Neonatal malaria in Nigeria -a 2 year review

BACKGROUND: In view of the fact that a significant proportion of neonates with malaria may be missed on our wards on the assumption that the disease condition is rare, this study aims at documenting the prevalence of malaria in neonates admitted into our neonatal ward. Specifically, we hope to describe its clinical features and outcome of this illness. Knowledge of these may ensure early diagnosis and institution of prompt management. METHODS: Methods Hospital records of all patients (two hundred and thirty) admitted into the Neonatal ward of Olabisi Onabanjo University Teaching Hospital, Sagamu between 1st January 1998 and 31(st )December 1999 were reviewed. All neonates (fifty-seven) who had a positive blood smear for the malaria parasite were included in the study. Socio-demographic data as well as clinical correlates of each of the patients were reviewed. The Epi-Info 6 statistical software was used for data entry, validation and analysis. A frequency distribution was generated for categorical variables. To test for an association between categorical variables, the chi-square test was used. The level of significance was put at values less than 5%. RESULTS: Prevalence of neonatal malaria in this study was 24.8% and 17.4% for congenital malaria. While the mean duration of illness was 3.60 days, it varied from 5.14 days in those that died and and 3.55 in those that survived respectively. The duration of illness significantly affected the outcome (p value = 0.03). Fever alone was the clinical presentation in 44 (77.4%) of the patients. Maturity of the baby, sex and age did not significantly affect infestation. However, history of malaria/febrile illness within the 2 weeks preceding the delivery was present in 61.2% of the mothers. Maternal age, concurrent infection and duration of illness all significantly affected the outcome of illness. Forty-two (73.7%) of the babies were discharged home in satisfactory condition. CONCLUSION: It was concluded that taking a blood smear to check for the presence of the malaria parasite should be included as part of routine workup for all neonates with fever or those whose mothers have history of fever two weeks prior to delivery. In addition, health education of pregnant mothers in the antenatal clinic should include early care-seeking for newborns

Heterotophic pregnany: case report and short literature review

No Abstract. Nigerian Medical Practitioner Vol. 48(5-6) 2005: 128-12

Household triggers of bronchospasm in children aged less than two years with hyperreactive airway: a multicentre experience

Aims and Objective: Bronchospasm is rarely seen in children less than two years of age unless they are genetically predisposed to allergy and atopy. Hyperreactive airway presenting with bronchospasm in such children is commonly misdiagnosed and managed as chest infections. This study therefore aims at examining the trigger factors of bronchospasm in these children.Setting/Method: The study was carried out in two private medical centres in Ilorin between June 2002 and May 2003. All children below the age of 2 years presenting with cough and breathlessness of sudden onset with audible wheeze were screened historically for the trigger factors of bronchospasm in their environment. Result: Nine hundred and twenty eight patients were recruited for the study over the one year period. The mean age of the children was 5.4 ± 1.3 months (range: 3 weeks to 24 months). There are two peaks of seasons during which the condition is common (July to September, and January to March). There is a male preponderance with a M:F ratio of 1.3:1. The presenting symptoms were cough (100%), breathlessness (100%), expiratory wheeze (97%), restlessness (65%), sleeplessness (63%), excessive sweating (57%), excessive crying (45%), family history of asthma / allergy / atopy (42%), inability to eat / suck (33%), running nose (31%), abdominal pain in the older infant (27%), vomiting (13%),and exhaustion (7%). The observed clinical signs are: tachypnoea (100%), recessions (100%), rhonchi (100%), dehydration (27%), cyanosis (5%), and hepatomegaly (3%) identified trigger factors include: insecticide spray in 36%, fumes from frying oil in 12%, smoke from kerosene stove in 10%, firewood smoke in 8%, dust in 9%, exposure to cold air and fan in 9%, perfume spray in 8%, mosquito coil smoke in 3%, and kerosene aspiration in 1%. All the children responded well to nebulised salbutamol, while only 7% required the addition of steroid and other supportive care where necessary. Conclusion: Identified household trigger factors of bronchospasm in children less than two years of age include: insecticide spray, fumes, smoke from stove and firewood, and exposure to cold air. The elimination of these factors from the environment of the affected child would go a long way in preventing the attacks. Keywords: infants, bronchospasm, trigger factors, nebulised salbutamolSahel Medical Journal Vol. 8(3) 2005: 55-5

Determinants of poor prognosis in children with cerebral malaria in an urban city of Nigeria

No Abstract.Tropical Journal of Health Sciences Vol. 14 (1) 2007: pp.4-1