Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East, Nigeria

Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA.Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score.Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score ≤ 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done.Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and post-dates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and post -dates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001).Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns.Keywords: Newborn, birth asphyxia, Hypoxic Ischemic Encephalopathy (HIE) outcomes, predictors of survival

Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East, Nigeria

Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA. Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score. Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score 64 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done. Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and post-dates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and post-dates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001). Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns. DOI: https://dx.doi.org/10.4314/ahs.v19i1.29 Cite as: Uleanya ND, Aniwada EC, Ekwochi U, ND U. Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, SouthEast, Nigeria. Afri Health Sci. 2019;19(1). 1554-1562. https://dx.doi.org/10.4314/ahs.v19i1.2

Observed Causes of Severe Respiratory Distress among Children with Congenital Heart Disease

Background: Severe respiratory distress is a clinical feature commonly observed among children with congenital heart disease (CHD), butthe underlying cause is often misdiagnosed. Objectives: This study is aimed at determining the common causes of severe respiratory distress observed among children with CHD. Methods: This study was a retrospective study on children who had severe respiratory distress with underlying CHD seen between June 2017 and June 2018, and were consecutively recruited from two teaching hospitals. Results: Forty‑seven children aged 2 months to 15 years were admitted for severe respiratory distress secondary to CHD at our center between June 2017 and June 2018. The most common CHD was isolated ventricular septal defect (VSD), which made up 36.2%, followed by tetralogy of Fallot with 23.4%. Identifiable causes of respiratory distress in these children were restrictive airway disease (36.2%) as the most common cause, followed by pulmonary edema from congestive cardiac failure (27.7%). Among children with heart failure, 57.1%, 47.4%, 0%, and 50% of infants, children aged 1–5, 6–10, and above 10 years, respectively, were affected. Conclusion: Restrictive airway disease was noted as the most common cause of severe respiratory distress among children with CHD. Keywords: Children, congenital heart disease, restrictive airway disease, severe respiratory distres

Clinical Profile and Electrolyte Abnormalities in Hospitalized Under‑Five Children with Acute Gastroenteritis in a Tertiary Health Facility

Background: Electrolyte abnormalities constitute the leading causes of morbidity and mortality in younger children with acute gastroenteritis.The aim of the study was to determine the clinical profile and pattern of electrolyte abnormalities in under‑five children hospitalized for acutegastroenteritis from November 1, 2014, to January 31, 2015. Methodology: This was a cross‑sectional descriptive study among hospitalized under‑five children with acute diarrhea who were consecutively recruited from November 1, 2014, to January 31, 2015. Relevant clinical data were obtained, while the physical examination was done on all subjects. Serum electrolytes values were determined using the ion‑selective electrode system and compared with standard reference ranges. The data were analyzed using SPSS version 21.0 with the level of statistical significance set at P < 0.05. Results: A total of 108 under‑five children were studied. The majority (101; 93.5%) were <24 months of age, while 41 (38%) of low socioeconomic class background. Metabolic acidosis was the most common electrolyte abnormality followed by hyponatremia and hypokalemia occurring singly or in combination. The case fatality rate was 13 (12.0%). The electrolyte derangements associated with mortality were hypokalemia and acidosis: 11 (84.6%) each, 9 (69.2%) had hyperchloremia, while 6 (46.2%) were reported to have hyponatremia. Conclusion: Electrolyte derangements are common in under 5 years children with acute diarrhea with increased mortality in those with severe acute malnutrition. Proper health education is needed to ensure adequate nutrition and timely use of low‑osmolar oral rehydration solution as well as early referral of cases with persistent gastrointestinal losses in order to save lives. Keywords: Acute gastroenteritis, electrolyte abnormalities, under‑five childre

Tobacco use: prevalence, pattern, and predictors, among those aged 15-49 years in Nigeria, a secondary data analysis

Introduction Tobacco use is a major global public health challenge. It is a risk factor for most leading causes of death, and its health impacts span from conception to adulthood. This study aims to analyse tobacco use data from the 2013 Nigerian Demographic and Health Survey (NDHS), assessing the prevalence, pattern, and socio-demographic correlates of tobacco use among Nigerians aged 15-49 years. Methods A secondary data analysis involving 2013 NDHS was done. Data on 17 322 respondents were extracted from 36 800 participants. This number represents respondents with complete data on outcome variables of interest. Primary Sampling Unit defined on the basis of Enumeration Areas from the 2006 census was used. Head of selected household, all men and women aged 15-49 were studied. Data was collected using questionnaires. A chi-squared test and a binary logistic regression model were used in the analysis. Results Generally, 6.6% of the respondents smoked cigarettes, 1.7% used snuff, 0.4% smoked pipe, and 0.2% chewed tobacco. Based on gender, 6.6% males and 6.3% females smoked cigarettes, 0.3% males and 0.4% females smoked cigarettes as well as used snuff. Predictors of cigarette use included being in age group 25- 34 years (AOR 5.8; 95% CI 4.6-7.2), being ≥35 years (AOR 4.1; 95% CI 4.1-6.8), having attained primary education (AOR 1.4; 95% CI 1.2-1.8), living in north region (AOR 1.3; 95% CI 1.1-1.5), as well as being a Moslem (AOR 0.6; 95% CI 0.5-0.7). Conclusions A minor proportion of both genders uses tobacco with the commonest form being cigarettes. The commonest combination was cigarettes and snuff, even on stratification by gender. The identified predictors were age in categories, educational level and religion