Comparative analysis of glucose-6-phosphate dehydrogenase levels in pre-term and term babies delivered at University of Ilorin Teaching Hospital

Glucose-6-phosphate (G6P) is an enzyme in the hexose monophosphate shunt required for the production of reducing equivalents needed to mop up free radicals. thereby keeping hemoglobin in its free state. Deficiency of the enzyme can cause severe neonatal jaundice. The aim of this study was to compare G6PD levels in pre-term and term babies, and evaluate the extent to which G6PD deficiency determines the severity of jaundice in various gestational age groups. Samples of cord blood collected from consecutively delivered babies in the University of Ilorin Teaching Hospital, Nigeria, were assayed for G6PD levels, and the babies were observed for jaundice during the first week of life. Those who developed jaundice had serial serum bilirubin measured. Nine hundred and thirty-three babies had G6PD assayed, with 348 being G6PD deficient, giving a hospital based prevalence of 37.3%. Of the 644 who were followed up, 143 (22.2%) were pre-term and 501(77.8%) were term babies. Babies with gestational age (GA) 27–29 weeks had the highest G6PD levels. However, there was no significant variation among the different gestational age groups (F=0.64, P=0.64). Jaundice occurred more in pre-term compared to term babies with a relative risk of 2.41 (χ2=60.95, P=0.00001). Occurrence of jaundice in pre-term babies was irrespective of G6PD status (χ2=0.2, P=0.66, RR=1.09, CI=0.83<RR<1.43). There is an inverse relationship between gestational age and the occurrence of jaundice (R2=-0.874). Pre-term babies are more likely to have higher G6PD levels, but occurrence of jaundice in pre-term babies is irrespective of G6PD status. More severe jaundice (especially for gestational age) occurring in pre-term babies requires critical care

Knowledge, practice and acceptability of HPV vaccine by mothers of adolescent girls in Ilorin, Nigeria

Background: Human Papilloma Virus (HPV) is a sexually transmitted cause of carcinoma of the cervix. An important determinant of the success of a primary preventive strategy like HPV vaccination is the knowledge and willingness of parents to vaccinate adolescents before sexual debut. Materials and methods of study: A cross sectional descriptive survey of mothers of girls in 8 secondary schools in Ilorin was carried out from February to April 2015. Schools were selected using multi staged sampling. Descriptive and inferential statistics were performed with Chi Square and ANOVA. Results: There were 470 questionnaires returned for analysis out of 600, giving a response rate of 78.3%. One hundred and sixty-one (34.3%) knew HPV to be sexually transmitted infection and 40.4% knew it was the cause of cervical cancer. While 35.1% were aware of HPV vaccine, only 1.9% had ever vaccinated their children.Less than half (44.9%) were willing to vaccinate their children. Women with good knowledge of HPV and cervical cancer were more willing to vaccinate their children than women with poor knowledge (P &lt;0.001). Conclusion: There is poor knowledge of HPV and practice of vaccination among mothers in llorin. Willingness of mothers to vaccinate their daughters is suboptimal. Mother’s knowledge is an important determinant of HPV vaccination of adolescents

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.

OBJECTIVES: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. DESIGN: Descriptive case study. SETTING: Neonatal intensive care units in Nigeria. PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential

Maternal Factors Associated With Early Spontaneous Singleton Preterm Delivery in Nigeria

Background: Knowledge of the maternal factors predisposing to preterm deliveries should affect the anticipatory care of mothers at risk of delivering preterm babies and improve perinatal outcome. Objective: To determine the maternal socio-biological characteristics associated with the delivery of early spontaneous singleton preterm babies in a sample of Nigerian Women. Methods: The study was conducted at a teaching hospital in the Guinea savannah belt of Nigeria. Two groups of patients were recruited. Group A consisted of women who delivered babies prior to a gestational age of ² 34 weeks, while Group B were mothers who delivered at 37 or more weeks. Data collected on each subject included maternal post-partum weight, height, obstetric data and social characteristics. Results: A total of 171 mothers were studied; 69 in Group A and 102 in Group B. There was no significant difference between the socio-demographic profiles of the two groups. Factors significantly associated with preterm delivery were body mass index (BMI) ² 20.0 [Odds Ratio (OR) 14.6; 95% CI: 3.2-66.1]; previous preterm delivery [OR: 4.5; 95% CI: 1.5-13.3]; parity 1-2 [OR: 2.1; 95% CI: 1.1-4.0] and previous abortion [OR: 1.6; 95% CI: 1.2-2.4]. These associations were still demonstrable after adjusting for confounding variables, with BMI being the strongest determinant of preterm delivery. Maternal height alone and previous uterine curettage were not significantly associated with preterm delivery. Conclusion: Low BMI, low parity, previous preterm delivery and previous abortions were the maternal factors associated with early spontaneous singleton preterm delivery in a sample of Nigerian women. Key Words: Maternal, Labour, Preterm Births, Prematurity, Perinatal [Trop J Obstet Gynaecol, 2002, 19: 32-35

Intrauterine Growth Standards: A Cross-Sectional Study in A Population of Nigerian Newborns

The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA) of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the average weights of both sexes were similar; however, beyond this time point there was a consistent increase in the average weight of the males over the female babies. Growth curves for Nigerian newborn babies were generated and showed that the mean birth weight of Nigerian preterm babies was lighter than that of babies in Colorado. The impact of these differences on the classification of newborns will require further evaluation

Serum brain natriuretic peptide in healthy Nigerian newborn babies

Background: Brain natriuretic peptide (BNP) is a sensitive biomarker that is valuable in the management of childhood heart failure. Studies have reported racial differences in the level of BNP, especially in the adult population. The level of BNP in healthy Nigerian newborn babies is unknown. Hence, we determined the level of BNP in healthy term appropriate for gestational age (AGA) newborn babies. Methods: This was a cross sectional study,85 healthy term AGA newborn babies aged 24 to 72 hours. The babies had relevant demographic parameters documented in a proforma and BNP assay analysed using ELISA method. Results: The median IQR serum BNP level was 341.43 (313.39 to 425.45) pg/ml. The median level in females, was higher than males, {393.86 (296.97- 460.62) pg/ml vs328.05 (313.61-389.39) pg/ml, p &gt;0.05}.There was no significant relationship between serum BNP and birth weight, chronological age, gestational age, or mode of delivery (p&gt;0.05 in each case). Conclusion: The study demonstrated high BNP levels in healthy term Nigerian newborns. There was no relationship between BNP, the chronological age, birth weight, gender, gestational age or mode of delivery in babies between 24 to 72 hours of life

Measles in a Tertiary Institution in Bida, Niger State, Nigeria: Prevalence, Immunization Status and Mortality Pattern

Objectives: Measles is a highly infectious immunizable disease with potential for eradication but is still responsible for high mortality among children, particularly in developing nations like Nigeria. This study aims to determine the hospital based prevalence of measles, describe the vaccination status of children managed for measles at the Federal Medical Centre, Bida, Niger state and to identify the parental disposition to measles vaccination.Methods: This is a cross-sectional study carried out over a period of 18 months beginning from July 2007. All children with a diagnosis of measles made clinically and reinforced with serological test in the WHO Measles, Rubella and Yellow Fever laboratory in Maitama District Hospital, Abuja were recruited. Informed consent was obtained from the parents/care givers. Structured questionnaire was used to obtain information and data analysis was by SPSS version 15.Results: One hundred and nine children were managed for measles, constituting 8�0of total admission over the study period. The male to female ratio was 1.2:1. Of the 109 children with measles, 90 (82�20did not receive measles vaccination. Eighty-eight (80�20of the parents or guardian felt vaccination was bad for various reasons. Of the 23 (21.1�20children whose parents or guardians were positively disposed to vaccination, one death was recorded while the remaining seven deaths were recorded among children whose parents were negatively disposed to vaccination. All the deaths were in the non-vaccinated group below 2 years of age.Conclusion: Measles is still a major health burden in our community. The majority of affected children were not vaccinated due to negative parental disposition. Continuous health education is required for change the disposition of the parents/guardian and improve vaccination coverage to minimize measles associated morbidity and mortality

Familial Ectrodactyly Syndrome in a Nigerian Child: A Case Report

Ectrodactyly, also known as Split-Hand/Split-Foot Malformation (SHFM) is a rare genetic condition characterized by defects of the central elements of the autopod. It has a prevalence of 1:10,000-1:90,000 worldwide. The X-linked and autosomal dominant types have been described. It can occur as an isolated malformation or in combination with other anomalies, such as tibial aplasia, craniofacial defects, and genitourinary abnormalities. Ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC) is an example of ectrodactyly syndrome accompanied by multiple organ defects. Ectrodactyly has been reported in Africa, especially in several families in remote areas of central Africa but there has not been any published work on ectrodactyly in Nigeria. A baby was born in Ilorin, North Central Zone of Nigeria, with an uneventful prenatal and delivery history but was noticed to have malformation of the two hands and the two lower limbs at birth which are replica of the father’s malformation. We present this case to highlight familial ectrodactyly in Nigeria and prepare us to improve upon simple prenatal diagnosis and management of the challenges associated with patients with congenital malformation in Nigeria and other developing countries

Parental perception of human papillomavirus vaccination of prepubertal girls in Ilorin, Nigeria

Context: Human papillomavirus (HPV) vaccination of young girls is yet to be a routine practice in Nigeria and parents' acceptance may influence immunization of their children. Aims: The aim of this study is to determine beliefs and concerns of parents about HPV vaccination of girls. Subjects and Methods : A cross-sectional survey of parents of girls between 10 and 15 years in 12 selected secondary schools of Ilorin using a self-administered questionnaire designed by researchers was conducted. Statistical Analysis Used: Data analysis involved univariate and bivariate analyses with SPSS version 20. The level of significance for all tests was set at 5%. Results: The respondents were 470 mothers between 31 and 50 years, 58.1% had at least secondary school education, 70.2% were employed, and 22.8% belonged to the upper social class. Of the study participants, 35.1% were aware of HPV vaccine and 33.8% knew that the vaccine was available in Nigeria. While 55.8% of mothers believed that all girls should be vaccinated, 19.5% responded that only sexually active girls should have it. Among all respondents, full protection, need for repeated doses, and age of the girls were significantly related to willingness to vaccinate statistically (P < 0.05). These concerns were not significant among mothers that were aware of HPV vaccines. Conclusions: There is low awareness of HPV vaccine among mothers in Ilorin despite the high prevalence of cervical cancer in our environment. Parental perception of HPV vaccines in terms of concerns and beliefs was significantly related to willingness of mothers to vaccinate their daughters

URINARY IODINE LEVELS OF PRIMARY SCHOOL CHILDREN IN ILORIN, NIGERIA

Background: Iodine deficiency is one of the commonest micronutrient deficiencies. Globally, it is the commonest cause of preventable mental retardation and also associated with impaired physical growth. The current iodine nutrition of school children in Ilorin, North-Central Nigeria is not known. Objective: The study aimed to determine the urinary iodine levelsv(UIL) of school children in Ilorin and explored the relationship with socio-demographic variables. Methods: This cross-sectional study was carried out among primary schools children in Ilorin, Nigeria. We recruited school children aged 6-12 years through a multi-staged sampling method. Relevant data including socio-demograhic variables were obtained with a pretested study proforma. The recruited school children had urinary iodine determined using the Sandell-Kolthoff method. Data analysis was with Statistical Package for Social Sciences version 20.0. Results: The median with interquartile range (IQR) of urinary iodine level was 117.2 (99.6-148.6) µg/L. Of the 480 recruited children, 336 (70.0%) had normal urinary iodine levels while 144 (25%) had mild iodine deficiencyand two (0.4%) had excess urinary iodine levels. Pupils with iodine deficiency was higher among public schoolsthan those in private schools (33.3% vs 23.6%, χ2= 150.149, p< 0.022). The median UIL of the age-group 6-9 years was higher than the 10-12year age group (p=0.026). However, the median UIL values were comparable across gender, socioeconomic strata and mother’s educational level. Conclusions: This study showed that a quarter of the children still has mild iodine deficiency despite salt iodisation policy adopted by the country. Also, the iodine levels were not influenced by socio-demographics