Babies born to mothers co-infected with HIV and malaria are at increased risk for CM. All babies born by HIV positive mothers should be screened for CM.
Background: Down syndrome (DS) is a common chromosomal disorder associated with congenital heart disease (CHD) which could lead to severe morbidity or mortality. Objective: To determine the frequency and spectrum of clinical features, CHD and other comorbidities in children with DS in a tertiary care centre in Nigeria. Method: Consecutive children with clinical features of DS were recruited. The frequency of clinical features and co-morbidities were noted. All the children had echocardiographic evaluation to identify those with CHD. Results: A total of 64 children was recruited of which 36 (56%) were male. Fifty one (80%) had CHD of which atrio-ventricular septal defect (AVSD) was the commonest, being found in 20 (39%) children. Common clinical features present were oblique eyes in 64 (100%), depressed nasal bridge in 60 (94%) low set ears in 53 (83%) and epicanthal folds in 50 (78%). Conclusions: Prevalence of CHD amongst DS children in this study was 80% with AVSD being the commonest. The most prevalent clinical features seen in these children were oblique eyes, epicanthal fold, depressed nasal bridge, low set ears, hypertelorism and hypotonia.
Among mothers coinfected with malaria and HIV, vertical transmission of malaria and HIV was not associated with each other. HAART reduces vertical transmission of HIV especially if started before pregnancy.
Background. There is a dire need for paediatric critical care (PCC) services, but their availability in tertiary hospitals in Nigeria is not well defined. Objective. We evaluated self-reported PCC practice, resources, and perceived challenges in various zones of the country, using paediatric residents’ perspective. Methods. This is a descriptive cross-sectional survey, carried out at an Intensive Course in Paediatrics at the University of Benin Teaching Hospital, Nigeria. Participants’ PCC practice and perceived adequacy of PCC resources and services were assessed using a 100 mm uncalibrated visual analogue scale (VAS). A comparison between northern and southern zones was done. A 2-sided
p
value < 0.05 was considered significant. Results. A total of 143 residents participated in the study, 37.1% of them were male, and 62.9% were female. Their mean age was 34.6 ± 3.2 years. They were mainly (86.7%) from federal institutions across the country. Less than a half (46.7%) of the trainees attended to critically ill children daily, but only 4 out of every 10 respondents stated that such severely ill children survived till hospital discharge; 12.1% of the trainees had PICUs in their institutions. Financial constraints hindered PICU admissions. PCC staff were relatively fewer in northern zones than southern zones (
p
<
0.05
). Their perceived adequacy of PCC equipment and services were low (VAS scores 32.7 ± 2.6 and 30.9 ± 2.8, respectively) with a strong positive correlation between the two measurements (r = 0.839;
p
<
0.001
). Conclusion. There is an unmet need for PCC practice in Nigerian tertiary hospitals with a resultant low survival rate of critically ill children. PCC training curricula and improved critical care resources are desirable in the setting.
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