
prevalence of
underweight (WAZ<-2) and
brain tumours, seen at the NHA in the past 5 years.
wasting (WHZ <-2) z-scores were 19.6% and 14.2 %
Materials and Methods:
We
retrospectively reviewed
respectively. Factors associated with any form of malnu-
all paediatric brain MRI performed at the NHA from
trition were orphan hood (p=0.02); cerebral palsy
January 2012 to December 2016. The indications for
(p<0.01); presence of at least one form of feeding prob-
imaging,
clinical presentation, findings on examination,
lem (p=0.00) and feeding pattern less than the minimum
management and outcome, were obtained from the clini-
acceptable feeding frequency (p=0.001).
cal notes. Imaging was performed pre and post contrast,
Conclusion: Identifying
the presence
of feeding
problem
using 0.2T and 0.3T open MRI machines. The salient
as
well as dietary counseling of caregivers may amelio-
radiological features of brain tumours, were docu-
rate the burden of malnutrition as a co-morbidity in chil-
mented.
dren living with chronic neurologic disorders in Ile-ife.
Results: A
total number
of 597
Paediatric brain
MRI
were performed in the period of the study. 54 (9.05% )
of
the patients were diagnosed with brain tumours. The
Cerebral Palsy in Nigerian children: profile and im-
age range of patients was 4 months to 16years, with an
pact on educational opportunities
average age of 7.8years. The sex ratio was M:F =2:1.
Indications for imaging were mainly for diagnosis and
Lagunju IA, Oyinlade OO, Famosaya AA, Balogun TAB,
follow up post surgery, in patients who presented with
Ibeh J, Adelaja A, Oluleye A
seizures, headache, visual abnormalities and others.
Department of Paediatrics, College of Medicine,
Supratentorial (27.7%) tumours were the most common,
University of Ibadan, Ibadan & University College
followed by Posterior fossa tumours (25.92%), and Sel-
Hospital, Ibadan.
lar and parasellar tumours ( 14.8%). Others were Pineal
tumours (11.1%) Arachnoid cyst 9.3% , and others
Background: Cerebral
Palsy (CP)
is the
leading cause
of
69
th
th
childhood neurodisability in Nigeria. Affected children
from 24 to 27 January 2017.Doctors and nurses at-
face the added burden of inadequate facilities for reha-
tending the conference were invited to complete a struc-
bilitative care and diminished educational opportunities.
tured questionnaire on knowledge of the sleep recom-
Objectives: We
set out
to determine
outcomes and
ac-
mendations by the AAP. Data was analysed with SPSS
cess to educational opportunities in a cohort of Nigerian
version 22.
children with CP seen at the UCH, Ibadan.
Results: A
total of
72 (24%)
of 300
responded compris-
Methods: All
new cases
of CP
were prospectively
fol-
ing 52 doctors (72.2%) and 20 nurses (27.8). While 44
lowed for 12 months to determine access to neuro-
(61.1%) said they were aware of the AAP recommenda-
rehabilitative care and educational opportunities.
tions, only 30 (41.7%) correctly knew the recommended
Results: 304
children with
CP were
enrolled, 187
males
back to sleep position and 10 (13.9%) knew the pre-
and 117 females. Age at presentation ranged from 6
ferred position when baby was awake. Fifty (69.7%)
months to 14 years, median 16.0 months. The leading
wrongly felt side sleeping was protective against SIDS.
risk factors for CP were severe perinatal asphyxia
Forty-two (58.3%) were frequently asked by mothers
(42.4%), bilirubin encephalopathy (23.4%), intracranial
about the best sleep position. Twenty-eight (53.8%) of
infections (20.0%) and prematurity (6.6%). Spastic CP
the doctors and 2 nurses (10%) selected the back posi-
was predominant (83.2%) and about two-thirds of the
tion as the recommended sleeping position (p = 0.02).
children had severe functional impairment in GMFCS
Conclusion: Knowledge
of recommended
sleep prac-
classes IV and V. Of the 117 children who were of
tices is suboptimal amongst paediatric doctors and
school age, 46 (39.3%) were enrolled in school; 37
nurses. There is need for increased acquisition of knowl-
(31.6%) were in main-stream/regular schools and only 9
edge by them so as to guide mothers correctly.
(7.7%) were in special schools. Children with severe
Key words: Knowledge,
infant, sleep
position, doctors,
functional impairment and associated malnutrition were
nurses
less likely to be enrolled in school (p<0.001) and
(p=0.001) respectively. Twelve months post-enrolment,
199 (65.5%) had defaulted from rehabilitative care.
Periodic Paralysis in a Nigerian Child: A Case
Children with associated epilepsy were less likely to
Report
default from care (p=0.024, OR 2.394, 95% CI 1.082,
5.293).
Imoudu IA, Ahmad H, Yusuf MO, Afegbua DS
Conclusion: CP
remains a
leading cause
of neurodisabil-
Ismail MK, Umara T
ity in Nigerian children. The major risk factors are pre-
Department of Paediatrics, Federal Medical Centre
ventable causes. Only about one-third of affected chil-
Azare, Nigeria.
dren are given opportunities for any form of education at
Email: tomhe164@yahoo.com
all and access to specialised education is greatly limited.
Keywords: Cerebral
palsy, disability,
rehabilitation,
Introduction/Background: The periodic
paralyses are
a
educational opportunities.
rare
group of muscle channel opathies characterized by
intermittent attacks of episodic muscle weakness of vari-
able
duration. They include a group of diseases ensuing
Knowledge of recommended sleep practices for
from mutations in the SCN4A, CACNA1S and KCNJ2
infants amongst paediatric doctors and nurses
genes. Typically, symptoms begin in the first or second
attending Paediatric Association of Nigeria (PAN)
decade of life.
Conference in Kaduna, Nigeria
Case Report: This
case describes
a 13
year-old girl
with
generalized epilepsy who presented with a 9- year his-
Isezuo KO, Ibitoye PK, Onankpa BO, Adamu A
tory of recurrent attacks of inability to walk. Attacks
Jiya FB, Sanni MA, Omar M, Inoh I
which occurred at a frequency of 2-3 times a year with
Department of Paediatrics,
Usmanu Danfodiyo
spontaneous resolution were often triggered by exposure
University Teaching Hospital, Sokoto
to
cold, strenuous exercise and rarely by convulsions. At
Email: khadisez@yahoo.com
presentation, the index episode had been on-going for 2
days. The diagnosis was based mainly on clinical fea-
Background: The
American Academy
of Paediatrics
tures; the delay in onset of the paralytic episodes as well
(AAP) started the Back to sleep campaign since 1992 to
as
the drop in serum K levels during attacks are sugges-
reduce the incidence of Sudden infant death syndrome
tive of hypokalaemic periodic paralysis. Management of
(SIDs) and expanded its recommendations in 2011 to
the index acute paralytic episode and prophylaxis were
include provisions to ensure safe sleep environment for
accomplished with oral acetazolamide administration.
infants. Health workers, especially doctors and nurses
Conclusion: In
addition to
emphasizing the
paucity of
who are in contact with infants are to ensure correct in-
data on this group of diseases, this report draws attention
formation is given to parents. However, knowledge gaps
to
the relative ease with which acute paralytic episodes
still exist among health workers in many countries.
can be prevented in a resource-poor setting.
Objective: To
assess knowledge
on SIDs
and recom-
Keywords: Periodic
paralyses, Channel
opathies,
mended sleep practices for infants among doctors and
Epilepsy, Acetazolamide, Nigerian, Child.
nurses attending Paediatric Association of Nigeria
(PAN) Conference in Kaduna, Nigeria
Methods: A
cross-sectional study, carried
out between
70
Pattern of Childhood Seizure Disorders and Electro-
paediatric neurology clinic over a period of 7 years were
encephalographic Correlates Among Children in
evaluated clinically and by neuroimaging studies. All
Sokoto, North-Western Nigeria
were followed up for a minimum period of 12 months.
Results: There
were a
total of
83 new
cases of
paediatric
Ahmad MM, Ahmed H, Abubakar M, Abubakar FI
stroke; 72 (86.7%) ischaemic and 11 (13.3%) haemor-
Yusuf A, Ahmed HK
rhagic. Age at first stroke ranged from 1 week to 15
Department of Paediatrics, Usmanu Danfodiyo
years, median 7.25years. Risk factors identified for
University Teaching Hospital, Sokoto, Nigeria
stroke were sickle cell disease (SCD) (62.7%), adverse
Email: murisbn@yahoo.com
intrauterine/perinatal events (16.9%), meningitis (9.6%),
cerebral aneurysms/AVM (3.6%), cyanotic congenital
Background: Seizure
disorder (epilepsy)
is one
of the
heart disease (CHD) (3.6%) and Moyamoya disease
common chronic neurologic disorders in the paediatric
(3.6%). Thirty nine (47.4%) had moderate – severe mo-
age-group.
It has both medical and psycho-social signifi-
tor
disability. Stroke was recurrent in 25 (30.1%) and by
cance. Its diagnosis is mainly based on clinical history
the end of 1 year, 18 (21.7%) children had dropped out
(eye witness account or a video recording) of the ictal
of
school on account of severe motor disability and
events. Electroencephalogram (EEG) helps in comple-
learning difficulties. Stroke due to SCD was associated
menting/confirming the diagnosis.
with an increased risk of recurrence (p<0.001) and an
Aim: To
determine thepattern
of paediatric
epilepsy and
increased risk of dropping out of school (p<0.046).
inter-ictal EEG correlates in children attending Paediat-
Conclusion: Two
of every
three strokes
in Nigerian
chil-
ric Neurology clinic, UDUTH Sokoto.
dren are due to SCD, with attendant high risk of recur-
Methodology: A
descriptive analysis
of the
pattern of
rence, severe motor disability and high school drop-out
seizure disorders and EEG correlates in children with
rates. Institution of primary stroke prevention measures
epilepsy seen in UDUTH Sokoto was conducted over
in
SCD will significantly reduce the burden of childhood
44months (January, 2014 to August, 2017).
stroke in Nigeria.
Results: Three
hundred and
three cases
of Seizure
disor-
Keywords: Stroke,
childhood, disability
der (epilepsy) were studied, constituting 47.2% of all
Paediatric Neurology cases seen in the Clinic over the
period. The mean age of the cases was 6.1±4.5 years
EEG findings in Paediatric Epilepsies in a newly
(range 3months to 15years). Infants accounted for 18.2%
established Paediatric Neurology Unit in FMC
of
the cases. Male to female ratio was 1.9:1. Generalized
Umuahia, South Eastern Nigeria: challenges and
tonic-clonic seizure was the predominant presentation
prospects
(64.4%), followed by myoclonic forms (12.9%) and
Ukpabi IK , Ogbonnaya GU , Ojinnaka NC ,
1
2
3
mixed seizures (9.6%). Absence seizure was the least
observed (1.7%). Cerebral palsy was the commonest
identifiable risk factor in 24.4% of the cases. Only 176
Introduction: Accurate
diagnosis and
appropriate treat-
(58.1%) of the patients had an EEG test, out of which
ment are the keys to reducing the high burden of care
83% showed epileptiform features.
and cost of treatment of paediatric epilepsies in develop-
Conclusion: Paediatric
seizure disorder
constitutes
ing countries. EEG remains the most important investi-
nearly half of all paediatric Neurology presentations in
gative tool in establishing a clinical diagnosis of epi-
our center. Cerebral palsy was the commonest identifi-
lepsy. There is still limited access to this key diagnostic
able risk factor. Inter-ictal EEG yield of epileptiform
tool in our resource-poor setting leading to misdiagnosis
discharges among the clinical cases was high.
and inappropriate treatment. We report the EEG find-
Key words: childhood,
EEG, seizure,
Sokoto
ings, challenges and prospects in a newly established
Paediatric Neurology Unit of Federal Medical Centre
Umuahia, Southeastern Nigeria.
Paediatric Strokes: Risk Factors and Short-Term
Method: Routine
inter-ictal EEG
of children
with epi-
Outcomes
lepsy seen in the paediatric neurology clinic of Federal
Medical Centre Umuahia and those referred from other
Lagunju I, Brown BJ, Oyinlade AO, Esione A, Ibeh J,
health facilities for the test, over a 20-month period was
Balogun TAB, Adelaja A, Sodeinde OO.
reviewed. The clinical diagnosis before and after the
Department of Paediatrics, College of Medicine,
EEG test were noted.
University of Ibadan, Ibadan & University College
Result: A
total of
80 EEGs
were recorded
from 80
chil-
Hospital, Ibadan
dren aged between 3 months to 16 yrs. There was a high
yield of electroencephalographic abnormalities with the
Introduction: Childhood
stroke adversely
affects cogni-
clinical diagnosis of epilepsy established in 97.5% of
tion, functional independence, educational opportunities
cases. EEG evaluation resulted in 7.5% reduction of
and the overall quality of life. There are limited reports
cases labeled as generalized seizures with similar in-
on
the pattern of stroke in African children.
crease in cases of localization- related epilepsies, al-
Objectives: To
determine the
pattern, risk
factors and
though this was not statistically significant (p=0.405)
short-term outcomes in a cohort of Nigerian children
Conclusion: It
is shown
that although
the diagnosis
of
with stroke.
epilepsy is clinical, EEG is indispensable in establishing
Methods: Consecutive
new cases
of stroke
seen in
a
accurate diagnosis in order to ensure appropriate treat-
71
ment and good prognosis, and this is possible even in a
“infancy”
(p=0.039, OR=3.154, 95% CI (1.160, 9.386),
newly established paediatric neurology unit in a devel-
and “conjunctivitis” (p=0.018, OR=5.097, 95% CI
oping country.
(1.320, 19.688). Compared with those who were RSV-
positive, a significantly higher proportion of RSV-
negative subjects had complications (12.2%
vs . 38.0%;
Respiratory syncytial virus infection in hospitalized
p=0.002), but the prevalence of bacteraemia was compa-
children with acute lower respiratory infections at
rable between the two groups (31.7% vs.
32.9%;
the unilorin teaching hospital: Discriminating pa-
p=0.894). All bacteria positive RSV-ALRI had a diag-
rameters of virus-positive cases
nosis of pneumonia, none had bronchiolitis (p=0.024).
Conclusions: RSV-associated
severe ALRI
is a
common
Oladele DM, Johnson, Abdul-Wahab BR, Adedoyin OT,
cause of hospitalization in infants, especially during the
Ibrahim RM, Gobir AA
rainy season in Ilorin. We proffer that more efforts be
Disease Unit, Department of Paediatrics & Child
‘invested’
into implementing the current “global best
Health, University of Ilorin Teaching Hospital/
practices” for preventing RSV -associated ALRI. The
University of Ilorin, Ilorin, Kwara State, Nigeria
current bacteriological data also underscores a possible
need for a prompt (empirical) antibiotic treatment in all
Background :
Whereas a
legion of
viruses has
been
RSV-associated ALRI with a diagnosis of pneumonia.
shown to play a causative role in acute lower respiratory
Keywords: Respiratory
syncytial virus
(RSV); acute
infections (ALRI), RSV continues to dominate the aetio-
lower respiratory infections (ALRI); discriminating pa-
logical landscape with respect to the specific ALRI syn-
rameters; pneumonia; bronchiolitis.
dromes of bronchiolitis and pneumonia in under-five
children. Earlier reports on RSV-associated ALRI in
Nigerian children emanated from (community-based)
Cognitive Performance of Asthmatic Nigerian Chil-
prevalence or incidence data, garnered over a decade
dren and Adolescents
ago.
The current study sought to determine the preva-
, Johnson Abdul-Wahab BR , Gobir
* ∆
Mohammed
SS
++ ∆
lence
of RSV-associated ALRI among hospitalized un-
#
∆
,
Adeboye MAN , AbdulKadir MB
* π
Aishatu
A
** ∆
der-fives,
compare the socio-demographic, clinical and
Ibraheem RM
¶ ∆
radiographic
features, as well as the outcome variables,
Paediatric Cardiorespiratory/Infectious Disease and
∆
between
RSV-positive and RSV-negative ALRI.
Neurology Units,
π
Methods: This
was a
descriptive cross-sectional study
of
120
consecutive children (aged two to 59 months) with
Department of Paediatrics & Child Health, University
ALRI, carried out over a 12-month period (June 2015-
of Ilorin Teaching Hospital
May
2016). For each subject, the relevant socio-
& University of Ilorin, Ilorin, Kwara State, Nigeria
demographic risk factors, clinical and radiographic pa-
rameters were documented, in addition to the results
Background & Objectives:
Conflicting reports
abound
from
blood cultures and viral studies of nasal washings.
on
the cognitive expectations among asthmatic children.
Viral antigen was identified using chromatographic im-
Yet, their possible proneness to hypoxic episodes and
munoassay. Admission outcomes were categorized into
school absenteeism would be expected to have an ad-
“death”
and “survival”; duration of stay and complica-
verse
effect on cognition. The need for building a more
tions were recorded in survivors. Data analysis was
positive self-esteem and indeed, a better adherence to
done, using the SPSS 20.0 software package.
treatment plan among asthmatics have informed the pre-
Results: Thirty-eight
(92.7%) of
the RSV-positive
cases
sent study to clarify the possible cognitive expectations
were seen during the rainy months of May through Oc-
in
a cohort of asthmatic Nigerian children and adoles-
tober. The prevalence of RSV infection was 34.2%.
cents.
The mean±SD age of subjects was 11.4±10.3 months.
Methods :
Cognitive performance scores
of 66
asthmatics
Infants (2-12 months) constituted 77(64.1%) of the sub-
aged 6-17years, and the corresponding scores among 66
jects. Pneumonia was diagnosed in 98(81.7%)subjects,
apparently healthy age- and gender-matched non-
while 22(18.3%) had bronchiolitis. The percentage of
asthmatic controls were compared in this cross-sectional
infants (aged two-<12 months) was 82.9% in the RSV-
study.
After documenting the relevant sociodemographic
positive subjects and was significantly higher than that
and
anthropometric data, the Raven’s Progressive Matri-
of
54.4% in the RSV-negative group (p=0.002). Com-
ces
(RPM) psychometric test was administered to sub-
pared
with the RSV-negative group, RSV-positive sub-
jects
and controls. Test scores and other data generated
jects recorded significantly higher prevalence of each of
were analysed and using the relevant statistical tools.
nasal discharge (82.9% vs . 62.0%) ,
conjunctival redness
Results: The
median {Interquartile range
(IQR)} RPM
(24.4% vs . 8.9%); chest indrawing (
70.7% vs . 48.1%);
test score recorded in asthmatic subjects was 50.0(25.0 –
rhonchi
with or without crepitation (34.1% vs .
16.5%)
75.0), and this was significantly higher than the corre-
and head nodding (22.0% vs . 7.6%)
(p<0.05 for each of
sponding values of 32.5(10.0 – 50.0) among controls
t h
e
c
l i n i c a l
p
a r a m e t e r s
c
o m p a r e d ) .
( p =0.016). Compared with controls,
asthmatics consti-
Comparable radiographic findings were recorded among
tuted a significantly greater proportion of the ‘high
the RSV-positive and RSV-negative groups. Logistic
(RPM score) grade’ category of study participants
regression analysis of the relevant variables identified
(p=0.043, OR=2.124, 95% CI=1.017-4.437). Also, sig-
the independent predictors of RSV-positive ALRI as
nificantly greater proportions of participants (subjects
72
and controls) from the higher socio-economic classes
Patterns and adverse effects associated with child
recorded RPM scores categorized as “High grade”, com-
labour
in Enugu Nigeria
pared with the corresponding proportion of study par-
Bisi-Onyemaechi AI, Chikani UN, Oguonu T
1
1
1
ticipants from the lower social classes (
p <0.001). Also,
1
higher RPM grades were significantly associated with
Department of Paediatrics, College of Medicine,
high (tertiary) maternal educational status, among asth-
University of Nigeria.
matic participants, as well as non-asthmatic controls
Email: adaobi.bisi-onyemaechi@unn.edu.ng
( p =0.002 and
p <0.001 respectively); high paternal edu-
cational
status was significantly associated with the high
Background: Child
labour deprives
children of
their
RPM cognitive grade, only among controls (
p =0.013).
childhood, their potential and their dignity, and is harm-
Logistic regression of the relevant variables identified
ful to their physical and mental development.
high parental social class and paternal
educational at-
Aim: The study is to determine the pattern and adverse
tainments ,
as the two main predictors of a
high RPM test
effects associated with child labour in Enugu.
-grade in
both subjects
and controls.
Methods: Children
aged between
6 and
17 years
were
Conclusions:
The putatively higher cognitive scores
studied. They were selected randomly from streets,
among asthmatics in the current study may be usefully
shops and markets in Enugu. Child labour was defined
deployed for a more positive anticipatory guidance (with
as
any type of economic task, paid, unpaid, or exploita-
respect to cognition), and hence strengthen a better treat-
tive, engagement by a child. Qualitative data were ana-
ment plan adherence. Clearly, larger series are required
lyzed using descriptive statistics.
for validation, and indeed to clarify the genetic basis for
Results: There
were 171
children with
mean age
of 12.5
an
‘above average’, or ‘superior intellect’ among
asth-
years
enrolled. Majority (62%) were males and thirty-
m
a
t
i
c
s
.
five (20.5%) of the children were out of school, while
Keywords: Bronchial
asthma; Cognitive
performance;
62% live with both parents. The most common activities
Nigerian children; RPM IQ-test Social Paediatric
were hawking (32%) and shop keeping (18.6%) and
domestic work (11%).The average duration of activity
was 8 to 12 hours. Only females (11%) were engaged in
Assessment of Stress and its Predictors among
baby-sitting and house-keeping work, similarly males
Female Medical Doctors in South-East Nigeria
only (10%) were involved in loading/offloading goods.
Fifty-five percent worked to support their families finan-
Ofiaeli O*,Nri-Ezedi C.A*,
cially. Some of the children had various forms of re-
*Department of Paediatrics
ward: cash payments (42%), school funding(18%), food
Nnamdi Azikiwe University Teaching Hospital, Nnewi.
(9%)
for their services. Adverse conditions experienced
Email: chisomnriezedi@gmail.com
by
the children while working include prolonged work
hours (53%), sexual abuse (48%), physical assault
Introduction: Stress
is a
common notion
associated with
(9.6%), hunger (9.6%), burn injury (1.7%).
the medical profession. Among female doctors, this un-
Conclusion: A
sizeable proportion
of children
were still
stable mental state in addition to reducing work produc-
exposed to in various forms of child labour which have
tivity can in turn impair the neuro-developmental and
detrimental effects on their wellbeing.
cognitive function of their offspring.
Objectives: To
evaluate the
mental state
of female
medi-
cal practitioners in South East Nigeria.
Paediatricians’ perspectives on industrial actions by
Methods: A
cross-sectional study that
assessed the
medical doctors in Nigeria
prevalence of stress and its predictors among female
Okechukwu C,
1
Readon C, Ideh T
2
medical practitioners using the international K-10 stress
assessment scoring system.
Department of Paediatrics and Child Health, University
Results: 236
female medical
doctors were
evaluated in
of Port Harcourt Teaching Hospital,
Port- Harcourt, Rivers State, Nigeria.
1
this study. Overall, 37.3% were found to be stressed:
21% mildy stressed, 10% moderately stressed and 6%
Department of Paediatrics, University of Benin
Teaching Hospital, Benin, Edo State, Nigeria.
2
severely stressed. Significant predictors of stress were
observed in subjects 31-40 of years, mothers with more
Email: chiomaokechukwu412@gmail.com
than 3 kids, and night calls while non-significant predic-
tors were seen in resident doctors, subjects whose
Background: Industrial
actions have
become a
frequent
spouses reside in a different location and spouses who
means by which medical doctors attempt to communi-
are medical practitioners.
cate their grievances to the government. Paediatricians
Conclusion/Recommendation: An increased
level of
are frequently caught between a desire to support the
stress was observed in almost all female medical doctors
course of their medical association and caring for their
who are mothers; with stressors largely work related.
patients.
Advocacy to and interventions by employers of labour
Aim: To
assess the
opinion of
paediatricians concerning
will greatly aid in mitigating potential stressors thus
strike actions, the aetiology and their preferred method
enhancing the mental state of our female doctors.
of
communicating grievances to the community or gov-
Keywords: mental,
stress, female,
doctors, Nigeria
ernment.
Methods: A
cross-sectional descriptive study
was done
73
on
participants attending a paediatric conference in Ni-
than males (40.5%) or both sexes (13.5%). Factors asso-
geria. There were 102 respondents, who cut across the 6
ciated with sexual abuse were coming from a polyga-
geopolitical zones of Nigeria, consisting of paediatric
mous home, having separated parents, hawking and as-
consultants, residents and nurses. The study was done
sisting trading parents.
using self-administered questionnaires and analysed
Conclusion: This
study portrays
the vicious
pattern of
using SPSS version 20.
sexual abuse among male in-school adolescents. There
Results: 49%
of respondents
did not
support industrial
is
need for parental education and environmental meas-
actions while 21% of persons were undecided. Only 29
u r
e s
t
o
p r
e v e n t
t h
e
m
e n a c e .
(28.4%) of respondents supported industrial actions. 86
Keywords: Male
sexual abuse,
adolescent, pattern.
(84.3%) of respondents volunteer their services even
when their medical association is on strike. Poor remu-
neration (36%), poor working conditions (24.3%) and
Impacted Corn Cob in the Anus: An Unusual Pres-
failure of the government to keep to promises to doctors
entation of Child Sexual Assault
(19.9%) were the top 3 reasons given for strike actions.
39
(38.2%) of respondents admitted to a desire to relo-
Garba MA, Umar LW, Musa S, Makarfi HU
cate to continue medical career outside Nigeria if given
Akeredolu F
the opportunity.
Infectious Disease Unit, Department of Paediatrics,
Conclusion: Industrial
action is
not the
paediatricians’
Ahmadu
Bello University Teaching Hospital, Zaria,
preferred means of communicating grievances. Other
Nigeria
means of communication like continuous dialogue
Email: drkaita@yahoo.com
should be employed for stability in health care delivery.
Key words: Paediatrician,
Nigeria, industrial
action,
Introduction :
Child sexual
assault has
gained worldwide
strike, medical doctors
attention as a medico-social problem with significant
immediate and long-term impact on victims, their fami-
lies and society. This abhorrent deviant act may present
Prevalence and pattern of child sexual abuse among
with bizarre manifestations including various objects
male secondary school adolescents in Ibadan, Nigeria
inserted into body orifices of victims. We report a rare
case of foreign object impaction in a boy.
1
1,2
Adenowuro OE,
Balogun FM
Objectives :
To report
a case
of impacted
object follow-
1
Institute of Child Health, College of Medicine,
ing serial anal sexual assault in a boy.
University of Ibadan, Ibadan, Nigeria
Case report: A
7-year old
boy presented
with a
4-week
2
University College Hospital, Ibadan, Nigeria
history of foul smelling, purulent anal discharge with
Email: folushom@yahoo.com
anorexia, fever and severe anal pain. He had been as-
saulted on several occasions over a two-year period by a
Background: Child
sexual abuse
is a
vile crime
which
man who lures him with candies and inserts a corn cob
exposes its victims to adverse lifelong consequences.
into his anus before having penetrative anal sex inter-
More focus have been on female child sexual abuse but
course with him. The last episode of such occurred five
the male child also experience this abuse and require
weeks prior to presentation. On examination, he was
appropriate interventions as well. Detailed investigations
acutely ill, underweight, pyrexic, with foul smelling
regarding the pattern of male child sexual abuse is im-
body odour. He had firm, non-tender sausage-shaped
perative to curtail the menace.
masses in the iliac fossa. The anus was patulous with
Objectives: This
study determined
the prevalence
and
copious foul smelling purulent discharge. A corn cob,
pattern of sexual abuse among male secondary school
4x4 cm size was found stuck in the anal canal which
adolescents in Ibadan metropolis, Nigeria.
was manually removed. Abdominal ultrasound was nor-
Methodology: Cross-sectional study
design was
used
mal while serological tests for STDs were negative. He
with respondents recruited via three-stage sampling.
did well on antibiotics. The authorities were informed
Two local government areas, 12 secondary schools and
and he was commenced on psychotherapy.
472 male adolescents were selected. Self-administered
Conclusions :
This report
highlights the
bizarre presenta-
semi-structured questionnaires were used to collect
tions of sexual assault in children. Childcare practitio-
socio-demographic data and details on sexual abuse. The
ners should be wary of the possibility of foreign bodies
data was analyzed with the aid of SPSS software using
insertion in victims, which may lead to severe conse-
descriptive statistics, Chi-square and Logistic Regres-
quences.
sion at p<0.05.
Keywords: Anal;
Rectal; Foreign
body; Insertion;
Sex-
Results: Mean
age of
the respondents
was 13.4±1.9
ual
abuse; Assault; Child
years. The overall prevalence of sexual abuse was
29.0% and the abuse occurred most in the perpetrator’s
home
(54.1%). More victims had been sexually abused
during afternoon (51.4%) than evening or night (40.5%).
The
commonest perpetrators of non-contact sexual
abuse were friends (55.5%), neighbours (22.7%) and
family members (20.9%). More victims had experienced
contact sexual abuse exclusively by females (46.0%)