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


Nigerian J Paediatrics 2019 vol 46 issue 2

Nigerian J Paediatrics 2019 vol 46 issue 2

Issue
Archives
Instructions
Submit Article
Search
Contact Us
 
 
Home
Issue
Archives
Instructions
Submit Article
Search
Contact Us
Home
Quick Navigation
Paediatrics Association of Nigeria 50th Annual General and Scientific Conference
Niger J Paediatr 2019; 46 (2):73 – 121
PANCONF 2019 ANNUAL GENERAL CONFERENCE
Abstracts of Proceedings
CC – BY
50th Annual General and Scientific Conference of the Paediatrics
Association of Nigeria (PANCONF), 24th - 26th January, 2019
Neonatology
OA102
OA101
A comprehensive review of Neonatal Morbidity and
The current pattern of facility-based perinatal and
Mortality in Lagos-Island, South Western Nigeria
neonatal mortality in Sagamu, Nigeria
Olutekunbi OA, Irewole-Ojo F, Oshinowo O, Oladeji A,
Ogunlesi TA , Ayeni VA , Ogunfowora OB , Jagun EO
1
1
1
2
Olutola E, Odunsi O, Aina O
1
Department of Paediatrics, and Department of Obstet-
2
Department of Paediatrics,General Hospital, Lagos-
rics and Gynaecology, Olabisi Onabanjo University
Island. Lagos
Teaching Hospital, Sagamu, Nigeria.
Email: vintada@yahoo.com
Email address: tinuade_ogunlesi@yahoo.co.uk
Introduction and Objective: Mortality occurring in the
Background: Perinatal and neonatal mortality rates have
neonatal period accounts for about 46% of all under-five
been described as sensitive indices of the quality of
deaths with Nigeria as one of the significant contribu-
health care services. Regular audits of perinatal and neo-
tors. Therefore, neonatal statistics is vital to the attain-
natal mortalities are desirable to evaluate the various
ment of the Sustainable Developmental Goal 3 (SDG 3)
global interventions. The objective was to describe the
which aims to reduce neonatal mortality to as low as 12
current pattern of perinatal and neonatal mortality in a
per 1000 live births in 2030. Our objective is to describe
Nigerian tertiary health facility.
the pattern of morbidity and mortality in the inborn and
Materials and Methods: Using a prospective audit
out born units of Massey Street Children’s Hospital,
method, the sociodemographic parameters of all perina-
Lagos-Island South Western Nigeria over a 12 month
tal and neonatal deaths recorded in a Nigerian tertiary
period.
facility between February 2017 and January 2018 were
Materials and Method: Retrospective data of consecu-
tive admissions into the neonatal units from August 1
st
studied.
2017 to July 31 2018 were analysed.
st
Results: There were 1019 deliveries with stillbirth rate
of 27.5/1000 total births and early neonatal death (END)
Results: A total of 2186 babies were admitted into the
rate among in-born babies of 27.2/1000 live births. The
inborn and out born wards during the study period. 1181
overall perinatal mortality rate for in-facility deliveries
(54%) were males and 1005 (46%) females. 1954
was 53.9/1000 total births and neonatal mortality (till 28
(89.4%) were discharged and 22 (1%) discharged
days of life) rate of 27.2/1000 live births. Maternal char-
against medical advice (DAMA). Major admissions
acteristics included unbooked status (88.2%), at least
were Prematurity 829 (37.9%), Asphyxia 486 (22.2%),
secondary education (75%) and lower socioeconomic
Neonatal Sepsis 288 (13.2%) and Neonatal Jaundice 189
status (80.8%). Severe perinatal asphyxia (36.8%), pre-
(8.6%). The total mortality was 203 (9.3%) with Prema-
maturity (36.8%), severe hyperbilirubinaemia (8.8%),
turity accounting for 137 (67.5%) and Perinatal As-
congenital malformations (5.9%) and tetanus (2.9%)
phyxia 42 (20.7%) of the mortalities.
were the causes of neonatal deaths while obstructed la-
Conclusion: Neonatal deaths are mostly due to prema-
bour (25.0%) and intra-partum eclampsia (21.4%) were
turity. Other preventable morbid conditions contribute to
the two leading maternal conditions associated with
it. Advancement in neonatal care is therefore essential in
stillbirths. Gestational age < 32 weeks, age < 24 hours
the accelerated attainment of the SDG 3.
and inborn status were significantly associated with
END (p = 0.002, p <0.001 and p = 0.002 respectively).
Conclusion: The intra-facility perinatal mortality rate
OA103
was high though stillbirth rate was relatively low. This
poses a challenge for the achievement of the Sustainable
Acute Kidney Injury In Asphyxiated Neonates: The
Development Goals in Nigeria.
Utility Of Serum Neutrophil Gelatinase-Associated
Lipocalin In Early Diagnosis
Udoh MP, Ikpeme EE, Udo JJ
Department of Paediatrics University of Uyo Teaching
Hospital, Uyo
Email: enobong.ikpeme@gmail.com
Introduction: The increased morbidity and mortality
from acute kidney injury (AKI) following birth asphyxia
74
can be reduced by early diagnosis with prompt interven-
the Bactec® 9050 System. Positive samples were sub-
tion.
Neutrophil
Gelatinase-Associated
Lipocalin
jected to standard microbiological methods. Pathogen
(NGAL) has been demonstrated to be a highly sensitive
identification was done using API 20E system
early marker of acute kidney injury following birth as-
(Biomerieux) and antibiotics susceptibility determined
phyxia, thus could be utilized for early detection of renal
by the disk diffusion method using the M100-CLSI 2017
dysfunction for early intervention to prevent long term
standards.
sequalae. Studies on the clinical utility of serum and
Results: Overall, a pathogen was identified in 56/595
urine biomarkers of AKI in neonates are limited in Af-
(9.4%) samples processed in 2017. The most frequently
rica and almost non-existent in Nigeria. This study was
identified pathogens were klebsiella pneumoniae, 13/56
therefore carried out to determine the clinical utility of
(23.2%), enterococcus specie, 8/56 (14.3%) and pantoea
serum NGAL as an early marker of acute kidney injury
specie 3, 7/56 (12.5 %). All seven pantoea isolates were
in asphyxiated neonates in the newborn unit of the Uni-
found in August 2017, accounting for 7/14 (50.0%) of
versity of Uyo Teaching Hospital, Uyo, Akwa Ibom
pathogens identified that month. All pantoea isolates
State of Nigeria.
were sensitive to Ciprofloxacin, Gentamycin and
Methods: This was a descriptive cross-sectional study of
Imipenem while 6/7 (85.7 %) were resistant to Ceftria-
one hundred and four asphyxiated term neonates and
zone, Cefuroxime, Ceftazidime and Ampicillin. Mortal-
one hundred and four healthy controls matched for ges-
ity in pantoea-positive cases was 4/7 (57.1%), contribut-
tational age, conducted between July 2015 and February
ing to 18/56 (35.3%) neonatal sepsis mortality in August
2016. Their serum NGAL levels were measured within
2017. This was significantly higher than the 2017 annual
6 hours of life using the highly sensitive Enzyme Linked
average neonatal sepsis mortality of 79/392 (20.2%)
Immunosorbent Assay0 (ELISA) technique. Using se-
[p=0.01; 95%CI (3.12, 28.70)].
rum creatinine and urine output criteria, patients were
Conclusion: The high mortality and resistance to com-
discriminated into AKI and no AKI groups.
monly-used antibiotics associated with pantoea specie 3
Results: The serum NGAL levels in subjects ranged
infections indicate a need for closer monitoring of pat-
from 30-247ng/ml with mean value of 105.65±57.30ng/
terns of sepsis and more effective infection control pro-
ml which was remarkably higher than levels in controls
grams in these settings.
that ranged from 16-88ng/ml with mean value being
46.13±16.10ng/ml (p<0.001). With serum creatinine
criteria, 11.5% of the subjects had AKI while 34.6% had
OA105
AKI with urine output criteria. Subjects of the AKI
Neonatal Outcome in new-borns admitted into a Free
group had significantly higher serum NGAL values than
Maternal and Under-five Health Facility in South-
those of no AKI group (100ng/ml vs 50ng/ml with
west Nigeria: a 5 year review
p<0.001).
Akinkunmi BF , Abiodun MT , Badejoko OO , Eniowo
1
2
3
Conclusions: Serum NGAL is a useful biomarker in
PI Ogundele T , Odunlade CO , Akinlosotu AM
3
1
1
1
detecting AKI in asphyxiated neonates within the first 6
1
hours of life.
Department of Paediatrics University of Medical Sci-
ences Laje road Ondo, Department of Paediatrics and
2
Child Health University of Benin, Benin city and
3
OA104
Formerly Mother and Child Hospital Ondo
An Outbreak of Pantoea Specie 3 In The Special
Email: bakinkunmi@unimed.edu.ng
Care Baby Unit University of Abuja Teaching Hospi-
tal in August 2017
Background and Objectives: Neonatal mortality contrib-
utes significantly to under-five mortality more so in de-
Richard C , Olateju EK , Medugu N , Olanipekun G ,
1
2
1,3
1
veloping countries were facilities for sick new born are
Ocheikwu J , Izevbigie N , Megafu C , Odili V , Ebruke
1
1
1
1
scarce. A review of the outcome in our newborn unit
1,4
BE , Obaro S
1
over a 5 year period may help to highlight inferences
1
International Foundation Against Infectious Disease in
that can be useful in the planning and implementation of
Nigeria, Abuja Nigeria,
2
University of Abuja Teaching
successful newborn care in similar settings.
3
Hospital, Gwagwalada Nigeria.
National Hospital,
Materials and Methods: This was a retrospective study
Abuja Nigeria and University of Nebraska Medical
4
of 3427 neonate admitted into newborn unit of Mother
Center, Omaha, Nebraska, USA
and Child Hospital Ondo from Dec 2012 – December
Email: joybest200@yahoo.com
2017.
Results: The entire neonate admitted during the study
Introduction and Objectives: Pantoea specie 3, an un-
period were included in this review, both the inborn and
common cause of human infection, could be fatal in
outborn. A total of 3427 newborns were admitted during
neonates. We report an outbreak of Pantoea specie 3 in
the period. Male to female ratio was 1.3:1. The mortality
the Special Care Baby Unit, University of Abuja Teach-
in this study was13.9%, the major causes of death was
ing Hospital in August, 2017.
prematurity, perinatal asphyxia, and neonatal sepsis.
Methods: All neonates admitted with a suspicion of sep-
72.6% of the neonates were discharged, 2.8% were re-
sis had blood culture samples collected as part of a sur-
ferred, 9.6% discharged against medical advice while
veillance program for newborn sepsis between January-
0.9% absconded from the hospital
December 2017. Blood samples were processed using
Conclusions: Neonatal mortality still remains a great
75
challenge to achieving developmental goals. Adequate
and their drug sensitivity. The aim of the study was to
antenatal care to prevent the preterm delivery, supervi-
determine the prevalence of neonatal sepsis, the patho-
sion of delivery by health workers skilled in neonatal
gens responsible and their drug sensitivity in the neona-
resuscitation, availability of resuscitative equipments
tal unit of DASH, Lafia.
and multipronged approaches to reduce occurrence and
Material and Method: This was a descriptive cross-
prompt treatment of neonatal sepsis will reduce neonatal
sectional study conducted effectively over a period of
morbidity and mortality
two months from January 2018. Neonates admitted into
the neonatal unit for neonatal sepsis had blood taken for
culture before commencement of antibiotics. Clinical
OA106
features and maternal risk factors for sepsis were docu-
Ablepharon Macrostomia Syndrome: First Case
mented.
Report in West Africa
Results: There were 480 live deliveries in the hospital
over the study period out of which 106 were admitted
Nwaneli EI. , Chukwuka JO. , Uju CM. , Epundu NC.
1
1,2
1
1
with various features suggestive of sepsis. Sixty-five
1
Department of Paediatrics, Nnamdi Azikiwe University
(13.5%) had confirmed sepsis. E.coli accounted for 29
Teaching Hospital, Nnewi, Anambra State, Nigeria and
(45%), Staph. spp - 21 (32%); Kliebsella - 13 (20%) and
2
Department of Paediatrics, Faculty of Medicine,
Proteus spp - 2 (3%). All four isolates were highly sen-
Nnamdi Azikiwe University, Awka, Anambra State, Ni-
sitive to ciprofloxacin and gentamycin. E.coli and klieb-
geria.
sella showed significant resistance to ceftriaxone, and
Email: zinneli@yahoo.com
Proteus spp was completely resistant to amoxicillin and
ampicillin-cloxacillin. Fever was the commonest symp-
Background:
Ablepharon
Macrostomia
Syndrome
tom occurring in 61% of subjects.
(AMS) is an extremely rare congenital ectodermal dys-
Conclusion: The commonest cause of neonatal sepsis in
plastic disease characterized by craniofacial, skin, skele-
the study environment was E. coli. Resistance to con-
tal and genital abnormalities. Less than 20 cases have
ventional drugs used in the treatment of neonatal sepsis
been reported worldwide since the first case report in
was noted.
1977.
Case Report: We report the case of a 6-day old male
Infectious diseases
neonate delivered to unrelated parents. On presentation,
OB101
we found a dysmorphic term neonate with absent eye-
lids, eyelashes and eyebrows, ectropion of both eyes,
Ownership and Appropriate Use of Long Lasting
triangular shaped head, depressed nasal bridge with
Insecticidal Nets among Febrile Children Visiting a
small triangular nose, small and low set malformed ears,
Tertiary Health Centre in South East Nigeria
large fish shaped mouth, hyper pigmented thick anterior
abdominal wall, absent prepuce amongst other features.
Dr Nwaneli EI, Egbuonu I, Ebenebe J, Nri-ezedi CA,
Skull X-ray showed absence of the zygomatic bones.
Ofiaeli OC, Umeadi NC
The patient was managed as a case of AMS in a multid-
Email: zinneli@yahoo.com
isciplinary fashion.
Conclusion: AMS remains an extremely rare congenital
Introduction: Long lasting insecticidal nets (LLIN)s
anomaly. There is no agreement on the mode of inheri-
play crucial role in malaria control. It is however effec-
tance but authors have suggested autosomal recessive,
tive when used nightly, <5 years/undamaged and <20
autosomal dominant, sporadic and familial occurences.
1
wash times. The NMCP targeted that at least 80% of
Absence of the prepuce and hyperpigmentation of the
households own 2 or more ITN while 80% of under-
anterior abdominal wall as was seen in our patient have
fives sleep under ITN nightly. As such, there was a
not been reported. More case reports are needed to be
scale up of mass LLIN distribution in the recent times in
able to delineate the full spectrum of clinical features
Anambra State which was reported to improve the own-
that can be seen in patients with AMS.
ership and use of LLIN among children. The main ob-
jective of this study was to determine the ownership and
OA107
appropriateness of LLIN use among the febrile children
Neonatal Sepsis: Aetiological Agents And Drug Sen-
seen at Nnamdi Azikiwe University Teaching Hospital,
sitivity In Dalhatu Araf Specialist Hospital (Dash),
Nnewi.
Lafia
Materials and method: This was a cross sectional de-
scriptive study conducted on 246 febrile children aged 6
Abolodje E, Sirajo B and Ozhe J
months to 17 years. The children were consecutively
Department of Paediatrics, Dalhatu Araf Specialist
recruited and data was collected using a structured inter-
Hospital, Lafia
viewer administered questionnaire.
Email: efexabo@gmail.com
Results: Majority of the households (97.4%) who owned
LLIN received it from the Government’s mass LLIN
Introduction and Objectives: Neonatal sepsis is an im-
distribution campaign. There was a huge gap between
portant cause of neonatal morbidity and mortality in
ownership of LLIN (84.6%) and its appropriate use
developing countries. Its successful treatment requires
(22.6%). Amongst the households who owned LLIN,
background knowledge of common aetiological agents
74.5% do not use it nightly,10.6% used LLIN which was
76
≥5 years old/damaged and 3.3% were still using LLIN
OB103
which has been washed ≥20 times.
Epidemiological trend of Post-Neonatal Tetanus in a
Conclusion: This study demonstrated inappropriate use
Nigerian Teaching Hospital (2010-2017)
of LLIN. Hence, mass LLIN campaign should also focus
on the education of caregivers on its appropriate use.
Ogunfowora OB, Ogunlesi TA, Oba-Daini OO
Department of Paediatrics, Olabisi Onabanjo University
Teaching Hospital, Sagamu, Nigeria
OB102
Email: tinuade_ogunlesi@yahoo.co.uk
Molecular characterization of extended-spectrum
beta-lactamase producing Enterobacteriaceae from
Background: Tetanus remains an important cause of
pediatric patients in Central and Northwestern Nige-
childhood deaths in sub-Saharan Africa despite being a
ria
vaccine-preventable disease. This study was aimed at
determining the current epidemiological trend of Post-
Duru C* , Olanipekun G , Okorie C , Ajose T
1
1
1
1
Neonatal Tetanus (PNT) in a Nigerian tertiary health
Medugu N , Ebruke B , Obaro S
1,2
1
1,3
facility.
1
International Foundation Against Infectious Disease in
Materials and Methods: A retrospective study of the
Nigeria, Abuja Nigeria National Hospital, Abuja Nige-
2
cases of post-neonatal tetanus managed at the Olabisi
3
ria and
University of Nebraska Medical Center,
Onabanjo University Teaching Hospital, Sagamu, south-
Omaha, Nebraska, USA.
west Nigeria between January 2010 and December 2017
Email: ijeomaaduru@yahoo.com
was done.
Results: There were 67 cases of PNT out of 3,986 ad-
Introduction and Objectives: Little is known about types
missions (1.7%) over the study period. The annual
of extended-spectrum β -lactamases (ESBL) in pediatric
prevalence rates declined from 3.3% in 2010 to 0.9% in
patients in Nigeria. We evaluated the prevalence and
2017. The majority were aged 6-12 years (55.2%), males
resistance patterns among ESBL in children,n across
(64.2%) and belonged to the lower socio-economic
health facilities in central and northwestern Nigeria.
classes IV and V (98.4%). The mean duration of illness
Methods: Blood samples from children age <5years with
was 3.1 ± 2.2 days while the mean incubation period
suspected sepsis were processed using automated Bac-
was 10.4 ± 5.4 days. The portal of entry was identifiable
tec® System from Sept 2008-Dec 2016. Enterobacteri-
among 54 (88.5%) children. Most cases were not immu-
aceae were identified using Analytical Profile Index
nized against tetanus (73.8%), had incubation period > 1
(API20E®) and antibiotic susceptibility profile deter-
week (49.2%), period of onset >24 hours (47.5%) and
mined by the disc diffusion method. Multidrug-resistant
had severe and very severe disease (57.4%). The overall
strains were evaluated for ESBL by the combination
Case Fatality Rate (CFR) was 39.3% contributing 12.6%
disc method as recommended by Clinical and Labora-
of total childhood deaths. Death was significantly asso-
tory Standard Institute. Real-time PCR was used to elu-
ciated with duration of illness less than 24 hours (p =
cidate genes responsible for ESBL production.
0.032) and presence of severe and very severe disease (p
Results: Of 21,000 children screened, 2,625(12.5%)
= 0.005).
were culture-positive. ESBL production was detected in
Conclusion: Although the prevalence rates of PNT de-
160/413(38.7%) Enterobacteriaceae available for analy-
clined over the eight-year period, the disease still con-
sis, comprising Klebsiella pneumoniae 105/160(65.6%),
tributed major fractions of post-neonatal childhood
Enterobacter cloacae 21/160(13.1%), Escherichia coli
deaths from unmet intensive care needs among severe
22/160(13.8%) ,Serratia species 4/160(2.5%), Pantoea
and very severe cases.
species 7/160(4.4%) and Citrobacter species 1/160
(0.6%).Most
ESBL isolates
were
susceptible
to
Imipenem (94.4%), Meropenem (96.4%) and Amikacin
OB104
(96.1%). Resistance rates for antibiotics tested were
Complementary and Alternative Medicine Use
Ceftriaxone (58.4%), Aztreonam (56.2%), Ceftazidime
Among HIV-Infected Children at the Paediatric HIV
(58.4%) and sulphamethoxazole-trimethoprim (63.0%).
Programme, University College Hospital, Ibadan.
Frequently detected resistance genes were bla TEM
1 ,2
1,2
Brown BJ,
1,2
Ogunbosi BO, Oni TO,
2
134/160(83.8%),
bla CTX-M
133/160(83.1%)
and
Oladokun RE
bla SHV 106/160(66.3%). Co-existence of bla CTX-M,
1
Department of Paediatrics, Faculty of Clinical Sci-
bla TEM and bla SHV was seen in 94/160(58.8%),
ences, College of Medicine, University of Ibadan and
bla CTX-M and bla TEM in 118/160(73.8%), bla TEM
Department of Paediatrics, University College Hospital,
and bla SHV in 97/160(60.6%) and bla CTX-M and
Ibadan
bla SHV in 100/160(62.5%) isolates.
Email: tundeogunbosi@yahoo.com
Conclusion: Our findings suggest a high prevalence of
ESBL
resistance
to
commonly-used
antibiotics
Introduction and Objectives: The use of complementary
in Enterobacteriaceae bacteremia in children in this
and alternative medicine (CAM) is common among in-
study. Further studies on the transmission dynamics of
dividuals with chronic conditions. There is little infor-
resistance genes could help in the control of ESBL resis-
mation about the prevalence and pattern of CAM use
tance in these settings.
among HIV-infected children in Nigeria. This study
evaluates the pattern of CAM use among them and some
77
associated factors.
Results: Male participants constituted 54.9%. Overall
Methods: This was a prospective cross-sectional study
mean age was 47±31 months and mean WBC was
7807±4888/mm . Geometric mean parasite density using
3
among a sub-set of a large cohort of HIV-infected chil-
dren receiving care at the Paediatric HIV programme at
assumed and actual WBC were 15,870 parasite/µL and
the University College Hospital, Ibadan. Consecutive
14,139 parasite/µL ( ρ<0.001) respectively. Bland
patients presenting in clinic were enrolled and data col-
Altman plots showed that mean differences between
lected using a proforma. Results were summarized using
parasite densities calculated from assumed and actual
descriptive statistics.
WBC densities were close to zero suggesting no remark-
Results: A total of 80 children were enrolled in the
able systematic bias.
study, most were males 43(53.1%) and ages ranged be-
Conclusion: Using an assumed white blood cell counts
tween 1 and 14 years, with a mean (SD) of 8.5(3.7.)
for calculating parasite density appears appropriate in
years. About half, 38(46.9%) had ever used CAM, but
children aged 3 to 12months for in Southwest Nigeria.
only 2(2.5%) were currently using CAM. The most
commonly used CAM was oral herbal preparation 31
(81.6%) and most of them 26(68.4%) were introduced
OB106
by relatives. Children from low socioeconomic class and
HIV Encephalopathy (HIVE) in children at the
orphans were more likely to have used CAM. Although
University of Port Harcourt Teaching Hospital, Port
a significant proportion, 37 (97.3%) were willing to dis-
Harcourt, Nigeria
close to their doctors, only 11(28.9) had disclosed. All
disclosed because their doctors specifically asked. Most
Paul NI, Okoh BAN, Alikor EAD, Ogbonna-Njoku C
18(42.8%) who had not disclosed thought it was not
Department of Paediatrics, University of Port Harcourt
necessary for the doctors to know.
Teaching Hospital
Conclusion: CAM use is common among HIV-infected
Email: nsypaul@yahoo.co.uk
children, especially oral herbal preparations. This may
potentially cause drug interactions and poor adherence
Introduction: HIV encephalopathy (HIVE) is associated
to ART and outcomes. Physicians need to explore this
with cognitive impairment in children. Early diagnosis
when attending to these children.
and initiation of HAART may reduce its associated mor-
bidity.
Objective: To determine the prevalence of HIVE and
OB105
other comorbidities in children with HIVE at the Uni-
Appropriateness of Assumed Versus Absolute White
versity of Port Harcourt Teaching Hospital (UPTH).
Blood Cell Counts for Estimation of Malaria Parasite
Materials and Method: The case notes of all HIV posi-
Density in Children Population in Ibadan Southwest
tive children presenting to the Paediatric Department of
Nigeria
the UPTH from January to June 2017 were studied.
Children who met the diagnostic criteria for HIVE were
Olofin ZF , Orimadegun AE and Falade CO
1
2
1,3,4
selected. The socio-demographic characteristics, mode
1
Department of Pharmacology & Therapeutics, Insti-
2
of HIV transmission, CD4 count and associated comor-
tute of Child Health, Institute for Advanced Medical
3
bidities of the patients were retrieved. Obtained data was
Research & Training, and Department of Clinical
4
analyzed using Epi Info version 7.2. Comparisms of
Pharmacology, University College Hospital, Ibadan,
subgroups was carried out using the chi square test
Nigeria.
while statistical significance at 95% confidence interval
Email: folexmedic@yahoo.com
was p value < 0.05.
Results: A total of thirty-five out of the 196 HIV posi-
Introduction and Objectives: Estimation of malaria para-
tive children had HIVE, giving a prevalence rate of
site density is important in diagnosis and assessment of
17.9%. The mean age for the males was 6.4 ± 3.2 years
individuals on antimalarial drugs. The use of either pa-
and 5.0 ± 2.8 years for the females. There was no statis-
tient’s actual white blood cell (WBC) counts or an as-
tically significant difference observed between the sexes
sumed value of 8000/mm to calculate malaria parasite
3
(t = 1.35, p = 0.187). The mean age at diagnosis of
density is still controversially discussed in literature.
HIVE was 3.4 ± 3.2 years. The route of transmission for
This study was carried out to investigate the agreement
all
the
subjects
was
mother-to-child-transmission
between the two methods of calculating malaria parasite
(MTCT). Tuberculosis was the most prevalent co-
density in children.
morbidity occurring among the patients.
Materials and method: Data on parasite and WBC
Conclusion: The prevalence of HIVE in children at the
counts were extracted from 796 case record forms of
UPTH is high and Tuberculosis is the commonest co-
children aged 3 to 120 months who participated in four
morbidity. Early infant diagnosis, use of modern diag-
antimalarial clinical trials conducted between 1998 and
nostic tool and early initiation of HAART are advocated
2014. Criteria for enrolment into the clinical trials in-
to reduce its associated morbidity.
cluded symptoms compatible with acute uncomplicated
malaria, microscopically confirmed malaria parasitaemia
of at least 1000/µL and absence of danger signs of se-
vere malaria. All the studies received relevant ethical
approval.
78
OB107
Introduction and Objective: Thrombospondin-1 (TSP-1)
Comparative Effect of Four Antimalarial Treat-
and 25-hydroxyvitamin D (25-OHD) play significant
ments on Haematocrit in Children in Southwest of
roles in the pathogenesis of sickle cell anaemia (SCA).
Nigeria
TSP-1 enhance cellular adhesion and inflammation,
hence contributing to vaso-occlusive crisis (VOC); con-
Olofin ZF , Orimadegun AE and Falade CO
1
2
1,3,4
versely, 25-OHD retard inflammation and may lower
1
Department of Pharmacology & Therapeutics, Insti-
2
rate of pain episodes. We determined serum levels of
tute of Child Health, Institute for Advanced Medical
3
TSP-1 and 25-OHD in Nigerian children with SCA and
Research & Training, and Department of Clinical
4
matched haemoglobin AA controls; and assessed the
Pharmacology, University College Hospital, Ibadan,
relationship between the two biomarkers.
Nigeria.
Methods: Ninety children (32 SCA in steady state, 30
Email: folexmedic@yahoo.com
SCA in VOC and 28 HbAA controls) were studied. Se-
rum TSP-1 and 25-OHD levels were measured with
Introduction and Objectives: Anaemia in malaria has
ELISA and HPLC respectively.
both central (dyserythropoiesis) and peripheral causes.
Results: The mean TSP-1 of children with VOC
The aim of this study was carried out to compare change
(204.4±102.9ng/mL) was significantly higher than those
in haematocrit following four antimalarial treatments
in steady state (148.4 ±82.7ng/mL, p = 0.022) and
among children of microscopically confirmed Plasmo-
HbAA controls (99.9 ±41.3ng/mL, p<0.001). Similarly,
dium falciparum infection.
the mean TSP-1 of those in steady state was signifi-
Materials and method: Relevant data were extracted
cantly higher than controls (p = 0.007). However, mean
from 313 case record forms of children aged 3-119
serum 25-OHD of the children with VOC was lower
months enrolled in antimalarial clinical trials in South-
than those in steady state (28.9±8.2ng/mL versus 37.1
west Nigeria between 1998 and 2014. Symptoms com-
±12.3ng/mL, p = 0.004). There was a significant inverse
patible with acute uncomplicated malaria, parasite den-
correlation between TSP-1 and 25-OHD among the
sity of at least 1000/µL and absence of chronic illness or
VOC subgroup only (r = -0.57, p = 0.001). The mean
danger signs of severe malaria were enrolment criteria.
TSP-1 of the 28 children with SCA who had suboptimal
Change in haematocrit level from base line through the
25-OHD (213.5 ±118.6ng/mL) was higher than 144.2
treatment period and 28 days post treatment were com-
±58.7ng/mL of the 34 with SCA and normal serum vita-
pared
among
children
treated
with
Artemether-
min D, p = 0.008.
Lumefantrine (82), Chloroquine (34), Artovaquone-
Conclusion: Children with SCA, especially those with
Proguanil (41) and Artesunate-Amodiaquine (156).
VOC, had high serum TSP-1 and low 25-OHD. Also, an
Results: There were 169 males and 144 females and
inverse relationship exists between 25-OHD and TSP-1
overall median age of the patients was 25 months. Mean
in children with VOC. These findings provide basis for
difference (95% CI) in haematocrit among children were
further studies into the regulation of TSP-1 by vitamin
4.7% (95% CI = 3.6, 5.8), 2.4% (95% CI = 0.5, 4.4),
D.
4.4% (95% CI = 2.7, 6.0), and 3.8% (95% CI = 3.0, 4.7)
for Artemether-Lumefantrine, Chloroquine, Artova-
quone-Proguanil and Artesunate-Amodiaquine, respec-
OC102
tively. Using the general lineal model, repeated measure
Remission of Acute Promyelocytic Leukaemia in a
analysis showed that there was significant difference in
Child Following the Use of Retinoic Acid Alone After
the mean haematocrit level over the 28 day follow up
Failure of Anthracycline Based Chemotherapy in a
among the four treatment groups (p = 0.020) even after
Resource Constrained Country
adjusting for sex and age and there were no significant
1
Brown BJ, Fasola FA, Adebayo BE, Ogunkunle OO
2
1
1
interactions between covariates and haematocrit.
1
Department of Paediatrics and Department of Haema-
2
Conclusion: All children experienced increase in haema-
tocrit after treatment and the changes differ among anti-
tology, College of Medicine, University of Ibadan,
malarials.
Ibadan
Email: biosbrown@yahoo.com
OC101
Introduction and Objective: All trans-retinoic acid
Thrombospondin-1 and Vitamin D in children with
(ATRA) is able to induce complete remission (CR) in
sickle cell anaemia
patients with acute promyelocytic leukemia (APL).
However, it cannot eliminate the leukaemic clone and to
1
Adegoke SA, Smith OS, Adeniyi AT, Adekile AD.
2
3
4
4
be effective it must be used in combination with anthra-
1
Department of Paediatrics and Child Health,
cycline-based chemotherapy. The objective of this report
2
Department of Chemical and Department of Paediat-
3
is to describe the case of a boy with APL who failed to
rics, Pathology, Obafemi Awolowo University (OAU),
achieve remission using chemotherapy but achieved
Ile-Ife, Nigeria
remission using ATRA alone. The challenges of man-
4
Department of Paediatrics, Faculty of Medicine, Ku-
agement in a developing country were also highlighted.
wait University, Kuwait.
Methods: This is a case report based on information
Email: adegoke2samade@yahoo.com
obtained from the patient’s case record from diagnosis
till present status.
79
Results: An 11-year-old boy presented with recurrent
contrary, patients with alpha thalassemia had lower
fever and pallor of 4 weeks’ duration. Main findings on
mean corpuscular volume, mean corpuscular hemoglo-
physical examination were pallor and hepatomegaly.
bin, and white blood cell count (WBC) (p ˂0.05). There
Full blood count and peripheral blood film were in keep-
were 6 (10.3%) patients with leg ulcers and none of
ing with acute Leukaemia and cytologic examination of
them had alpha thalassemia, (p=0.0384).
his bone marrow was in keeping with APL. His parents
Conclusion: This study confirms that coexistence of
could not afford ATRA required to be used in combina-
alpha thalassemia with SCA significantly influenced the
tion with chemotherapy. He was placed on Doxorubicin
clinical and laboratory indices of the patients. The coex-
and cytosine arabinoside. Chemotherapy was stopped
istence of this genetic modifier was associated with in-
after four courses without achievement of remission. His
creased bone pain crisis and protects against sickle leg
parents eventually accessed ATRA which was used as
ulcers among the patients.
monotherapy and achieved remission. He subsequently
developed cardiomyopathy which was managed. He was
subsequently maintained with ATRA, Mercaptopurine
OC104
and Methotrexate and has remained in remission 3 years
Total Antioxidant Capacity, Total Oxidative Status
after.
and Oxidative Stress Index Are Related to Sickle Cell
Conclusion: All effort should be made to make ATRA
Disease Severity in Children
available to complement chemotherapy in order to in-
Smith OS, Adegoke SA, Akinlosotu MA, Ajose OA
1
2
3
4
crease the chances of cure in patients with APL.
1
Affiliations:
Department of Chemical Pathology,
Obafemi Awolowo University (OAU) Teaching Hospi-
OC103
tals Complex, Ile-Ife, Nigeria.
2
Influence of Deletional Alpha Thalassemia on Clini-
Department of Paediatrics and Child Health, OAU,
cal and Laboratory Parameters of Young Nigerians
Ile-Ife, Nigeria.
3
with Sickle Cell Anaemia
Department of Paediatrics, University of Medical
Sciences, Ondo, Nigeria.
1 ,2,3
2
3
4
Olatunya OS,
Albuquerque DM,
Taiwo AB,
Department of Chemical Pathology, OAU, Ile-Ife,
3
4
5
6
Fatunla OAT,
Faboya OA,
Kayode TS,
Adekile
Nigeria.
AD, Costa FF
2
Email: adegoke2samade@yahoo.com
1
Department of Paediatrics and Department of Medical
4
Biochemistry, College of Medicine, Ekiti State Univer-
Introduction and Objectives: Total anti-oxidant capacity
sity, Ekiti State, Nigeria
(TAC), total oxidant status (TOS) and oxidative stress
2
Hematology and Hemotherapy Center, University of
index (OSI) measure the cumulative level of oxidative
Campinas, São Paulo State, Brazil
stress. In this study, we evaluated serum levels of over-
3
Department of Paediatrics and Department of Chemi-
5
all oxidative stress markers in children with sickle cell
cal Pathology, Ekiti State University Teaching Hospital,
anaemia (SCA) and matched healthy controls, and deter-
Ado-Ekiti
mined the relationship with the disease severity.
6
Department of Pediatrics, Faculty of Medicine, Kuwait
Materials and method: One hundred and fifty-six chil-
University, Kuwait.
dren, comprising of 78 with SCA aged 1 - 15 years and
Email: simeon.olatunya@eksu.edu.ng
78 age- and sex-matched haemoglobin AA controls were
studied. Serum TOS, OSI and TAC were determined by
Introduction and Objective: There is scarcity of infor-
ELISA kits. Severity of the SCA was determined using
mation on the influence of genetic markers on the clini-
clinical and laboratory parameters as previously de-
cal and laboratory parameters among Nigerian sickle
scribed.
cell anemia (SCA) patients. This study determined the
Results: Children with SCA had lower mean serum TAC
prevalence of deletional alpha thalassemia and its influ-
(0.83±0.31UAE)
than
controls
(1.19±0.24U/ml),
ence on the laboratory parameters and clinical manifes-
p<0.001. However, the mean serum TOS and OSI of
tations in a group of young Nigerian SCA patients.
children with SCA was higher than in the control
Patients and Methods: One hundred patients with SCA
(13.33±4.64 vs. 9.70±2.72U/ml and 20.95±16.75 vs.
and 63 controls were studied. The diagnosis of SCA was
8.68±3.76 respectively), p<0.001. SCA subjects with
confirmed by DNA studies. Alpha thalassemia (3.7 κ b
mild disease (0.91±0.27UAE) had higher mean serum
and 4.2 κ b α -globin gene deletions), genotyping was
TAC than those with moderate disease (0.54±0.27UAE)
done by multiplex gap-PCR method. Laboratory pa-
(p<0.001). On the other hand, the mean TOS and OSI
rameters including: complete blood count, hemoglobin
were lower in those with mild than moderate disease
quantitation, serum lactate dehydrogenase (LDH) and
(12.64±4.32
vs.
15.63±5.07U/ml,
p=0.016,
and
bilirubin were determined with standard techniques.
16.26±10.25 vs. 36.61±23.89 p<0.001 respectively).
Results: Alpha thalassemia was found in 41 (41.0%)
Sickle cell disease severity score had negative correla-
patients compared to 24 (38.1%) controls (p=0.744) and
tion with TAC (r= -0.60, p<0.001) but positive correla-
all were due to the 3.7 κ b α -globin gene deletions. Al-
tion with TOS (r = 0.3, p=0.008) and OSI (r= 0.6,
pha thalassemia was associated with more frequent bone
p<0.001).
pain crisis, higher hemoglobin concentration, red blood
Conclusion : Children with SCA had lower TAC but
cell count, and HbA 2 level among the patients. On the
higher TOS and OSI than matched controls. Oxidative
80
stress markers had significant relationship with SCD
OC106
severity.
Iron deficiency, still a rarity in children with sickle
cell anaemia in Ile-Ife, Nigeria.
OC105
Odunlade OC, Adeodu OO, Owa JA, Obuotor EM.
1
2
2
3
Effects of Hydroxyurea on Renal and Hepatic
Department of Paediatrics, University of Medical
Functions Among Children with Sickle Cell Disease
Sciences, Ondo State.
in UATH Gwagwalada, Abuja
Department of Paediatrics and Child Health, Obafemi
Awolowo University, Ile-Ife, Nigeria.
1
1,2
Uche Nnebe-Agomadu, Ade-
1
Erigbuem John Ifeanyi,
Department of Biochemistry, Obafemi Awolowo Univer-
1
1
bayo Innocent Adogah,
Oyeleye Ayotunde,
Esther
sity, Ile-Ife, Nigeria.
James, Evelyn Kumode.
1
Email: drolufunky@gmail.com
1
Department of Paediatrics, University of Abuja Teach-
ing Hospital, Abuja.
Introduction/ Objective: Iron deficiency continues to be
2
Department of Paediatrics, College of Health Sciences,
a prevalent among children in Nigeria and sub-Saharan
University of Abuja.
Africa countries. In this study, children with SCA were
Email: erigbuemii@gmail.com
evaluated for iron deficiency.
Material and Methods: The study was done at the Paedi-
Introduction: Hydroxyurea remains the only widely ap-
atric Haematology Clinic of Obafemi Awolowo Univer-
proved medication for the prevention of complications
sity Teaching Hospitals’ Complex, Ile -Ife. Forty-eight
in sickle cell disease (SCD). It increases the production
HbSS subjects in steady state and 48 age and sex
of HbF, which inhibits the polymerization of HbS and
matched HbAA controls were evaluated. Serum ferritin
the sickling process in SCD. Patients with SCD are at
levels, FBC, free erythrocyte protoporphyrin (FEP) were
increased risk for organ damage due to recurrent sick-
assayed in both groups. Serum ferritin less than 25 ng/
ling. Hydroxyurea might therefore prevent chronic organ
dL, FEP greater than cut off for age, MCV and MCH
damage by reducing sickling process. However, whether
less than cut off for age were regarded as indicating iron
hydroxyurea causes idiosyncratic adverse effects on
deficiency.
organ functions, renal and hepatic as reported by a few
Results: The mean of serum ferritin levels was 381.2
studies is still being understudied.
(1.0), and it was significantly higher than the controls,
Aims: To determine the effects of hydroxyurea therapy
with mean of 46.1 (0.9), (p < 0.001).FEP was lower in
on renal and hepatic functions in a cohort of Nigerian
subjects but none was iron deficient compared with con-
children with SCD aged 1-18 years.
trols. The mean haemoglobin concentration subjects
Methods: Children with SCD who were on hydroxyurea
were S significantly lower than the controls (p < 0.001).
for at least 12 months were studied. The dose of Hy-
Subjects had lower MCV compared with controls. How-
droxyurea ranged between 15mg/kg to 25mg/kg and
ever, this was not statistically significant. Iron defi-
renal and hepatic functions were prospectively evaluated
ciency was not detected in subjects in comparison to a
using serum Electrolyte, Urea, Creatitine, the amino
prevalence of 43.75% in the controls. Iron deficiency
transaminases and total bilirubin levels respectively.
anaemia (IDA) was found in 16.7% of the controls.
Result: 26 Children; 15(57.7%) males and 11(42.3%)
Conclusion: A high prevalence of iron deficiency was
females with M:F = 1.4:1 and mean age 11.1 years were
noted in the control group. Patients with SCA were not
studied. Their sodium, potassium, urea and creatinine
iron deficient, despite their anaemia. Iron supplementa-
levels were measured before commencing hydroxyurea
tion remains
(baseline), then 3 months and 12 months after hydroxy-
unnecessary as part of the routine management of chil-
urea use. There was no significant difference in the
dren with SCA in our practice.
baseline, 3 months and 12 months post hydroxyurea
values for electrolytes, urea and creatinine levels. There
was also no significant difference in the baseline, 3
OC107
months and 12 months post hydroxyurea levels of the
Comprehensive Sickle Cell Care: The Role of a
transaminases. However, there was a steady rise in the
Nurse Coordinator in UATH, Gwagwalada, Abuja
total bilirubin levels although also not significant.
1
Esther James, Uche Nnebe-Agumadu, Evelyn Ku-
2,3
1
Conclusion: Use of moderate dose of hydroxyurea in
mode, Adebayo Innocent Adogah.
3
children for 12 months show no significant impairments
1
on renal and hepatic functions. Studies with larger sam-
Department of Nursing, University of Abuja Teaching
ple size and longer duration of study are however advo-
Hospital, Gwagwalada, Abuja.
2
cated.
Department of Paediatrics, College of Heath Sciences,
University of Abuja.
3
Department of Paediatrics, University of Abuja Teach-
ing Hospital Gwagwalada, Abuja
Email: estherpj2014@gmail.com
Background: SCD is a global public health problem
with Nigeria bearing the highest burden of the disease.
81
The role of health education in the comprehensive care
score and other characteristics at the PEDs using Stata
of children with SCD and their families is central to
statistical software.
care. There is inadequate emphasis on the role of pre-
Results: Of the 34 studied Tertiary PEDs, 52.9% were
ventive care and parental/patient education in the routine
located in northern Nigeria.
The mean preparedness
management offered in most centres in Nigeria.
performance score was 43.88%.About half (52.94 %;
Aim: To discuss the impact of a preventive and anticipa-
n=18/34) of the centres had dedicated Physician head
tory approach to care, offered in the contest of a compre-
but few (5.9%/2/34) had APLS certification. The medi-
hensive sickle cell care, in UATH through structured
cation, equipment (r-0.98, p=0.001) and emergency trol-
health education to improve knowledge of SCD, pro-
ley (r-0.94, p=0.001) strongly correlated with prepared-
mote access to patient-centred care and enhance well-
ness score. Southern PEDs had higher score in equip-
being of patients and their families.
ment availability (p=0.029) and performance prepared-
Method: The nurse delivers structured health education
ness score (P-value = 0.005) than Northern PEDs and
on routine health maintenance twice weekly to patients
the proportion of medical officers (p=0.010) and avail-
and families using the acronym “FARMIS”. Counselling
ability of medication (P<0.05) were statistically differ-
is also done before the commencement of hydroxyurea
ent by region.
therapy and during monitoring. She identifies and deals
Conclusions: This study reports a global deficiency but
with challenges with medication and clinic compliance
remediable state of emergency care preparedness among
or barriers to accessing effective care. Operates the unit
PEDs in tertiary centres in Nigeria. This study highlights
24/7 help line and organises the parent support group.
the need for: training and advanced certification of ED
Result: A 250% increase in patient enrolment with an
staff and enhanced medication and equipment procure-
established trustful relationship between health care pro-
ment nationwide, to improve outcome.
viders and children and their family members. There is
improved health-seeking behaviour, self-care, compli-
ance with clinic visits and drug use.
OD102
Conclusion: Structured and well-implemented health
Delayed Presentation among Critically Ill Children
education with parental satisfaction is indispensable
Visiting Children Emergency Room of University
tools in the comprehensive care of children with SCD in
College Hospital Ibadan
Nigeria
Adeniyi T , Labaeka AA , Orimadegun AE , Tongo
1
1
1, 3
OO
1, 2
OD101
1
Department of Paediatric, University College Hospital
Ibadan, Department of Paediatric, University of Ibadan
2
Paediatric Emergency Departments in Nigeria: How
and Institute of Child health, University of Ibadan
3
Prepared Are They To Provide Emergency Care?
Email: yemilabaeka2@yahoo.com
Enyuma COA,
1,2,3
Laher AE, Moolla M, Feroza M,
1
1
1
Olorunfemi G .
4
Introduction: Childhood morality remains a major pub-
1
Department of Emergency Medicine, Faculty of Health
lic health problem in Nigeria and most developing coun-
Sciences, University of the Witwatersrand, Johannes-
tries, majority of which are due to preventable problems
burg, South Africa, Department of Paediatrics, Faculty
2
like pneumonia, severe malaria, prematurity and acute
of Medicine, University of Calabar. Nigeria, Children
3
diarrhoeal disease. Many of these deaths are related to
Emergency Unit, Department of Paediatrics, University
delayed presentation in hospital. Early recognition and
of Calabar Teaching Hospital. Nigeria and Division of
4
prompt effective intervention of critically ill children
Epidemiology and Biostatistics, School of Public health,
will help in reducing childhood mortalities. This study
University of the Witwatersrand, Johannesburg, South
aimed to assess the reasons behind delayed presentation
Africa
among children presenting critically ill in a tertiary hos-
Email: drcarlenyuma@yahoo.com
pital in Nigeria.
Materials and Method: Prospective observational study
Introduction and objective: Paediatric emergency care is
of 1180 children who visited the Children’s emergency
not yet fully developed in low and middle income coun-
room of the UCH Ibadan between June 2017 and August
tries. However, the magnitude of the challenges has not
2018. The patients were triaged using the World Health
been well characterised in Nigeria. The study assessed
Organisation (WHO) Emergency Triage Assessment and
paediatric emergency care preparedness
Treatment guideline.
Methods: This is a national cross sectional study of the
Results: The predominant age group was 12 59
emergency care preparedness among Paediatric Emer-
months 41.7% (492). While majority of the children
gency Departments (PED) in Nigeria. Facilities were
were males 723 (61.3%), and only 52 children (4.4%)
recruited from federating units using quota sampling. A
were on any health insurance coverage. The mean dura-
self- administered questionnaire and check list were
tion of symptoms before presentation was 7 ± 12 days.
used to obtain information on the availability of: skilled
After triaging 187 (15.8%) and 967 (81.9%) children
personnel, medication, equipment and emergency trol-
had emergency and priority signs respectively. Majority
ley, Preparedness performances were assessed using a
(54.5%) of patients had been on self-medication prior to
point score scale. Chi-square and correlation tests were
presentation and 26.2% had been to more than one
used to determine associations between preparedness
health facilities. About 58.2% of the parents of children
82
with emergency signs thought the symptoms were not
Background: Under-five mortality rate is an important
serious hence the delay in presentation while 30.2%
index of child mortality and an indicator of a country’s
presented late because of fear of cost of health care.
level of socioeconomic development and quality of life.
Conclusion: Majority of care givers underestimated the
An audit of the common causes of childhood mortality
severity of symptoms as the reason for delayed presenta-
is essential in ensuring optimum health of under-fives.
tion.
Aim and Objectives: To determine the magnitude,
causes and determinants of under-five deaths at FMC
Umuahia.
OD103
Methods: A retrospective review of all post-neonatal
Oxygen prescription for children at the emergency
under- five deaths in the Children’s Emergency Room
facility in Unilorin Teaching Hospital, Nigeria
from January 2012 to December 2016 was done and
information analyzed.
Ibraheem RM, Oyedepo JT, Ameen-Ikoyi B, Abdulkadir
Results: Of a total of 6141 under-fives, 197 died giving
MB, Gobir A.A, Johnson ‘W.B.R.
a mortality rate of 3.2% (32 per 1000 live births). Mor-
Department of Paediatrics, University of Ilorin &
tality rate was higher during infancy (p = 0.039). There
University of Ilorin Teaching Hospital, Ilorin, Kwara
was no gender difference (p = 0.262). Leading causes of
State, Nigeria.
death were sepsis, severe malaria, diarrheal disease,
Email: rasheedahbidmus@yahoo.com
meningitis, pneumonia and severe acute malnutrition.
Deaths due to malaria occurred more beyond infancy (p
Introduction and Objectives: Supplemental oxygen ther-
= 0.032) while those due to pneumonia were more
apy is an intervention that can reduce hypoxaemia-
among infants (p=0.012). Diarrheal disease caused more
related morbidity and mortality. It is a drug with its own
deaths during the dry weather season (p = 0.009). About
indication, route of administration, dosage and side ef-
40% of the deaths occurred within 24 hours of admis-
fects and should be prescribed as such. The study identi-
sion.
fied the prescribing pattern of supplemental oxygen for
Conclusions: The leading causes of under-fives deaths
children presenting to the emergency facility at Unilorin
in our centre are preventable infectious diseases. Intensi-
Teaching Hospital.
fication of goal-targeted, disease specific preventive
Materials and Method: This is a quasi-interventional
measures is recommended.
study involving children admitted through the emer-
gency paediatric unit. A two-hour presentation was
made on oxygen therapy and the prescriptions made one
OD105
week pre- and post-presentation were compared. Data
Childhood Dead before Arrival at The Wesley Guild
was collected on the oxygen saturation levels (SpO 2 )
Hospital, Ilesa Nigeria: A Call for Concern and Im-
before and after oxygen commencement, delivery de-
provement in Health Care Delivery
vice, flow rate, target SpO 2 and monitoring.
1,2*
Oke OJ, Adegoke SA,
1,2
Adeniyi AT, Kuti BP,
1
Results: A total of 35 oxygen prescriptions were re-
Alade-
komo TA.,
1,2
Oyelami AO
1,2
viewed, 17 (48.6%) were retrieved before the presenta-
1
tion while 18 (51.4%) were reviewed after the presenta-
Department of Paediatrics, Wesley Guild Hospital,
Ilesa, Department of Paediatric and Child Health,
2
tion. Post-presentation, 18 (100%) prescriptions indi-
cated the dose of oxygen which was significantly higher
Obafemi Awolowo University, Ile-Ife, Nigeria
than the 13 (76.5%) that indicated oxygen dosage before
Email: kutitherapy@yahoo.com
the presentation, p =0.045. Prescriptions stating the de-
livery device pre-presentation were six (35.3%) and post
Background: Dead-before-arrival (DBA) is a term used
-presentation were 18(100.0%), p =0.001. The number of
to describe patients who are presented to the hospital
prescriptions bearing the target oxygen saturation sig-
with no sign of life at presentation. These cases of mor-
nificantly increased from three (17.6%) pre-education to
tality are often overlooked and not included in mortality
18 (100.0%) posteducation, p =0.001. There were no
records of most health facilities thereby underreporting
significant differences between prescriptions indicating
mortality cases. This study sets out to assess the preva-
SpO2 pre- and post- oxygen commencement, and moni-
lence, pattern and possible causes of DBA at the Wesley
toring of SpO 2 levels before and after the presentation.
Guild Hospital (WGH), Ilesa.
Conclusion: Training of health personnel on oxygen
Methods: Verbal autopsy was used to prospectively
therapy will ensure its appropriate prescription as a drug.
study all cases of childhood DBA at the CEW of the
hospital over a four-month period (September to Decem-
ber, 2017). Socio-demographic history, symptoms be-
OD104
fore demise and treatment received, as well as suspected
Under- Five Mortality at The Children’s Emergency
cause(s) of death were documented. The mortality was
Room of Federal Medical Center, Umuahia
also compared with the in-hospital care mortality during
the period.
Ibeneme CA, Ezuruike EO, Korie FC, Chukwudi NK
Results: Twenty-five (7.3%) of the 343 admission to the
Department of Pediatrics, Federal Medical Center,
CEW during the period were cases of DBA. These were
Umuahia, Abia State, Nigeria
significantly more than the total in-hospital mortality
Email: chik4sco@yahoo.co.uk
during the period [25(7.3%) vs. 17 (4.9%)] and 10
83
(40.0%) of the cases of DBA were infants with male:
OD107
female of 1.8. Severe anaemia (56.0%) from possible
Diffuse Cutaneous Systemic Sclerosis- A Rare Skin
complicated malaria and severe head injury from road
Disorder in A Nigerian Child
traffic crash were the predominantly recognised causes
of DBA. About two-thirds only used home remedies
Ezomike NE ¹, Onyekonwu C²
before demise.
¹Depatment of Pediatrics UNTH Ituku/Ozalla Enugu,
Conclusion: In-hospital mortality may be a tip of the
²Department of Medicine UNTH Ituku/Ozalla Enugu
iceberg as cases of DBA and even those who did not
Email: nkeirukaezomike@gmail.com
present at all may take the lion share of childhood mor-
tality. Making basic health care available and affordable
Introduction: Diffuse cutaneous systemic sclerosis
to the populace may help reduce the burden of DBA.
(dcSSc) is rarely been reported among African children
especially in Nigeria. The clinical features and outcome
in children are different from the adult. It has a high
OD106
morbidity and mortality. This report aims to revisit this
Prevalence of Skin Diseases among Primary School
rare paediatric skin disorder.
Children in Port Harcourt
Methods and Results: Case report and MEDLINE
(Pubmed) search of the English literature using the
Alex-Hart B.A and Altraide D
1
2
words ‘systemic sclerosis’, and diffuse scleroderma’. A
Department of Paediatrics* and Department of Internal
16-year-old female student presented with a three-year
Medicine**, University of Port Harcourt Teaching Hos-
history of generalized skin thickening and two-year his-
pital.
tory of discoloration of the skin, and difficulty in open-
Email: balaalexhart@ymail.com
ing the mouth. Examination revealed salt and pepper
appearance of the skin, photosensitive hypertrophic
Introduction and objective: Skin diseases are common
plaques on both the right arm and ear, fish mouth de-
among children in resource poor settings where there is
formity, skin thickening and pitted scars on the fingers.
low level of hygiene, overcrowding and warm humid
Skin was thick and had hypopigmented patches on the
climates.
However, there are no known community
chest and back. Raynaud’s phenomenon was positive. A
based studies on its prevalence in Rivers State. This
clinical diagnosis of diffuse systemic sclerosis was
study aimed to evaluate the prevalence and types of skin
made. Erythrocyte sedimentation rate, and anti-
diseases among primary school children in Port Har-
topoisomerase I (antiScl-70) were raised {30mm/hr
court, Rivers State.
westergren and >320U/Ml (<7 to 10U/mL) respec-
Materials and methods: This cross sectional study was
tively}.
Antinuclear antibody (ANA) was posi-
conducted in five primary schools in Port Harcourt over
tive1:160, homogeneous pattern. Complete count, chest
a three - month period from September to November
computed tomography, upper gastrointestinal endo-
2017. Multistage sampling technique was used to re-
scopy, electrocardiography, abdominopelvic ultrasound,
cruit 524 pupils for the study. Interviewer administered
liver function tests, serum electrolyte, urea and
questionnaire was used to obtain information on socio-
creatinine findings were essentially normal. She was
demographics and a team of investigators examined
commenced on oral hydroxychloroquine and penicil-
each pupil for evidence of skin diseases.
lamine. A regular 6 monthly follow up revealed clinical
Results: There were 263 (50.2%) males and 261 (49.8%)
improvement.
females, with male to female ratio of 1.01: 1. Their ages
Conclusion: High index of suspicion and early compre-
ranged between 5 to 16 years, with a mean age of
hensive investigations are needed in management of this
9.5±2.22. The prevalence of skin lesions among the pu-
skin disorder.
pils was 35.3% (185/524). The commonest skin disease
found was Tinea capitis 20.5% (38/185). Skin infections
and inflammatory dermatitis accounted for 39.5% and
OA201
14.1% respectively of the skin diseases found.
The
The birth prevalence and spectrum of congenital
commonest inflammatory dermatitis found was Sebor-
heart disease in Jos, Nigeria
rhoeic dermatitis 53.8% (14/26). Gender and age had no
Ige OO , Yilgwan CS , Ayatse F , Nkereuwem E , Baba
1
1
2
3
significant influence on the prevalence and pattern of
FJ , Osayi LA , Sagay AS , Kanki P , Bode-Thomas F
2
2
4
5
1
skin diseases found.
1
Conclusion: There was a high prevalence of skin dis-
Affiliations:
Department of Paediatrics, Univer-
sity of Jos/ Jos University Teaching Hospital, Depart-
2
eases among primary school children in Port Harcourt.
Effective preventive measures should be implemented in
ment of Paediatrics, Jos University Teaching Hospital,
3
Medical research council, Gambia, Department of
4
primary schools in Port Harcourt.
Obstetrics and gynaecology, University of Jos/ Jos Uni-
versity Teaching Hospital and Havard th chan school
5
of public health, boston, USA
Email: kemidr@hotmail.com
Introduction and objectives: congenital heart defects
(chd) are the most common types of birth defects. They
84
are also an important cause of morbidity and mortality.
anorectal malformations (3), duodenal atresia (2), en-
studying the birth prevalence of chd in important in or-
cephalocoele (1) and prune belly syndrome (1). Eleven
der to provide current and accurate data to assess the
babies had dysmorphic features and the likely syn-
epidemiologic significance of the defects. We sought to
dromes included down syndrome (7), and turner, di-
determine the birth prevalence and spectrum of chd
george and holt-oram syndromes in one infant each.
among babies in Jos, Nigeria.
Associated chd was present in 12 (41.4%) babies. Three
Materials and methodology : this is a cross- sectional
(75%) of the four babies with cleft lip and palate, one of
study where babies aged less than one week of age who
the four with omphalocoele and four the 11 with dys-
were born or admitted into two main hospitals in jos and
morphic facies had chd.
an immunization center were recruited into the study.
Conclusion: evaluation for chd is valuable in babies with
An echocardiogram was performed on all babies re-
obvious congenital malformations particularly those
cruited after obtaining relevant demographic and clinical
with suspected chromosomal abnormalities, ompha-
information.
locoeles and cleft lip/ palate.
Results : there were 2,350 babies recruited into the
study; male to female ratio of 1.03:1. Excluding patent
ductus arteriosus (pda) and patent foramen ovale (pfo),
OA203
chd was present in 39 of them giving a birth prevalence
Prevalence and risk factors for hypertension among
of 16.6 per 1,000 live births. The commonest chd de-
school children in ilorin, north-central Nigeria
tected was isolated ventricular septal defect (vsd) in 15
1
Ibrahim OR, Afolabi JK, Ojuawo A, Adedoyin OT,
2
2
2
babies. Ten babies had combined atrial septal defect
2
Mokuolu OA, Abdulkadir MB
2
(asd) and vsd. Isolated pulmonary valve stenosis was
1
present in 5 babies. Other types of chd seen include
Department of Paediatrics, Federal Medical Centre,
Katsina, Katsina State, Department of Paediatrics and
2
atrioventricular septal defects (avsd) in two, isolated asd
in two, and double outlet right ventricle (dorv), single
child health, University of Ilorin & University of Ilorin
ventricle, coarctation of the aorta (coa), truncus arteri-
Teaching Hospital, Ilorin, Kwara State.
osus and hypoplastic left heart syndrome (hlhs) in one
Email: ibroplus@gmail.com
baby each.
Conclusion: the birth prevalence of chd is higher than
Introduction: despite the numbers of studies on child-
estimated figures.
hood hypertension in nigeria, only a few have explored
the risk factors, which were limited to family history of
hypertension, the role of obesity/over-weight. Thus, this
OA202
study determined the prevalence of hypertension and
The association of congenital heart disease with other
risk factors (socio-demographic, family history of hy-
obvious congenital malformations in Jos, Nigeria
pertension, history of snoring, bmi, waist circumference
and hip circumference) amongst the primary school chil-
Ige OO , Yilgwan CS , Ayatse F , Nkereuwem E , Baba
1
1
2
3
dren in ilorin.
FJ , Osayi LA , Sagay AS , Kanki P , Bode-Thomas F
2
2
4
5
1
Methods: A total of 1745 school children aged 6-12
1
Department of Paediatrics, University of Jos/ Jos Uni-
years were recruited using a systematic random sam-
versity Teaching Hospital, Department of Paediatrics,
2
pling method. The pupils had bp measurements using
Jos University Teaching Hospital, Medical research
3
the fourth report guideline. Those with bp greater than
90 percentile had repeat bp measurements on two more
th
council, Gambia, Department of Obstetrics and Gynae-
4
cology, University of Jos/ Jos University Teaching Hos-
occasions (two and four weeks after initial measure-
pital and Havard th chan school of public health, bos-
5
ment). Relevant history were collected using proforma
ton, USA
while the pupils had anthropometric measurement fol-
Email: kemidr@hotmail.com
lowing standard methods. Data were analysed using spss
version 20.
Results: prevalence of systolic hypertension at 1 visit
st
Introduction and objective: congenital heart disease
was 6.2% (109/1745), 2
nd
and 3
rd
(chd) has been found to be more common in children
visits were 3.4%
with other congenital malformations. Studying this asso-
(60/1745) and 2.3% (40/1745) respectively. Prevalence
of systolic hypertension (3 visit) was higher amongst
rd
ciation in our environment is vital for proper genetic
counseling and early intervention. The aim of the study
the females than males (0.9% vs 1.7%, χ2=8.377,
p=0.004. Prevalence of diastolic hypertension (3 visit)
rd
is to determine the birth prevalence of coexisting chd in
babies with other obvious congenital malformations in
was higher in females than males, (0.7% vs 0.2%,
Jos, Nigeria.
χ2=5.437 p= 0.034). The analysis of risk factors for hy-
Materials and methods: we performed echocardiograms
pertension showed no significant relationship with re-
on babies with obvious congenital malformations aged
spect to socio-economic class, family history of hyper-
less than one week delivered at or admitted into two
tension, birth order, snoring, and anthropometrics.
major hospitals, or seen at the main immunization clinic
Conclusion: prevalence of systolic and diastolic hyper-
in jos for the presence of congenital heart disease (chd).
tension in the studied children were 2.3% and 0.9%
Results: out of 2,024 babies clinically examined, 29 had
socio-economic class, family history, snoring, body
congenital malformations; these were: – omphalocoeles
mass index, hip circumference, and waist-to-hip were
(5), bilateral cleft lip and palate (4), meningocoele (4),
not associated with high blood pressure
85
OA204
clonal disease characterized by the proliferation of cd1a-
Community engagement for prevention of rheumatic
positive immature dendritic cells.its clinical presentation
fever and rheumatic heart disease in plateau state
is highly variable and may range from isolated, self-
healing skin and bone lesions to life-threatening multi-
Yilgwan CS , Ige OO, Larab SA, Bode-Thomas F
1
1
2
1
system disease. There is therefore a high index of suspi-
1
Department of Paediatrics University of Jos and heart
cion needed for diagnosis.
aid trust, Jos, Department of history and Anthropology,
2
Objective: to highlight the clinical presentation of lch in
University of Jos
a 13-year-old girl.
Email: yilgwan@hotmail.com
Case and methods: c a, is a 13-year-old female who
presented with abdominal pain and generalized body
Background: rheumatic heart disease (rhd) continues to
weakness of 3 months, weight loss and abdominal swell-
be an important public health problem among the poor
ing of 2 months. Pain was generalized, intermittent and
and disadvantaged in nigeria. Prevention efforts hinged
there was no change in bowel habit. Weakness was se-
on community education show promise for the control
vere enough to prevent patient from carrying out normal
and possible eradication of the diseases.
daily activities. on examination she was chronically ill
Objective: we sought to evaluate community knowl-
looking, moderately pale, not dehydrated, afebrile with
edge, attitudes, practices, and barriers to treatment with
significant generalized lymphadenopathy.there was ten-
respect to painful (streptococcal) pharyngitis, the harbin-
derness at the right hypochondrium, epigastric, umbili-
ger of rheumatic fever (rf) and rhd, so as to develop cul-
cal region and multiple abdominal masses. Liver and
turally relevant educational materials for effective pre-
spleen were not palpable. She had ptosis of left eye with
vention initiatives.
left facial nerve palsy, paraplegia, left pleural effusion.
Methods: we conducted two structured focus group dis-
Initial diagnosis of non- hodgkin’s lymphoma was made.
cussions in the native language, one each for males (17)
lymph node histology was in keeping with langerhan
and females (19) not affected with rhd, drawn from a
histiocytosis. patient has been commenced on vin-
berom-speaking community on the perceived causes of
blastine, prednisolone and intrathecal methotrexate with
painful sore throat, health seeking behavior and prac-
good clinical improvement.
tices, and the health system barriers that influence the
Conclusion: this report emphasizes the need for physi-
effective treatment of sore throat and thus development
cians to have a high index of suspicion as lch can pre-
of rhd.
sent in both sexes and in different forms.
Results: most participants were female (53%) and
ranged from 21 – 72 years with a mean age of 40 ±13.4
years. Almost all the participants admitted to ever hav-
OA206
ing suffered from painful sore throat. Majority believed
Reducing incidence of cervical cancer: knowledge
it is caused either by wind, hamarttan, dust, improper
and attitudes of caregivers in Nigerian city towards
sleeping positioning leading to collection of saliva in the
human papilloma virus vaccination
throat and/or drinking cold water. Only one participant
Bisi-Onyemaechi AI , Chikani UN , Nduagubam O
1
1
2
associated it with an infectious origin. None related it to
1
the development of heart disease. Many believed sore
Department of Paediatrics, College of Medicine,
throat could lead to cancer. Majority used local remedies
University of Nigeria
2
such as potash and palm oil while some brushed their
Department of Paediatrics, Enugu State University
throat with wood ash and salt or took strepsils and/or
Teaching Hospital Parklane.
vitamin c purchased over the counter. key barriers to
Email: adaobi.bisi-onyemaechi@unn.edu.ng
appropriate treatment of painful sore throat were lack of
funds for hospital bills/drugs, local beliefs and use of
Introduction: despite the high prevalence of human
local remedies, and unsolicited advice from neighbours
papilloma virus (hpv) infections and cervical cancer in
and family members.
Nigeria, utilization of the hpv vaccine as an effective
Conclusions: there is poor knowledge about the causes
preventive measure remains low. This study was to find
and complications of painful sore throat in our commu-
out the knowledge and attitudes of and factors that deter-
nity. This contributes to poor access to its appropriate
mine acceptance of hpv vaccine for their pre-adolescent
treatment and increases the risk of rf/rhd. There is urgent
girls by caregivers.
need to salvage this situation via appropriate community
Materials and methods: this was a cross-sectional de-
educational initiatives.
scriptive study of 508 caregivers of female children in
Enugu Nigeria. A semi-structured questionnaire was
OA205
used to collect information on knowledge of hpv, cervi-
Langerhan histiocytosis: a case report
cal cancer, hpv vaccine and its acceptance. The data was
analysed using descriptive statistics.
Udechukwu NP, Okike C, Okiche CY
Results: five hundred and eight (508) caregivers of fe-
Department of Paediatrics, Federal Teaching Hospital
male children were interviewed. Less than half, 221,
Abakaliki, Ebonyi State.
(43.5%) knew about hpv, among these, 163 knew how
Email: patcy42@yahoo.com
hpv is transmitted. Only 12 (2.4%) of the caregivers
know that an hpv infection is a risk factor for cervical
Introduction: langerhans cell histiocytosis (lch) is a rare
cancer. 132 (59.7%) were aware of an hpv vaccine. Only
86
26 (19.7%) of those aware of a vaccine agreed it can
Immunology/Infectious Diseases/ Social Paediatrics
effectively prevent cervical cancer. Lack of awareness
about the vaccine and accessibility were reasons given
OB201
by parents on why their female children did not receive
The Many Faces of Juvenile Systemic Lupus Erythe-
the vaccine.
matosus: Report of Four Cases Seen Within Four
Conclusion: despite high levels of education, awareness
Months Lagos State University Teaching Hospital,
of hpv, hpv vaccine and the risks for cervical cancer
Ikeja, Lagos
remains low among caregivers in Enugu, south-east,
1,2
Faleye AD, Adelowo OO, Olaosebikan BH,
1
1
Nigeria. Awareness and accessibility were the major
2,3
Akinwumi IN, Animasahun BA, Solarin AU, Ade-
2,3
2
2
determinants of hpv vaccine uptake among the caregiv-
kunle MO, Ubuane PO
2
ers. There is a need for massive and sustained awareness
1
creation to increase hpv vaccination uptake in Nigeria.
Rheumatology Unit, Department of Internal Medicine,
Lagos State University Teaching Hospital, Ikeja, Lagos,
Nigeria.
2
OA207
Department of Paediatrics, Lagos State University
Comprehensive care for children with SCD in Nige-
Teaching Hospital, Ikeja, Lagos.
3
ria: A national challenge: the university of Abuja
Department of Paediatrics, Lagos State University Col-
teaching hospital experience
lege of Medicine, Ikeja, Lagos.
Email: faleyeayo2013@gmail.com
1
Uche Nnebe-Agumadu, Adebayo Innocent Adogah,
2
2
Esther James, Evelyn Kumode
2
Introduction & Objectives: Juvenile systemic lupus ery-
1
Department of Paediatrics, College of Health Sciences,
thematosus (JSLE)-a chronic multisystem autoimmune
University of Abuja.
disorder of childhood- is potentially more fatal than
2
Department of Paediatrics, University of Abuja
adult systemic lupus erythematosus (SLE). There are
Teaching Hospital, Abuja.
scanty reports of JSLE from Black Africans partly due
Email: ucagums@yahoo.com
to missed diagnosis, because it clinically mimics com-
mon paediatric diseases like malaria, sepsis and sickle
Background: the burden of sickle cell disease in our
cell anaemia. To highlight its protean presentation, we
society remains a significant public health concern de-
reviewed cases of JSLE diagnosed at the Lagos State
spite improvement in care and survival reported in the
University Teaching Hospital, Ikeja, Lagos, within a
western world. Within the past decade, the fgn has taken
four-month period.
steps to tackle the scourge of scd that afflicts numerous
Materials & Methods: Retrospective review of records
Nigerian children and families yet morbidity and mortal-
of children diagnosed with JSLE at the Adult Rheuma-
ity remain high because of absence of accessible quality
tology Clinic and Paediatric Wards of LASUTH from
health care services and public health interventions. In
May-August, 2018.
the absence of a universal cure for scd, treatment is pri-
Results: Four (n=4) girls, aged 8-14 years, fulfilled the
marily aimed at reducing impact of the disease on the
American College of Rheumatology (ACR)’s diagnostic
patients and their families, thereby improving quality of
criteria for JSLE. The duration of symptoms before di-
life and survival through a comprehensive care that
agnosis ranged from 5-12 months. The presentations
starts with early detection and follow-through anticipa-
included recurrent severe anaemia (n=3), arthritis (n=2),
tory care and systematic follow-up. Components of a
arthralgia (n=2), malar rash (n=2), seizures (n=1) oral
comprehensive care are simple and uncomplicated tech-
ulcers (n=1), pericarditis (n=1), photosensitivity (n=1)
nology that should be within reach of resource-poor
and renal injury (n=1). Laboratory findings included
countries, yet most hospitals in Nigeria lack access to
elevated ESR [ranged from 76 to 150; (n=4)], positive
this care.
ANA (n=4), positive anti-dsDNA (n=4), hypocompli-
Aim: to review strides taken in uath to establish a com-
mentinaemia C3 & C4 (n=2), positive anti-Smith anti-
prehensive health care for scd patients and their families
body (n=2) and massive proteinuria (n=2). All the pa-
amidst challenges of a weak health delivery system.
tients responded dramatically to steroids and disease-
Methods: the unit developed structured health education
modifying anti-rheumatic drugs and were discharged
programs, provided effective and accessible preventive
stable, however, one patient died from an acute flare
and clinical care, transition clinic, hydroxy urea therapy
four weeks post-discharge.
and a family support group.
Conclusion: Diagnosis of JSLE was delayed presumably
Result: increased patient enrolment, improved patient
due to similarity of its presentation to common child-
wellbeing, patient and family satisfaction.
hood diseases. JSLE may not be as rare as commonly
Conclusion: through dedication and commitment to
thought, thus its prompt diagnosis and treatment requires
change, the unit is transforming lives of patients and
high clinical suspicion.
families. Our patient-centered model can be generalized
to hospitals in Nigeria that care for scd children in the
absence of paediatric haematologists.
87
OB202
Aim/ Objectives: To determine the rate of viral suppres-
Impact of Antiretroviral Therapy On Immunity and
sion among adolescents on antiretroviral therapy in
Malaria Among Febrile HIV Infected Children Seen
NHA Abuja, and the factors associated with viral sup-
in A Tertiary Hospital, Sokoto, Nigeria
pression (age, adherence, ART line).
Materials and methods: Data was collected from the
1
Amodu-Sanni M, Ahmed H, Jiya NM, Yusuf T, Sani
1
1
1
1
adolescent patient clinic proforma/ registry drawn up
UM, Isezuo KO, Ugege MO, Mikailu A J.
1
1
1
from January 2018 to October 2018. Data was entered
1
Department of Paediatrics, Usmanu Danfodiyo Univer-
into Excel spreadsheet and analysed with SPSS version
sity Teaching Hospital, Sokoto
23. Level of significance was set at 0.05.
Email: maryamamodusanni@gmail.com
Results: There were a total of 194 adolescents aged 10
to 18 years seen during the period of study with 56.2%
Introduction: Coexistence of Malaria with HIV in Sub-
being males and 43.8% females. Forty- one (21.1) % of
Saharan African and its attendant high morbidity and
our patients have WHO clinical stage 1 disease, 58
mortality could be a threat that can reverse the gain of
(29.9) % were stage 2,46 (23.7%)were in stage 3 , 30
ART in HIV-infected children.
(15.5%)were in stage 4 while 19 (9.8 %) were not
Objectives: Determine impact of ART on immunity and
staged. Good viral suppression of <1000 copies/ml were
malaria among febrile HIV-infected children seen at
achieved in 86% of patients. Age significantly affected
UDUTH, Sokoto.
rates of viral suppression with the young adolescents
Method: Cross-sectional study among HIV-infected
having the best suppression (p value= 0.049). Adher-
children on ART that presented with fever and newly
ence, gender and ART line did not significantly affect
diagnosed ART-naïve HIV-infected children between
rates of viral suppression as p value was > 0.05 in these
May-October, 2016. The participants had the following
settings.
investigations; blood film for MP, PCV, CD4 T-cell
+
Conclusion: There is a significant relationship between
count. Data was analyzed using SPSS 23.0. A p-value
age and viral suppression emphasizing the need for in-
<of 0.05 was considered significant.
volvement of adolescents in their care plan.
Result: A total of 100 febrile HIV- infected children on
ART, and 40 febrile newly diagnosed HIV- infected
children not on ART were recruited. The mean age of
OB204
the children on ART was 4.20+3.90years, comparable
Disclosure of Paediatric HIV status in Nigeria to
with 6.00+4.10years for those not on ART (p=0.315).
family members and significant others: psychosocial
The mean CD4 T -cell count was 403cells/ul and
+
outcomes and impact
194cells/ul respectively (p=0.0001). Prevalence of ma-
laria among the febrile HIV-infected children on ART
1
Nwoyeocha C A, Oluleye OA,
2
1,2
Brown B J
was 60% (60/100) compared to 100% (40/40) among
1
College of Medicine, University of Ibadan,
those not on ART ( χ =25.6, p=0.0001). Among the 60
2*
2
Department of Paediatrics, University College Hospi-
HIV-infected children on ART who had malaria, 12
tal, Ibadan
(20.0%) had severe malaria compared to 34(85.0%)
Email: biosbrown@yahoo.com
among the 40 controls ( χ =25.6, p=0.0001). CD4 T-
2*
+
lymphocyte level correlates negatively with malaria
Introduction and Objectives: Disclosure of HIV status is
parasite density among the two groups, however, not
fraught with potential psychosocial complications. There
statistically significant (r= -0.082, p=0.33).
is paucity of studies on disclosure of HIV status of chil-
Conclusion: ART boosted immunity and reduced ma-
dren to family members. The objectives of this study
laria prevalence and severity. Effort should be intensi-
were to describe family members and significant others
fied towards early diagnosis and prompt commencement
to whom HIV status is disclosed, their response to the
of ART in HIV-infected children and inclusion of ma-
disclosure and the psychosocial impact of disclosure to
laria control programs.
them.
Materials and method: This was a cross-sectional study
of school age HIV infected children attending the Paedi-
OB203
atric HIV clinic of the University College Hospital
Rate of Viral suppression in Adolescents Attending
Ibadan. Primary caregivers of children aged 6 years -17
ART clinic NHA Abuja
years were interviewed after informed consent and insti-
tutional ethical approval using a questionnaire that ex-
Oyesakin AB, Otuneye AT,Dr Oniyangi O , Hamza N,
plored the objectives of the study.
Oyinwola F, Enyong EE
Results: Two hundred children were studied, 198 had
Email: wwunmibade@gmail.com
HIV positive mothers out of whom disclosure to the
fathers had been done in 180 (90.9%). Disclosure of
Introduction: Human immunodeficiency virus infection
HIV status had been done to extended family members
is a major public health crisis in Nigeria. Antiretroviral
in 64% of cases, to the family spiritual leaders in 14% of
therapy is required for all individuals with HIV infec-
cases and to the children’s teachers in 1.5% of cases.
tion. Adolescents living with HIV need to be willing to
Response to disclosure was supportive in all cases ex-
accept antiretroviral therapy in order to improve adher-
cept in family members in whom only 84.4% were sup-
ence and achieve sustained viral suppression.
portive. Some family members kept their children from
88
playing with the HIV infected children. Disclosure re-
OB206
sulted in parental separation and abandonment of the
Occupational Exposure to Blood and Body Fluids
children with the mothers in 23 (11.5%) of the study
among Interns in a Tertiary Hospital in Port
participants.
Harcourt, Nigeria.
Conclusion: Disclosure of children’s HIV status to fam-
ily members may result in undesirable psychosocial out-
Paul NI, Jaja T, Opara PI, Wobo K.
comes. Affected parents need to be supported in the
University of Port Harcourt Teaching Hospital
process.
Email: nsypaul@yahoo.co.uk
Introduction: Health care workers especially interns
OB205
may be at increased health risk due to exposure to blood
Respiratory Diphtheria in 2 Children Presenting to
and body fluids.
A Tertiary Hospital in Nnewi, South – East Nigeria:
Objective: To determine the prevalence of occupational
A Case Series
exposure to blood and body fluids (EBBF) among in-
terns at the University of Port Harcourt Teaching hospi-
1
Ofiaeli OC., Umeadi NG., Ebenebe JC., Ndukwu CI,
1
1
1
tal (UPTH).
1
Asogwa IO, Ofiaeli OAR
2
Materials and Method: This cross-sectional study was
1
Department of Paediatrics, Nnamdi Azikiwe University
carried out among interns at the UPTH. Informed writ-
Teaching Hospital, Nnewi, Anambra state and Depart-
2
ten consent was obtained. The obtained data from a self-
ment of Microbiology, Nnamdi Azikiwe University
administered questionnaire and Infection Control Team
Teaching Hospital, Nnewi, Anambra state.
records were analysed using SPSS version 21.
Email: ofiaeliogochukwuchioma@gmail.com
Results: Eighty-four interns were studied giving a re-
sponse rate of 93.3%: 40 (47.6%) were males while 44
Background: Respiratory diphtheria is an acute and in-
(52.4%) were females giving a male: female ratio of
fectious disease that can progress to cardiac and neuro-
1:1.1. Thirty-two (38.1%) were aware of the availability
logical complications ultimately resulting in increased
of sharp bins, 55 (65.5%) recapped and discarded into
morbidity and mortality in affected individuals. Diagno-
waste bins while 4 (4.8%) discarded into sharp bins
sis was made in line with the WHO clinical case defini-
without re-capping. Prevalence of EBBF was 89.3%.
tion for Diphtheria. This case series reports 2 probable
Thirty-one (41.4%) had Blood and Body Fluid Splash
cases of complicated respiratory diphtheria presenting
(BBFS), 22 (29.3%) had Needle Stick Injury (NSI)
within 3 weeks of each other to the Paediatrics Depart-
while 22 (29.3%) had combined NSI and BBFS. Thir-
ment of NAUTH, Nnewi.
teen (29.5%) of the NSI occurred during rotation in Pae-
Case I: This was a 5-year-old female who presented on
diatrics. Seventeen (32.1%) and 16 (30.2%) of BBFS
referral with a history of fever, throat pain, noisy breath-
occurred during Obstetrics and Gynaecology and Paedi-
ing and facial fullness, in whom bull neck and mem-
atrics rotation respectively. Eleven (25%) reported the
brane in the throat had been observed. She presented
NSI to the Infection control team (ICT) and 3 (27.3%)
tachycardic, in respiratory distress, with elevated JVP
completed 28 days of Highly Active Anti-Retroviral
and soft tender liver and still had a greyish membrane in
Therapy (HAART). Common reason for not reporting
the throat. She was managed as a case of Diphtheric
was not been aware of the Infection Control Team (ICT)
Carditis and discharged after 24 days on admission in
in 10 (30.3%).
stable condition.
Conclusion: There is a need for improved training and
Case II: This was also a 5-year-old, male, who presented
close supervision of interns.
with a history of fever, difficulty in swallowing, change
of voice (progressing from hoarseness to whispers),
cough and staggering gait. Onset of the illness was asso-
OB207
ciated with membrane in the throat, bull neck and stri-
Sexual assault among paediatric patients in a tertiary
dor. Examination revealed cranial nerve deficits, apho-
hospital in south-east Nigeria: a 2-year retrospective
nia, hypotonia and staggering gait. CSF analysis was
study
within normal. He was managed as a case of Diphtheric
Neuropathy and was discharged home in stable condi-
Anyanwu OU, Daniyan OW, Ogbonna-Nwosu C,
tion after 16 days on admission. C. diphtheria IGG done
Ezeanosike OB, Ojukwu JU
2 weeks post discharge was 0.19 IU/ml.
Department of Paediatrics, Federal Teaching Hospital,
Conclusion: Respiratory diphtheria still occurs in chil-
Abakaliki
dren in our environment especially in view of our low
Email: onyinyeanyanwugc@gmail.com
practice of booster vaccination. A high index of suspi-
cion is needed to diagnose and properly nurse these chil-
Introduction and Objectives: Sexual assault is any sex-
dren back to health.
ual contact or behaviour that occurs without explicit
consent of the victim. Children are increasingly becom-
ing victims with most cases not reported due to the fear
of stigmatization. The study was carried out to describe
the pattern of sexual assault among children attending
the Children Out-Patient Department of Federal
89
Teaching Hospital, Abakaliki.
sources of information were health workers and previous
Materials and methods: This was a retrospective study
usage were associated with good knowledge about SSS
of cases of sexual assault that presented at the Children
(p<0.05).
Out-Patient Department of FETHA between 1 Septem-
st
Conclusion: One-half of the caregivers were aware of
ber, 2016 and 31 August, 2018. Cases of sexual assault
st
SSS but majority (97.1%) had poor knowledge of the
were identified from the medical records of affected
preparation and usage. There is need for awareness crea-
children. Relevant information was extracted from the
tion, community sensitization and periodic training and
records and entered into a profoma. Data analysis was
re-training about the preparation and usage of SSS to
done using SPSS version 22.
further reduce the burden of diarrhoea-related death.
Results: A total of 10,400 children attended the Children
Out-Patient Department during the period of study out
of which 78 were found to have been sexually assaulted,
OC202
giving a prevalence of 0.8%. There were 74 (94.9%)
Diarrhoeal Home Management; Knowledge And
females and 4 (5.1%) males. The mean age of cases was
Utilization Of Ort Among Mothers Of Under-Five In
8.95 + 4.78 (1-16) years while that of the perpetrator
Ibadan, Nigeria
was averagely 18.00 + 8.56 (6-50) years. The perpetra-
tor was known to the victim in 58 (73.0%) of cases.
Olopha OO
Fifty-seven (73.1%) cases presented to the hospital
Department of Public Health Nursing, University
within six days of the assault.
College Hospital, Ibadan, Oyo state, Nigeria
Conclusions: Although the prevalence of sexual assault
Email: bunmiolopha@yahoo.co.uk
in this study appeared to be low, there is need for in-
creased vigilance on the part of parents/care givers as
Introduction and Objectives: Diarrhoea remains one of
the perpetrators were usually known to the victims.
the leading causes of childhood mortality in many devel-
oping countries, despite the popular cost-effective rec-
ommended strategies. Oral Rehydration Therapy (ORT)
Gastroenterology
has been advocated as the single most potent strategy
OC201
for reducing both morbidity and mortality associated
Awareness and knowledge about the preparation and
with the disease, yet many childhood deaths are being
usage of salt sugar solution among caregivers of chil-
recorded on account of diarrhoea. The study examined
dren at the Wesley Guild Hospital, Ilesa, Nigeria
mother’s awareness, knowledge and utilization of ORS
in the management of under-five diarrhoea.
Oso BI, Oladimeji O, Folarin OF, Ologun BG, Kuti
1
1
1
1
Materials and Methods: A descriptive cross sectional
BP,
1,2*
Oyelami AO
1,2
community-based study involving 418 mothers of under
1
Department of Paediatrics, Wesley Guild Hospital,
-five in Ibadan was employed. Multistage sampling was
Ilesaand
used to select the study participants from six LGAs and
2
Department of Paediatrics and Child Health, Obafemi
a structured questionnaire was used to elicit information.
Awolowo University, Ile-Ife, Nigeria
Data were analysed using SPSS. Level of significance
Email: kutitherapy@yahoo.com
was determined at P<0.005.
Results: The study recorded high prevalence of under-
Background: Salt sugar solution (SSS) is home-made
five diarrhoea (77.0%), high awareness level of ORS
readily available fluid that can be successfully used to
(92.1%), good access to diarrhoeal control information
replace fluid loss during diarrhoeal episodes in children.
(71%), but deficient knowledge of ORS/SSS preparation
This study sets out to determine the awareness and
(83.6/93.1%). Similarly, only one-third of the caregivers
knowledge about the preparation and usage of SSS
would adopt ORT as the first line treatment in diarrhoeal
among caregivers of children at the Wesley Guild Hos-
management, majority (61.8%) instead would visit the
pital (WGH), Ilesa.
chemist and other alternatives. In this study, knowledge
Method: Pre-tested data proforma was used to obtain
of preparation of ORT is significantly associated with
information from study participants about their level and
respondents’ age, location (rural/urban) and parity
source of knowledge and usage of SSS for their children
status.
with diarrhoea. Those who gave correct amount of sugar
Conclusion: Despite high level of ORT awareness and
and salt in the right quantity of water were classified as
good access to diarrhoeal control information, respon-
having good knowledge. Factors associated with good
dents showed poor knowledge of diarrhoeal manage-
knowledge and usages were determined.
ment and sub optimal utilization of ORS. There is need
Result: Two hundred and seventy-one (55.8%) of the
to reinforce maternal education regarding home manage-
486 recruited caregivers were aware of SSS and 44.0%
ment of under-five diarrhoea, and to also check the
claimed their source of information was from health
quality of information being given to them.
workers while 34 (7.0%) got their information from
family and friends. Although 158(32.5%) caregivers
claimed to have given their children SSS during past
diarrhoeal episodes, only 2.9% of them have correct
knowledge of the preparation and usage of SSS. Care-
givers with post-secondary education, those whose
90
OC203
Paediatrics, Ahmad Sani Yariman Bakura Specialist
Hospital, Gusau and Department of Paediatrics, Fed-
4
Spectrum of Upper Gastrointestinal Endoscopic
Findings in Children in Kaduna, North-western
eral Medical Centre, Gusau.
Nigeria.
Email: dimeji74@gmail.com
Bello AK , Mado SM , Musa S
1
2
3
Introduction and Objectives: Severe acute malnutrition
1
Department of Medicine ABU/ABUTH Zaria,
(SAM) is still a major public health problem in develop-
2
Department of Paediatrics ABU/ABUTH Zaria
ing world with attendant morbidities and mortality. Chil-
3
Department of Paediatrics ABU/ABUTH Zaria.
dren with complicated SAM are managed in hospital
Email: akbello06@gmail.com
facility to improve their survival rate. The objective was
to determine the pattern and outcome of management of
Introduction and Objectives: Endoscopy is an important
SAM among children admitted in the study area.
diagnostic and interventional procedure for children
Materials and Methods: A retrospective observational
study carried out between 1 June, 2016 and 31 May,
st
st
presenting with recurrent abdominal pain, vomiting, and
haematemesis. The procedure is not readily available in
2017 in Paediatric wards of Ahmad Sani Yarima Bakura
most hospital because of unavailability of appropriately
Specialist Hospital, Gusau. The hospital records of chil-
sized endoscope. We report the upper Gastrointestinal
dren admitted with SAM were retrieved and relevant
(GI) endoscopic findings in children aged 16 days-17
information were retrieved. Data were analyzed using
years referred to ABUTH Zaria for upper GI endoscopy.
the SPSS 22.0.
Materials and Method: This was a retrospective study of
Results: One hundred and forty-one (11.6%) had SAM
all children referred for upper GI endoscopy within a
among 1,212 admissions into Paediatric unit over the
period of 2 years, February 2014 to January, 2017.
study period. M: F ratio was 1.9:1. One hundred and
Results: Eighty-six children were referred for upper GI
seven (75.9%) were aged 12.1 – 24.0 months with the
endoscopy. There were 32 males (37.2%), and 54 fe-
mean age of 20.8(±6.5) months. One hundred and thirty-
males (62.8%). The mean age was 13 years. Recurrent
eight(97.9%) of the mothers had no formal education,
abdominal pain, dyspepsia and upper GI bleeding were
102(72.3%) large family size and 130(92.2%) were of
the major indications for referral. Findings in the oe-
lower socio-economic background. One hundred and
sophagus were 39(41.9%) Normal oesophageal mucosa,
thirty-three (94.3%) were not exclusively breastfed with
Hiatus hernia 24(27.9%) and esophagitis 15(17.4%)
suboptimal complementary feeding practices in 117
being the commonest abnormalities seen in the oesopha-
(82.7%). One hundred and six (75.2%) were non-
gus while 6(7.0%) cases of oesophageal varices, and one
oedematous and 35(24.8%) oedematous forms; dehydra-
case (1.2%) of oesophageal foreign body (coin) and 1
tion was seen in 83(58.9%) cases. One-hundred (70.9%)
(1.2%) of oesophageal atresia were also seen. The gas-
had ready to use therapeutic milk formula (F75/F100)
tric mucosa was normal in 15(17.4%) cases while 36
with 125(88.7%) discharges and 12(8.5%) mortalities.
(41.9%) had Gastritis and 23(26.7%) had gastric ero-
Conclusion: SAM is still persistent in our community
sions. Three (3.9%) patients had portal hypertensive
with striking demographics and attend antmoderate case
gastropathy, while 6 had bile reflux and 1(1.2%) patient
fatality rate in this facility. There is need for more ef-
each had foreign body (metal zipper), Gastric antral di-
forts on improving the demographics towards prevention
verticular, and Gastric ulcer respectively. In the duode-
and reduction of mortality rate associated with SAM in
num 3 (3.5%) patients had duodenal ulcer, while 1
our community.
(1.2%) patient had worms and another 1(1.2%) had for-
eign body (metal peg pin). Normal duodenal mucosa
and duodenitis were seen in 71 (82.6%) and 10 (11.6%)
OC205
cases respectively with only 3 (3.5%) cases of duodenal
Point-of-Admission Serum Electrolyte Profile of
ulcer. We also found 1 case each of duodenal foreign
Children with Acute Diarrhoea as seen in a Tertiary
body (metal peg pin) and duodenal worms. Overall,
facility in Sokoto
there were 7 (8.2%) patients with normal upper GI endo-
scopic findings.
Ugege MO, Ibitoye PK, Yusuf T, Omar M, Adamu A,
Conclusion: Hiatus hernia, and gastritis were the com-
Garba BI.
monest abnormalities in children undergoing upper GI
Department of Paediatrics, Usmanu Danfodiyo
endoscopy
University Teaching Hospital Sokoto
Email: shallyben@yahoo.com
OC204
Introduction and objectives: Fluid, electrolytes and acid
Demographics and outcome of children admitted
base disturbances are responsible for most deaths due to
with Severe Acute Malnutrition in a State Specialist
acute diarrhoea. This study aimed at describing the point
Hospital, Gusau, North-West Nigeria.
-of-admission serum electrolyte profile of children with
acute diarrhoea.
1
Yusuf T, Hashim RM, Garba BI, Ahmad MM, Baba
2
1
1
1
Materials and Methods: In this study, the serum electro-
J, Sanni NA, Onazi SO
2
4
lyte at admission, bio data, clinical features and outcome
1
Department of Paediatrics, Usmanu Danfodiyo
1
of children with acute diarrhoea, aged 29 days to 10
years, seen between 1 January to 31 December 2016
st
st
University Teaching Hospital, Sokoto, Department of
2
91
in the department of Paediatrics, UDUTH, Sokoto were
and 43 – 59 months age categories had a significant in-
retrospectively analysed.
crease in the MUAC (p < 0.008) only. The change in
Results: Of the total of 154 subjects, 101(65.6%) were
anthropometric indices was significantly greater in chil-
males (M: F ratio of 1.9:1). Majority 140(91.0%) were ≤
dren aged 6 -23 months than those aged 24-59 months (p
36 months. Twenty-four (15.6%), 105(68.2%), and 14
= 0.0003). It was also greater in children aged 6 – 12
(9.1%) were mildly, moderately and severely dehy-
months than those aged 13-23months (p = 0.0051).
drated, while 11(7.1%) were not dehydrated. Hypona-
Conclusion: Supplementary feeding had a better effect
traemia, hypokalaemia and metabolic acidosis occurred
on the anthropometric indices of under fives with MAM
in 100 (64.9%), 67(43.5%) and 21(13.6%) subjects re-
when initiated within the first two years than beyond. It
spectively. There were 10(6.5%) deaths. Only potassium
was most effective in those aged 6 – 12 months.
level was significantly affected by degree of dehydration
(p = 0.018). Duration of diarrhoea greater than or equal
to 7 days was significantly associated with hypokalae-
OC207
mia while greater than or equal to 3 days, with metabolic
Prevalence and Pattern of Adolescent Malnutrition
Acidosis (p=0.001, and 0.03 respectively). Diarrhoea
in a Semi-Urban Community in Sokoto, Northwest-
duration more than 3 days and under nutrition were sig-
ern
nificantly associated with death.
Nigeria
Conclusion: The degree of dehydration appears to be a
good predictor of the occurrence of hypokalaemia. Diar-
Yusuf T, Jibrin B, Mohammed AH, Hano IJ
rheal duration is a risk factor for hypokalaemia, meta-
Department of Paediatrics, Usmanu Danfodiyo
bolic acidosis and death. There is need for intensified
University Teaching Hospital, Sokoto.
community health education on early and appropriate
Email: dimeji74@gmail.com
home treatment and hospital presentation once diarrhoea
duration is more than 3 days, to prevent deleterious diar-
Introduction and Objective: Adolescence is accompa-
rhoea consequences.
nied by increase in nutritional requirements due to the
rapid growth and development associated with it. Ado-
lescent nutritional status extends to adulthood and a pre-
OC206
disposing factor to childhood malnutrition and non-
Effect of Age at Initiation of Supplementary Feeding
communicable diseases in adulthood. The objective was
On Physical Growth of Underfives with Moderate
to determine the prevalence and pattern of malnutrition
Acute Malnutrition
among adolescent in a semi-urban community in
Sokoto.
2
Udoh EE , Esu EB
1
Materials and Methods: An observational study carried
1
Paediatrics Department, University of Uyo Teaching
out between January and March, 2018 at Gwiwa com-
Hospital, Uyo, Akwa Ibom State, Nigeria and Depart-
2
munity, Wamakko LGA, Sokoto State. The demograph-
ment of Public Health, Faculty of Allied Medical Sci-
ics, weight and height and BMI were documented. Nu-
ences, University of Calabar, Cross River State, Nigeria
tritional status was determined using the WHO BMI
Email: rejoicerejoice2001@yahoo.com
tables for appropriate age and gender. The socio-
economic class of the participants was determined the
Introduction and Objective: Moderate acute malnutrition
Oyedeji’s classification. Data were analyzed using the
(MAM) is a leading cause of under five morbidity and
SPSS 22.0. A p-value of <0.05 was considered signifi-
mortality globally. Timely initiation of supplementary
cant.
feeding would reverse the disorder. This study was
Results: One hundred and ninety-eight adolescents par-
aimed at determining the most appropriate age for initi-
ticipated in the study. One hundred and thirty-two
ating supplementary feeding in under fives with MAM.
(66.7%) were aged 10.0 – 13.9 years with the mean age
Materials and Method: A comparative clinical trial was
of 12.6(±2.3) years. There were 84(42.4%) males with
conducted between May 2016 and April 2016 in Akwa
M:F ratio of 1:1.4. One hundred and eight (54.6%), 63
Ibom State. The eligible children with MAM received
(31.8%) and 27(13.6%) were from lower, middle and
supplementary rations of nutritional formulations daily
upper
socio-economic
classes
respectively.
Sixty
for four months while still on their regular family diet.
(30.3%) were stunted, 33(16.7%) wasted, 24(12.1%)
Their anthropometric indices (weight, height and mid
were severely wasted and 3(1.5%) were overweight.
upper arm circumference) were assessed periodically.
Age ( p =0.008) and socio-economic status ( p = 0.04) sig-
The difference between the changes in their anthropom-
nificantly influenced the degree of wasting and over-
etric indices based on age group at the end of the study
weight.
was the outcome measure. It was considered statistically
Conclusion: Double burden of under nutrition and over-
significant if p-value was < 0.05.
weight exists among adolescents in the study area with
Results: There were 141 evaluable children of whom 51
under nutrition being more prevalent. There is need for
were 6 – 12 months, 58 were 13 – 24 months, 19 were
efforts at prevention to reduce its impact on non-
25 – 42 months and 13 were 43 – 59 months. Supple-
communicable diseases and the nutritional status of fu-
mentary feeding resulted in a significant increase in all
ture generations of our community.
the anthropometric indices of those 6 – 12 months and
13 – 23 months of age (p < 0.004). The 25 – 42 months
Endocrinology/Adolescent Health
92
OD201
ences across centres. We thus reviewed the pattern of
Prevalence and Associated factors of Insulin Resis-
endocrine disorders seen at the paediatric endocrine unit
tance among Obese and overweight Nigerian Adoles-
of the Lagos State University Teaching Hospital, Lagos,
cents in Secondary Schools
Nigeria.
Materials &Method: Data was extracted from clinical
Odiadi N, Jaja T, Oduwole A
records of the Paediatric Endocrine Unit from March
Paediatric Endocrinology Training Centre for West
2017 to September 2018 and diagnoses categorised as
Africa, University of Lagos Teaching Hospital
diabetes, disorders of puberty, thyroid disorders, disor-
Email: Tamunopriyej@yahoo.com
ders of sexual differentiation (DSD), growth disorders,
obesity , and others.
Background: Insulin resistance has been implicated as
Results: Eighty-three (83) patients with endocrine disor-
an underlying cause of most non communicable diseases
ders were evaluated over the 18- month period. Diabetes
and complications associated with obesity. The aim of
(26.5%), disorders of puberty (18.0%) and thyroid disor-
this study is to determine the prevalence of insulin resis-
ders (13.3%) were the most prevalent diagnoses. Almost
tance and correlated factors amongst overweight and
all (91.7%) of the patients with pubertal disorders were
obese adolescents and a comparative group of normal
girls and most (83%) of those with obesity were boys.
weight adolescents.
Conclusion: The most common paediatric endocrine
Methodology: A descriptive cross sectional study of 235
disorders at our centre were diabetes, disorders of pu-
overweight and obese adolescents aged 10 to 19 year
berty and thyroid disorders.
and 119 comparative groups. Insulin Resistance (IR)
was determined using the Homeostatic Model Assess-
ment of IR determined from fasting insulin and glucose
OD203
level.
Dyslipidaemia in Nigerian Children and Adolescents
Results: Insulin resistance was reported in 90(25.4%) of
living with Diabetes Mellitus: Prevalence, pattern
all subjects studied. Prevalence in overweight and obese
and Associated factors
adolescents was 88(37.4%) significantly higher than 2
(1.7%) of normal weight subjects (p=0.001). The mean
Jaja Tamunopriye, Yarhere Iroro
HOMA IR values peaked at age of 17-19 years in both
Paediatric Endocrinology Unit, Department of Paediat-
sexes and also in overweight and obese subjects. Over-
rics, University of Port Harcourt Teaching Hospital
weight and Obese subjects are 35 times more likely to
Email: Tamunopriyej@yahoo.com
have IR compared to normal weight subjects (CI 8.44-
145.24) p=0.001. Subjects in high social class were 2.49
Background: Dyslipidaemia in children and adolescents
times more likely to have IR compared to middle and
with Diabetes can precipitate and worsen the presenta-
lower class(CI 1.06-5.86) p=0.04. There was no statisti-
tion of chronic complications. The aim of this study is to
cally significant association observed between respon-
determine the frequency and pattern of dyslipidaemia in
dents’ school type, sex, age, family history of diabetes,
children living with diabetes followed up at a paediatric
hypertension and obesity with Insulin resistance
endocrine clinic
(p>0.05).
Methodology: The study was a cross sectional descrip-
Conclusion: Study shows that Insulin Resistance is sig-
tive study of 22 children living with diabetes followed
nificantly prevalent in Overweight and obese compared
up in a tertiary health care facility. Demographic data
to normal weight subjects. Prevalence was independent
was retrieved from case files and fasting lipid profile
of age, sex and family history of diabetes or obesity.
and HbA1c was done for all subjects at no cost. Lipid
abnormalities were defined based on the Expert Panel on
Integrated guidelines for cardiovascular health risk re-
OD202
duction in children and adolescents.
Paediatric Endocrine Disorders at a Tertiary Centre
Result: Twenty-two subjects aged 7 to 18 years were
in Lagos: An 18-Month Review
studied, with mean age of 14.94±3.59. There were 12
(54.5%) females. The mean age of females (14.99±3.70)
1
Akinola IJ, Ubuane PO Odusote OO, Njokanma OF
1
1
2
was not significantly different from mean age of
1
Department of Paediatrics, Lagos State University
14.88±3.64 for males (p =0.95). Mean duration of diabe-
Teaching Hospital, Ikeja, Lagos, Nigeria Department of
2
tes was 3.37±2.38 years. Prevalence of lipid abnormali-
Paediatrics and Child Health, Lagos State University
ties includes hypertriglyceridaemia (86.4%), hypercho-
College of Medicine, Lagos, Nigeria
lesterolemia (22.7%), abnormal HDL-C (36.4%), LDL-
Email: ronkeakinola051gmail.com
C (13.6%) and Non-HDL-C (22.7%). Hypercholes-
terolemia was significantly higher in females (p-0.02)
Introduction& Objectives: Childhood endocrine disor-
and prevalence of hypertriglyceridaemia was higher in
ders were previously thought to be rare and perhaps less
subjects 12 years and above (p=0.019). There was no
important than the more commonly reported disorders in
statistically significant difference in mean levels of vari-
the paediatric age group. The establishment of paediatric
ous lipids between males and females. Nine (40.9%) of
endocrine units have shown that these cases are not un-
subjects had more than one lipid abnormalities. There
usual. Moreover, reports on the pattern of Paediatric
was no statistically significant association between lipid
endocrine disorders in Nigeria suggest regional differ-
abnormality with age, sex, weight category and HbA1c.
93
Conclusion: Lipid abnormalities are prevalent in chil-
Introduction and Objectives: The increasing access to
dren with Diabetes. Programmes should therefore be
electronic-media technologies has resulted in an upsurge
targeted at improved lipid levels to delay and prevent
in their use for health interventions. There is however
chronic complications.
inadequate information on the use of electronic-media
technologies among Very Young Adolescents (VYA)
aged 10 – 14 years in many developing countries. The
OD204
study objectives were to describe access of VYAs to
Socio-Demographic Determinant of Glycaemic Con-
electronic-media technologies and feasibility of reaching
trol Among Children with Type 1 Diabetes in South
them with electronic-media interventions.
Eastern Nigeria
Materials and Methods: The adolescents were selected
by
multi-stage
sampling.
Information
on
socio-
Ogugua CF, Chikani UN, Ibekwe MU Onoh AE,
1
2
3
1
demographic characteristics, access to electronic-media
Ibe BC
4
technologies and willingness to participate in electronic-
1
Federal Teaching Hospital Abakaliki, University of
2
media-based interventions was obtained. Descriptive
Nigeria Teaching Hospital Enugu, and Federal
3
and inferential statistics were conducted; level of signifi-
Teaching Hospital Abakaliki/Ebonyi State University.
cance was p<0.05.
Email: ugochikani@yahoo.com
Results: The mean age of the 976 VYAs was 11.9±1.2
years; 50.3% were males, 81.7% lived with both parents
Introduction: Diabetic complications have been identi-
and 34.0% owned a mobile-phone. Significantly more
fied as the major cause of morbidity and mortality in
VYAs who described their families as financially better
persons with type 1 diabetes mellitus. Lack of appropri-
off; owned mobile phones (37.6%) compared to those
ate glycaemic control is a significant risk factor for the
who felt their families were financially same (30.4%)
onset and progression of long term complications of
and worse off (20.0%) than others. Approximately 56%
diabetes. Identifying the determinants of glycaemic con-
said their family owned a desktop, laptop or tablet. Ap-
trol is therefore imperative.
proximately 73% of VYAs were willing to participate in
Aim: To identify the socio-demographic determinants of
mobile-phone or internet-based interventions and stud-
glycaemic control among children with type 1 diabetes
ies. Preferred communication channels were phone-calls
mellitus in south eastern Nigeria
(39.5%), text-message (25.9%), social network sites
Method: It was a cross-sectional hospital based study of
(14.5%) and social media applications (10.6%).
children aged 3-18 years with T1DM. Fifty-eight chil-
Conclusion: About a third of the very young adolescents
dren with type 1 diabetes mellitus were consecutively
owned a mobile phone and many were willing to partici-
enrolled after obtaining consent. A questionnaire was
pate in electronic-media-based interventions. Interven-
completed recording their demographic variables and
tions targeting VYAs need to incorporate additional
their HbA1c was estimated.
avenues (face-to-face sessions in schools, health facili-
Result: There were 71 subjects with type 1 diabetes mel-
ties and other adolescent-friendly sites) in order to reach
litus enrolled. 38(52.5%) of them were males. Mean age
the majority of this age-group.
(years) was 13.7±0.3. Mean age at onset of diabetes was
11.6years (range 3-16), mean duration of diabetes was
2..3years (range 0.4 – 8years), mean HbA1c value was
OD206
10.5% (range 6.4-14%), Age, age at onset of diabetes,
Effect of Peer Education On Knowledge of Human
duration of diabetes and caregivers involvement in dia-
Papilloma Virus and Cervical Cancer Among Female
betes management were strong determinants of glycae-
Adolescent Students in Benin City, Nigeria
mic control (p<0.05).
1
Sadoh AE, Okonkwo C, Nwaneri DU, Ogboghodo
2
1
1
Conclusion: Younger age, young age at onset of diabe-
BC, Eregie CO, Oviawe O, Famuyiwa O.
1
1
1
tes, and short duration of diabetes and caregivers’ in-
1
volvement in diabetes management were strong indica-
Institute of Child Health, University Of Benin, Benin
City and Department of Obstetrics and Gynaecology,
2
tors for better glycaemic control.
University of Benin, Benin City
OD205
Email: evawere.sadoh@uniben.edu
Feasibility of Reaching Very Young Adolescents in
Ibadan, Nigeria with Electronic-Media-Based Interven-
Introduction: Cervical cancer, a major cause of morbid-
tions
ity and mortality especially in low and middle income
countries is caused by Human Papilloma Virus (HPV).
2,3
Olumide AO , Adebayo ES
1, 2
In developed countries, lack of information among the
1
Institute of Child Health, College of Medicine, Univer-
target population (adolescents) is a major contributor to
sity of Ibadan, Nigeria, Society for Adolescents and
2
suboptimal uptake of HPV vaccines. The aim of this
Young People’s Health in Nigeria (SAYPHIN)
study was to assess the knowledge of female secondary
3
Child Development and Family Studies, Department of
school students about cervical cancer, its treatment and
Home Science and Management, Federal University of
prevention, and to determine if their knowledge could be
Agriculture, Abeokuta, Ogun State, Nigeria
improved using peer-to-peer transfer of knowledge.
Email: daisyolu@yahoo.co.uk,
Methods: This was an intervention study. The knowl-
aoolumide@com.ui.edu.ng
edge and awareness of female adolescent students of
94
four secondary schools were assessed using a pre-tested
traception among adolescent mothers perpetuated
self-administered questionnaire prior to the training of
through intergenerational miss-information on family
some of the students (peers). The trained students deliv-
planning. Advocacy targeted at market populations and
ered messages on cervical cancer and HPV using fliers
further research on mechanism of action for traditional
containing key information (peer training) to their
methods especially the herbs is needed.
school mates in formal delivery in a class setting. The
knowledge and awareness of students’ post -peer training
was then assessed.
Pulmonology/General Paediatrics
Results: There were 1337 and 1201 students who re-
sponded to the pre- and post-peer training evaluation
OA301
respectively. Awareness of cervical cancer, knowledge
Clinical Characteristics of Childhood Asthma In
of risk factors and cause of cervical cancer was low (2.4-
Lagos, Nigeria
46%) prior to the peer training and these improved sig-
nificantly to 51.3-99.3% following peer training. Mean
Odusote OA, Akinola IJ, Ubuane PO, Ogunleye AM
knowledge score prior to training was 12.94±9.23 and
Department of Paediatrics, Lagos State University
this increased significantly to 53.74±10.69 following
Teaching Hospital, Ikeja, Lagos, Nigeria.
peer training p<0.0001.
Email: todusote@gmail.com
Conclusion: Peer training is effective in improving
knowledge and awareness of female adolescents about
Introduction: Globally, asthma is the commonest
HPV and cervical cancer.
chronic disorder of childhood with increasing preva-
lence especially in developing countries. Knowledge of
the demographic and clinical profile of asthmatic chil-
OD207
dren identifies gaps in care and provides data for prudent
Acceptance and Utilisation of Modern contraception
allocation of resources for optimal care. We evaluated
among Adolescent mothers in Bodija Market,
baseline demographic and clinical profile of asthmatic
Ibadan, Nigeria
children assessing routine care at the Paediatric Allergy,
Dermatology and Pulmonary Medicine Unit of Lagos
Owolabi OI, Balogun FM
1
1, 2
State University Teaching Hospital, Ikeja.
1
Institute of Child Health, University of Ibadan, Nigeria
Methodology: Children with asthma were prospectively
and Department of Paediatrics, University College
2
recruited consecutively (ongoing). With a structured
Hospital, Ibadan, Nigeria
questionnaire and clinical evaluation, we obtained
Email: owolabitomiwa@yahoo.com
demographic and clinical data, including presence of
comorbidities: allergic rhinitis (AR), allergic conjuncti-
Introduction and Objective: Almost all child birth
vitis (AC), atopic dermatitis (AD) and food allergy
among adolescents aged 15 to 19 years occur in devel-
(FA). Asthma severity was evaluated using GINA
oping countries including Nigeria. They have an enor-
guidelines.
mous unmet need for contraceptives and these results in
Results: Fifty-seven children aged 7.7±3.4 years (range:
repeat pregnancies. Bodija Market is known for its
6 months to 15 years) were recruited. Two-thirds (64%)
strong socio-political and commercial networks and it is
were aged 5-10yrs, predominantly boys (67%). Half
a repository for adolescent mothers who are engaged in
(52%) had mild persistent asthma while intermittent and
various capacities. This study set to access contraceptive
moderate persistent constituted 33% and 15%, respec-
use among adolescent mothers in Bodija market.
tively. More than three-quarters (77%) had allergic co-
Methods: The study, as part of an ongoing doctoral re-
morbidities. Prevalence of specific co-morbidities were
search, was conducted at the infant welfare clinic in the
AR (63%), AC (27%), AD (8%) and FA (2%). Although
primary health centre in Bodija Market. Twelve In-depth
most were referred with clinical diagnosis of asthma,
interviews and a Key informant interview were con-
none of them were diagnosed with the comorbidities
ducted with all consenting adolescent mothers and
until presentation in our unit. Presence of co-morbidities
health worker present at the clinic. Interviews were re-
was not associated with asthma severity (OR=0.176;
corded, transcribed verbatim; and coded inductively
95% CI: 0.02-1.15, p=0.138).
using Atlas. Ti and emerging themes were drawn and
Conclusion: Majority of the subjects had mild persistent
synthesised.
asthma and more than three quarters (77%) had previ-
Results: All the adolescent mothers were currently not
ously-undiagnosed atopic co-morbidities. There is need
using any modern contraception and had no intention to
to empower health-care practitioners and asthma care
use. They indicated preference for traditional family
units to optimally diagnose and treat comorbid allergic
planning methods which include the use of herbs and
conditions.
traditional contraceptive rings. The adolescent mothers
believed that modern forms of contraception are danger-
ous and the major concern was possible infertility as a
side effect. Their major source of information about
contraception were older mothers n (aunts and mothers,
area sisters) around them
Conclusion: There is a low acceptance of modern con-
95
OA302
Gusau, Zamfara state, Nigeria.
2
Serum inflammatory cytokines and antioxidant
Department of Paediatrics, Ahmadu Bello University
micronutrients in children with Community
Teaching Hospital, Zaria, Kaduna state, Nigeria and
3
Acquired Pneumonia at the Wesley Guild Hospital,
Department of Chemical Pathology, Ahmadu Bello
Ilesa
University Teaching Hospital, Zaria, Kaduna state,
Nigeria.
Kuti BP , Adetola HH , Kuti DK , Smith OS
1,2
1
1
3
Email: festusdele@gmail.com
Oyelami AO
1,2
1
Department of Paediatrics, Wesley Guild Hospital,
Introduction and objectives: Acute pneumonia is a lead-
Ilesa, Nigeria, Department of Paediatrics and Child
2
ing infectious cause of death among children under five
Health, Obafemi Awolowo University, Ile-Ife, Nigeria,
globally and in Nigeria. Optimal vitamin D status may
3
and
Department of Chemical Pathology, Obafemi
facilitate the ability of immune cells to fight against in-
Awolowo University Teaching Hospital Complex,
fection like pneumonia. We assessed the relationship
Ile-Ife, Nigeria
between serum vitamin D [25(OH)D] level and acute
Email: kutitherapy@yahoo.com
pneumonia in children aged 1-59 months at ABUTH,
Zaria.
Background: Pneumonia is an infectious agents-induced
Materials and Methods: This cross-sectional study in-
acute inflammatory disease of the lung which is a major
volved 135 children with pneumonia and 135 apparently
cause of childhood morbidity and mortality in develop-
healthy controls. Acute pneumonia was diagnosed using
ing countries. The role of inflammatory mediators and
the revised World Health Organization criteria and chest
modulators in childhood pneumonia is poorly explored.
radiological signs. Serum 25(OH)D concentrations were
Methods: Children aged one month to 14 years with
determined using a vitamin D ELISA kit. We compared
WHO-defined community acquired pneumonia (CAP)
the mean serum 25(OH)D levels in both groups and also
and their age and sex-matched apparently healthy coun-
determined odds ratio (OR) of pneumonia.
terparts were consecutively recruited over a seven-
Results: The mean serum 25(OH)D level of children
month period. Relevant history and examination find-
with pneumonia (52.14±21.87 nmol/l) was significantly
ings were documented and their serum cytokines and
lower than that of controls (60.91±32.65 nmol/l), p =
micronutrients assayed and compared using standardised
0.010. Most of the children (n =220, 81.4%) had serum
High Performance Liquid Chromatography (HPLC)
25(OH)D levels of ≤75.0 nmol/l (low serum vitamin D).
methods.
The proportion of children with low serum vitamin D
Results: Eighty children (40 each for CAP and controls)
levels was significantly higher in the pneumonia group
M: F=1.4:1 were recruited. Fifteen (37.5%) were infants
(n = 123, 91.1%) than the control group (n = 97, 71.9%),
and eight (20.0%) were school age children. The com-
p < 0.001. In a multiple logistic regression model, serum
plications of pneumonia at presentation included heart
25(OH)D level >75 nmol/l was associated with de-
failure 6.0 (15.0%), pleural effusion 7 (17.5%) and con-
creased odds of acute pneumonia, (adjusted OR = 0.33,
vulsions 2 (5.0%). Serum pro-inflammatory cytokines
p = 0.007).
(IL-1 β, 2, 8 and 12) were higher, while anti-
Conclusion: Low vitamin D level was associated with
inflammatory cytokines (IL-11 and 13) were lower in
decreased risk of acute pneumonia. Improving vitamin
children with pneumonia than the controls. (p<0.05)
D status in these children may reduce their pneumonia
Levels of serum Cytokines and micronutrients were not
risk.
associated with pneumonia complications and severity.
Serum Zinc, Selenium, Vitamin C and E were lower in
children with pneumonia than controls, but only Zn and
OA304
Vitamin C attained statistical significance. The micronu-
Pattern and Outcome of Respiratory Diseases among
trients correlated negatively with pro-inflammatory cy-
Children Admitted In the Emergency Facility of
tokines and positively (though weakly) with anti-
University Of Ilorin Teaching Hospital, Nigeria
inflammatory cytokines.
Conclusion: CAP is associated with elevated serum pro-
Ibraheem RM, Aderemi JA, Abdulkadir MB, Gobir AA,
inflammatory cytokines and possible resultant higher
Johnson ‘WBR
need for anti-inflammatory mediators and anti-oxidants.
Department of Paediatrics, University of Ilorin & Uni-
Micronutrient (antioxidant) supplementations may help
versity of Ilorin Teaching Hospital, Ilorin, Kwara State,
to prevent, reduce and ameliorate the inflammatory
Nigeria.
processes in these children
Email: raheedahbidmus@yahoo.com
OA303
Introduction and Objectives: Globally respiratory dis-
Relationship Between Serum Vitamin D Level And
eases, comprising a broad range of disease conditions
Acute Pneumonia In Children Aged 1 – 59 Months
due to infectious and non-infectious causes, is a cause of
At Ahmadu Bello University Teaching Hospital
childhood morbidity and mortality and thus, identifica-
(Abuth), Zaria
tion of the burden of respiratory illness will ensure ap-
propriate interventions towards reducing its attendant
2
3
Mado SM, Yusuf R.
2
Akeredolu FD, Akuse RM,
1
morbidity. The study was conducted to identify the pres-
1
Department of Paediatrics, Federal Medical Centre,
entation and outcome of respiratory illness in hospital-
96
ized children at University of Ilorin Teaching Hospital,
were the car seat (67.0%) and seat belt (68.1%). Over-
North-Central Nigeria.
all, 118(61.8%) had good knowledge about the use of
Materials and Method: This is a retrospective cross-
CCR but only 20(10.5%) knew the appropriate age for
sectional study involving children admitted through the
the use of booster seat. 130(68.1%) of parents reported
emergency paediatric unit over five years (January 2013
that they use CCR with 116(60.7%) using it regularly.
-December 2017). Data on demography, diagnosis, co-
The parents with good attitude towards the use of CCR
morbidities and complications, duration of admission,
were 107(56.0%) but only 11(5.7%) agreed that the use
and outcome were collected and analyzed using SPSS
of CCR should be enforced. Female parents and those
20.
who knew about CCR significantly had good attitude
Results: Of the total 7012 children admitted, 1939
towards its use.
(27.7%) were due to respiratory diseases with a median
Conclusion: A fair number of parents studied had good
age of 16 (interquartile range {IQR} 7-36) months.
knowledge and attitude towards the use of CCR but
Males were 994(51.3%) and 945(48.7%) females. Infec-
there is a need to increase their knowledge and the use
tious diseases were the most common cause of admis-
of CCR for their children.
sion. The highest admissions due to infective and non-
infective respiratory diseases were pneumonia (50.1%)
and aspiration pneumonitis (5.1%) respectively. The
OA306
median duration of hospital stay was four days [IQR- 2
Evaluation of health-related quality of life among
to 6 days]. Overall, respiratory diseases accounted for
children with and without nephrotic syndrome in
20.7% (119/574) mortality among all admissions while
Enugu, Southeast Nigeria
the
all-respiratory
disease
mortality
was
6.1%
(119/1939). The major contributors to mortality were
Mbanefo NR, Aronu AE, Odetunde OI, Okafor HU
pneumonia, aspiration pneumonitis and tuberculosis
Department of Paediatrics, University of Nigeria
accounting for 81(68.1%), 12(10.1%) and nine (7.6%)
Teaching Hospital, Enugu.
deaths respectively.
Email: odetoyintola@yahoo.co.uk
Conclusion: Pneumonia and aspiration pneumonitis are
major contributors to morbidity and mortality due to
Introduction and Objectives: Quality of Life (QOL) is a
respiratory diseases for which interventions towards
multidimensional concept that includes subjective
improving childhood health indices should be priori-
evaluations of both positive and negative aspects of life.
tized.
Evaluation of health-related quality of life (HRQoL)
using specific tools conveys essential information about
OA305
a patient that is not be obtained through the routine clini-
Child car restraint: What parents in Ibadan know
cal or conventional laboratory or radiological assess-
and what they do
ment. This study aimed to evaluate the HRQoL of chil-
dren with nephritic syndrome and compare it with chil-
Balogun FM , Balogun JA , Akinyemi OO
1,2
2,3
2,4
dren without nephrotic syndrome in Enugu, Nigeria
1
Institute of Child Health, College of Medicine, Univer-
Materials and methods: This was a comparative cross
Nigeria University College
2
sity of Ibadan, Ibadan,
sectional study to assess the health-related quality of life
Hospital, Ibadan, Ibadan, Nigeria Department of Sur-
3
of children with nephrotic syndrome as subjects and age
gery, College of Medicine, University of Ibadan, Ibadan,
and gender matched apparently healthy children as con-
trols using PedsQL
TM
Nigeria Department of Health Policy and Management,
4
4.0 Scale Score and data obtained
University of Ibadan, Ibadan, Nigeria
were analyzed with Statistical Package for Social Sci-
Email: folushom@yahoo.com
ences (SPSS) version 19.
Results: The HRQoL scores of children with NS were
Introduction and objectives: Road traffic crashes (RTC)
significantly lower than those of healthy controls (p <
is the leading cause of paediatric trauma in Nigeria.
0.001). All the domains on the PedsQL scale were nega-
However, there are proven safety measures which can
tively affected, with the worst scores in the school func-
protect children when transporting them in vehicles
tioning domain. The mean PedsQL scores in the school
should RTC occur. This study described the knowledge,
domain were 59.70 ± 18.56 in children with NS com-
practice and attitude regarding safe paediatric vehicular
pared with 89.40 ± 8.12 seen in healthy control (p <
transport among parents of children attending private
0.001). Emotional functioning was negatively affected
elementary schools in Ibadan, Nigeria.
by increasing age.
Materials and methods: This was a cross sectional study
Conclusions: HRQoL of children with nephrotic syn-
in three randomly selected elementary schools. Self-
drome is significantly lower than that of apparently
administered questionnaire was used collect data among
healthy children, and this affects all assessment do-
191 parents on sociodemographic characteristics, knowl-
mains. Therefore, it is recommended that the assessment
edge and practice of safe paediatric vehicular transport
of HRQoL of children with nephrotic syndrome and
and attitude towards it. Data was analysed using descrip-
appropriate intervention should become a component of
tive statistics and Chi square test with α=0.05.
clinical care.
Results: Mean age of respondents was 40.12±7.6 years
and 64(33.5%) were males. Almost all (92.1%) knew
about child car restraint (CCR) and the best known CCR
97
Nephrology
mine the prevalence, types of CAKUT, intervention and
OB301
outcome of the patients.
Paediatric Haemodialysis at the University College
Method: A cross-sectional study involving consecutive
Hospital Ibadan Nigeria: An Update
patients presenting with various types of CAKUT at the
nephrology clinic and emergency room from December
1,2
Asinobi AO
1,2
Ademola AD, Lawal TA,
1,2
2015 to September 2018.
1
Department of Paediatrics, Faculty of Clinical
Results: A total of seventy-one patients presented with
Sciences, College of Medicine, University of Ibadan,
CAKUT during the thirty-four months period. The
Oyo State
prevalence of CAKUT was 1.8 per 1000 patients over
2
Department of Paediatrics, University College Hospital
the 34 month period. The patients were between ages of
Ibadan, Oyo State
1 day to 144 months. The median age was 48 months.
Email: dr_deboademola@yahoo.co.uk
42.2% of the patients presented at age greater than or
equal to 5 years, 22.5% under fives, 15.5% infants,
Introduction and Objective: Haemodialysis is poten-
19.7% neonates. Male to female ratio was 3.7: 1. Only
tially lifesaving in the management of children with
12.7% of the patients had antenatal ultrasound diagnosis
acute kidney injury (AKI) or end-stage renal disease
of CAKUT. The spectrum of CAKUT include posterior
(ESRD). However, in many parts of sub-Saharan Africa
urethral valve (32.4%), pelviureteric junction obstruc-
paediatric renal replacement therapy (RRT) is not read-
tion (26.7%), polycystic kidney disease (9.9%), ectopic
ily accessible. Haemodialysis may however have a role
kidneys (8.4%), renal dysplasia (8.4%), renal agenesis
in paediatric RRT in low resource settings. We reviewed
(5.6%), multicystic dysplastic kidneys (5.6%), ureteric
haemodialysis in our centre to provide an update on the
duplication (2.8%), ureterocele (2.8%), meatal stenosis
role of paediatric haemodialysis
(1.4%), ureterovesical junction obstruction (1.4%), cys-
Methods: We reviewed the haemodialysis register and
tocele (1.4%), extravesical cyst (1.4%) and crossed
the paediatric nephrology unit database for persons who
fused ectopia (1.4%). Majority presented with features
were aged 19 years and below who received haemodi-
of bladder outlet obstruction (31%), 22.5% with ab-
alysis from January 2011 – December 2017 in terms of
dominal mass and incidental findings in 18.3%. Features
demography, diagnosis and in-hospital mortality.
of urinary tract infection were found in 50.7% of the
Results: A total of 144 children were recruited, aged 2-
patients and more than half of them (52.1%) had posi-
19 (10.6± 4.4) years, and 62.5% males. 100 participants
tive urine culture for a particular organism. Acute kid-
(69.4%) had AKI, while the others had ESRD. The pa-
ney injury was diagnosed in 12.7% of the patients out of
tients with AKI and ESRD were aged 9.7 ± 4.5 years (58
which 4.3% progressed to chronic renal failure. Surgical
%, males); 12.4 ± 3.6 years (72.7%, males) respectively.
interventions include valvotomy, nephrectomy, pye-
The main causes of AKI were sepsis (16%), malaria
loplasty depending on the type of CAKUT.
(16%), intravascular haemolysis of unknown cause
Conclusion: Early detection and diagnosis of CAKUT is
(14%) and nephrotic syndrome (10%), while the main
essential to plan treatment modality. Also, follow up is
causes of ESRD were chronic glomerulonephritis in 34
very vital to ensure proper management of complica-
(77.3%) and posterior urethral valves in 5 (11.4%). In-
tions that could occur.
hospital mortality data was available in 117 patients and
mortality occurred in 8 of 84 patients (9.5%) with AKI
and 3 of 33 patients (9.1%) with ESRD.
OB303
Conclusions: Haemodialysis is remains useful in the
Bartter Syndrome in a Four-Year-Old Nigerian Boy
management of children with AKI or ESRD in low re-
with recurrent vomiting
source settings.
Fawale OO , Akinwunmi AI , Amao KO , Adeniji OE ,
1*
1
1
1
Ologun BG , Adeniyi AT , Kuti DK , Folarin OF , Oke
1
1
1
1
1, 2
1,2
OJ , Aladekomo TA
1, 2
OB302
,Oyelami AO
1
Congenital abnormalities of the kidney and genital
Department of Paediatrics, Wesley Guild Hospital,
Ilesa, Nigeria and
2
tract in LASUTH
Department of Paediatrics and
Child Health, Obafemi Awolowo University, Ile-Ife, Ni-
1
Solarin AU, Oladimeji AB, Ikuerowo SO, Akinola
1
2
3
geria
RA, Kayode-Awe OM, Nwankpele TO, Lamina MO, Ani-
Email: Mayowafawale@gmail.com
masahun BA
Department of paediatrics, Department of surgery, and
2
Background: Bartter syndrome is a rare renal tubular
3
Department of radiology, Lagos state university teach-
disease characterized by hypokalemic metabolic alkalo-
ing hospital ikeja, Lagos.
sis with hypercalciuria and renal salt wasting. It is a very
Email: asolar234@gmail.com
rare metabolic disease with reported prevalence of 1 in
1,000,000. There is paucity of reports of the condition in
Background: Congenital abnormalities of the kidney and
Africa.
genital tract (CAKUT) are well recognized as causes of
Case report: We report the case of AM, a four-year-old
chronic kidney disease in children. Antenatal diagnosis
Nigerian boy who presented with growth failure
plays an important role in early detection to forestall
(stunting and wasting), recurrent episodes of persistent
progression of the disease. This study aimed to deter-
vomiting warranting in-hospital care on three occasions
98
over a period of 16 months, no fever and no diarrhoea.
OB305
Examination findings revealed features of severe dehy-
Lupus Nephritis in Nigerian Children: a single
dration, carpopedal spasm and generalized body weak-
centre experience
ness. Laboratory investigations revealed hyponatremia
3
(serum sodium = 103 mmol/L), hypokalemia (serum
¹Solarin AU, ¹Faleye AD, Olaosebikan BH
potassium = 2.0mmol/L), severe hypocalcaemia and
¹ ˒ ²Animasahun BA, ¹Lamina OM, ¹Oladimeji AB
hypercalciuria (Urinary calcium creatinine = 0.37) and
¹Department of Paediatrics, Lagos State University
increased urinary loss of sodium, chloride and potas-
Teaching Hospital, Ikeja, Lagos, ²Department of paedi-
sium. Serum renin was also elevated (8.1ng/ml/hr).
atrics, Lagos State University College of Medicine,
Ikeja, Department of Medicine, Lagos State University
3
These are the essential diagnostic features of Bartter
syndrome. In addition to correction of severe dehydra-
Teaching Hospital,Ikeja
tion, the patient was commenced on calcium, magne-
Email: asolar234@gmail.com
sium and potassium supplements and nutritional reha-
bilitation. He is presently being followed up in the
Introduction: Systemic lupus erythematosus (SLE) is a
clinic.
severe chronic autoimmune disease affecting all organ
Conclusion: This case report illustrates the need to have
systems including the kidneys, the term juvenile SLE is
high index of suspicion of metabolic diseases and or
used when it occurs in children less than 16years. Lupus
renal tubular disorders in children with growth failure
nephritis (LN) is one of the most fatal complications of
and recurrent vomiting particularly in the absence of
JSLE.
infectious causes.
Objectives: To increase awareness of Lupus nephritis as
one of the major complications of JSL and to determine
predictors of poor outcome in children with LN
OB304
Materials & Methods: This is a retrospective study of 6
Epidemiology of Childhood Renal Disorders at
cases of lupus nephritis out of 8 cases of JSLE managed
University of Abuja Teaching Hospital, Abuja
on the paediatric ward in LASUTH within a period of 2
years
Anigilaje EA and Adesina CT
1
Results: Seven females and 1 male were diagnosed with
Department of Paediatrics, University of Abuja
SLE after fulfilling the ACR criteria with a mean age of
Teaching Hospital
1
10.6(±5.7). 6(75%) out of the 8 had renal symptoms,1
Email: demolaanigilaje@yahoo.co.uk
male and 5 females, hypertension in 50% (4 out of 8),
oliguria in 25% (2 out of 8), nephritis in 25% (2 out of
Introduction and Objectives: In recent times, epidemiol-
8), nephrotic syndrome in 62.5% (5 out of 8) and 25%
ogical data are demonstrating a significant contribution
(2 out of 8) had renal failure. All had renal biopsy rang-
of renal disorders to childhood morbidity and mortality
ing from class II to VI. All were managed with corticos-
in developing countries. The knowledge of the burden
teroid, 3 with mycophenolate mofetil, 3 with cyclophos-
childhood renal disease in developing countries is re-
phamide and 2 with azathioprine. Overall survival was
quired for preventive and management purposes.
66.7%, 2 patients died, one due to associated central
Objective: The aim is to review the prevalence and spec-
nervous system comorbidity and the other died at home
trum of renal disease seen at the University of Abuja
from an unknown cause.
Teaching Hospital (UATH), Gwagwalada, Abuja, Nige-
Conclusion: Lupus nephritis is a common presentation
ria.
of JSLE and a major predictor of poor prognosis. It oc-
Methods: A retrospective review of data of children
curs in Nigerian children and a high index of suspicion
aged 1 month to 17 years, admitted to the Paediatric
Is needed to make a diagnosis.
Unit of the UATH over a period of 4 years between
January 2013 and December 2016.
Results: Four thousand, three hundred and twenty-seven
OB306
children were admitted during the study period, with
Asymptomatic Bacteriuria in Healthy Primary
163 having renal disorders, giving a prevalence of 3.7%.
School Children in Enugu, Nigeria
There was a progressive increase in the proportion of
1
Chime Paschal, Obu HA, Okafor HU
2
3
paediatric renal diagnoses during the study period, from
1,2,3
3.1% in 2013 to 5.4% in 2016. Urinary tract infection
Department of Paediatrics, College of Medicine,
(30.7%) and acute kidney injury (30.7%) were the most
University of Nigeria, Enugu, Nigeria.
common disorders. Most of the renal disorders were
Email: paschal.uwadiegwu@unn.edu.ng
seen in the preschool children, less than 5 years of age.
Conclusion: There is a need for stakeholders and policy-
Introduction and Objective: Asymptomatic bacteriuria
makers to take cognizance of the continuous contribu-
(ASB) is common although the prevalence varies widely
tion of renal disorders to childhood morbidity and mor-
with age, gender and the presence or absence of genitou-
tality in Nigeria.
rinary abnormalities. ASB has been reported to be asso-
ciated with an increased risk of symptomatic UTI espe-
cially in the presence of risk factors and may actually
represent the beginning of symptomatic UTI. This study
therefore sought to determine the burden of ASB and
99
sensitivity pattern of isolates in primary school children
functional and structural abnormalities in 29 (17.5%).
in Enugu.
Ninety-nine(59.6%) acknowledged that it was time con-
Materials and Methods: This was a cross-sectional de-
suming, and 42(25.3%) stated that it was difficult to
scriptive survey involving apparently healthy primary
practice in a busy clinic.
school children aged 6 to 12 years. A pre-tested, care-
Conclusion: The Clinical reasoning tool promises to be
giver administered questionnaire was used to obtain
invaluable in patient management. However, broader
information about the participants including age, sex,
development of critical thinking skills is crucial, and
history of fever and antibiotic usage in the two weeks
teachers should aid students appreciate the complexity
preceding the study. Following a clinical examination, a
of patient care building on basic sciences to make the
sample of spot mid-stream urine was collected from
tool more effective.
each participant for dipstick urinalysis and urine micros-
copy and culture.
Results: Out of the 400 children, 175 (43.75%) were
OC302
males and 225 (56.25%) were females. The mean age of
Simulation-based Education in Nigeria: A Survey of
the children was 10.13 ± 1.81 years.14.25% (57/400) of
Paediatric Care Providers and Trainees
children had ASB, with gender specific prevalence of
1
2
1
Umoren RA, Ezeaka VC,
2
13.7% (24/175) and 14.7% (33/225) for males and fe-
Fajolu IB,
Chukwu E,
2
Ezenwa BN, Spiekerman, C, Akintan P.
1
2
males respectively. The prevalence of ASB was higher
1
among the early adolescents (14.4%) and lower in the
University of Washington, Seattle, Washington, U.S.A.;
2
pre-adolescents (13.6%). Escherichia coli (43.8%) and
College of Medicine, University of Lagos, Lagos,
Staphylococcus aureus (22.8%) were the most common
Nigeria.
organisms isolated.
Email: ezeakac@yahoo.com
Conclusion: The prevalence of ASB is high in primary
school children in Enugu, higher in females with Es-
Introduction: Simulation-based Education (SBE) using
cherichia coli as the commonest bacterial isolate. Rou-
manikin-based and virtual reality (VR) simulation mo-
tine evaluation of these children for bacteriuria is recom-
dalities is increasing in high-resource settings. This
mended.
study aims to explore the access to and perceived utility
of various SBE modalities by healthcare providers and
Medical Education and Clinical Skills
learners in Nigeria.
Methods: A paper-based 35-item survey on SBE was
OC301
administered to 350 healthcare providers and learners
Reasons for difficulties encountered by students and
during simulation workshops at the 2018 PANCONF
interns while using Clinical Reasoning as a diagnos-
Abuja and at LUTH, Lagos.
tic and management tool in medicine at University of
Results: 279 surveys were completed (RR 82%).
Port Harcourt Teaching Hospital
Respondents were mostly 21-30 years (121, 43%) and
female (187, 67%), with physicians (97, 36%) and
Yarhere IE, Briggs DC, Okechukwu C
nurses (62, 23%) in both general (109, 65%) and sub-
Ogbonnaa-Njoku C
specialty (22, 13%) practice with 5-10 years of experi-
Department of Paediatrics, University of Port Harcourt
ence (62, 37%) in a tertiary care setting (169, 64%).
Teaching Hospital, Nigeria
Manikin-based training was more common in practicing
Email: iroro.yarhere@uniport.edu.ng
providers, particularly in Basic Life Support (p<0.05).
Although the majority of physicians and medical stu-
Introduction and Objectives: A systematic clinical deci-
dents (181, 96%) owned smart phones, more students
sion-making skill is crucial to avoid diagnostic errors.
(33, 35%) were aware of VR training than practicing
The Clinical reasoning tool based on Blooms’ taxonomy
physicians (27, 28%) and nurses (11, 19%), p<0.05.
has been in use by the Department of Paediatrics, Uni-
Only 9% (n=25) of respondents had experienced an
versity of Port Harcourt Teaching Hospital (UPTH) and
online or VR simulation. Perceived challenges to using
proposed to be a useful adjunct to aid this process of
VR simulation for training were lack of awareness (129,
reflective thinking. However, little is known about the
46%), VR equipment (64, 23%) and standardized mod-
effectiveness of this tool in daily clinical use, as well as
ules (56, 20%). Nearly all respondents felt SBE should
the difficulties encountered during its use.
be expanded for continuing education, teaching and/or
Materials and Methods: This was a cross-sectional
research. If facilities were available, 97% would recom-
study using pre-piloted structured questionnaires admin-
mend the use of online simulation.
istered to 131 prospective house officers and 67 final
Conclusions: Many healthcare workers in LMICs lack
year medical students at UPTH. Information on basic
access to manikins but the majority own smart phones.
terms, knowledge and application of the Clinical reason-
There is a crucial need to expand SBE online simula-
ing domains was sought. The Likert scale was used to
tions for teaching, continuing education and research.
assess attitudes towards use of the tool. P values <0.05
was considered significant.
Results: A total of 166 respondent results were analysed.
Specific areas of difficulties identified were with making
a diagnosis in 50(30.1%) respondents and identifying
100
OC303
Washington, U.S.A.
eHBB/mHBS-DHIS2: Mobile Virtual Reality
Email: amsamairami@yahoo.com
Newborn Provider Training in Helping Babies
Breathe Component of Essential Newborn Care
Background: Simulation-based education (SBE) modali-
ties including mobile virtual reality (VR) are increas-
1
Umoren RA, Bucher S, Mairami A, Purkayastha S,
2
3
2
ingly utilized in healthcare training. However, little is
1
Bresnahan B, Ezeaka VC, Esamai F, Paton C, on
4
5
6
known of the perceptions of healthcare workers towards
behalf of eHBB/mHBS-DHIS2 project team.
this training modality. The objective of this study was to
1
University of Washington, Seattle, Washington, U.S.A.;
engage healthcare workers in usability testing of eHBB,
2
Indiana University, Indianapolis, Indiana, U.S.A.;
a mobile VR simulation on neonatal resuscitation.
3
National Hospital, Abuja, University of Lagos, Idi-
4
Methods: Twenty-four healthcare workers in paediatrics
Araba, Lagos, Nigeria;
5
Alupe University College,
and labour & delivery wards at National Hospital, Abuja
Alupe, Kenya; Oxford University, Oxford, U.K.
6
accessed eHBB through mobile phones and basic VR
Email: amsamairami@yahoo.com
headsets. Data was collected through surveys, direct
observation, and open-ended questions in recorded 30-
Background: Around 10 million babies a year are born
minute sessions. Responses were analyzed using de-
who do not breathe or cry. Helping Babies Breathe is an
scriptive statistics.
evidence-based global neonatal resuscitation training
Results: Participants were female (23, 96%), 31-40 years
program. However, there are challenges to maintaining
(15, 63%). Four registrars (16%), 15 nurses (63%) and 5
training fidelity and encouraging continuous training
midwives (21%) participated in the study. Most had 5-
and improvement that include lack of mechanisms and
10 years of experience (12, 50%). While 17(71%) had
tools for objective feedback, delays in data collection
previous exposure to manikin-based training, and 9
and analysis, and high staff turnover rates. To address
(38%) were aware of VR, none had used VR. The aver-
these challenges, computer-based simulations are in-
age time to task completion such as drying, stimulation
creasingly used for self-directed learning before, or after
and positive pressure ventilation was tracked. Sugges-
attending an in-person course.
tions for improvement were integrated. Successful task
Methods: eHBB is a mobile virtual reality training app
completion on first click for first time users increased
developed on the Unreal™ engine platform to augment
from 60% to 100%. All testers were willing to test new
healthcare worker neonatal resuscitation training in low
versions of eHBB and recommended online simulation
and middle income countries. Healthcare workers use
for training.
mobile phones with low-cost VR devices such as
Conclusions: There is both need and opportunity to ex-
Google cardboard™ to practice their skills through three
pand simulation-based education beyond the current
mobile virtual reality simulations based on Helping Ba-
scope using mobile VR simulations. Rigorous testing of
bies Breathe 2nd edition curriculum, a component of the
eHBB by end-users resulted in significant improvements
Essential Newborn Care training program. The inte-
to usability and fidelity. This approach to co-design of
grated application: eHBB/mHBS powered by DHIS2, is
mobile VR simulations should be used to increase ac-
currently available for android phones and requires no
cess to standardized SBE in Nigeria.
internet access for use.
Results: Healthcare workers and students who partici-
OC305
pated in formal eHBB usability testing and focus group
A targeted systematic review of cost analyses for im-
discussions at the National Hospital, Abuja reported that
plementation of simulation-based healthcare training
the simulations were appealing, clear, easy-to-use, high-
methodologies
quality and engaging. On a scale of 1-5, testers gave an
1
Hippe D; Umoren R; McGee A; Bucher S
1
1
2
average response of 4.3 (0.7) to the question "How
1
likely are you to use this activity for practicing HBB
Bresnahan B
1
skills?"
University of Washington, Seattle, Washington, U.S.A.
and Indiana University, Indianapolis, Indiana, U.S.A.
2
Conclusions: eHBB/mHBS-DHIS2 is integrated mobile
virtual reality training and data collection apps to aug-
Email: bres@uw.edu
ment healthcare worker neonatal resuscitation training in
low and middle income countries.
Background: In recent decades, there has been a steady
increase in the use of simulation-based education (SBE)
OC304
for training healthcare providers in technical and non-
eHBB: Preliminary Testing and Evaluation of a
technical skills. Despite reliable evidence of the effec-
Virtual Reality Simulation on Neonatal Resuscitation
tiveness of this approach, there is a paucity of cost-
benefit assessments of SBE. To inform an ongoing SBE
1
Mairami AB, Paton C, Asangansi I, Otuneye AT,
2
3
1
study in neonatal resuscitation in LMICs, we sought to
1
Audu LI, Edgcombe H, Mairami FZ, McGee A,
2
1
4
assess the published cost-related literature pertaining to
2
Muinga N, Mukhtar-Yola M, Rossner J, Winters N,
1
2
2
SBE in neonatal resuscitation.
4
Umoren RA.
Methods: We conducted a literature search using the
1
National Hospital, Abuja, F.C.T, Nigeria; Oxford Uni-
2
PubMed database (March 21, 2018). Two targeted que-
versity, Oxford, U.K.; eHealth4everyone, Abuja, F.C.T ,
3
ries were developed: one more narrowly targeted cost
Nigeria; and University of Washington, Seattle,
4
analyses of neonatal resuscitation training and another
101
more broadly searched for cost analyses of medical
their new places of work as ongoing training and men-
simulation-based training in general.
toring of new hires was not being done.
Results: The more targeted query on neonatal resuscita-
tion training identified 16 articles, three of which in-
Neurology
volved cost analyses of training program implementa-
tions (1-3). The broader query on simulation-based
OD301
training in medicine in general identified 109 articles,
Sleep Habits and Sleep Problems Of School-Aged
from which 95 abstracts were reviewed. Nearly half
Children In Ile-Ife, South Western Nigeria
(49%) of studies were from the United States, 15% in
2
Olorunmoteni OE , Komolafe MA
1
continental Europe, 11% in Canada, and 9% in the
Champion Seun-Fadipe
3
United Kingdom.
1
Conclusions: Despite the potential benefits associated
PaediatricNeurology Unit, Department Of Paediatrics
with simulation-based education programs, relatively
And Child Health, Obafemi Awolowo University,
Ile-Ife, Nigeria, Adult Neurology Unit, Department Of
2
few articles report cost analyses for the implementation
of simulation-based training programs in LMICs.
Internal Medicine, Obafemi Awolowo University,
Ile-Ife, Nigeria, Department Of Mental Health,
3
Healthcare stakeholders and decision makers would
benefit from assessments of program expansion costs
Obafemi Awolowo University Teaching Hospitals’ Com-
associated with transitioning from smaller-scale to larger
plex, Ile-Ife, Nigeria.
-scale regional or national implementations across multi-
Email: doc_tosino@yahoo.com
ple centres.
Introduction: Sleep is an important physiologic function
required for an optimal cognitive, social, and emotional
OC306
development of children. Early school start times has
What Happens After Helping Babies Breathe
been established to have adverse effect on sleep in chil-
Training Is Completed?
dren while interventions involving delaying school start
times have improved sleep outcomes in children. How-
Aneji CU , Muomalu CN , Okeke CN , Agwu EL
1
2
2
2
ever, there is a dearth of studies on the impact of school
2
Eze F , Umeh RE
2
start times on sleep in African children. Thus, this study
University of Texas Health Science Centre at Houston,
sought to determine the sleep pattern and problems of
USA and Obijackson Hospitals, Okija Anambra State
elementary school pupils in South-western Nigeria and
Email: wapsco75@yahoo.com
their relationship with school start times.
Methods: This descriptive cross-sectional study in-
Background: Neonatal mortality rate remains disturb-
volved primary schools in Ile-Ife, South-western Nige-
ingly high in Nigeria despite significant decline in parts
ria. The children were recruited from selected schools
of the developing world. Helping Babies Breathe (HBB)
using multistage sampling technique. The Children’s
program is an evidence-based educational program de-
Sleep Habits Questionnaire (CSHQ) was used to assess
signed to teach neonatal resuscitation techniques in re-
the sleep habits and problems of the children while the
source-limited areas.
school start times was obtained from the School princi-
Objective: To determine the mobility of HBB trainers
pals and the arrival time in school was obtained from the
and providers, if trained providers are utilizing the HBB
children and their parents.
skills and to know the degree of on-going peer training
Results: 148 children attending four schools were stud-
and mentoring occurring after completion of training.
ied. The mean±SD time in bed (TIB), bed time, rise time
Methods: Health care workers (HCW) from rural South
and school arrival time of the respondents were
East, Nigeria received one day training on HBB by
8.8±1.2hours, 9.1±0.9pm, 5.9±0.9am and 7.6±0.5am
trained facilitators. All HCW received pre and post
respectively. About half (41.2%) of the respondents had
OSCEs evaluating baseline knowledge and performance
total score > 41 on CSHQ which suggests the presence
prior to and after the workshop. Participants were sur-
of sleep disturbance in them with a higher percentage in
veyed 1 year after completion of their training using a
the bedtime resistance subscale. There was no signifi-
10 item questionnaire.
cant association between the total score on CHSQ and
Results: Of the 72 HCW trained, only nine received
the school start time as well as the TIB. However, total
prior neonatal resuscitation training. Most (99%) re-
score on CSHQ suggesting presence of sleep problems
ported use of HBB skills; drying and positioning were
was significantly higher in respondents attending private
the most used method (86%) followed by suctioning
schools ( p = 0.015) and those who had perceived trouble
(76%) while BMV use reported 0%. The reasons for this
sleeping ( p = <0.017).
included lack of equipment and attrition of skills. One
Conclusion: Sleep disturbances are present in Nigerian
year after the training 100% of the facilitators remained
children. Further studies using polysomnography is rec-
in the original place of work while 53% of those trained
ommended to confirm the presence of sleep disorders.
had moved to other facilities where HBB skills and
Education of parents on healthy sleep hygiene may help
knowledge were not utilized.
to improve sleep in the children.
Conclusion: There was significant trained health worker
mobility within a year of training. Due to lack of HBB
training equipment, trained staff had limited impact in
102
OD302
gramme and the incidence of stroke in children with
First anti-epileptic drug medication and outcomes
SCD following the introduction of routine TCD screen-
after the first 6 months of treatment in a paediatric
ing as part of the comprehensive care of children with
neurology service in Nigeria
SCD in our centre.
Methods: A prospective longitudinal study. All children
Lagunju IA, Oyinlade AO, Busari O, Ibeh J, Adeigbe A,
with SCD offered routine TCD screening since July
Oni O, Idowu O, Olaleye A
2009 were carefully followed and outcomes docu-
Department of Paediatrics, University College Hospital,
mented.
Ibadan
Results: Five hundred and seventy-four children had
Email: ilagunju@yahoo.co.uk
TCD examinations over the 9-year period and a total of
2,345 TCD examinations were performed. Duration of
Background: Children in the developing world are dis-
follow up ranged from 3 months to 9 years. Stroke risk
proportionately affected by epilepsy and access to ap-
was classified as standard, conditional and abnormal risk
propriate anti-epileptic drugs (AED) is limited. There
in 354 (61.7%), 156 (27.2%) and 64 (11.1%) respec-
have been increasing efforts in reducing the epilepsy
tively. None of the caregivers consented to chronic
treatment gap in Africa.
transfusions. One hundred and seventy-eight children
Objectives: To evaluate the AED prescription pattern
with elevated TCD velocities were compliant on hy-
and the seizure outcomes in the first 6 months of ther-
droxyurea (HU), with adverse drug reaction in one
apy.
(0.2%) child. There was one stroke event in the cohort,
Methods: All new cases of epilepsy seen in the Paediat-
giving an incidence of 1.7/1,000. All the children on HU
ric Neurology clinic, University College Hospital,
had sustained reduction in their TCD velocities.
Ibadan, Nigeria were prospectively followed for a mini-
Conclusion: Routine TCD for primary stroke prevention
mum period of 6 months. Detailed seizure history, EEG,
in SCD represents a cost-effective intervention even in
with/without neuroimaging were obtained to diagnose
resource-constrained settings. Routine TCD screening
and classify epilepsy.
with the administration of HU in children with elevated
Results: 386 children with epilepsy were enrolled. Age
TCD velocities has resulted in a drastic reduction in the
at first epileptic seizure ranged from 1 month to 15
burden of childhood stroke due to SCD in Ibadan,
years, median 3 years. Epilepsy was generalised in 241
Nigeria in the last decade
(62.4%) and focal in 145 (37.6%). Sixty-eight (17.6%)
and 53 (13.7%) children had a history of neonatal sei-
OD304
zures and previous episodes of status epilepticus respec-
Intelligence Quotient of Neurologically impaired
tively. The leading AEDs prescribed as first treatment
children Attending Neurology Clinic in a Nigerian
were carbamazepine 215 (55.7%) and sodium valproate
Tertiary Institution
131 (33.9%), with use of phenobarbitone in 22 (5.7%).
By the end of the first 6 months of treatment, 85
Adeboye MAN, Katibi OS, Adegboye OA, Ojuawo A,
Afolabi JK, Buhari OIN , Adegunloye OA , Bello SO,
+
+
(22.0%) children had a change in AED and 207 (53.6%)
remained on monotherapy. Children with associated
Omefe PN, Abdulazeez TA
neurological co-morbidities were more likely to have a
Department of Paediatrics, University of Ilorin/UITH,
change from the first AED prescribed by 6 months of
Department of Behavioural Sciences, University of
treatment (p<0.001).
Ilorin/UITH, Ilorin, Kwara state
Conclusion: Carbamazepine and sodium valproate are
Email: adeboyeman@gmail.com
the leading AEDs used as first line treatment in our ser-
vice. One in five children in our cohort would require a
Background: The need to identify the intellectual capa-
change of AED within the first 6 months of therapy.
bility of Neurologically impaired children which dictates
their educability can be estimated through their intelli-
gence quotient (IQ). Draw a man test for IQ estimation
OD303
is available, easy and has been validated in Nigeria.
Primary Stroke Prevention In Nigerian Children
Method: Through a prospective, cross-sectional study
With Sickle Cell Disease: A Decade Of Routine
that lasted 12 months (January-December, 2011), chil-
Transcranial Doppler Screening In A Resource-Poor
dren aged 4 years and above without severe motor/
Country
sensory deficit attending Neurology clinic were re-
cruited. Routine clinic care was given after which they
Lagunju IA, Brown BJ, Esione A, Ibeh J, Sodeinde OO
were requested to draw a person. The parents or care
Department of Paediatrics, University College Hospital,
givers were instructed not to make any suggestion or
Ibadan
hint, and no time limit was given. Their drawings were
Email: ilagunju@yahoo.co.uk
assessed using the 52 parameters of Ziler and interpreted
accordingly. Ethical procedures were adhered to. Analy-
Background: Sickle cell disease (SCD) is the leading
sis was done using SPSS version 16 and an interactive
cause of stroke in Nigerian children. Routine transcra-
calculation tool for chi-square tests of goodness of fit
nial Doppler ultrasonography provides a window of op-
and independence.
portunity for primary stroke prevention.
Results: Seventy-five (45 male, 30 female) children met
Aims: To evaluate the effectiveness of our TCD pro-
the inclusion criteria. Their clinical conditions were
103
Epilepsy 48 (64%), Cerebral Palsy 6 (8%), ADHD 5
OD306
(6.7%), Down Syndrome 4 (5.3%), Speech/Hearing im-
Severe Juvenile dermatomyositis with normal muscle
pairment 3 (4.0%), Hypothyroidism 2 (2.7%) and 7
-derived enzymes in a Nigerian girl
(9.3%) others. Their ages ranged from 4 years to 16
Aliu R , Jalo I , Isaac EW , Alkali YS , Lawan AI E-
1
1
1
1
2
years ( mean±SD = 9.7± 3.8years ). Their IQ distribu-
bisike KJ
1
tion were Normal 4 (5.3%), Borderline 12 (16.0%), Mild
1
Mental Retardation 16 (21.3%), Moderate Mental Retar-
Department of Paediatrics, College of Medical
dation 19 (25.3%), Severe and Profound Mental Retar-
Sciences, Gombe State University/Federal Teaching
Hospital Gombe, Gombe State and Department of
2
dation 24 (32.0%).
Conclusions: Ninety-six percent of the study population
Histopathology, College of Medical Sciences, Gombe
had IQ below normal. Epilepsy was the commonest con-
State University/Federal Teaching Hospital Gombe,
dition seen in the Paediatric Neurology clinic and all
Gombe State.
categories of IQ are seen among children with epilepsy.
Email: aliu.abdurrazaq11@gmail.com
Background: Juvenile dermatomyositis (JDM) is a rare
OD305
autoimmune myopathies occurring in children less than
Paediatric Neuromuscular Disorders in Ile-Ife: A
16 years old with. It is distinguished by proximal muscle
Three-Year Review
weakness and a characteristic rash. Very few cases have
been reported in the Black Africans from JDM registry
2
Abiodun J. Kareem , Ayogu Musa
2
Oluwatosin EOI,
1,2
report. Although not all enzyme rise with inflammation
1
Department of Paediatrics and Child Health, Obafemi
in an individual, alanine aminotransferase is most com-
Awolowo University (OAU), Ile-Ife and Department of
2
monly elevated. Finding of lymphoid structures in mus-
Paediatrics, Obafemi Awolowo University Teaching
cle biopsy portends severe disease. A 14-year-old Nige-
Hospitals Complex (OAUTHC), Ile-Ife.
rian girl with clinical and histopathologic features of
Email: doc_tosino@yahoo.com
severe JDM is presented here.
Objective: To heighten the index of suspicion of JDM in
Background: Neuromuscular disorders are disorders
Black Africans
affecting the motor unit. Therefore, these disorders com-
Case Report: A 14-year-old girl with 3 years history of
prise of diseases affecting the anterior horn cells, periph-
body rashes, rash on the eyelids, swelling around the
eral nerves, neuromuscular junction as well as the mus-
eyes, and 1 year history of proximal muscles weakness
cles.
with inability to walk and difficulty raising the arms.
Objectives: To describe the pattern of presentation,
There were joint pains, swelling, stiffness, and hair loss.
clinical presentation and challenges with the manage-
Examination revealed a chronically ill child with helio-
ment of children with neuromuscular disorders in Ile-Ife.
trope rash around eyelids and alopecia. Generalized
Methods: We recruited children presenting to the Paedi-
scaly skin, areas of desquamation and ulceration, thick-
atric Neurology Clinic of the Ife Hospital Unit of
ened palms with Gottron papules on the knuckle, elbow
OAUTHC with clinical features suggestive of neuro-
and knee joint contractures. Power was 3 in the proximal
muscular disorders consecutively. Data obtained in-
upper limbs but normal in distal muscles. Alanine ami-
cluded biodata, duration of symptoms, predisposing fac-
notransferase 33IU (10-46), aspartate aminotransferase
tors, investigation results and diagnosis.
44 IU (10-46), ESR 108mm/hr (0-20), muscle biopsy
Results: Twenty patients were recruited during the three-
showed foci of perivascular lymphocytic infiltration
year period of the study with their ages ranging between
with plasma cells. Diagnosis of JDM was made using
fourteen days to fifteen years. Peripheral neuropathy
Bohan and peter criteria. High-dose pulse intravenous
was the most common type of neuromuscular disorder
methylpredinisolone, daily oral prednisolone, weekly
as it was seen in 13 (65 %) of the patients out of which
methotrexate, calcium and vitamin D supplements, folic
92% had mononeuropathy. The forms of mononeuropa-
acid and physiotherapy were commenced.
thy seen included sciatic nerve palsy {9 (45 %)} and
Erb’s palsy 3(15 %). The only patient with polyneuropa-
thy had Gullain-Barre syndrome. Myopathies were seen
P001
in four patients comprising of two cases of Duchenne
Infantile Fibrosarcoma: A Rare Childhood Malig-
Muscular dystrophy and two cases of congenital myopa-
nancy In A Nigerian Child
thy while one patient had Myasthenia gravis. Investiga-
Onukwuli VO , Ezenwosu OU , Akubuilo UC , Ezomike
1
1
1
tions done included muscle biopsy and serum creatinine
UO , Okafor OC , Chukwu BF , Ekenze SO , Ikefuna
2
3
1
2
kinase assay as appropriate. However, electromyography
1
AN , Emodi IJ
1
and nerve conduction velocities were not done in any of
1
Department of Paediatrics, Department of Surgery,
2
the patients due to its non-availability.
and Department of Morbid Anatomy, University of Ni-
3
Conclusion: Neuromuscular disorders are seen in chil-
dren though the spectrum and risk factors often differ
geria, Ituku Ozalla Enugu.
from adults. There is a need to improve awareness and
Email: osita.ezenwosu@unn.edu.ng
provide resources needed for prompt diagnosis.
Background: Infantile Fibrosarcoma is a rare malignant
tumour of infancy that is seen in children below the age
104
of one year. It occurs most frequently in the extremeties.
were taken to the nearest 0.1 centimetre. Their height for
Surgical resection is usually curative and chemotherapy
Age Z-score and Body Mass Index for Age Z-score were
is active against gross residual disease.
determined. They were categorised as having normal
Case Presentation: We report the case of a three-month
height, very tall or stunted and, normal weight for
old female who presented with swelling of the right calf
height, overweight or wasted respectively.
noticed at two weeks of life. Swelling progressively
Results: The majority of the subjects 134(81.2%) had
increased in size with no associated history of trauma,
normal weight for height, while 3(1.8%) were over-
fever or weight loss. Pregnancy and delivery history
weight, 23(13.9%) were wasted and another 5(3.0%)
were uneventful. Examination showed right calf with a
were severely wasted. One hundred and forty-four
mass measuring 25cm in diameter and the normal left
(87.3%) were of normal height, only 1(0.6%) was very
calf measuring 17cm in diameter (measurements taken
tall, 15(9.1%) were stunted while another 4(2.4%) were
from a point 7cm from the lateral malleolus). The mass
severely stunted.
was firm, non-tender and attached to the underlying
Conclusion: Stunting was documented in 11.5% of chil-
structure. Other examination findings were essentially
dren and adolescents with SCA while wasting and over-
normal. Doppler ultrasound showed increased vasculari-
weight were seen in 16.9% and 1.8% respectively. There
sation of the mass as well as encased blood vessels
is need to improve the nutritional status in this cohort of
(arteries and veins) of the right calf. Tissue histology
children and adolescents with increased potential risk for
showed malignant mesenchymal proliferation and nu-
nutritional deficits.
merous mitotic figures in keeping with infantile fi-
brosarcoma. Immunohistochemistry done also con-
firmed the diagnosis. She had surgical excision of the
P003
tumour and was subsequently commenced on chemo-
Knowledge and Awareness of Sickle Cell Genotype
therapy for the residual tumour masses with blood ves-
Among Adolescents in Enugu, Nigeria
sels.
Ezenwosu OU , Chukwu BF , Nnajekwu UC , Ezenwosu
1
1
1
Conclusion: Although rare, it is important to consider
IL , Ikefuna AN , Emodi IJ
2
1
1
infantile fibrosarcoma as a differential diagnosis of soft
1