Nigerian Journal of Paediatrics

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

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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

Olutola E, Odunsi O, Aina O

Department of Paediatrics, and Department of Obstet-

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

studied.

2017 to July 31 2018 were analysed.

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

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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

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

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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

Conclusions: Serum NGAL is a useful biomarker in

PI Ogundele T , Odunlade CO , Akinlosotu AM

detecting AKI in asphyxiated neonates within the first 6

hours of life.

Department of Paediatrics University of Medical Sci-

ences Laje road Ondo, Department of Paediatrics and

Child Health University of Benin, Benin city and

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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 ,

1,3

veloping countries were facilities for sick new born are

Ocheikwu J , Izevbigie N , Megafu C , Odili V , Ebruke

scarce. A review of the outcome in our newborn unit

1,4

BE , Obaro S

over a 5 year period may help to highlight inferences

International Foundation Against Infectious Disease in

that can be useful in the planning and implementation of

Nigeria, Abuja Nigeria,

University of Abuja Teaching

successful newborn care in similar settings.

Hospital, Gwagwalada Nigeria.

National Hospital,

Materials and Methods: This was a retrospective study

Abuja Nigeria and University of Nebraska Medical

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

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

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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.

1,2

with various features suggestive of sepsis. Sixty-five

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

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,

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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.

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

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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

≥5 years old/damaged and 3.3% were still using LLIN

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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

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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

Neonatal Tetanus (PNT) in a Nigerian tertiary health

Medugu N , Ebruke B , Obaro S

1,2

1,3

facility.

International Foundation Against Infectious Disease in

Materials and Methods: A retrospective study of the

Nigeria, Abuja Nigeria National Hospital, Abuja Nige-

cases of post-neonatal tetanus managed at the Olabisi

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

Imipenem (94.4%), Meropenem (96.4%) and Amikacin

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(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,

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,

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

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

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

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

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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

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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

1,3,4

selected. The socio-demographic characteristics, mode

Department of Pharmacology & Therapeutics, Insti-

of HIV transmission, CD4 count and associated comor-

tute of Child Health, Institute for Advanced Medical

bidities of the patients were retrieved. Obtained data was

Research & Training, and Department of Clinical

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

(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.

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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

1,3,4

versely, 25-OHD retard inflammation and may lower

Department of Pharmacology & Therapeutics, Insti-

rate of pain episodes. We determined serum levels of

tute of Child Health, Institute for Advanced Medical

TSP-1 and 25-OHD in Nigerian children with SCA and

Research & Training, and Department of Clinical

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),

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

Brown BJ, Fasola FA, Adebayo BE, Ogunkunle OO

interactions between covariates and haematocrit.

Department of Paediatrics and Department of Haema-

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

Adegoke SA, Smith OS, Adeniyi AT, Adekile AD.

be effective it must be used in combination with anthra-

Department of Paediatrics and Child Health,

cycline-based chemotherapy. The objective of this report

Department of Chemical and Department of Paediat-

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-

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.

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

crease the chances of cure in patients with APL.

Affiliations:

Department of Chemical Pathology,

Obafemi Awolowo University (OAU) Teaching Hospi-

OC103

tals Complex, Ile-Ife, Nigeria.

Influence of Deletional Alpha Thalassemia on Clini-

Department of Paediatrics and Child Health, OAU,

cal and Laboratory Parameters of Young Nigerians

Ile-Ife, Nigeria.

with Sickle Cell Anaemia

Department of Paediatrics, University of Medical

Sciences, Ondo, Nigeria.

1 ,2,3

Olatunya OS,

Albuquerque DM,

Taiwo AB,

Department of Chemical Pathology, OAU, Ile-Ife,

Fatunla OAT,

Faboya OA,

Kayode TS,

Adekile

Nigeria.

AD, Costa FF

Email: adegoke2samade@yahoo.com

Department of Paediatrics and Department of Medical

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

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-

Department of Paediatrics and Department of Chemi-

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.

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

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.

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.

1,2

Uche Nnebe-Agomadu, Ade-

Erigbuem John Ifeanyi,

Department of Biochemistry, Obafemi Awolowo Univer-

bayo Innocent Adogah,

Oyeleye Ayotunde,

Esther

sity, Ile-Ife, Nigeria.

James, Evelyn Kumode.

Email: drolufunky@gmail.com

Department of Paediatrics, University of Abuja Teach-

ing Hospital, Abuja.

Introduction/ Objective: Iron deficiency continues to be

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.

Esther James, Uche Nnebe-Agumadu, Evelyn Ku-

2,3

Conclusion: Use of moderate dose of hydroxyurea in

mode, Adebayo Innocent Adogah.

children for 12 months show no significant impairments

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.

cated.

Department of Paediatrics, College of Heath Sciences,

University of Abuja.

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.

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, 3

1, 2

OD101

Department of Paediatric, University College Hospital

Ibadan, Department of Paediatric, University of Ibadan

Paediatric Emergency Departments in Nigeria: How

and Institute of Child health, University of Ibadan

Prepared Are They To Provide Emergency Care?

Email: yemilabaeka2@yahoo.com

Enyuma COA,

1,2,3

Laher AE, Moolla M, Feroza M,

Olorunfemi G .

Introduction: Childhood morality remains a major pub-

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

like pneumonia, severe malaria, prematurity and acute

of Medicine, University of Calabar. Nigeria, Children

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

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

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,

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-

tion while 18 (51.4%) were reviewed after the presenta-

Department of Paediatrics, Wesley Guild Hospital,

Ilesa, Department of Paediatric and Child Health,

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

(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

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

significant influence on the prevalence and pattern of

FJ , Osayi LA , Sagay AS , Kanki P , Bode-Thomas F

skin diseases found.

Conclusion: There was a high prevalence of skin dis-

Affiliations:

Department of Paediatrics, Univer-

sity of Jos/ Jos University Teaching Hospital, Depart-

eases among primary school children in Port Harcourt.

Effective preventive measures should be implemented in

ment of Paediatrics, Jos University Teaching Hospital,

Medical research council, Gambia, Department of

primary schools in Port Harcourt.

Obstetrics and gynaecology, University of Jos/ Jos Uni-

versity Teaching Hospital and Havard th chan school

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

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

Ibrahim OR, Afolabi JK, Ojuawo A, Adedoyin OT,

babies. Ten babies had combined atrial septal defect

Mokuolu OA, Abdulkadir MB

(asd) and vsd. Isolated pulmonary valve stenosis was

present in 5 babies. Other types of chd seen include

Department of Paediatrics, Federal Medical Centre,

Katsina, Katsina State, Department of Paediatrics and

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

dren in ilorin.

FJ , Osayi LA , Sagay AS , Kanki P , Bode-Thomas F

Methods: A total of 1745 school children aged 6-12

Department of Paediatrics, University of Jos/ Jos Uni-

years were recruited using a systematic random sam-

versity Teaching Hospital, Department of Paediatrics,

pling method. The pupils had bp measurements using

Jos University Teaching Hospital, Medical research

the fourth report guideline. Those with bp greater than

90 percentile had repeat bp measurements on two more

council, Gambia, Department of Obstetrics and Gynae-

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-

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

Introduction and objective: congenital heart disease

was 6.2% (109/1745), 2

and 3

(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

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)

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

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

system disease. There is therefore a high index of suspi-

Department of Paediatrics University of Jos and heart

cion needed for diagnosis.

aid trust, Jos, Department of history and Anthropology,

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

associated it with an infectious origin. None related it to

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

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

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,

Nigeria. Awareness and accessibility were the major

2,3

Akinwumi IN, Animasahun BA, Solarin AU, Ade-

2,3

determinants of hpv vaccine uptake among the caregiv-

kunle MO, Ubuane PO

ers. There is a need for massive and sustained awareness

creation to increase hpv vaccination uptake in Nigeria.

Rheumatology Unit, Department of Internal Medicine,

Lagos State University Teaching Hospital, Ikeja, Lagos,

Nigeria.

OA207

Department of Paediatrics, Lagos State University

Comprehensive care for children with SCD in Nige-

Teaching Hospital, Ikeja, Lagos.

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

Uche Nnebe-Agumadu, Adebayo Innocent Adogah,

Esther James, Evelyn Kumode

Introduction & Objectives: Juvenile systemic lupus ery-

Department of Paediatrics, College of Health Sciences,

thematosus (JSLE)-a chronic multisystem autoimmune

University of Abuja.

disorder of childhood- is potentially more fatal than

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.

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

Amodu-Sanni M, Ahmed H, Jiya NM, Yusuf T, Sani

adolescent patient clinic proforma/ registry drawn up

UM, Isezuo KO, Ugege MO, Mikailu A J.

from January 2018 to October 2018. Data was entered

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

Nwoyeocha C A, Oluleye OA,

1,2

Brown B J

was 60% (60/100) compared to 100% (40/40) among

College of Medicine, University of Ibadan,

those not on ART ( χ =25.6, p=0.0001). Among the 60

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-

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

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-

Ofiaeli OC., Umeadi NG., Ebenebe JC., Ndukwu CI,

tal (UPTH).

Asogwa IO, Ofiaeli OAR

Materials and Method: This cross-sectional study was

Department of Paediatrics, Nnamdi Azikiwe University

carried out among interns at the UPTH. Informed writ-

Teaching Hospital, Nnewi, Anambra state and Depart-

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

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-

Conclusion: One-half of the caregivers were aware of

ber, 2016 and 31 August, 2018. Cases of sexual assault

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

Materials and Methods: A descriptive cross sectional

BP,

1,2*

Oyelami AO

1,2

community-based study involving 418 mothers of under

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

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

OC203

Paediatrics, Ahmad Sani Yariman Bakura Specialist

Hospital, Gusau and Department of Paediatrics, Fed-

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

Introduction and Objectives: Severe acute malnutrition

Department of Medicine ABU/ABUTH Zaria,

(SAM) is still a major public health problem in develop-

Department of Paediatrics ABU/ABUTH Zaria

ing world with attendant morbidities and mortality. Chil-

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,

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.

Yusuf T, Hashim RM, Garba BI, Ahmad MM, Baba

Materials and Methods: In this study, the serum electro-

J, Sanni NA, Onazi SO

lyte at admission, bio data, clinical features and outcome

Department of Paediatrics, Usmanu Danfodiyo

of children with acute diarrhoea, aged 29 days to 10

years, seen between 1 January to 31 December 2016

University Teaching Hospital, Sokoto, Department of

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.

Udoh EE , Esu EB

Materials and Methods: An observational study carried

Paediatrics Department, University of Uyo Teaching

out between January and March, 2018 at Gwiwa com-

Hospital, Uyo, Akwa Ibom State, Nigeria and Depart-

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

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)

Akinola IJ, Ubuane PO Odusote OO, Njokanma OF

was not significantly different from mean age of

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

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.

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

multi-stage

sampling.

Information

socio-

Ogugua CF, Chikani UN, Ibekwe MU Onoh AE,

demographic characteristics, access to electronic-media

Ibe BC

technologies and willingness to participate in electronic-

Federal Teaching Hospital Abakaliki, University of

media-based interventions was obtained. Descriptive

Nigeria Teaching Hospital Enugu, and Federal

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).

Sadoh AE, Okonkwo C, Nwaneri DU, Ogboghodo

Conclusion: Younger age, young age at onset of diabe-

BC, Eregie CO, Oviawe O, Famuyiwa O.

tes, and short duration of diabetes and caregivers’ in-

volvement in diabetes management were strong indica-

Institute of Child Health, University Of Benin, Benin

City and Department of Obstetrics and Gynaecology,

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

Institute of Child Health, College of Medicine, Univer-

target population (adolescents) is a major contributor to

sity of Ibadan, Nigeria, Society for Adolescents and

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

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

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, 2

State University Teaching Hospital, Ikeja.

Institute of Child Health, University of Ibadan, Nigeria

Methodology: Children with asthma were prospectively

and Department of Paediatrics, University College

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-

OA302

Gusau, Zamfara state, Nigeria.

Serum inflammatory cytokines and antioxidant

Department of Paediatrics, Ahmadu Bello University

micronutrients in children with Community

Teaching Hospital, Zaria, Kaduna state, Nigeria and

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

Email: festusdele@gmail.com

Oyelami AO

1,2

Department of Paediatrics, Wesley Guild Hospital,

Introduction and objectives: Acute pneumonia is a lead-

Ilesa, Nigeria, Department of Paediatrics and Child

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

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

Mado SM, Yusuf R.

Akeredolu FD, Akuse RM,

morbidity. The study was conducted to identify the pres-

Department of Paediatrics, Federal Medical Centre,

entation and outcome of respiratory illness in hospital-

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

Institute of Child Health, College of Medicine, Univer-

Materials and methods: This was a comparative cross

Nigeria University College

sity of Ibadan, Ibadan,

sectional study to assess the health-related quality of life

Hospital, Ibadan, Ibadan, Nigeria Department of Sur-

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

Nigeria Department of Health Policy and Management,

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

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.

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

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 ,

Ologun BG , Adeniyi AT , Kuti DK , Folarin OF , Oke

1, 2

1,2

OJ , Aladekomo TA

1, 2

OB302

,Oyelami AO

Congenital abnormalities of the kidney and genital

Department of Paediatrics, Wesley Guild Hospital,

Ilesa, Nigeria and

tract in LASUTH

Department of Paediatrics and

Child Health, Obafemi Awolowo University, Ile-Ife, Ni-

Solarin AU, Oladimeji AB, Ikuerowo SO, Akinola

geria

RA, Kayode-Awe OM, Nwankpele TO, Lamina MO, Ani-

Email: Mayowafawale@gmail.com

masahun BA

Department of paediatrics, Department of surgery, and

Background: Bartter syndrome is a rare renal tubular

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

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

(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

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

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

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

Chime Paschal, Obu HA, Okafor HU

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

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

Umoren RA, Ezeaka VC,

13.7% (24/175) and 14.7% (33/225) for males and fe-

Fajolu IB,

Chukwu E,

Ezenwa BN, Spiekerman, C, Akintan P.

males respectively. The prevalence of ASB was higher

among the early adolescents (14.4%) and lower in the

University of Washington, Seattle, Washington, U.S.A.;

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-

Umoren RA, Bucher S, Mairami A, Purkayastha S,

ingly utilized in healthcare training. However, little is

Bresnahan B, Ezeaka VC, Esamai F, Paton C, on

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

University of Washington, Seattle, Washington, U.S.A.;

engage healthcare workers in usability testing of eHBB,

Indiana University, Indianapolis, Indiana, U.S.A.;

a mobile VR simulation on neonatal resuscitation.

National Hospital, Abuja, University of Lagos, Idi-

Methods: Twenty-four healthcare workers in paediatrics

Araba, Lagos, Nigeria;

Alupe University College,

and labour & delivery wards at National Hospital, Abuja

Alupe, Kenya; Oxford University, Oxford, U.K.

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

Hippe D; Umoren R; McGee A; Bucher S

average response of 4.3 (0.7) to the question "How

likely are you to use this activity for practicing HBB

Bresnahan B

skills?"

University of Washington, Seattle, Washington, U.S.A.

and Indiana University, Indianapolis, Indiana, U.S.A.

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

Mairami AB, Paton C, Asangansi I, Otuneye AT,

study in neonatal resuscitation in LMICs, we sought to

Audu LI, Edgcombe H, Mairami FZ, McGee A,

assess the published cost-related literature pertaining to

Muinga N, Mukhtar-Yola M, Rossner J, Winters N,

SBE in neonatal resuscitation.

Umoren RA.

Methods: We conducted a literature search using the

National Hospital, Abuja, F.C.T, Nigeria; Oxford Uni-

PubMed database (March 21, 2018). Two targeted que-

versity, Oxford, U.K.; eHealth4everyone, Abuja, F.C.T ,

ries were developed: one more narrowly targeted cost

Nigeria; and University of Washington, Seattle,

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

Olorunmoteni OE , Komolafe MA

continental Europe, 11% in Canada, and 9% in the

Champion Seun-Fadipe

United Kingdom.

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

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,

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

ever, there is a dearth of studies on the impact of school

Eze F , Umeh RE

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-

years ( mean±SD = 9.7± 3.8years ). Their IQ distribu-

bisike KJ

tion were Normal 4 (5.3%), Borderline 12 (16.0%), Mild

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

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

Abiodun J. Kareem , Ayogu Musa

Oluwatosin EOI,

1,2

report. Although not all enzyme rise with inflammation

Department of Paediatrics and Child Health, Obafemi

in an individual, alanine aminotransferase is most com-

Awolowo University (OAU), Ile-Ife and Department of

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

tions done included muscle biopsy and serum creatinine

UO , Okafor OC , Chukwu BF , Ekenze SO , Ikefuna

kinase assay as appropriate. However, electromyography

AN , Emodi IJ

and nerve conduction velocities were not done in any of

Department of Paediatrics, Department of Surgery,

the patients due to its non-availability.

and Department of Morbid Anatomy, University of Ni-

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

Conclusion: Although rare, it is important to consider

IL , Ikefuna AN , Emodi IJ

infantile fibrosarcoma as a differential diagnosis of soft

tissue mass in infants and even in children. Surgical ex-

Department of Paediatrics, University of Nigeria

cision of tumour mass remains the mainstay of treat-

Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

ment. However, chemotherapy is necessary for inoper-

Department of Community Medicine, University of

able or residual tumours.

Nigeria Teaching Hospital, Ituku/Ozalla, Enugu,

Nigeria

Email: osita.ezenwosu@unn.edu.ng

P002

Nutritional Status of Children and Adolescents with

Introduction: Adolescence appears to be the best time to

Sickle Cell Anaemia In Gwagwalada, Abuja

improve the knowledge and awareness of personal geno-

type. It is necessary to first assess their baseline knowl-

+Adebayo Innocent Adogah, +*Uche Nnebe-Agumadu,

edge and awareness in order to identify the existence or

+*Okechukwu Adaline Adaora, +*Onalo Richard,

otherwise of gap to be filled.

+*Anigilaje Ademola Emmanuel.

Objective: To assesses the knowledge and awareness of

*Department of Paediatrics, College of Health Sciences,

sickle cell genotype among adolescents.

University of Abuja.

Methods: In four hundred and nine senior students of

+Department of Paediatrics, University of Abuja Teach-

Federal Government College, Enugu who gave assent, a

ing Hospital, Abuja.

pretested, structured questionnaire was administered on

Email: innadogah@gmail.com

socio-demography, awareness of genotype and genotype

in those aware, perception of Sickle cell trait and Sickle

Background: Sickle cell anaemia is known to be associ-

Cell Anaemia (SCA). Thereafter, the school’s admission

ated with growth failure. It’s multi -systemic manifesta-

records were used to extract each student’s actual geno-

tions potentially affects growth leading to wasting and

type to compare with the stated genotype. The knowl-

stunting. Individuals with SCA have been found to

edge scores were summed on a binary basis with 1 point

weigh significantly less when compared with those with

assigned for a correct answer while zero was given for

HbAA genotype. Frequent vaso-occlusive crises lead to

an incorrect response.

decrease appetite and consequently growth retardation.

Results: Majority (94%) of the respondents reported

Also, increased haemolysis in SCA results in increased

being aware of their genotype and two-thirds had the

metabolic requirements for erythropoiesis and conse-

awareness during school admission. In specific knowl-

quently consumption of nutrients and thus increase risk

edge of sickle cell, 89.7% of the participants miscalcu-

for poor growth.

lated the probability of having a child with SCA in mar-

Aims: To determine the nutritional status of children and

ried carrier couple and 71.9% misidentified the propor-

adolescents with SCA in Gwagwalada, Abuja using their

tion of Nigerians with sickle cell trait. Only few of the

anthropometric parameters.

adolescents (7.3%) had high sickle cell knowledge

Methods: A cross-sectional descriptive study of 165

scores. Age, gender, class and socio-economic class

children and adolescents aged 2 to 17 years with SCA.

have neither significant association nor correlation with

Their weight were read to the nearest 0.5kg, also, height

knowledge of sickle cell.

105

Conclusion: There is limited knowledge of sickle cell

P005

among adolescents in the secondary school. There is

Hepatitis B virus infection among children with

need to identify effective approach to increase their

Sickle Cell Disease at the Ekiti State University

knowledge.

Teaching Hospital, Ado-Ekiti

Babatola AO , Olatunya OS ,Faboya OA, Ajayi AO

Department of Paediatrics, Ekiti State, Department of

P004

Medical Biochemistry, and Department of Medicine,

Impacts of Sociobiologic Factors on The Neuro-

Cognitive Functions of School Children with Sickle

Ekiti State University, Ado-Ekiti, Nigeria.

Cell Anaemia

Email: mamafunky@yahoo.co.uk

Adegoke SA, Oke JO, Akinlosotu MA, Adeyemo MA,

Background: Sickle cell disease (SCD) is characterized

Mohammed LO, Fawale OO, Adeniji EO, Adeodu

by acute clinical symptoms which may include severe

OO.

anaemic episodes requiring blood transfusion. The fre-

Department of Paediatrics and Child Health, Obafemi

quent use of blood products for patients with sickle cell

Awolowo University (OAU), Ile-Ife, Nigeria,

diseases may put them at risk of contracting Hepatitis B

Department of Paediatrics, University of Medical

virus (HBV) infection especially if such blood products

Sciences, Ondo, Nigeria.

are not properly screened. HBV infection may result in

Department of Haematology and Blood Transfusion,

cirrhosis of the liver and liver cell cancer. This study

Ladoke Akintola University Teaching Hospital, Osogbo,

determined the prevalence of HBV infection among

Nigeria.

children with sickle cell disease in comparison with age-

Department of Paediatrics, OAU Teaching Hospitals

matched controls at the Ekiti State University Teaching

Complex, Ile-Ife, Nigeria.

Hospitals (EKSUTH), Ado-Ekiti.

Email:adegoke2samade@yahoo.com

Methods: The study was descriptive cross sectional that

involved 116 SCD patients and aged matched controls

Background: Sickle cell anaemia (SCA) may impair

attending paediatric clinics at EKSUTH. HBV screening

attention,

memory,

intelligence

and

academic

was by Enzyme Linked Immunosorbent Assay method

performance. This study assessed the cognitive function

(Hepatitis surface antigen WB (Multi) kits by Standard

(intelligent quotients, IQ and academic performance) of

Diagnostic INC. Republic of Korea.

children with SCA and determine the influence of socio-

Results: The mean ages of the SCD patients and controls

biologic factors on this neurocognitive functioning.

were 8.35± 4.50 years and 8.92± 3.25 years respectively.

Methods: Academic performance, average sessional

The seroprevalence of Hepatitis B infection among the

academic and IQ scores were determined in children

children with sickle cell disease and control was 0.86%

with SCA and matched controls. Influence of social,

each (p =1.00). There was a statistically significant dif-

clinical, nutritional and haematological data was

ference in the transfusion rate among SCD patients

assessed using bivariate and multivariate analyses.

(31.0%)

when

compared

with

controls

(12.9%)

Results: More controls than subjects obtained high

(p=0.001). Most (98.3%) of the SCD patients and con-

scores in the Academic Performance Questionnaire,

trols were fully vaccinated against Hepatitis B infection.

p=0.003. The mean sessional score was also higher in

Conclusion: The seroprevalence of Hepatitis B infection

the controls (73.9±20.2%) than SCA (63.4±26.1%),

among SCD patients and controls is low. This may be

p=0.028. However, there was no difference in their

due to the protective effect of high Hepatitis B vaccina-

mean IQ scores (64.8±14.6% vs. 64.6±19.6%, p=0.733).

tion rate and high quality of care among our study popu-

Among children with SCA, age, class and disease

lation.

severity scores had negative correlation with average

sessional

scores

(p=0.004,

0.031

and

0.038

respectively). Duration of school absenteeism and IQ

P006

scores however positively correlated with average

Dipstick urinalysis as a predictor of acute kidney

sessional scores, p=0.009 and 0.007 respectively. The

injury (AKI) and mortality among children with

type of school also influenced academic performance

Lassa fever (LF)

(p=0.008). Gender, social class, nutritional status and

Adetunji AE, Olomu SC, Isibor EE, Mbanefo K,

haematological data did not influence academic

Idialu-Eigbobo JO, Muebonam EB, Owobu A C, A-

performance or IQ of the subjects. Long school

zubuike CO, Ogbaini-Emovon E, Günther S, Ibadin

absenteeism (OR=4.1, 95%CI =2.2 – 8.4, p=0.003) and

low

(OR=2.9,

95%CI

=1.3 – 7.7,

p=0.024)

MO, Okokhere PO, Akpede GO.

independently predicted poor academic performance.

Department of Paediatrics, Institute of Lassa Fever

However, none independently predicted low IQ.

Research and Control,

and Department of Medicine, Irrua Specialist Teaching

Conclusion: Children with SCA performed less

Hospital, Irrua, Edo State, Nigeria. Bernhard-Nocht

academically, though their IQ was comparable to

controls. Age, type of school, class of participants,

Institute for Tropical Medicine- WHO Collaborating

disease severity and duration of school absenteeism

Centre for Arboviruses and Hemorrhagic Fever Refer-

influences cognition of children with SCA.

ence and Research, Virology, Bernhard-Nocht-Str. 74-

Hamburg, Germany, Department of Paediatrics,

106

University of Benin/University of Benin Teaching Hospi-

Conclusion: The occurrence of ectopic elimination of

tal, Benin, Nigeria, and Department of Paediatrics,

Schistosoma ova should guide teachers, clinicians and

Ambrose Alli University/Irrua Specialist Teaching

laboratory scientist in the management of this interesting

Hospital, Ekpoma/Irrua, Edo State, Nigeria.

phenomenon.

Email: tunjiwale2007@yahoo.com

P008

Background: Many facilities in the resource-poor set-

Link Between Maternal Body Mass Index And Child

tings where LF is endemic lack resources for the investi-

Nutritional Status In Ekom Iman, Nigeria: Implica-

gation of renal function or abstain for fear of nosocomial

tions For Child Health Care

transmission of infection. Dipstick urinalysis (DUA)

could be a readily available diagnostic and prognostic

Ifak N I, Adediran K I

tool in this regard but there is a lack of reports on its

Institute of Child Health, College of Medicine, Univer-

utility. The study investigated the correlation between

sity of Ibadan, Nigeria

the prevalence of AKI, case fatality and DUA results.

Email: rolaadediran@yahoo.com

Methods: Retrospective observational study of a cohort

of 58 children with confirmed LF. DUA was done using

Background: Maternal BMI could be a proximate deter-

standard commercial strips while AKI was assessed us-

minant of child nutritional status. The link between

ing KIDGO criteria. Groups were compared using χ2 or

mothers and their children’s nutritional status has not

Fisher’s exact tests.

been fully explored more so in Ekom Iman , Etinan,

Results: Overall, 27/58 (47%) had full data on both

Local Government Area (EIE,LGA). This study was

DUA and AKI status; 12 had hematuria plus proteinuria

conducted to examine the relationship between maternal

(H/P), 11 had hematuria (H, n = 5) or proteinuria (P, n =

and child nutritional status in EIE, LGA, Akwa Ibom

6) and 4 neither. Nine of the 12 with H/P versus 4/15

State, Nigeria.

with H, P or neither [OR (95% CI) = 8.25 (1.45, 46.85),

Methods: A three-stage sampling technique to select 297

p = 0.013] and 2/11 with H or P [OR (95% CI) = 13.5

mother-child pairs, an interviewer-administered semi-

91.8, 101.1), p = 0.006]had AKI. Six of 12 with H/P

structured questionnaire to collect information on socio-

versus 2/15 with H, P or neither [OR (95% CI) = 6.5

demographic characteristics and calibrated weighing

(1.00, 42.17), p = 0.099 and 8/13 with versus 0/14 with-

scale and measuring bar to take anthropometric meas-

out AKI died ( p = 0.001).

urements were utilised. Mothers’ BMI and children’s z -

Conclusion: Hematuria with proteinuria correlates with

scores of Weight-for-Age (WA) and Height-for-Age

both the risk of AKI and death in LF and could be a use-

(HA) were determined using WHO 2006 standards. Data

ful guide on the need for referral for specialized care.

were analysed using descriptive statistics, Chi-square

and logistic regression tests at 5% level of significance.

P007

Results: Mothers’ age was 26.1±5.5 years, 14.1% were

Ectopic Elimination of Schistosoma Haematobium

underweight while 11.8% were obese. Age of children

Ova: A Case Report

was 40.3±13.6 months and prevalence of wasting, un-

derweight and stunting were significantly higher among

Abubakar Y, Bugaje MA, Akuse R, Mohammed JA,

children of underweight than normal weight mothers

Adewunmi OA, Shuaibu R, Abdu-Raheem FO

(23.8% versus 9.1%, 35.7% versus 15.3% and 31% ver-

Department of Paediatrics, Ahmadu Bello University

sus 19.3% respectively). The likelihood of having nor-

Teaching Hospital, Zaria

mal WA was higher in children whose mothers had nor-

mal weight (OR: 2.66; 95% CI: 1.02-6.94).Children of

Background: Ectopic elimination of ova of Schistosoma

overweight mothers were six times more likely to have a

haematobium via stool is rare but does occurs either due

higher HA than those of underweight mothers (OR:

to ‘Spill over’ effect or the expression of interspecific

6.12; 95% CI: 1.19-31.45).

interactions and heterospecific mating between different

Conclusion: Mothers’ Body Mass Index is an important

species of schistosomes. This report is to highlight the

determinant of children’s nutritional status. Programmes

possibility of excreting ova of Schistosoma haemato-

to improve children’s nutritional status should also ad-

bium via unusual route.

dress maternal nutrition.

Methods: A Case Report of a 9-year primary school boy

is presented

Results: A 9-year old boy presented with fever, abdomi-

P009

nal pain, vomiting and terminal haematuria. He had his-

Simultaneous Occurrence of Papulonecrotic Tuber-

tory of waddling in streams. Other children living in the

culid and Erythema Induratum in A Child: Case

same area as the patient also had history of passage of

Report and Review of the Literature

blood in urine. Urine microscopy and stool microscopy

Nkeiruka Ezomike E,

1, 2

Carol Hlela

1,3

both showed ova of Schistosoma haematobium , and

urine culture yielded Klebsiella spp. He was managed

Division of Dermatology, Red Cross Children's Hospi-

Africa, Depart-

for Schistosoma haematobium infection with superim-

tal, Rondenbosch, Cape Town, South

posed Urinary Tract Infection.

He was treated with

ment of Paediatrics, University of Nigeria Teaching

Hospital, Ituku-Ozalla, Enugu, Nigeria and Division of

praziquantel and antibiotics. The presence of S. haema-

tobium ova in the stool is an ectopic elimination.

Dermatology, Groote Schuur Hospital, Cape Town,

107

South Africa

pling method. Urinalysis using early morning urine

Email: nkeirukaezomike@gmail.com

specimen was done and those with positive results had

repeat urinalysis.

Background: Tuberculosis (TB) is a global public health

Results: Urinary abnormalities were found at first

concern, especially in developing countries. Hypersen-

screening in 134 (9.3%) subjects with 87 (6.1%) having

sitivity reactions to TB, (tuberculids) occur rarely and

isolated proteinuria (IP), 36 (2.5%) isolated haematuria

their coexistence is even rarer in children. Tuberculids

(IH) and 11 (0.8%) combined proteinuria and haema-

can be papular (papulonecrotictuberculid), nodular

turia (CPH). Isolated haematuria was significantly asso-

[erythema induratum (EI)], micropapular (lichen scrofu-

ciated with age, gender and family socioeconomic class.

losorum).

Haematuria increased with increasing age of subjects.

( χ =23.09, p=<0.0001), more in males (4.0%) than fe-

Methods: Case report and MEDLINE (Pubmed) search

males (1.1%) ( χ =12.42, p=0.0004), and more in chil-

of the English literature using the words ‘papulonecrotic

dren from lower socioeconomic class (3.6%) ( χ =8.06,

tuberculid’, ‘simultaneous occurrence’ and erythema

induratum’.

p=0.018).

Results: A 4-year-old boy presented with a skin eruption

Conclusion: Significant urinary abnormalities occur

on the arm, abdomen and ears, of two weeks’ duration.

sufficiently in apparently healthy school children. Rou-

Reddish bumps later appeared on the legs. In addition,

tine urine screening may be justified as this would help

the patient had cough, loss of appetite, nausea and mal-

in early identification of those with possible renal abnor-

aise. Examination revealed two types of skin lesions.

malities.

The first consisted of few erythematous papules, with

central necrosis, on the lateral aspect of the left upper

arm, ear helices and trunk. There were also several sym-

P011

metrically distributed non-tender erythematous nodules,

Posterior Urethal Valve at A Paediatric Nephrology

some with necrosis, on the shins and calves. Histology

Unit in South Western Nigeria

of the papules revealed an intense wedge-shaped necro-

1,2

Asinobi AO

1,2

Lawal TA, Ademola AD,

sis with perivascular inflammation in the dermis. Biopsy

of a leg nodule showed extensive dermal and fat necro-

Department of Paediatrics, University College Hospital

Ibadan, Oyo State, Department of Paediatrics, Faculty

sis with granulomatous lymphocytic infiltration. These

findings are compatible with the clinical diagnosis. Hilar

of Clinical Sciences, College of Medicine, University of

and paratracheal adenopathy was found on Xray and

Ibadan, Oyo State

sputum was positive, by polymerase chain reaction

Email: tope_lawal@yahoo.com

(PCR), for Mycobacterium tuberculosis DNA . The pa-

tient was commenced on anti-tuberculosis medications

Background: Posterior urethral valve (PUV) is the most

and subsequently, the lesions have improved.

severe form of obstructive uropathy in the paediatric

Conclusion: We report the concomitant occurrence of

population occurring exclusively in boys. Management

PNT and EI, with confirmed TB, with unusual clinical

of posterior urethral valves is challenging in many parts

features in a young child.

of sub-Saharan Africa. To provide data on Posterior

urethral valves in sub-Saharan Africa, we reviewed the

cases of PUVs seen over a 21-month period.

P010

Methods: Information was obtained from the paediatric

Proteinuria and Hematuria in Apparently Healthy

nephrology unit data base of children admitted with a

Primary School Children in Sabon Gari Local

diagnosis of posterior urethral valve between March

Government Area of Kaduna State, Nigeria

2016 and December 2017.

Results: Twenty-five cases were seen during the study

Odogwu O, Wammanda RD, Akuse RM.

period. Their ages ranged from 3days to 13 years

Dept of Paediatrics Ahmadu Bello University Teaching

(median age24 months). Eight (32%) presented during

Hospital Zaria, Nigeria.

the first year of life and of this number, one (12.5%)

Email: obiomaodogwu@yahoo.com

presented in neonatal period. The commonest cause of

hospital admission was urosepsis, 37.5% of the urine

Background: Proteinuria and /or haematuria may be a

cultures however yielded no growth, and half of the

transient finding in children but when persistent may

cases were due to Pseudomonas aeroginosa. 9(32.1%)

indicate underlying renal disease. Asymptomatic chil-

had surgical intervention (Mohan’s valve ablation or

dren with urinary abnormalities may progress to End

Endoscopic Valve ablation). Thirteen (%) had renal fail-

Stage Renal Disease (ESRD). Early detection of renal

ure. Three of the subjects received dialysis and of this

diseases through screening could help reduce morbidity,

number, two had haemodialysis. The in-hospital mortal-

mortality and associated health costs. This study aimed

ity rate was 12.0%

to determine the prevalence of proteinuria and haema-

Conclusion: PUVs are not uncommon and remain an

turia in apparently healthy children in Sabon Gari Local

important cause of urosepsis and renal failure in the pae-

Government Area of Kaduna State.

diatric population in sub-Saharan Africa. Efforts to

Methods: One thousand, four hundred and thirty-five

further improve outcomes are needed.

(1435) apparently healthy primary school children were

enrolled in the study using systematic stratified sam-

108

P012

Introduction and Objectives: Retention in care is a com-

Successful management of two extremely low birth

mon challenge in paediatric HIV treatment programmes.

weight babies using simple techniques at LAUTECH

This is often aggravated by the high orphan rate among

Teaching Hospital, Ogbomoso – A Case

them. This study described the retention in care status in

a large cohort of HIV-infected children and the effect of

Sayomi BA*, Joel-Medewase VI.*, Onigbinde MO*

orphan status.

*Department of Pediatrics Child Health, LAUTECH

Methods: This was a retrospective cross-sectional study

Teaching Hospital, Ogbomoso.

of a large cohort of HIV-infected children receiving care

Email: calldrbukky@yahoo.com

at the Paediatric HIV programme at the University Col-

lege Hospital, Ibadan. An electronic data base was inter-

Background: Extremely low birth weight (ELBW) in-

rogated to ascertain retention status of HIV-infected

fants are babies born with birth weight less than 1000g

children enrolled at the clinic and their orphan status.

and are usually extremely preterm babies born earlier

Results were summarized using descriptive statistics.

than the gestational age of 28 weeks.

Results: A total of 892 HIV-infected children were en-

Statement of problems: The burden of prematurity is

rolled at the study site over the 7-year period studied.

high globally; this is worse off in the developing coun-

Most were males 476(53.3%) and the mean (SD) age of

tries with poor resources to take care of these babies.

enrolled children was 90.8(58.8) months. Of the enrol-

Prematurity accounts for as high as 28% of neonatal

lees, 365(40.9%) were still in care, 356(39.9%) were on

mortality globally with 90% of these occurring in the

antiretroviral therapy (ART) and 9(1.0%) were yet to

developing countries with poor resources. Survival of

commence ART. 71(8.0%) had died, 2(0.2%) were de-

the preterm babies particularly the ELBW babies has

faulting their due clinic appointment, 85(9.5%) had been

improved in the developed countries with the advent of

transferred, 43(50.6%) of these to adult ART service and

improved technology in the neonatal intensive care unit

42(49.4%) to other HIV treatment programmes. 369

and the introduction of antenatal steroids and surfac-

(41.4%) were lost-to-follow-up, of these 140(37.9%)

tants. This is, however, not the same in developing

were yet to commence ART and 229(62.1%) were al-

countries where mortality of ELBW babies is still very

ready on ART. Among 460 children with documented

high.

orphan status, 53(11.5%) orphans were lost-to-follow-

Cases: We report two cases of ELBW babies weighing

up, compared to 46(10.0%) non-orphans.

650g and 700g delivered at the gestational ages of 26

Conclusion: Retention in care at the paediatric HIV pro-

weeks and 30 weeks respectively which were success-

gramme was low. A significant proportion were lost to

fully managed at LAUTECH Teaching Hospital, Ogbo-

follow-up, among those on ART and those yet to com-

moso. Simple techniques like minimal handling, buccal

mence ART. Orphan status might be a contributing

colostrums, intensive phototherapy and improvised tech-

factor.

nologies, like the bubble CPAP were employed with

monofilament bulb to provide warmth as part of incuba-

tor care. They were discharged at 14weeks and 10 weeks

P014

chronologic age respectively at weight of 2kg and 1.6kg

Neonatal Hypoglycaemia: Prevalence and Outcome

respectively with no obvious neuro-developmental ab-

in Dalhatu Araf Specialist Hospital (DASH), Lafia

normalities.

Conclusion: We conclude that, though there are enor-

Abolodje E, Sirajo B and Ozhe J

mous challenges in the management of ELBW babies

Department of Paediatrics, Dalhatu Araf Specialist

with resultant high morbidity and mortality, when par-

Hospital, Lafia

ticular attention is paid to simple techniques like mini-

Email: efexabo@gmail.com

mal handling, buccal colostrum, intensive phototherapy

and with improvised technologies, like the bubble CPAP

Background: Hypoglycaemia is one of the recognized

and monofilament bulb to provide warmth as part of

medical emergencies in a neonatal unit. The diagnosis of

incubator care, we can reduce the morbidity and mortal-

neonatal hypoglycaemia requires a high index of suspi-

ity of ELBW babies in resource poor settings.

cion due to the fact that it presentation is protean. Early

diagnosis and treatment could prevent long term compli-

cations, and death. The aim of the study was to deter-

P013

mine the prevalence of hypoglycaemia and the associ-

Retention in Care of HIV-infected Children at the

ated risk factors among neonates admitted into the neo-

Paediatric HIV Treatment Programme, UCH

natal unit of DASH, Lafia.

Ibadan: A 7 Year Cohort

Methods: This was a descriptive cross-sectional study

conducted between January 2018 and June 2018. Neo-

1,2

Ogunbosi BO, Adelaja AO,

Brown BJ,

nates admitted into the unit with various medical condi-

1,2

Oladokun RE

tions had their random blood sugar (RBS) done at pres-

Email: tundeogunbosi@yahoo.com

entation using rapid glucose test strip mounted on

Department of Paediatrics, Faculty of Clinical

ACCU-CHEK (Active) glucometer device. Neonatal

Sciences, College of Medicine, University of Ibadan

clinical parameters, maternal clinical parameters and

Department of Paediatrics, University College Hospi-

maternal socio-demographics were recorded based on a

tal, Ibadan

predesigned proforma.

109

Results: A total of 220 neonates were studied out of

gallstones and biliary obstruction.

which 67 neonates had hypoglycaemia ( ≤2.6 mmol/l),

Conclusion: Abnormal liver function is common in SCA

giving a prevalence of 30.5%. Hypoglycaemia was sig-

even in the absence of liver disease. Sickle cell hepato-

nificantly associated with preterm neonates, neonates

pathy is rare in children but may present as AHSCC,

who were not on oral feeds at presentation and survival

AHSS and AIHC.

outcome (p<0.05).

Conclusion: Hypoglycaemia is a common emergency in

P016

the neonatal unit. Preterm neonates and neonates who

Prevalence, Causes andOutcome of Heart Failure in

were not on oral feeds at presentation were particularly

Children Seen in Irrua Specialist Teaching Hospital

at risk. Mortality was strongly associated with hypogly-

(Isth), Edo State

caemia.

AI Odike, C Kesieme, H Onyerikam, I Onyeke

P015

Department of Paediatrics, Irrua Specialist Teaching

Sickle Cell Hepatopathy: Prevalence and Presenta-

Hospital, Edo, Nigeria

tion in Children with Sickle Cell Anemia seen in

Enugu State University Teaching Hospital, Parklane,

Background: Heart failure is an important cause of mor-

Enugu

bidity and mortality in children in Nigeria. Over the

years, there has been little or no change in the pattern

Eneh CI , Uwaezuoke SN , Amadi OF

and outcome of heart failure among these children de-

Egwuonwu AC , Chukwu CJ

spite advances in diagnoses and treatment of causes of

Paediatric Department, Enugu State University Teach-

heart failure. Most causes of heart failure in Nigerian

ing Hospital (ESUTH), Parklane, Enugu state.

children are preventable and treatable, especially at the

Paediatric Department, University of Nigeria Teaching

early stages.

Hospital, Enugu, Nigeria.

A study of the cases of heart failure presenting in the

Email: zomafrank @ yahoo.com

Emergency Paediatric unit of ISTH over a 36-month

period (January 1 2011 to December 31 2013)was

Background: Sickle cell hepatopathy (SCH) refers to the

undertaken. The aim is to document the prevalence,

range of hepatic pathologies from a variety of hepatic

causes and outcome of heart failure in these children,

insults in Sickle Cell Disease (SCD) patients related to

and create a baseline for future studies.

sickling, multiple transfusions, chronic haemolysis and

Methods: The study was a retrospective study of all

less commonly hepatic infarcts, abscesses, etc. There is

cases of heart failure in children, aged 1 – 180 months,

paucity of published literature on the clinical conditions

diagnosed at the children emergency room (CHER) of

which constitute this entity.

ISTH from January 1 2011 to December 31 2013, inclu-

This study aims to evaluate the clinical and laboratory

sive. Their biodata, presenting features and outcome

evidence of SCH in paediatric SCA patients seen in this

were collected and analyzed by simple statistical meth-

tertiary health institution in South-East Nigeria.

ods.

Methods: The study was a prospective review of 100

Results: A total of 2604 children aged one month to 15

patients on regular follow-up; presenting with icteric

years were seen over this period in the CHER of Irrua

and anicteric hepatomegaly or right hypo-chondrial pain.

Specialist Teaching Hospital ( ISTH). Two hundred and

History of multiple blood transfusions and frequent

thirty seven (9.1%) of them had heart failure. This num-

haemolytic crises were obtained. Complete blood count

ber was made up of 144 males and 93 females, giving a

and blood film, liver function test (LFT), abdomino-

male-to-female ratio of 1.5:1. The ages of the children

pelvic ultrasound scan (USS), hepatitis virus serology

ranged from1 month to 180 months(15 years) and the

and serum ferritin were requested.

mean age was 32.85±37.03months Causes of heart fail-

Results: Thirty (30%) patients had clinical features

ure were anaemia(127,53.57%), acute respiratory infec-

mimicking SCH. Male-to- female ratio was 1:1. Only

tion (ARI)(77,32.49%), congenital cardiac diseases

10/30 (33.3%) patients had complete laboratory results.

(15,6.33%), acquired heart diseases(9,3.8%), sepsis

One (10%) had positive history of frequent blood trans-

(8,3.38%)

and

acute

glomerulonephritis

fusions. Vaso-occlusive crisis (VOC) was the most com-

(1.0,0.42%).Most cases of anaemic heart failure were

mon crisis. All had hepatomegaly with varying degrees

due to malarial anaemia(109,45.99%) Twenty four

of jaundice, while 2/10 (20%) also had right upper quad-

(10.1%)mortalities were recorded among these patients

rant (RUQ) pain. Nine of them (90%) had evidence of

during the period under review. Twelve children were

haemolysis on blood film with no significant haemoglo-

discharged against medical advice and 3 were referred

bin (Hb) drop from steady state levels. Mean Hb con-

on request. The rest made complete recovery.

centration was 6.7g/dl. One patient (10%) had evidence

Conclusion: Heart failure still constitutes a huge disease

of acute hepatic sequestration syndrome (AHSS). A pa-

burden in children in Nigeria. Most of the causes of

tient (10%) had LFT suggestive of acute intra-hepatic

heart failure are preventable. A lot need s to be done by

cholestasis (AIHC) and increased echogenicity on USS.

physicians in terms of prevention, urgent diagnosis,

Eighty percent (8/10) had mild-to-moderate derange-

prompt treatment and follow up if any positive change is

ment of LFT. Only one had evidence of acute hepatic

expected in terms of morbidity and mortality in children

sickle cell crisis (AHSCC) on USS. There were no evi-

with heart failure in Nigeria.

dence of hepatitis B and C infections, iron overload,

110

P017

Background: Dehydration and electrolyte imbalance are

Early Onset Hypocalcaemia Amongst Neonates In

the major causes of morbidity and mortality in children

The University Of Port Harcourt Teaching Hospital

presenting with acute watery diarrhoea. The aim of the

study was to determine the electrolyte abnormalities in

Anolue MA, Jaja TC, Opara PI

under-5 children hospitalized for acute watery diarrhoea

Department of Paediatrics, University of Port Harcourt

in Enugu, Nigeria.

Teaching Hospital, Port Harcourt, Rivers State

Methods: This was a cross sectional study in which un-

Email: mirabelleanolue@live.co.uk

der five children admitted for acute watery diarrhoea at

the Enugu State University Teaching hospital were con-

Background: Hypocalcaemia in newborns is a poten-

secutively recruited. Relevant history and physical ex-

tially life threatening metabolic disturbance. The aim of

amination to determine their various hydration statuses

this study was to determine prevalence of early onset

were obtained. Electrolyte values were determined us-

neonatal hypocalcaemia (EONH) in neonates in the Uni-

ing standard protocols at the hospital laboratory and

versity of Port Harcourt Teaching Hospital (UPTH) and

compared with standard reference. Data was analyzed

some predisposing Perinatal factors.

using SPSS version 20.0, while the level of significance

Methodology: This cross-sectional study was done in

was set at P < 0.05.

neonates seen in UPTH. Single serum ionized calcium

Results: A total of 108 children aged 3-59 months were

levels in neonates aged 0 to 72 hours was determined by

studied, with a male to female ratio of 1:1. Majority

ion selective electrode potentiometer. Information on

(101, 93.5%) were under 24 months of age. Metabolic

mother and baby were obtained using a structured pro-

acidosis was the most common electrolyte abnormality

forma.

followed by hyponatraemia, hypokalaemia, hyper-

Results: Three hundred and eighty-four neonates were

chloraeamia, hypochloraemia and hypernatraemia either

studied over six months. Two hundred and one (52.3%)

isolated or in combination. Acidosis, was significantly

were males. Mean age of 24 ± 19 hours and a median

associated with age less than 12months (p = 0.014),

age of 18 hours. Two hundred and eighty-one (73.2%)

while hyponataemia was significantly associated with

were delivered at term with a mean gestational age of

diarrhoea duration more than 7 days (p = 0.044). There

37.99 ± 2.36 weeks. Mean birth weight was 3.15 ± 0.69

were 13 deaths giving a case fatality rate was 12.04%.

Kg.

Hypernataemia (p = 0.037) and hypokalaemia (p =

The mean serum ionized calcium level was 1.24 ±

0.004) were significantly associated with mortality.

0.24mmol/l and lowest in neonates aged 25 – 48 hours

Conclusion: Electrolyte abnormalities are common in

(p=0.0001). Sixty-two neonates (16.1%) had hypocal-

children with acute diarrhoea. There is need for manda-

caemia with 12(11.7%) preterm and 50(17.8%) term

tory testing of electrolyte status in children presenting

babies. Seven (43.8%) severely asphyxiated babies had

with diarrhoea

hypocalcaemia (p value=0.002). There was no statisti-

cally significant association between gestational age at

birth, sex, birth weight and associated maternal morbid-

P019

ities with occurrence of EONH (p=0.61), (p=0.69, p

Systemic Lupus Erythematosus in A Nigerian Child:

=0.2, p=0.345 respectively). Fifteen (24.2%) neonates

Challenges of Diagnosis

with EONH were symptomatic.

Bakare RR, Katibi OS, Abdulkadir MB, Issa A

Conclusion: The prevalence of EONH in this study was

16.1%. Mean serum calcium level was lowest in babies

Ameen-Ikoyi I

aged 25-48hours. EONH was significantly commoner

Department of Paediatrics, University of Ilorin

in neonates with severe birth asphyxia. Presentation was

Teaching Hospital, Ilorin

largely asymptomatic. Screening for early detection is

Department of Paediatrics, University of Ilorin/

advocated.

University of Ilorin Teaching Hospital, Ilorin.

Email: straight2baks@yahoo.com

P018

Background: Systemic lupus erythematosus (SLE) is a

Electrolyte Abnormalities in Hospitalized

chronic autoimmune disease characterized by multisys-

Under-Five Children with Acute Diarrhoeal Disease

tem inflammation. It is uncommon in children and diag-

in Enugu, Nigeria

nosis may be challenging as highlighted in this report.

Case Report: An 11year old female adolescent presented

Eke CB, Edelu BO*, Ndu IK, Uleanya ND, Ekwochi

with 3-week history of high grade fever, non-specific

U, Chinawa JM, Amadi FO, Nwokoye IC

limb pain and widespread skin rash on the face, trunk

Department of Paediatrics, University of Nigeria

and limbs. At presentation, she was pale with significant

Teaching Hospital, Enugu, Nigeria.

mandibular and axillary lymphadenopathy and presence

Department of Paediatrics, Enugu State University

of oral ulcers.

Teaching Hospital, Enugu, Nigeria

She was managed for sepsis with a possible drug erup-

Department of Paediatrics, Federal Teaching Hospital,

tion to keep in view SLE and was commenced on intra-

Abakaliki, Nigeria

venous antibiotics. While on admission she did not re-

Email: onyedelu@yahoo.com

spond to antibiotics as the symptoms persisted. She also

convulsed and blood pressure was elevated on 5 day of

111

admission. Subsequent clinical findings and cardiovas-

creating unnecessary anxiety to the patient. Duration of

cular evaluation suggested a pericarditis and infective

service (< 5years) was the only independent predictor of

endocarditis. Serial blood cultures revealed no growth.

good knowledge on AEFI.

Antinuclear antibody tests and other immunologic tests

Conclusion: Majority of the RISP in the study area had

ordered could not be done because of financial con-

good knowledge and reporting practices on AEFI. How-

straints. Full blood count and X-ray of the joints were

ever, knowledge gap still exists; highlighting the need

normal but ESR was elevated. As a last resort to make a

for continuous on-the-job training and retraining of

definitive diagnosis of SLE, funds were raised for a lu-

these personnel.

pus band test which showed lupus erythematosus cells

on blood film and a skin biopsy revealed leukocytoclas-

tic vasculitis, consistent with SLE. She was subse-

P021

quently managed with high dose steroids with resolution

Socio-Demographic characteristics of Neonates with

of symptoms.

Severe Birth Asphyxia in Awka, Nigeria

Conclusion: This report highlights the myriad features

Emechebe G O , Ejiofor OS , Okoro JC , Ezeogu J

of SLE which can mimic other diagnostic entities. Nec-

essary immunologic tests needed in diagnosis were not

Department of Paediatrics Chukwuemeka Odumegwu

affordable. Making a definitive diagnosis helped in the

Ojukwu University Teaching Hospital Awka.

successful management of this child.

Department of Paediatrics Imo State University

Teaching Hospital Orlu

Email: emechebegeorge@gmail.com

P020

Knowledge, Attitude and Reporting Practices On

Background: Birth asphyxia is a common neonatal dis-

Adverse Events Following Immunization Amongst

order, and is responsible for significant morbidity and

Routine Immunization Service Providers in Primary

mortality. Low socioeconomic status has been associ-

Health Care Facilities of Sokoto State

ated with increased risk of developing severe birth as-

phyxia. The objective of this study was to establish the

Sani UM, *Oche MO, *Raji MO, *Umar A, Jiya NM,

relationship, between severe birth asphyxia and some

Ahmed H

socio- demographic variables of the affected neonates.

Department of Paediatrics, *Department of Community

Methods: This is a retrospective study of 112neonates

Health, Usmanu Danfodiyo University Teaching

with severe birth asphyxia treated at Prime Specialist

Children Hospital, Awka, from 1 Jan 2014 to 31 De-

Hospital Sokoto, Sokoto, Nigeria.

cember, 2015.

Background: Health workers at primary health care fa-

Results: Out of 112 neonates with severe birth asphyxia

cilities (PHCs) are primarily involved with routine im-

used for the study, 60 were males, while 51 were fe-

munization activities including detection, reporting and

males: giving a male: female ratio of 1.2:1. The age at

management of Adverse Event Following Immunization

admission ranged from 1hour to 1week, with a mean of

(AEFI). To undertake such responsibilities effectively,

2days±1.3 days. 371 neonates with birth asphyxia were

seen during the study period, (1 January, 2014 to 31

they need to have good knowledge on AEFI and its

management.

December, 2015). One hundred and twelve (30.2%),

Methods: This descriptive cross sectional study was

were categorized as severe; 60 were males, while 51

conducted among routine immunization health service

were females; giving a male: female ratio of 1.2:1. Ma-

providers (RISP) in PHCs of Sokoto State. A multi-

jority of the neonates (67.7%) were delivered in hospi-

stage sampling technique was used to recruit partici-

tals. Maternity homes, and health centres accounted for

pants from all the PHCs in one selected local govern-

28% of the deliveries; but accounted for [61.9%] of the

ment from each of the three health zones of the State. A

mortalities (P =0.028). Severe birth asphyxia increased

semi-structured self-administered questionnaire was

with decreasing social class. (P = 0.028) Decreasing

used to collect relevant information from eligible partici-

maternal age is associated severe birth asphyxia (P =

pants. Data were entered into SPSS version 20.0 and

0.026).

analyzed.

Conclusion: Low socioeconomic status, decreasing ma-

Results: Of the 285 distributed questionnaires, 258

ternal age and deliveries outside the hospital were sig-

(90.5%) were duly completed and returned. There were

nificantly associated with severe birth asphyxia in

150 (58.9%) males and 108 (49.1%) females, giving M:

Awka.

F ratio of 1.4:1. Mean age of the respondents was 34.24

+ 8.06 years (Range =19-58years). The proportion of

respondents with good knowledge (score >50%) on

P022

AEFI was 164 (63.6%) while those with fair (score 41-

An Audit of Some Prescriptions Written at the Lagos

49%) and poor (score <40%) knowledge were 37

State University Teaching Hospital

(14.3%) and 57(22.1%) respectively. Reporting prac-

BA Animasahun , MO Adekunle , AD Madise-wobo ,

1,2

tices were appropriate in 224 (86.8%) respondents. The

most common method for reporting was by manual fil-

and AB

ing of AEFI forms. Some patients would however, not

Department of Paediatrics, Lagos State University

report an AEFI to avoid being blamed, feeling guilty or

Teaching Hospital

112

Department of Paediatrics & Child Health, Lagos State

Results: A total of 1040 children aged 18 years and be-

University College of Medicine

low were admitted and managed. Males were 661

Email: deoladebo@yahoo.com

(63.6%) while females were 379 (36.4%) with M:F ratio

of 1.7:1. Two hundred and six (19.8%) children were

Background: A prescription is a legal document that

managed for various forms of severe malaria within the

should be carefully prepared. One of the duties of care

period, out of the overall admissions of 1040 within the

which a doctor owes a patient is to write a drug prescrip-

same period. There were 84 mortalities within the period

tion clearly, and failure to do so is negligence.

with severe malaria accounting for fifteen (17.9%).

Methods: The study was prospective and correlational

Cerebral malaria, Severe anaemia, Multiple convulsions

cross-sectional. Prescriptions which were presented over

without coma and Hypoglycemia accounted for 46.7%,

a period of three months at the fee-paying pharmacy of

33.3%, 13.3% and 6.7% respectively.

the Lagos State University Teaching Hospital were au-

Conclusions: Severe malaria still constitutes a major

dited by comparing it with the World Health Organisa-

cause of morbidity and mortality in children. Delays at

tion standard for good prescription. The data were ana-

presentation due to ignorance and poverty are a key hin-

lysed using the statistical package for social sciences

drance as well as delays at the health facility due to in-

(SPSS) version 21.0.

sufficient space, qualified personnel and facilities were

Results: A total of 611 prescriptions were audited. Only

contributory factors.

70% indicated the age of the patients. The strength of

drug was written in only 66.1%. The prescriber’s name

was written in 54%. Information for package label was

P024

documented in 4.3%, less than 20% had the initials or

Experiences of fathers of babies admitted into a neo-

signature of the prescriber. In all, only 0.8% complied

natal unit (SCBU) in Port Harcourt, Nigeria

excellently, 65.8% were good, 29.8% were average

while 3.6% rated poorly. The overall mean score of all

Opara PI*, Alinnor AE**

the prescription was good (7-9) with no significant dif-

Department of Paediatrics University of Port Harcourt/

ference between the departments.

University of Port Harcourt Teaching Hospital

Conclusion: There is a need to develop a standard pre-

Email: peaceibo@yahoo.com.au

scription policy at the Lagos State University Teaching

Hospital that will help in reducing medication errors.

Background: In time past mothers were regarded as sole

caregivers of NICU babies, however the fathers’ role is

now increasingly being recognized. Mothers are in-

P023

volved in providing care such as feeding, hygiene, and

Pattern and Outcome of Severe Malaria Among

kangaroo mother care. Fathers are usually called on for

Children Managed at The Emergency Paediatrics

medical bills and usually enter the neonatal unit for ob-

Unit of a Tertiary Health Institution in North Cen-

servational visits. We explored experiences of father’s

tral Nigeria

whose infants were managed in, and had been dis-

charged from the SCBU of UPTH, Port Harcourt, Nige-

Simon CL , Bello SO , Abolodje E , Ikekwe MK , Ugwu

ria.

Methods: This was a cross sectional study carried out in

1. Department of Paediatrics, Dalhatu Araf Specialist

the neonatal clinic of UPTH over a period of 10 weeks.

Hospital, Lafia Nasarawa State

Participants were fathers who had brought their babies

Email: Surajudeenbello4@yahoo.com

for follow up. Information obtained using interviewer

administered questionnaires included biodata, occupa-

Background: Severe malaria is a life threatening mani-

tion and experiences during their babies’ stay in SCBU.

festation of malaria caused by protozoan parasite with

Results: There were forty participants. Eighteen (45.9%)

asexual plasmodium falciparum being the culprit most

babies spent 8-21 days in hospital. 33 (82.5%) fathers

times. It has remained a disease of public health impor-

had family support. 25 (62.5%) found the experience

tance in view of its contribution to morbidity and mor-

stressful, 5 (12%) confusing, 4 (10%) frightening. Four-

talities especially among children. The World Health

teen (35.1%) reported disruption to family life. Twenty-

Organization (WHO) affirms that more than 60% of

two (55%) reported disruptions in social activities like

malaria and its severe forms occurred in Africa and

clubs and visitations. Eight (18.9) and 10 (27%) had

about 80% of its mortalities seen in the same region.

problems at work and lost money respectively. In 27

This study set out to determine the prevalence of severe

(73%), the experience brought them closer to their part-

malaria, forms of severity as well as its outcome among

ners, while 16 (43.2%), reported that less attention was

children admitted at the Emergency Paediatrics Unit

given to other children. 33 (82.5%) received enough

(EPU) of the Dalhatu Araf Specialist Hospital (DASH)

information about their babies, mostly from doctors

Lafia North – Central Nigeria.

(70%). Staffs were reported as friendly by 29 (78.4%)

Methods: A retrospective descriptive hospital based

Conclusion: Fathers found the SCBU experience stress-

study was done from 1st September 2017 to the 31st

ful and need to be given more support in and outside the

August 2018. Patients register and folders were used to

hospital.

retrieve some relevant information that included Demo-

graphic data, clinical signs and outcome.

113

P025

and outcomes in a level three neonatal care unit in Nige-

Comparative study of locally fabricated photother-

ria, and consider priority tasks for improvement of care

apy machines in the management of significant neo-

in our facility.

natal hyperbilirubinaemia

Methodology: This is a retrospective review of the ad-

mission and discharge statistics of the special care baby

Ogunlesi TA, Ayeni VA, Ogunfowora OB.

unit (SCBU), University of Abuja Teaching Hospital,

Department of Paediatrics, Olabisi Onabanjo University

which was carried out over a period of two years, span-

Teaching Hospital, Sagamu, Nigeria

ning from September 2016 to August 2018. Data were

Email: tinuade_ogunlesi@yahoo.co.uk

acquired from the unit records book for admissions and

discharge, and were analyzed using SPSS version 21.

Background: One of the challenges of managing signifi-

Results: A total of 1430 neonates were admitted over

cant neonatal hyperbilirubinaemia in resource-poor set-

the period under review of which 812 were males and

tings is limited access to effective imported photother-

618 were females with a M: F ratio of 1.3:1. Six hun-

apy machines hence the need to embark on a trial of

dred and two neonates of the total admissions were pre-

appropriate technology.

terms (42.1%) while 828 (57.9%) were term. Common

Methods: A cohort of babies with significant hyper-

reasons for admission were neonatal infections (sepsis,

bilirubinaemia managed with locally fabricated photo-

meningitis, and congenital pneumonia), perinatal as-

therapy machines (2014-2016) were compared with his-

phyxia, neonatal jaundice, congenital malformations,

torical controls managed with conventional photother-

surgical conditions and other illnesses. Of these cases,

apy machines (2007-2010) for severity of hyper-

the commonest were sepsis (50.2%) for preterms; jaun-

bilirubinaemia and requirements for Exchange Blood

dice (28.4%) and asphyxia (24.8%) for term neonates.

Transfusion.

The mortality rate was 21.8%, with prematurity account-

Results: A total of 96 babies in the subject group and

ing for 67% of the total mortality, and severe perinatal

202 babies in the control group were studied. The babies

asphyxia accounted for 49% of the mortalities among

in both groups were comparable in age, sex and gesta-

term neonates.

tional age. The proportion of babies with peak TSB

Conclusions: The morbidity and mortality indices re-

>30mg/dl was significantly higher among the controls

main similar to neonatal morbidity /mortality statistics

compared to the subjects (p < 0.001). The interval be-

within our sub region. However, improvement in neona-

tween the commencement of phototherapy and the peak

tal care with emphasis on infection prevention

TSB was greater than 1 day among 30.2% (29/96) sub-

(scrupulous hand washing), health education on im-

jects compared to 74.3% (150/202) babies in the control

proved health seeking behavior- utilization of antenatal

group (p < 0.001). The mean duration of phototherapy

facilities as well as hospital deliveries will significantly

was significantly shorter for the subjects compared to

improve the morbidity and mortality statistics.

the controls; 5.4 ±2.6 days Vs 8.5 ± 2.7 days (p <0.001).

EBT was performed for 38.5% of the subjects and

51.5% of the controls. Single sessions of EBT were re-

P027

quired for 78.4% of the subjects compared to 45.2% of

Plagiarism: A Cross-Sectional Survey Of Awareness

the controls (p = 0.001). All the 20 subjects with ABE

And Knowledge Of Child Health Workers And

arrived at the hospital with the complication while 0.9%

Trainees

of the controls developed ABE after hospitalization.

1,2

Diaku-Akinwumi IN,

1,2

Conclusion: The locally fabricated phototherapy

Ubuane PO,

Animasahun BA,

Ogunleye AM, Akinola AO

machines were effective in the management of signifi-

cant hyperbilirubinaemia.

Department of Paediatrics, Lagos State University

Teaching Hospital, Ikeja, Lagos, Nigeria.

Department of Paediatrics & Child Health, Lagos State

P026

University College of Medicine, Ikeja, Lagos, Nigeria.

Pattern of Admissions and Outcome in The Special

Dr PO Ubuane, Department of Paediatrics Lagos State

Care Baby Unit Of University Of Abuja Teaching

University Teaching Hospital, Ikeja, Lagos, Nigeria.

Hospital, Gwagwalada: A Two Year Retrospective

Email: peterubuane@gmail.com

Study

Background: Plagiarism is intentional, or unintentional,

Jibril AO, Olateju EK, Ajanaku IT, Airede KI.

reproduction of an author’s works without appropriate

Department of Paediatrics, University of Abuja

acknowledgement. It includes, but is not limited to,

Teaching Hospital, Gwagwalaga, FCT.

‘verbatim copying without quotation marks and appro-

Email: mazaiamina@hotmail.com

priate referencing’ or ‘verbatim copying, changing few

words but maintaining sentence structure.’ Inadequate

Background: Sepsis, Asphyxia and Prematurity remains

knowledge and practice of aspects of plagiarism has

the commonest causes of morbidity and deaths in the

resulted in embarrassing punishments of researchers,

neonatal period in developing countries. Understanding

including in Nigeria. However, the knowledge of plagia-

why this pattern persists should drive policies to im-

rism among health-workers in Nigeria is unknown.

prove neonatal morbidity and mortality statistics.

Methods: Researcher-designed, self-administered ques-

This paper aims to delineate the patterns of admission

tionnaire was filled by conveniently-sampled attendees

114

at the 46 Annual Conference of Paediatric Association

who sought healthcare from a health facility for mental

of Nigeria (PANConf), Abuja, Nigeria in January, 2018.

health problems least perceived the received health ser-

The questionnaire had eight questions on various forms

vices as adolescent-friendly. Expected characteristics of

of plagiarism. The number of correct answers scored

health services by the adolescents were adolescent-

(Knowledge Score, KS) was graded as ‘poor’ (<4),

specific health clinics, friendly health care providers and

‘intermediate’ (4- 6) and ‘good’ (>6).

affordable cost of treatment.

Results: Respondents (n=103) included consultants

Conclusion: Adolescents in Ibadan currently view re-

(56.3%) and residents (24.3%). Most (95%) were aware

ceived health services as adolescent-friendly. However,

of plagiarism for a median (IQR) duration of 10.0 (9.0)

the management of mental health problems in adoles-

years. Mean KS was 5.3 ± 1.6. KS was ‘intermediate’

cents should incorporate adolescent friendly elements

and ‘poor’ in 65.6% and 14.6% of respondents, respec-

entrenched at every level of the health system.

tively. Only six respondents (6.2%) correctly answered

all eight questions. KS was not associated with age

(p=0.629), sex (p=0.394), residency training (p=0.325),

P029

number of publications (p=0.642), awareness of plagia-

Skin Disorders in A Referral Paediatric Dermatology

rism (p=0.912) or prior training on plagiarism

Clinic in Nigeria

(p=0.811).

Katibi O.S, Oyedepo J.T, Issa A, Arinde B, Ojuola O

Conclusion: Despite high awareness of plagiarism, ma-

jority of paediatrics residents and consultants had inter-

Department of Paediatrics, University of Ilorin & Uni-

mediate knowledge of plagiarism which put them at risk

versity of Ilorin Teaching Hospital, Ilorin, Kwara State,

of committing it. Training units need to conduct robust

Nigeria.

formal training in ethical writing, formulate written anti-

Department of Paediatrics, University of Ilorin Teach-

plagiarism policy and deploy plagiarism software as

ing Hospital, Ilorin, Kwara state, Nigeria

deterrence.

Email: jadesolaoyedepo@yahoo.com

Background: Skin disorders are common problems in

P028

children that can be easily managed. Some disorders

Perception About Adolescent-Friendly Characteris-

however may not be easily diagnosed or managed, hence

tics of Healthcare Services Received By In-School

referrral to specialists for management. A review of skin

Adolescents In Ibadan, Nigeria

disorders seen at a tertiary paediatric dermatology was

carried out.

Adeleke OA and Balogun FM .

1,2

Methods: A retrospective audit of children less than 19

Institute of Child Health, College of Medicine,

years of age referred to the paediatric dermatology clinic

University of Ibadan, Nigeria

of the University of Ilorin Teaching Hospital between

University College Hospital, Ibadan, Nigeria

March 2010 and April 2018. Relevant demographic in-

Email: folushom@yahoo.com

formation and clinical history pertaining to the skin dis-

order were recorded and data was analysed with SPSS

Background: Adolescents are predisposed to risky

version 20.0.

health behaviours which expose them to health prob-

Results: A total of 511 patients were reviewed and 605

lems. The adolescent-friendly model helps to create ado-

dermatologic diagnoses were made Dermatitis, 186

lescent-responsive health systems; Nigeria currently has

(36.4%)was the most common category of skin disorder

no country-specific report on the adolescent-friendly

seen, followed by infections/infestations, 144 (28.2%)

characteristics of the health services rendered to her ado-

and urticaria 60 (11.7%). Atopic dermatitis (19.6%),

lescents. This study identified various health problems

seborrheic dermatitis (10.8%) and viral warts (10.4%)

for which in-school adolescents in Ibadan North-East

were the leading specific diagnoses.

Infections/

Local Government Area sought healthcare, determined

infestations occurred more frequently among preschool-

their perception of received healthcare services with

ers ( p <0.05) while adolescents had more disorders of the

regards to its “adolescent - friendliness” and explored

skin appendage ( p =0.004).

their expected characteristics of healthcare services.

Conclusion: This study highlights the frequent skin dis-

Methods: This was a school-based cross-sectional study

orders seen in a paediatric dermatology clinic in Nigeria.

that utilized mixed method design using concurrent tri-

Some of the disorders were chronic while some of them

angulation. Three-staged sampling technique was em-

were uncommon dermatoses that needed specialist care.

ployed to select 500 students for school survey while

purposively selected students participated in four FGDs.

Questionnaires was used to collect quantitative data,

P030

while the FGDs were digitally recorded. Descriptive

Outcome of multiple gestations in a Special Care

statistics and Chi-square test at α=0.05 were used for

Baby Unit in Port Harcourt,Nigeria

quantitative data analysis. Thematic analysis was used to

analyse qualitative data.

Opara PI*, Eneh AU**

Results: Perceived malaria (52.4%), acne (36.2%) and

Department of Paediatrics, University of Port Harcourt/

menstrual pain (17.0%) were the common health prob-

University of Port Harcourt Teaching Hospital

lems adolescents sought health care for. Adolescents

Email: peaceibo@yahoo.com.au

115

Background: The incidence of twin and higher-order

toms attributed to teething were fever (81.4%), reduced

multiple-gestation births is on the increase because of

appetite (62.0%), diarrhoea (60.9%) and vomiting

new treatments for infertility. Such births, worldwide

(57.0%). However, some believe that teething is associ-

are known to be associated with a substantially higher

ated with convulsion (19.8%), mouth ulcers (13.4%), ear

risk of morbidity and mortality compared to singletons.

discharge (13.2%), cough (8.5%), gum bleeding (8.3%),

The study aimed at determining morbidities and out-

and no symptoms (7.9%). Majority of the mothers

comes of twins and higher multiples admitted into a

(72.5%) believe that teething requires treatment.204

Special Care Baby Unit (SCBU) in Port Harcourt, Nige-

(39.5%) of the mothers had given their children oral

ria.

analgesics for teething while 128 (24.8%) administered

Methods: This was a retrospective review of data of

oral antibiotics; these medications were more likely to

twins and higher order multiples admitted into the

be prescribed at the hospital or purchased over the

SCBU of a tertiary hospital in Port Harcourt. Records

counter (p<0.01). Treatment given at home for teething

spanning over a 36-month period were retrieved. Infor-

include antitussives 131(25.4%), tepid sponging 82

mation obtained included biodata, morbidities, duration

(15.9%), anti-diarrhoeal drugs 76(14.7%), herbal con-

of admission and outcomes.

coction 46(8.9%), soothing paste 26(5.0%), enema 17

Results: There were 49 sets of twins and 6 sets of trip-

(3.3%), ice packs 15(2.9%), scarification of the body 14

lets resulting in 115 babies and constituting 7.9% of unit

(2.7%), gum fomentation 14(2.7%) and gum incision 12

admissions. There were 59 males and 56 females (M: F

(2.3%). Responders who attributed convulsion to teeth-

= 1: 1.1). Eighty-one (70.4%) were preterms. Sixty-one

ing were more likely to have incised their children’s

(53%) were admitted within one hour of birth. Prematur-

gums (p<0.01).

ity was the commonest reason for admission. Associated

Conclusion: This study revealed that sundry symptoms

morbidities were low birth weight, neonatal sepsis and

were attributed to teething and harmful home interven-

neonatal jaundice. Eighteen (15.6%) died while 16

tions were done for teething. There is a need to educate

(13.9%) discharged against medical advice, for financial

the society on teething and discourage harmful practices

reasons. Preterms had significantly longer hospital stay

for teething by caregivers.

(p = 0.005). Mortality was higher in babies born outside

the hospital and in extreme low birth weight babies.

Conclusion: Prematurity and its sequelae are common in

P032

multiple gestations. Education of mothers on the need

Risky Healthcare Practices Associated With Blood

for antenatal care and birth in specialized centers and

Borne Viruses Among Care Givers Of School Chil-

subsidizing healthcare services for preterms is important

dren In Nnewi, South – East Nigeria

to improve outcomes.

Ofiaeli OC, Ebenebe JC, Egbuonu I, Ezeama N

Nwaneli EI., Nri-Ezedi CA., Obichukwu NG

P031

Department of Paediatrics, Nnamdi Azikiwe University

Perception of Teething and Interventions by Mothers

Teaching Hospital, Nnewi, Anambra state.

In Ekiti

Department of Community Medicine, Nnamdi Azikiwe

University Teaching Hospital, Nnewi, Anambra state.

Olatunya OS ; Fadare JO ; Fatunla OAT , Babatola

1,2

Email: ofiaeliogochukwuchioma@gmail.com

AO , Olajuyin OA ,

1,2

Department of Paediatrics, College of Medicine, Ekiti

Background: Risky healthcare practices are those activi-

State University, Ado-Ekiti

ties that caregivers engage in while attempting to pro-

Department of Paediatrics, Ekiti State University

vide healthcare for their children/wards which increase

Teaching Hospital, Ado-Ekiti

the chances of acquiring various blood borne viruses by

Department of Clinical Pharmacology and Therapeu-

these children. This study was carried out to determine

tics, College of Medicine, Ekiti State University, Ado-

the risky healthcare practices among care givers of

Ekiti

school children in Nnewi, South-East Nigeria.

Department Ear, Nose, and Throat, Ekiti State Univer-

Methods: This was a cross-sectional study involving

sity Teaching Hospital, Ado Ekiti

caregivers of school children from public and private

Email: simeon.olatunya@eksu.edu.ng

nursery, primary and secondary schools across the four

autonomous communities in Nnewi. A pretested self-

Background: Teething is a physiologic process that be-

administered questionnaire was used for data collection.

gins during infancy. However, some mothers often at-

Results: Caregivers to 618 school children were studied.

tribute some symptoms to teething. In this study, we

Forty – six (7.4%) of the caregivers acknowledged that

their children had been transfused but a 3 of the time,

assessed the opinions and practices of mothers on teeth-

ing.

the blood was either unscreened or of unknown screen-

Method: This was a cross-sectional questionnaire based

ing status respectively. Sixty - one (9.9%) of the care-

study conducted among caregivers who brought their

givers had given their children/wards scarification marks

children to the out- patients’ department of the EK-

for various illnesses. Sixty percent of the time, the

SUTH.

marks were given with a razor and 30.9%, it was made

Results: In all, 516 mothers with a median age of 32

with a needle. Most of the children had received injec-

(range 19 – 63) years were studied. The leading symp-

tions (608, 98.4%) for various reasons but up to 26

116

(4.2%) of these were in a patent medicine store and the

orientation and education.

needles used were got from a solution/container and not

fresh from the packet in as much as 3.6% of the time.

Socio – economic class and maternal educational level

P034

had a significant association with where these injections

Trend, Prevalence and Challenge Associated with

were given (p = 0.014 and 0.011 respectively).

Preterm Newborns in Resource Constraints Setting,

Conclusion: Maternal educational level and socio –

Maiduguri, North-Eastern Nigeria

economic class play key roles in risky healthcare prac-

Mustapha Bello , Simon Pius , Bello Abdullahi

tices. There is the need to intensify awareness measures

Ibrahim

against these practices as well as increase advocacy for

subsidized child health services.

Department of Paediatrics, College of Medical Sci-

ences, University of Maiduguri

Email: simonpius2000@yahoo.co.uk, si-

P033

monp@unimaid.edu.ng

Attitude and Perceptions of Child healthcare Practi-

tioners in Nigeria to Autopsy Practice

Background: Prematurity or preterm births (PTB) are

babies born before 37 completed weeks after the last day

Okechukwu C,

Ideh RC.

last menstrual period (LMP). Worldwide more espe-

Department of Paediatrics and Child Health, Univer-

cially Africa, the prevalence of preterm births has in-

sity of Port Harcourt Teaching Hospital, Port Harcourt,

creased to 56.7% over the last decade. With improve-

Rivers State, Nigeria

ment of neonatal care, preterm babies are now single

Department of Paediatrics, University of Benin

most important causes of under-five death and long-term

Teaching Hospital, Benin, Edo State, Nigeria.

disability worldwide.

Email: chiomaokechukwu412@gmail.com

Study Objective: The aim of the study was to determine

the trend, prevalence and challenges of preterm babies at

Introduction and objectives: There has been a gradual

University of Maiduguri Teaching hospital, Maiduguri,

decline in interest in postmortem audit worldwide de-

North-eastern Nigeria.

spite the enormous potential values of the autopsies. In

Patients and Methods: A retrospective study done at

many paediatric centres across Nigeria, there is no pol-

Special Care Baby Unit (SCBU) of the Paediatrics De-

icy providing the use of autopsy statistics in the main

partment of the University of Maiduguri Teaching Hos-

pital, Maiduguri over an eight-year duration from 1

business of paediatric practice or as a means of assessing

January 2008 to 31 December 2015.

a centres’ performance. Even where such policy exists,

there is no compelling law for the incorporation of the

Results: There were 3435 admissions during the study

statistics into daily paediatric practice. This study set out

period, out of these 1129/3435 (32.86%) were preterm

to survey the attitude and perception of child healthcare

babies giving a prevalence of 32.9%. Males were 372

practitioners in Nigeria towards post-mortem examina-

(52.1%), while females were 342 (47.9%); he male to

tion in improving patients care.

female ratio of 1:1.08. Regression analysis with p –

Materials and Method: A cross-sectional descriptive

value < 0.1, factors including GA (P = 0.033), birth

study was done on participants attending a paediatric

weight (p = 0.024), duration of incubator care (p =

conference in Abuja, Nigeria. There were 250 respon-

0.001), place of delivery (p = 0.034) and APGAR score

dents, who cut across the six geopolitical zones of Nige-

at 5 minutes (p = 0.018) showed independent prediction

ria, consisting of paediatric consultants, residents and

of PTBs outcomes.

nurses. The study was done using self-administered

Conclusion: The babies who had incubator care were

questionnaires and data analysed using SPSS version 20.

about 3.5 times and 6.2 times respectively more likely to

Results: All (100%) participants believed autopsy prac-

survive. PTBs born without asphyxia (Apgar score at 5

tice was valuable and had a positive effect on medical

minute >7) were about 2.3 times more likely to survive

practice. Sixteen (6.4%) respondents never request for

the first six weeks of life.

autopsies, 120 (48.0%) respondents request for it rarely,

34 (13.6%) make a request often while 10 (4%) request

for autopsies very often. Eighty-four (33.6%) respon-

P035

dents have never attended an autopsy session. The inter-

Sedation Practice during Paediatric Electroencepha-

val between autopsies and issuance of reports ranges

lography (EEG) in Nigeria

from 0-3 weeks (48.0%) to > 6 weeks (8.8%). The usual

OE Olorunmoteni Saheed BA. Oseni , Oluwasola J

indications for requesting for autopsies include knowing

OKE

the cause of death (85%), inability to arrive at a clinical

diagnosis antemortem (71.2%) and improving clinical

Department of Paediatrics and Child Health, Obafemi

diagnosis skill and patient care (60.0%).

Awolowo University (OAU), Ile-Ife.

Conclusion: Autopsy practice is useful in paediatric

Email: doc_tosino@yahoo.com

practice but it is rarely requested for and infrequently

attended by the child healthcare practitioner. There is a

Background: Electroencephalography (EEG) is a neu-

need to change the attitude and perception of all health-

rologic procedure which requires patient co-operation

care workers in paediatric practice through proper

especially in Paediatrics. This is usually obtained

117

through induced sleep either by prior sleep deprivation

eye problems, 634 (80.1%) had surgical procedures and

or with the use of sedatives. Studies are lacking on the

158 (19.9%) had conservative management.

sedation practices when conducting Pediatric EEGs in

The mean age of the respondents was 7.06±4.89 with

Nigeria.

(minimum and maximum age of 1 and 17) years respec-

Objectives: To determine the knowledge and practices

tively. The mean ages of males and females were

of Neuroscientists in Nigeria concerning sedation during

7.52±4.59 years and 6.47±4.29 (with minimum and

EEG.

maximum age of 1 and 17) years respectively. This dif-

Methods: This questionnaire based survey was con-

ference was significant (p = 0.000). The mean number

ducted among Neuroscientists practicing in practice in

of days spent on admission by the respondents was

Nigeria who attended the Annual Conference of the Ni-

7.0±4.0 (with minimum and maximum of 1 and 22) days

gerian Society of Neurological Sciences in 2017 and the

respectively.

Paediatric Association of Nigeria Conference held in

Conclusions: A sizable portion of children with eye

2018.

problems in University College Hospital were of con-

Result: There were 70 respondents comprising of 30

genital origin. Since the prevalence of eye problems

(42.8 %) Consultants; 14 each in Adult neurology and

among children is high, it calls for public health concern

Paediatric neurology units respectively. In addition,30

in other to salvage the sight of our future generation

(42.8) Resident doctors and 10 (14.3) EEG Technolo-

gists were recruited. More than three-quarter (81.4 %) of

the respondents practice in a public, tertiary hospital and

P037

EEG is available at the centre of practice of 57 (81.40%)

Effect of adherence to follow up on outcome of

of the respondents while only 49 (70.0) do paediatric

Paediatric nutrition clinical trial

EEG. About 81.4% had a prior knowledge on sedation

Udoh, EE , Edem KB , Umoh RA , Okpokoworuk FS ,

during EEG though only 42(60.0) use sedation before

Nwazuluoke BN , Udo EN , Motilewa OO

EEG. Chloral hydrate is the most commonly (42.8 %)

Paediatrics Department, Dietetic Unit, Department of

used medication among those who use sedation. Only 5

Internal Medicine, and Community Health Department,

respondents involve Anaesthesiologists in Pre-EEG se-

dation while availability of equipment for resuscitation

University of Uyo Teaching Hospital, Uyo, Akwa Ibom

in the procedure room was reported in only 38.6 % of

State, Nigeria

respondents.

Email: rejoicerejoice2001@yahoo.com

Conclusions: There is a need to pay attention to the type

of sedative use and patient safety during EEG. Non-

Introduction: Paediatric nutrition clinical trial is the em-

pharmacologic measures to achieve patient co-operation

pirical evaluation of the effect of nutritional formula-

may be more effective.

tions in children. Adherence to follow up is crucial to

outcome. This study was aimed at determining the effect

of adherence to follow up on outcome of paediatric nu-

P036

trition trial.

Prevalence of Eye Problems among Children in Eye

Materials and Methods: A cluster randomized clinical

Ward in University College Hospital, Ibadan Oyo

trial was conducted between May 2016 and April 2017

State Nigeria

in Akwa Ibom State. Eligible children aged 6 – 59

months with moderate acute malnutrition (MAM) re-

Enwezu FK, Fakayode OA, Oluwatunmise TW, Bello T,

ceived supplementary ration of standardized milk-based

Ladun-Oluroye OO, Akinboade BO

formulation (SMBF), standardized non-milk based for-

University College Hospital, Ibadan, Oyo State, Nigeria.

mulation (SNMBF) or hospital-based formulation

Email: enwezuflorencekehinde@gmail.com

(HBF) at 50% of their daily caloric requirement for four

months. A two weekly follow up with clinical and an-

Introduction: Eye problems affect the whole spectrum of

thropometric assessment was performed. Adherence to

the population regardless of age, gender, race and ethnic

follow up was considered good if a patient kept all 16

group. Uncorrected eye problems among children have

weeks’ appointments or poor if there was a default of ≥

severe consequences for the child, family and society.

2 weeks. Comparison of recovery from MAM based on

Objective: To determine the prevalence of eye problems

adherence status at week 16 was the outcome measure.

among children in eye ward, in University College Hos-

It was deemed statistically significant if p-value was <

pital. Ibadan.

0.05.

Methods: In this retrospective study, total case study

Results: Of the 141 evaluable children, 50 received

records of 792 children admitted in the ward between

SMBF, 54 received SNMBF and 37 received HBF.

years 2013 to 2017 were reviewed for analysis. Data

Good adherence to follow up occurred in 36 (72.0%)

were analyzed using SPSS, version 20 software program

children treated with SMBF, 30 (55.6%) treated with

Results: This consisted of 446 males and 346 females

SNMBF and 17 (45.9%) treated with HBF. Adherence

(56.3% and 43.7% respectively). Majority 489(61.7%)

to follow up was significantly higher with the SMBF

than the HBF ( χ = 5.998; p = 0.014). In all, 83 (58.9%)

of the respondents had congenital eye problems

(congenital cataract, retinoblastoma etc.) while the

had good adherence to follow up. Recovery from MAM

remaining 303(38.3%) had acquired eye problems (due

was 70/83 (84.3%) and 44/58 (75.9%) in those with

to trauma, infections etc) Out of the 792 children with

good and poor adherence respectively (P = 0.208).

118

Conclusion: Good adherence to follow up was associ-

witnessed in developed countries.

ated with a higher proportion of recovery from MAM

Aim: To determine how National Health Insurance

than poor adherence though the difference was not sig-

Scheme (NHIS) in Nigeria impacts care for children

nificant.

with malignancies.

Methods: Semi-structured interviewer administered

questionnaire was administered to caregivers of children

P038

diagnosed with malignancies.

Predictors of Neonatal Mortality in A Tertiary

Result: fifty-four percent of the caregivers were females

Hospital in North-Central Nigeria

while 46% were males. Mean age of patients was 7

years. Leading malignancies in children studied were

Abolodje E, Sirajo B and Ozhe J

Nephroblastoma (20%), Burkitt lymphoma(17.1%),

Department of Paediatrics, Dalhatu Araf Specialist

Acute lymphoblastic leukemia(17.1%), Non Hodgkins

Hospital, Lafia

lymphoma (11.4%), Rhabdomyosarcoma (11.4%), Reti-

Email: efexabo@gmail.com

noblastoma (8%), Primitive neuro ectodermal tumour

(5.7%), others (12%). At diagnosis, 20% of the patients

Introduction and Objectives: The neonatal period is the

were enrolled in the NHIS, while 80% were not. Sixty-

most vulnerable time of a child’s life contributing to

eight percent of caregivers did not know about the

almost 50% of under-five mortality. Neonatal mortality

scheme, 7.1% had made unsuccessful attempts to regis-

rate in most developing countries is unacceptably high,

ter their children, 10.7% felt the scheme did not make a

and is a reflection of under-development. Therefore, the

difference in their child’s care and 14.3% were not en-

chances of survival of a newborn can be predicted from

rolled for other reasons including lack of money to reg-

the level of care the mother received during pregnancy,

ister. Average duration of symptoms before presentation

and how readily she can assess health care for her new-

to hospital was 11 weeks. There was a positive correla-

born. The study was aimed at determining the predictors

tion between enrolment of children and the average du-

of neonatal mortality in Dalhatu Araf Specialist Hospi-

ration of symptoms before presentation to hospital (r =

tal, Lafia.

0.3).

Materials and Method: The study was a retrospective

Conclusion: Advocacy is still needed for the NHIS

descriptive hospital based study carried out from Janu-

scheme to cover for complete paediatric oncology care.

ary 2018 to September 2018. The neonatal unit admis-

sion register and patients folders between the said peri-

ods were reviewed, and relevant clinical data, obstetric

P040

data and maternal socio-demographic data were docu-

Spontaneous perforation of cystic duct in a 3-month-

mented.

old Nigerian boy: A case report

Results: A total of 528 neonates were seen in the period

under review out of which 50 (9.5%) died on admission.

Musa S, Ogunsua OO*, Sholadoye TT*, Baba S*, Mado

Causes of mortality were prematurity - 17 (34%); peri-

SM, Idris HW, Abdullahi SM

natal asphyxia - 16 (32%), neonatal sepsis - 10 (20%)

Department of Paediatrics, Ahmadu Bello University

and others (14%). Mortality was strongly associated

Teaching Hospital, Shika, Zaria, Nigeria

with low socioeconomic class, prematurity, neonatal

*Division of Paediatrics surgery, Department of

sepsis (p< 0.05).

surgery, Ahmadu Bello University Teaching Hospital,

Conclusion: Improving the living standard and provid-

Shika, Zaria, Nigeria

ing for prevention and effective treatment of preterm

Email: asmaummama@gmail.com

labour and neonatal sepsis will reduce neonatal mortal-

ity.

Introduction: Biliary ascites due to spontaneous perfora-

tion of the extrahepatic bile duct is a rare condition in

infancy. The cystic duct is the part of extrahepatic bil-

P039

iary tract most rarely affected. Very few cases have been

National Health Insurance for Children in Nigeria:

described in the literature, this is likely to be the first

Impacts On Paediatric Oncology Practice in Nigeria

case of biliary ascites secondary to spontaneous cystic

duct perforation occurring in infancy reported from our

Adefehinti O

1,2

, Babalola TE , Kuti DK , Adeodu O

centre.

Paediatric haemato-oncology unit, Department of pae-

Methods: Consent was obtained from the parents of the

diatrics, Obafemi Awolowo University teaching hospi-

child. Ethical approval was also obtained from the Re-

tals complex, Ile-Ife and

Department of Paediatrics

search and Ethics Committee of Ahmadu Bello Univer-

and child health, Obafemi Awolowo University ,Ile-Ife.

sity Teaching Hospital, Shika, Zaria. The case notes of

Email: tolugifty@gmail.com

the child were summarized and the relevant literature

was reviewed to give the report a context.

Introduction: Pediatric malignancies are becoming more

Results: A three-month-old-boy presented with ten days

prominent in developing countries including Nigeria.

history of jaundice and acholic stool, a week history of

Early diagnosis and treatment, though capital intensive

progressive abdominal distention and a day’s history of

is essential in the management. A good financial support

fever. There was associated bilateral inguinal hernia,

system is important for a good treatment outcome as

excessive cry, refusal to feed and weight loss. Pregnancy

119

history was normal. He was acutely ill-looking, irritable,

complications. The youngest sibling aged 10years is

febrile with an axillary temperature of 37.7 C, mildly

presently ambulant with no echocardiographic evidence

pale, jaundiced with a greenish tinge, had a weight of

of cardiomyopathy.

4.7kg. He had gross ascites and bilateral reducible ingui-

Conclusion: Muscular dystrophy is a rare genetic disor-

nal hernia. Had predominantly conjugated hyper-

der associated with high physical and economic burden.

bilirubinaemia, and deranged clotting profile. Abdomi-

Mortality commonly results from cardio-respiratory

nal ultrasound scan revealed gross ascites.

complications.

Initially, he was managed for sepsis with obstructive

jaundice. Five days into the admission, there was no

significant improvement, bedside abdominal paracente-

P042

sis reveals thick yellow and foamy fluid and the diagno-

A One Year Situational Analysis of the Care of

sis of ruptured choledochal cyst was considered and had

Preterm Babies Managed in The Special Care Baby

exploratory laparotomy. Intra-operatively, the cystic

Unit (SCBU) of The Federal Medical Centre,

duct was perforated just few millimetre from the com-

Yenagoa, Bayelsa State, Nigeria

mon bile duct (CBD), no distal obstruction seen during

CBD exploration. Cholecystectomy and repair of the

Okosun OA, Tunde-Oremodu II, Ujuanbi A, Adighije

CBD was performed and the child did well postopera-

AC, Onwuzurike VU, Uche-Ajunwa P

tively.

Department of Paediatrics, Federal Medical Centre,

Conclusion: Perforated cystic duct though rare, should

Yenagoa, Bayelsa state, Nigeria

be suspected in infants presenting with jaundice, pro-

Email: ofureann@yahoo.com

gressive abdominal distension, acholic stools with or

without fever, and inguinal hernias, with a positive para-

Background: Prematurity remains a significant cause of

centensis. Early diagnosis and prompt surgical interven-

early neonatal deaths in Nigeria so this study determined

tion greatly reduce morbidity and mortality from the

the characteristics of preterm babies, and the clinical

disease.

care that influenced the outcome of preterm admissions

in Federal Medical centre (FMC), Yenagoa.

Methods: Using a structured proforma, data relating to

P041

preterms and the outcome of care was collected in this

Suspected Cases of Duchenne Muscular Dystrophy in

descriptive longitudinal study. Frequencies, means, stan-

three consecutive male siblings

dard deviations and chi square test were used calculated.

Level of significance was set at p value < 0.05

Ahmad MM, Sani UM, Ahmed H, Isezuo KO, Legbo JF,

Results: Preterm babies made up 24.2% of admissions.

Baba J, Mikailu AJ

Preterm survival and mortality rates were 62.4% and

Department of Paediatrics, Usmanu Danfodiyo

17.1% respectively. Most were late preterms (36.8%),

University Teaching Hospital, Sokoto

had low birth weights (51.3%), no perinatal asphyxia

Email: murisbn@yahoo.com

(67.0%), and were delivered via caesarean section

(57.3%). Mean gestational age, birth weight and length

Background: Muscular dystrophy is a rare degenerative

of babies were 32 weeks, 1.67 kg and 40.87cm respec-

muscle disorder inherited by x-linked recessive pattern.

tively. Most mortalities occurred in the first 10 days of

It is due to deficiency of dystrophin protein that main-

admission (14.0%). Leading maternal risk factors for

tains normal skeletal muscle structure and function.

prematurity were premature rupture of membranes and

Objective: To report an unfortunate occurrence of sus-

pre-eclampsia. Gestational age (p< 0.001), birth weight

(p< 0.001), 5 minute Apgar score (p = 0.047), place of

pected Duchenne muscular dystrophy in 3 consecutive

male siblings in a family.

delivery (p = 0.047), mode of delivery (p = 0.036) and

Case presentation: Three consecutive male siblings

length of incubator care (p = 0.034) were significantly

aged 17, 14 and 10years were presented at their early

associated with outcome of care.

childhood, to our Neurology clinic with similar histories

Conclusion: More effort needs to be put in to improve

of abnormal gait, difficulty rising up from lying position

the outcomes for preterm admissions.

and frequent falls while walking. Their symptoms were

first noticed between the ages of 4 and 6years. No simi-

lar history in the two female siblings aged 19 and

P043

7years. Parents are consanguineously married couple.

Typical Presentation of Organophospate Poisoning

On examination, all the patients had calf muscle hyper-

in Bisha, Saudi Arabia: Illustrative Case Series

trophy, positive Gower sign and waddling gaits. Muscle

Adeboye MAN, Elamin MB , Yusuf AA , Shoaib MB ,

creatinine kinase was 7-10 fold elevated. Muscle biopsy

Mohammed EID , Adegboye OA

and Genetic testing could not be done. The two elder

siblings had echocardiographic features of dilated car-

University of Ilorin/UITH,Ilorin; King Abdullah

diomyopathy and worsening gait abnormality. Despite

Hospital, Bisha, KSA+

treatment with inotropes and other anti heart failure

Email: adeboyeman@gmail.com

medications, their ventricular functions worsened pro-

gressively on follow up. They were said to have died

Introduction: Organophosphates were first discovered

suddenly, at home presumably from cardiac related

more than 150 years ago; however, their widespread use

120

began in Germany in the 1920s, when these compounds

children with diarrhea is taken to be N500.

were first synthesized as insecticides and chemical war-

Conclusion: The burden of diarrhea in children is high

fare agents. Organophosphates and carbamates are the

especially among infants, and this can be reduced

most frequently used insecticides worldwide. Their

through promotion of home-based management. This

other use in Bisha include hair treatment which makes

will be both cost saving and an effective way to institute

its poisoning a common finding.

antibiotic stewardship among households.

Methods: Case series involving three cases of organo-

phosphate poisoning were studied and compared. The

parameters assessed were age, gender, source of patient,

P045

premorbid sub-mentality, source of poisoning and out-

Knowledge of Primary Health Care Workers on zinc

come among others.

and low osmolarity ORS for under-five

Results: All the three cases were females aged 5 years

children with diarrhoea in Ibadan

and below. There were lots of similarities in the findings

1,2

based on the above parameters. Two children were con-

Bamidele OS ,

Adediran KI

scious while the third was drowsy at presentation. They

Institute of Child Health, University of Ibadan, Nigeria

were all successfully managed and discharged.

Institute of Child Health, University College Hospital,

Discussion: Many cases of organophosphate poisoning

Ibadan, Nigeria

were successfully treated as they presented early. Fami-

Email: mailolayinkaola@gmail.com

lies freely kept the compound at home or farm, not only

for domestic or farm work but also as hair treatment thus

Introduction and Objectives: Zinc plus low osmolarity

exposing the children to the toxic effects of the com-

oral rehydration salt solution (Zn+LoORS) is the current

pound. The parents were counselled against the use es-

recommendation for management of childhood diar-

pecially for hair treatment. It is hoped that the counsel-

rhoea because it gives improved health outcomes com-

ling would be utilised.

pared with the normal ORS. This is because Zn+LoORS

reduce the duration and severity of diarrhoeal incidence

apart from its rehydration and electrolyte replacement

P044

functions. Nigeria has adopted the current recommended

The epidemiology and economic consequences of

diarrhoeal management policies, but its knowledge by

diarrhoea in children

the primary health care workers (PHCWs) who are the

first line of contact is not known. The aim of this study

Maduka D. Ughasoro , Iwegbulam Chimaobi

is to determine levels of knowledge of Zn+LoORS

1.Department of Paediatrics, University of Nigeria

among PHCWs in Ibadan.

Enugu Campus, Enugu, Nigeria

Materials and Methods: Cross-sectional study was con-

2.Department of Paediatrics, Federal Medical Centre,

ducted in five local government areas of Ibadan me-

Umuahia, Abia State

tropolis. 200 non-medical PHCWs were recruited via

Email: kakatitis@yahoo.co.uk

three-staged sampling technique and information was

obtained with self-administered questionnaire. Key In-

Background: Diarrhea is a major public health problem

formant Interview (KII) of 10 matrons was done. Data

among children with huge health, and economic burden.

was analyzed using descriptive statistics and Chi-square

In this study, the epidemiology, prevalence, and eco-

test at p<0.05.

nomic burden of diarrhea in children were described.

Results: The PHCWs were 7 cadres, mean age

Methods: The medical records of children treated for

40.59±9.90 years, 95.5% females. Correct knowledge of

diarrhea from October 2017 to September 2018 were

Zn+LoORS for child with diarrhoea increased as age

reviewed. Information on their age, medical history, and

increases. Significantly, more of respondents older than

treatment received were abstracted. The direct medical

35 years (74.5%) correctly identified Zn+LoORS for

costs of the management of diarrhea were estimated.

child with diarrhoea compared to younger PHCWs. Cor-

Results: Out of 2199 children admitted in the emergency

rect knowledge of Zn+LoORS was higher among senior

room, 289 (13.1%) had diarrhea. The peak period of

community health extension workers compared to other

diarrhea were January (73/274: 27.6%) and February

cadres. KII revealed that many matrons could not differ-

(87/308: 28.2%) and the lowest incident was in Septem-

entiate between LoORS and ORS.

ber (2/149: 1.3%). Diarrhea was highest (70%) among

Conclusion: The PHCWs level of knowledge zinc and

children under 12 months of age. Males (66.6%) were

LoORS for childhood diarrhoea was low. There is need

more affected than females (33.4%). The socioeconomic

to improve their knowledge to ensure their optimal man-

class 2, 3, and 4 had prevalence of 50%, 37.5% and

agement of childhood diarrhoea.

12.5% respectively. The duration before presentation

was 4.1 days (2.3) and 30% had received treatment be-

fore presenting. Antibiotics was among the medications

given in all (100%) the children studied before attending

hospital, while those that had ORS was 22.2%. The av-

erage cost of treating diarrhea as in-patient was

N22878.4. The mean duration on admission was 2.9

days, based on which an estimated cost of homecare for

121

P046

P047

Benefits and Challenges of Renal Replacement

The Prevalence and Antibiotic Susceptibility Pat-

Therapy in Severe Lassa Fever in Resource-Limited

terns of Methicillin Resistant Staphylococcus aureus

Settings: Case Illustrations and Literature Review

in Postpartum Women and their Newborns in Abuja,

Nigeria

1Adetunji AE, 1Olomu SC, 1Isibor EE, 2Azubuike CO,

Ugboh R , Olayinka OB , Olanipekun G , Ocheikwu

1Mbanefo K, 1Idialu-Eigbobo JO, 3Muebonam EB,

AJ , Uzairue L , Ibekwe E , Egbetade T , Medugu N ,

1,3

1Owobu A C, 3Ogbaini-Emovon E, 4Günther S, 5Ibadin

1,4

Ebruke BE , Obaro S

MO, 2Okokhere PO, 6Akpede GO.

1Department of Paediatrics, Irrua Specialist Teaching

International Foundation Against Infectious Disease in

Hospital, Irrua, Edo State, Nigeria.

Nigeria, Abuja Nigeria

2Department of Medicine, Irrua Specialist Teaching

Ahmadu Bello University, Zaria, Nigeria.

Hospital, Irrua, Edo State, Nigeria.

National Hospital, Abuja Nigeria.

3Institute of Lassa Fever Research and Control, Irrua

University of Nebraska Medical Center, Omaha,

Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

Nebraska, USA.

4Bernhard-Nocht Institute for Tropical Medicine- WHO

Email: ugbohraphael@yahoo.com

Collaborating Centre for Arboviruses and Hemorrhagic

Fever Reference and Research, Virology, Bernhard-

Introduction

and

Objectives:

Methicillin-resistant

Nocht-Str. 74- Hamburg, Germany.

Staphylococcus aureus (MRSA) are a serious public

5Department of Paediatrics, University of Benin/

health challenge. We evaluated the prevalence and anti-

University of Benin Teaching Hospital, Benin, Nigeria.

biotic susceptibility patterns of MRSA in postpartum

6Department of Paediatrics, Ambrose Alli University/

women and their newborns in Abuja, Nigeria

Irrua Specialist Teaching Hospital, Ekpoma/Irrua, Edo

Methods: Vaginal swabs from postpartum women and

State, Nigeria.

throat swabs from their newborns were collected be-

Email: tunjiwale2007@yahoo.com

tween April 2016-March, 2017 in a tertiary hospital in

Abuja. Staphylococcus aureus isolated were identified

Background: Renal replacement therapy (RRT) could be

and antibiotic susceptibility testing (AST) done using

life saving in children with severe Lassa fever (LF) in

standard techniques.

endemic areas but it is attended by several challenges

Results: Overall, 49/1114(4.4 %) mothers and 12/1134

and there are very few reports of the experience. We

(1.1 %) newborns were colonized by Staphylococcus

therefore present illustrative cases of the benefits of

aureus, of which 31 (2.8 %) in mothers and 5 (0.4 %) in

RRT in the treatment of severe LF and discuss the chal-

newborns were MRSA.

lenges involved.

Susceptibility to antibiotics tested were: Clindamycin

Patients and Methods: Descriptive case illustrations plus

(87.8%; 83.3%), Gentamycin (71.4%; 83.0%), Cefoxitin

literature review.

(36.7%; 58.8%), Tetracycline (48.9%; 75.0%), Cipro-

Results: Case 1 was a 7 years old boy with LF compli-

floxacin (57.1%; 83.3%) and Penicillin (6.1%; 0.0%) for

cated by stage III acute kidney (AKI) which failed to

maternal and newbornisolates, respectively. All five

respond to conservative management, but instead devel-

newborn MRSA isolates were sensitive to vancomycin.

oped acute pulmonary oedema, worsening anaemia, hy-

Staphylococcus aureus co-colonization was detected in

pertension and worsening of fluid retention. Following 3

four maternal-newborn pairs, two of which were MRSA.

sessions of haemodialysis on the 9th, 11th and 14th days

In three (75.0%) maternal-newborn dyads with Staphy-

of admission, with intra dialysis blood transfusion given

lococcus aureus co-colonization, there was 100% con-

during the first session, he did well and was discharged

cordance in the antibiotic susceptibility profiles of ma-

for follow up after a 15-days course of ribavirin. Case 2

ternal and newborn S. aureus isolates.

was a 12-year-old girl with who also had stage III AKI

Conclusions: We report a notable carriage prevalence of

and was unresponsive to conservative management. She

MRSA in mothers and newborns in this study. Similar

developed encephalopathy, hypertension, and worsening

AST profiles in maternal and newborn isolates provide

fluid retention but did well with only 1 session of

some evidence of vertical transmission of MRSA in this

haemodialysis with intra-dialysis blood transfusion on

population. Efforts towards the control and prevention

the 4th day on admission. She was discharged for follow

of MRSA colonization could potentially help in reduc-

up after 17 days.

tions in newborn MRSA infection in these settings.

Conclusion: The provision of RRT, a challenge in the

settings of LF outbreaks, could improve survival in chil-

dren with severe LF.

Keywords: renal replacement therapy, Lassa fever