The performance of an Histidine rich protein-2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria parasitaemia among febrile under-five children at Nnewi

Background: Malaria remains a major cause of morbidity and mortality, thus there is need for quick, reliable inexpensive diagnostic tool to facilitate its prompt treatment especially in resource poor settings.Objectives: To compare the sensitivity of a locally available Histidinerich protein-2 based rapid diagnostic test (RDT) with the standard microscopy.Methods: This study was carried out to test the performance of an histidine rich protein -2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria among febrile under-five children attending Paediatric Clinic of NAUTH Nnewi. A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through an interviewer administered questionnaire. Blood sample was collected in EDTA bottle after observing universal precautions. All of them were tested with both Giemsa stained blood smear and Histidine rich protein-2 (HRP-2) rapid diagnostic test (RDT).Results: There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Average number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1- 14 days. Body temperature ranged from 35.9-40.40C with average of 37.7+0.80C. Forty (20%) were positive by microscopy while 42 (21%) were positive by rapid diagnostic test. Twenty-percent of those positive by microscopy (n=8) were negative by RDT while 23.8% of those positive by RDT (n=10) were negative by microscopy. Using microscopy as a gold standard, the sensitivity of the RDT was 80%, the specificity was 93.8%. The positive and negative predictive values were 76.2% and 94.9% respectively.Conclusion: Based on these findings, the RDT demonstrated reasonable concordance with microscopy and was recommended for use at every level of healthcare in the diagnosis of malaria.Keywords: Malaria, RDT, Microscopy, under- five

Pattern of childhood and adolescent malignancies at a tertiary health institution in South-east Nigeria : A ten year study

Background: Cancer remains a major cause of death in children and adolescents, and differs in adults in nature, distribution and prognosis1. A culture of case documentation is lacking in our environment and many cases go unreported.Study objectives: To document the pattern of childhood and adolescent malignancies at a tertiary health institution in south-east Nigeria over a ten year period (January 2004 to December 2013)Methodology: Details of all children and adolescents aged 18 years and below treated for malignancy were extracted from the cancer registry and the records unit of the histopathology department for the period beginning at January 2004 to December 2013 at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Information retrieved was verified against the hospital admission register, as well as the medical and histopathology records for all cancer patients over the period of interest.Results: Eighty-five cases of childhood and adolescent malignancy were treated at NAUTH, Nnewi between January 2004 and December 2013. Median age of the study population was 9years, with a range of 0.1– 18years, more males (56.50%) than females (43.50%). Commonest tumours were the Lymphomas (11.76%) comprising Non- Hodgkin’s lymphoma (80%), Hodgkin’s lymphoma (10%) and Large-cell lymphoma (10%), the Leukaemias (11.76%) comprising Acute myeloblastic leukaemia (80%) and Acute lymphoblastic leukaemia (20%). Others were Rhabdomyosarcoma (11.76%), Nephroblastoma (11.76%), Retinoblastoma (5.88%), Ovarian tumours (4.71%), the Soft tissue sarcomas-excluding rhabdomyosarcoma (3.53%) and Osteogenic sarcoma (3.35%)’.Conclusion: Study findings suggest that lymphoma, leukaemia, rhabdomyosarcoma and nephroblastoma are the commonest childhood and adolescent malignancies in south-east Nigeria.Keywords: Childhood, Adolescent, Malignanc

Neonatal lupus erythematosus in a Nigerian infant

Systemic lupus erythematosus is a chronic inflammatory autoimmune disease that affects all organ systems and follows a relapsing and remitting course with presentation ranging from indolent to fulminant. It is an uncommon condition in children and usually manifests as the cutaneous form in the paediatric age group. We report a case of neonatal lupus erythematosus in a six-week-old Nigerian infant seen at NAUTH, Nnewi. The objective of this report is to highlight the existence of this very rare condition in infants. A 6-week-old female infant presented at the paediatric unit of our facility with a history of a pre-auricular skin eruptions of five weeks and poor suckling of three weeks duration. The skin lesions persisted unchanged after 14 days of antibiotics. A skin snip was taken for histology and a diagnosis of neonatal lupus erythematosus was made.Key words: neonatal lupsus erythematosus, infant, Nnewi