The Impact of Recycled Neonatal Incubators in Nigeria: A 6-Year Follow-Up Study

Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries

Prevalence of Skin Diseases in Children with Human Immunodeficiency Syndrome Infection in Paediatric HIV Clinic of A Tertiary Hospital in Nigeria.

Background: HIV infection/AIDS being a multi-systemic disease affects the skin at various stages in course of the illness. A knowledge of the common skin diseases associated with HIV infection can lead to early detection, appropriate staging and commencement of appropriate care in the infected patients.Objective: The study was to document the prevalence and pattern of skin diseases in children with HIV infection seen at the Paediatric department of a tertiary centre in Nigeria.Methods: HIV positive children attending the PEPFAR HIV clinic of Lagos University Teaching Hospital, Nigeria were examined for the presence of skin lesions. Anthropometric measurements were also obtained. Blood samples were taken for CD4+ cell count, viral load and full blood count.Results: Two hundred and fourteen (214) patients were studied, consisting of 107 HIV infected children and 107 uninfected children as controls. Skin lesions were observed in 89 (83%) of the HIV infected patients, while only 72 uninfected controls had skin lesions. (p = 0.035). The predominant skin disease in the HIV infected children was Pruritic papular eruption (PPE) with a frequency of 25.9%, followed by fungal infections (24.6%). Herpes zoster was found only in HIV infected children (p = 0.041). There was a strong correlation between the degree of immunosuppression (as reflected by the value of age dependent CD4+ cell count/CD4+ percentage) and the prevalence of skin disease in the HIV infected patients. The presence of pruritic papular eruptions and Herpes zoster was associated with advanced immunosuppression.Conclusion: Skin diseases are common in HIV infection in our environment. Early detection of HIV infection can be made in the presence of skin diseases like Pruritic papular eruption and Herpes zoster.Keywords: HIV, kin diseases, prevalence, children, Nigeri

Bacterial pathogens and their antimicrobial susceptibitily patterns in the Out-Patient setting in Lagos

No Abstract. NQJHM Vol. 8 (4) 1998: pp. 256-26

Neonatal Mortality of Inborns in the Neonatal Unit of a Tertiary Centre in Lagos, Nigeria.

Background: Neonatal mortality is a useful index of assessing the socioeconomic development of an area. Its periodic evaluation is therefore a necessary and valuable audit index of the care given. The aim of this study is to document the neonatal mortality rate of inborn babies at Lagos University Teaching Hospital (LUTH) and describe the pattern of these deaths. Study Design: In-born neonatal admissions at the LUTH over a five-year period (January 1996 – December 2000) were retrospectively reviewed. Data on mortality, pregnancy, delivery and neonatal indices were extracted from ward records. Results: There were a total of 6,272 live births of whom 2,496 (39.8%) were admitted into the neonatal unit. One hundred and forty one of the neonates died giving a mortality rate of 22.5/1000. The neonatal deaths comprised of 120 early neonatal deaths and 39 late neonatal deaths. The yearly neonatal mortality rate showed a steady decline except for 1999 during which there was a slight rise. The incidence of neonatal deaths decreased with age, weight at birth and maturity. Low birth weight and birth asphyxia were the leading associated causes of death. Complications of pregnancy occurred in 45.4% of the mothers of these neonates with pregnancy induced hypertension as the most prevalent (62.5%). Conclusion: An overall inborn neonatal mortality rate of 22.5/1000 in our institution is still high but a declining trend is portrayed and will be further improved with the institution of measures to control or reduce the incidence of pregnancy induced hypertension, low birth weight and birth asphyxia. Keywords: Neonatal mortality, inborn babies, low birth-weight, hypertension, birth asphyxia, Lagos, Nigeria.NQJHM Vol. 15 (2) 2005: pp. 55-5

Bacterial pathogens causing neonatal sepsis in an out-born neonatal unit in Lagos, Nigeria

No Abstract. NQJHM Vol. 6 (3) 1996: pp. 149-15

Prune Belly Syndrome: A case Report

The Prune Belly Syndrome (PBS) is a anomaly. It comprises of a lax abdominal wall musculature, urinary tract anomalies, and cryptorchidism. Our patients had urinary tract infection and renal failure. These are well described consequences of the syndrome and are poor prognostic indices. This case report was undertaken in order to highlight the occurrence of this rare syndrome in our environment and to review its pathogenesis, presentation and management approach. The case for prenatal diagnosis and early integrated treatment is further discussed. Keywords: Prune belly syndrome, presentation, management. NQJHM Vol. 14 (2) 2004: pp. 175-17

ISOLATION, ANTIBIOGRAM AND CHARACTERIZATION OF VANCOMYCIN-RESISTANT STAPHYLOCOCCUS AUREUS FROM CLINICAL AND COMMUNITY ISOLATES IN ABAKALIKI, EBONYI STATE, NIGERIA

This study was aimed at isolating and characterizing vancomycin-resistant Staphylococcus aureus from clinical and community samples in Abakaliki, Ebonyi State, Nigeria. Seven hundred and nine (709) clinical and community samples were obtained for this study. Antibiotic susceptibility test was done using Kirby Bauer disc diffusion method. Vancomycin resistant Staphylococcus aureus (VRSA) isolates were detected using Kirby-Bauer disc diffusion method with vancomycin antibiotic disc (30 μg). Isolates were also screened for β-lactamase enzyme production. A total of 84 (27.7 %) and 120 (29.5 %) Staphylococcus aureus isolates were obtained from the clinical and community samples respectively using standard microbiological techniques. Results showed that 55 VRSA isolates were obtained from the samples with prevalence frequency of 36.9 % and 20 % for clinical and community isolates respectively. The clinical isolates were completely resistant (100 %) to nitrofurantoin, clindamycin, ceftazidime, tetracycline and penicillin. Gentamicin was the most effective antibiotic against the S. aureus isolates obtained from clinical samples as all the isolates were completely susceptible (100 %). Ciprofloxacin was the most effective antibiotic against the S. aureus isolates obtained from community samples with a susceptibility frequency of 100 %. This was closely followed by gentamicin (75 %) and erythromycin. Exactly 38.1 % and 24.2 % of the clinical and community S. aureus isolates were positive for beta-lactamase production respectively. The HA-VRSA and CA-VRSA isolates had MARI values within the range of 0.5 to 1.0. This present discovery of multi-drug resistant VRSA with high multiple antibiotic resistance indices is in Abakaliki is a serious public health issue. Therefore, there is an urgent need to keep a strict watch on VRSA emerging from Abakaliki. Keywords: CA-VRSA, HA-VRSA, MARI, beta-lactamase, antibiotic

Congenical malformations in Lagos: a survey of 22,288 consecutive newborns in the Lagos University Teaching Hospital (LUTH) over a 10-year period

No Abstract. NQJHM Vol. 8 (4) 1998: pp. 272-27