Prevalence of iron deficiency anaemia in anaemic under-5 children in Enugu South East Nigeria

Background: Iron deficiency anaemia has been described as the commonest type of nutritional anaemia in infancy and childhood. The associated adverse health sequelae include permanent behavioural and cognitive impairments. Early detection and prompt treatment are necessary to prevent these complications.Aim: To determine the prevalence and socio-demographic distribution of iron deficiency anaemia among anaemic under five children in Enugu.Subjects and methods: Under-five children presenting at a tertiary hospital were consecutively enrolled and screened for iron deficiency anaemia using haematocrit and serum ferritin levels. Iron deficiency anaemia was defined as haematocrit level <30% and ferritin level <12ng/ml.Results: Three hundred and twelve children (187 males, 125 females) aged below 60 months had a PCV check out of which 178 (57.1%) were anaemic (PCV< 30%). Of the anaemic group, 61(34.3%) had iron deficiency anaemia. Prevalence of iron deficiency anaemia was higher among the males (38.0%) [p=0.235], age group 13- 23months (40.0%) [p=0.575] and children from lower socioeconomic class (43.5%)[p=0.158]. There is a positive but weak correlation between serum ferritin and haematocrit levels [r= 0.11 p=0.130].Conclusion: The prevalence of iron deficiency anaemia in the study population was high and varies with the child’s age group, gender and parental socioeconomic class.Keywords: iron deficiency anaemia, serum ferritin, haemtocrit, Enugu

Pattern of morbidity and mortality of newborns admitted into the sick and special care baby unit of Enugu State University Teaching Hospital, Enugu state

Background: Being the highest contributor to under-5 mortality, neonatal mortality and morbidity has great impact to the attainment of millennium development goals 4 (MDG 4). In Nigeria and other developing countries, this indicator strongly poses a major challenge in achieving this goal. Objectives: To determine the morbidity and mortality pattern of admitted babies in the special care baby unit (SCBU) of Enugu State University Teaching Hospital (ESUTH).Materials and Methods: This is a comparative and descriptive longitudinal study of causes of morbidity and mortality between babies born within (inborn) and outside our hospital facilities (outborn) based on information on place of birth, APGAR scores, age on admission, diagnosis on  admission, duration of hospital stay, and outcome of newborns admittedinto the sick and SCBU over a 1 year period. Results: A total of 261 neonates were admitted during the period under review. The common causes of admissions seen from the study were perinatal asphyxia (80, 30.7%), low birth weight (64, 24.5%), neonatal sepsis (44, 16.9%), and neonatal jaundice (16, 0.06%). A total of 37 (14.2%) deaths were recorded during the period. The leading causes of deaths were severe form of perinatal asphyxia (18, 52.9%), neonatal sepsis (10, 29.4%), and very low birth weight (two, 0.06%). Fifty.five percent of all the deaths occurred within 24 h of admission. Death dueto asphyxia was more in babies born outside the hospital (outborn) than in babies born within the hospital (inborn). Equal number of outborn and inborn babies died from neonatal sepsis. The age at presentation to the sick baby unit was significantly lower in inborn (P = 0.004), while age at death was not different in both group of newborns (P = 0.876).Conclusion: The neonatal mortality rate and the causes of death in this study are similar to those documented by other studies in Nigeria and are largely preventable. Strengthening perinatal care, emergency obstetric services, and enhancement of neonatal resuscitation skills to traditional birth attendants (TBAs) and other community health workers are necessary to reduce the neonatal mortality in our setting and other rural settings across developing countries. Key words: Enugu, morbidity, mortality, newbor

Outbreak of serotype W135 Neisseria meningitidis in central river region of the Gambia between February and June 2012: A hospital-based review of Paediatric cases

Background: Meningitis still accounts for many deaths in children especially during epidemics in countries within the African meningitis belt. Between February and May 2012, the Gambia witnessed an outbreak of meningitis in two of its six regions. This study presents a clinical perspective of this outbreak in central river region of the Gambia. It evaluated the outbreak pattern, clinical features, and mortality among suspected cases that presented to the hospital during the outbreak. Methodology: This is a prospective observational study of suspected cases of meningitis that presented to the pediatric ward of the Bansang Hospital during the outbreak period. Confirmed cases of meningitis were consecutively  enrolled, and those with negative blood cultures presenting during the same period were employed as controls.Result: Two hundred and four suspected cases of meningitis presented to the pediatric ward during the outbreak. Ninety were confirmed as meningitis cases. The W135 strain of Neisseria meningitidis was responsible for 89 (98.9%) of meningitis cases seen with an incidence rate of 74.9/100,000 in children (0-14 years) and in.hospital case fatality rate of 7.9%. Highest attack rate was among the 12-49 months age group. Clinical features such as meningeal signs (neck stiffness), conjunctivitis, and joint swelling were seen more in cases than controls. Contact history with relatives, who had fever in previous 2 weeks prior to illness was significantly seen more in cases. Adjusted regression analysis showed 7.5 more likelihood of infection with positive contact history (odds ratio [OR]: 7.2 confidence interval [CI]: [3.39-15.73]). There was no significant difference in death outcome between cases and controls (OR: 0.78 CI: [0.29-2.13]). The double peak wave-like pattern of the epidemic curve noted during this outbreak suggests a disseminated outbreak originating from an index case with propagated spread.Conclusion: There is need for more effective surveillance and incorporation of vaccine against meningitis into the expanded program on immunization schedule of the Gambia and other countries within the meningitic epidemic belt.Key words: Neisseria meningitis, W135 strain, Outbreak, Children, Central River Regio