ISSN 03 02 4660         AN OFFICIAL JOURNAL OF THE PAEDIATRIC ASSOCIATION OF NIGERIA


Nigerian J Paediatrics 2017 vol 44 issue 1

Nigerian J Paediatrics 2017 vol 44 issue 1

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Paper Presentations
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 à 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, Maïga 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’hypothèse 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’hypothèse 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 , Maïga 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, Fundação
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 Mère 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.