Neonatal malaria in Nigeria -a 2 year review

BACKGROUND: In view of the fact that a significant proportion of neonates with malaria may be missed on our wards on the assumption that the disease condition is rare, this study aims at documenting the prevalence of malaria in neonates admitted into our neonatal ward. Specifically, we hope to describe its clinical features and outcome of this illness. Knowledge of these may ensure early diagnosis and institution of prompt management. METHODS: Methods Hospital records of all patients (two hundred and thirty) admitted into the Neonatal ward of Olabisi Onabanjo University Teaching Hospital, Sagamu between 1st January 1998 and 31(st )December 1999 were reviewed. All neonates (fifty-seven) who had a positive blood smear for the malaria parasite were included in the study. Socio-demographic data as well as clinical correlates of each of the patients were reviewed. The Epi-Info 6 statistical software was used for data entry, validation and analysis. A frequency distribution was generated for categorical variables. To test for an association between categorical variables, the chi-square test was used. The level of significance was put at values less than 5%. RESULTS: Prevalence of neonatal malaria in this study was 24.8% and 17.4% for congenital malaria. While the mean duration of illness was 3.60 days, it varied from 5.14 days in those that died and and 3.55 in those that survived respectively. The duration of illness significantly affected the outcome (p value = 0.03). Fever alone was the clinical presentation in 44 (77.4%) of the patients. Maturity of the baby, sex and age did not significantly affect infestation. However, history of malaria/febrile illness within the 2 weeks preceding the delivery was present in 61.2% of the mothers. Maternal age, concurrent infection and duration of illness all significantly affected the outcome of illness. Forty-two (73.7%) of the babies were discharged home in satisfactory condition. CONCLUSION: It was concluded that taking a blood smear to check for the presence of the malaria parasite should be included as part of routine workup for all neonates with fever or those whose mothers have history of fever two weeks prior to delivery. In addition, health education of pregnant mothers in the antenatal clinic should include early care-seeking for newborns

Point-of-admission hypothermia among high-risk Nigerian newborns

<p>Abstract</p> <p>Background</p> <p>Facilities which manage high-risk babies should frequently assess the burden of hypothermia and strive to reduce the incidence.</p> <p>Objective</p> <p>To determine the incidence and outcome of point-of-admission hypothermia among hospitalized babies.</p> <p>Methods</p> <p>The axillary temperatures of consecutive admissions into a Nigerian Newborn Unit were recorded. Temperature <36.5°C defined hypothermia. The biodata and outcome of these babies were studied.</p> <p>Results</p> <p>Of 150 babies aged 0 to 648 hours, 93 had hypothermia with an incidence of 62%. Mild and moderate hypothermia accounted for 47.3% and 52.7% respectively. The incidence of hypothermia was highest (72.4%) among babies aged less than 24 hours. It was also higher among out-born babies compared to in-born babies (64.4% <it>vs </it>58.3%). Preterm babies had significantly higher incidence of hypothermia (82.5%) compared with 54.5% of term babies (RR = 1.51; CI = 1.21 – 1.89). The incidence of hypothermia was also highest (93.3%) among very-low-birth-weight babies.</p> <p>The Case-Fatality-Rate was significantly higher among hypothermic babies (37.6% vs 16.7%; RR = 2.26, CI = 1.14 – 4.48) and among out-born hypothermic babies (50% vs 17.1%; RR = 0.34, CI = 0.16 – 0.74). CFR was highest among hypothermic babies with severe respiratory distress, sepsis, preterm birth and asphyxia.</p> <p>Conclusion</p> <p>The high incidence and poor outcome of hypothermia among high-risk babies is important. The use of the 'warm chain' and skin-to-skin contact between mother and her infant into routine delivery services in health facilities and at home may be useful.</p

Prevalence, types and demographic features of child labour among school children in Nigeria

BACKGROUND: To determine the prevalence, types and demographic features of child labour among school children in Nigeria. METHODS: A cross-sectional interview study of 1675 randomly selected public primary and secondary school pupils aged 5 to less than 18 years was conducted in the Sagamu Local Government Area of Ogun State, Nigeria from October 1998 to September 1999. RESULTS: The overall prevalence of child labour was 64.5%: 68.6% among primary and 50.3% among secondary school pupils. Major economic activities included street trading (43.6%), selling in kiosks and shops (25.4%) and farming (23.6%). No child was involved in bonded labour or prostitution. Girls were more often involved in labour activities than boys (66.8% versus 62.1%, p = 0.048): this difference was most obvious with street trading (p = 0.0004). Most of the children (82.2%) involved in labour activities did so on the instruction of one or both parents in order to contribute to family income. Children of parents with low socio-economic status or of poorly educated parents were significantly involved in labour activities (p = 0.01 and p = 0.001 respectively). Child labour was also significantly associated with increasing number of children in the family size (p = 0.002). A higher prevalence rate of child labour was observed among children living with parents and relations than among those living with unrelated guardians. CONCLUSION: It is concluded that smaller family size, parental education and family economic enhancement would reduce the pressure on parents to engage their children in labour activities

Child Labour and School Absence in Sagamu Local Government Area of Ogun State

This study reviewed school absences of 1675 school children over one academic year. One thousand and eighty (64.5%) of these school children were involved in child labour outside school hours. The scope of occupational activity was heterogeneous with hawking as the most prevalent form. The school absences of 1080 children involved in child labour were compared with those of 595 children who were not involved. The children involved in child labour had a mean number of days of school absence of 11.34 days while those who were not involved in child labour were absent for a mean number of 11.50 days. The difference was not statistically significant (p = 0.80). there was also no significant difference in the mean school absence duration among boys and girls in the two groups (p = 0.93 and 0.81 respectively). It is concluded that child labour does not increase significantly school absence rates in school children when such economic roles are performed outside school hours. Key Words: Child labour, child abuse, school children, school absence. Nigerian Medical Practitioner Vol. 46 No 1, 2004 (15-17

Profile of congenital malformations in Sagamu, Nigeria

The profile of congenital malformations seen in Sagamu, Southwestern Nigeria during a period of eight years is described. The result of this retrospective cross sectional study showed an incidence of congenital malformation of 10.7 per 1000 live births. Low order of parity (1 and 2) was mostly affected (65.8%), and 80.0% of mothers were aged between 20 and 34 years. Gastro intestinal malformations were the commonest (38.4%). In the largest number of cases (95.8%), diagnosis was made in the postnatal period, with the most frequent method of diagnosis being by clinical examination (93.6%). The male female ratio was 1.5: 1.0. Down's syndrome was usually associated with multiple malformations. The study identifies the need for early and skilled ultrasound evaluation of pregnant women, particularly those with risk factors and the need for good record keeping in all institutions with delivery facilities. Keywords: congenital malformations (CM), Sagamu, Nigeria Nigerian Medical Practitioner Vol. 49(4) 2006: 65-6

Massive Congenital Chylous Ascites in a Nigerian infant: A Case Report

Chyle leakage into peritoneal cavity is an uncommon disorder that may present at any age. It has been reported in many parts of the world particularly Europe, North America and Asia. However, reports from other parts like African and South America are virtually non-existent. We report a case of abdominal distension and bilateral giant inguinoscrotal hernia in a 2-day old neonate that presented at the Olabisi Onabanjo University Teaching Hospital, Sagamu. Physical examination and abdominal ultrasonography revealed a massive ascites, among other findings. Peritoneal tap yielded free-flowing fluid that was milky-white in appearance, thus confirming the diagnosis of chylous ascites. Key Words: Chyloperitoneum, Congenital chylous ascites, Neonatal ascites. Nig. Medical Practitioner Vol. 44(2) 2003: 26-2