Pattern of neurological diseases as seen in outpatient children: the experiences from Orotta Referral Hospital Asmara, Eritrea.

Objective: To determine the pattern of neurological diseases in children. Methods: This was a prospective cohort study of paediatric patients reporting to the Paediatric Neurological Clinic at Orotta Referral Hospital with neurological diseases. The systematic evaluation of patients was carried out from 2002 to 2005. Results: Altogether 736 children with age ranging from 3 months to 15 years being 61% boys and 39% girls, presented with different neurological disorders. Although the cases may have presented with more than one diagnosis (29.6%), the most frequent neurological diseases were epilepsy (25.9%), cerebral palsy(C/P) (19.3%) and post febrile neurological diseases (12.5%) and others. Out of all epileptic cases, grand mal(GTCS) (74%), partial seizures (5.6%), akinetic attacks(drop attacks) (5.6%) and petit mal (absence siezures) (3.2%) were the commonest types of epilepsy. In the majority of epilepsy (63.5%) no cause was found. There was no gender difference in all neurological disorders studied. Discussion and Conclusion: Epilepsy is a common disease in children. The prevailing enigma that epilepsy is rare in children is an unfounded myth making it imperative for appropriate index of clinical suspicion whenever a paediatric patient presents with unusual clinical pattern. The increased number of epileptic cases at first attendance with age calls for aggressive treatment at the early stages when neurological deficits are likely to occur as the disease may have spontaneously permanent remission. The high number of cases with cerebral palsy and post febrile illness neurological diseases necessitates urgent preventive measures and appropriate management in the country

Distribution of hepatitis B virus infection in Namibia

Background. Namibia regards hepatitis B virus (HBV) infection as a public health problem and introduced hepatitis B vaccinations for infants during 2009. However, information on HBV infection in the country remains limited, and effective public health interventions may be compromised in the absence of adequate evidence-based data. Available data from the World Health Organization (WHO) estimate that 15 - 60% of the normal population in many African countries may be positive for one or more of the HBV serological markers. Objective. To investigate the distribution of HBV infection in Namibia, using available laboratory data for 2013. Methods. A cross-sectional descriptive study was conducted using pre-existing electronic laboratory data on HBV infection. The data were retrieved from the central Namibia Institute of Pathology laboratory in Windhoek during January - December 2013. Tests were done on the following three main groups: (i) pregnant women during routine antenatal care (ANC) visits; (ii) patients with HIV/AIDS during antiretroviral therapy clinic visits; and (iii) any other individual suspected of having HBV infection. Results. Of a total of 77 238 hepatitis B surface antigen test results retrieved countrywide, 9 087 (11.8%) were positive. Of the positive results, 246/9 087 (2.7%) were in children aged 0 - 14 years, with the sexes equally affected. HBV infections increased markedly, particularly among females, in the age group 15 - 39 years, reaching a peak in the age group 30 - 34 years. Routine screening of pregnant women for HBV during ANC visits was found to be systematically conducted in only two regions, Ohangwena and Khomas. Conclusions. This study showed high proportions of positive results in pregnant women, patients with HIV/AIDS and individuals suspected of having HBV infection. The Ministry of Health and Social Services and stakeholders may wish to consider improving the routine and surveillance reporting systems for viral hepatitis and uptake of screening for pregnant women in all regions, and expanding HBV screening to other population groups. Population-based or similar studies are therefore required to determine the HBV prevalence and risk factors. This will assist Namibia in developing appropriate national viral hepatitis strategies as per WHO recommendations.S Afr Med J 2017;107(10):882-88

Knowledge Attitude and Practice Towards Skilled Care Attendance among Women of Reproductive Age Group in Eritrea

Introduction: Maternal Mortality Ratio (MMR) in Eritrea is one of the highest in the world. According to the EDHS of 1995, the MMR in Eritrea was 998 per 100,000. The MMR estimation of WHO/UNFPA/UNICEF for Eritrea is 630/100,000 live births. The Government of Eritrea in collaboration with its partners are implementing the Road Map for accelerating the reduction of maternal and neonatal mortality in Eritrea. Objective: To assess the Knowledge, Attitude and Practice (KAP) on the utilization of maternal and child health information and services among women of reproductive age group. Methods: A cross sectional community based study using standard questionnaire was conducted in three zones of Eritrea in April 2006 on 851 women in reproductive age group residing in 33 villages randomly selected. At 28% skilled care attendance rate and 95% confidence interval, the sample size was calculated to be 927. The response rate was 851 (91.8%) of the sample size. Results: A total of 851 (92%) women were interviewed and majority 652 (76.9%) were Moslems and the rest were Christians. About two-third (59.3%) of the women had no formal education. 88.7% of the respondents were housewives. 13.6% of the total 788 respondents had at least one abortion. Excessive bleeding was one of the leading causes of maternal death. The symptoms of mothers at the time of death as mentioned by the interviewed women were excessive bleeding for 18.8%, fast breathing for 12.5%, fever for 6.3% and others for 62.5%. Gash Barka zone hah the lowest skilled care attendance (SCA) (23.6%) as compared to the other two zones Northern Red Sea 39.3% and Southern Red sea (47.2%). Orthodox Christians had a higher level of SCA at birth (58.0%) as compared to (30.4%). Unmarried women have a higher level of SCA (66.0%) as compared to married women (35.3%). The study also elucidated that as educational level increases the SCA at birth also increases from 24.3% among uneducated women to 83.9% among those with grade 10-12. There was no significant change of SCA by age. Conclusion: The study revealed that skilled care attendance at birth is still very low as compared to other countries and bleeding is the major cause of maternal death. Education of women is crucial for service utilization. It is recommended that husbands should be targeted for Behavioral Change Communication and women to be empowered to make a decision of their destiny