Aetiology of neonatal jaundice in apparently well late-preterm and term neonates at a mission hospital, Southwestern Nigeria

Background: The knowledge of the aetiology for neonatal jaundice is important in the early detection and effective management of infants with or at risk of severe jaundice before hospital discharge. This study assessed the aetiological factors of neonatal jaundice among apparently well late preterm and termnewborns to ensure timely intervention where these risk factors exist.Method: This was a cross sectional study involving 174 apparently well neonates at a tertiary mission hospital. Detailed history, physical examination, relevant haematological and biochemical tests were undertaken. Significant jaundice was defined as serum bilirubin greater than 2 standard deviations above the postnatal age and weight dependent treatment concentration.Results: Of the 844 neonates admitted into the neonatal care unit, 174 (20.6%) had significant jaundice. Median age at presentation was 3 days (95% CI of median 3-4days). The mean ±SD gestation age and birth weight of the neonates at recruitment were 38.1±1.6 weeks and 3.1± 0.5kg respectively. Males were 108 (62.4%; M: F.1.6.1). The mean ±SD total serum bilirubin was 13.9±4.7mg/dl. Significant jaundice was more common with maternal-baby concordant paired blood group of AA, O-O compared with discordant materno-baby group pairs. Of the known causes of significant neonatal jaundice, G6PD deficiency (57-38.5%) ranked topmost. Half (87-50.0%) of the causes of significant jaundice were unidentified.Conclusion : G6PD deficiency remains the leading aetiology for significant neonatal jaundice. G6PD screening should be mandated before hospital discharge, compatible mother-baby blood group pairs do not rule the risk for significant jaundice; further research is required to elucidate other inherent unidentified aetiologies

Burden and outcome of respiratory morbidities among children and adolescents with sickle cell disease-A retrospective review of emergency presentations in some Nigerian tertiary institutions.

BackgroundDespite the huge burden of sickle cell disease (SCD) among Nigerian children, the burden and outcome of respiratory illnesses remain undocumented. Thus, we aimed to describe the spectrum and outcome of respiratory illnesses among SCD childrenand adolescentadmissions in ten Nigerian tertiary hospitals.MethodA retrospective review of the SCD admission records of children and adolescents with a confirmed diagnosis of respiratory illnesses from 2012 to 2021 in ten tertiary health facilities across five geopolitical zones in Nigeria was conducted. The data, collectedbetween March and June 2023, included the age, sex, diagnosis, complications, duration and outcome of hospitalization.ResultsOf the 72,333 paediatric admissions, 7,256 (10.0%) had SCD; the proportion of SCD from the total admission ranged from 2.1 to 16.3% in the facilities. Of the 7,256 children and adolescents with SCD, 1,213 (16.7%) had respiratory morbidities. Lower respiratory disease was the most common (70.0%) respiratory entity and the majority were pneumonia (40.1.0%), followed by acute chest syndrome (26.7%). Seventeen (1.4%) patients died; all had lower respiratory diseases [(acute chest syndrome ACS (11, 64.7%), pneumonia; 5, 29.4%, and asthma (1, 5.9%). Based on the proportion of deaths among overall SCD, the 17 death cases contributed 9.4% (95% CI 5.9 to 14.5). Factors associated with deaths included duration of hospitalization less than 72 hours and lower respiratory tract diseases.ConclusionSickle cell disease is a major contributor to hospitalization among Nigerian children and adolescents, with high respiratory morbidity and mortality. Pneumonia and acute chest syndrome were associated with mortality, andthe highest risk of death within the first 72 hours