Background:Neonatal tetanus is a vaccine preventable disease and is a leading cause of neonatal mortality in developing countries. The effectiveness of immunization and hygienic umbilical cord care practices in the prevention of the disease has been established.Objective:The objective of this study was to audit the scourge of neonatal tetanus in a tertiary health facility in a resource-limited setting.Materials and Methods:The study was a retrospective study. Case notes of neonates admitted with clinical diagnosis of tetanus into the Special Care Baby Unit (SCBU) between January 2009 and December 2010 were retrieved and evaluated to identify socio-demographic and clinical characteristics, mode of acquisition and severity of the disease, presence of co-morbidities, duration of hospital stay and outcome.Results:Most of the mothers had no tetanus immunization (66.7%) and the main social class of the children was class V (45.1%) and IV (41.2%), respectively. Only 29.4% of the mothers attended ante-natal care (ANC) while majority of the patients were delivered at home (94.1%). Half of the neonates presented with the severe form of the disease (51.0%). Sepsis is a prominent co-morbidity (59.2%). Morality was high with case fatality of 66.7%.Conclusion:This high prevalence of neonatal tetanus with high mortality is not only disappointing but unacceptable in the 21st century. Therefore, all efforts must be re-focused on current preventive strategies while pursuing new areas such as slow-release mono-dose tetanus vaccine and school health programme as well as advocacy on political will for the sustainability of immunization programmes of women of child-bearing age.

Background:Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate.Materials and Methods:In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate.Result:Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001).Conclusion:Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria.

Background: Malaria has remained a major public health problem in Nigeria with the under-five aged children and pregnant women being the most affected. The local epidemiological profile of the disease is dynamic owing to the continuous variation in the various determinants and hence the need for periodic re-evaluation. We aim to determine the prevalence of malariaparasitaemia among the under-five aged children and the effect of various determinants. Material and Method: In this cross-sectional study, 433 outpatients aged below 5 years with fever or history of fever in the previous 72hours were enrolled. Relevant information was obtained and recorded using a questionnaire. Thick and thin films were prepared from a finger or heel prick for each of the patients and subjected to microscopy. Result: The prevalence of malaria parasitaemia was 27.7%. Age, sex, nutritional status, socioeconomic class, temperature at presentation as well as ownership of insecticide treated nets had no significant effect on the prevalence of malaria (p>0.05). Only

Background. Tetanus toxoid immunisation of pregnant mother has remained the most effective strategy in eliminating neonatal tetanus. Impaired production and/or transplacental transfer of antibodies may affect the effectiveness of this strategy. We studied the effect of maternal HIV infection on serum levels and transplacental transfer of anti-tetanus antibodies. Methods. A total of 162 mother-baby paired serum samples were taken and analysed for anti-tetanus antibody levels using ELISA. Maternal HIV status was also determined by double ELISA technique. Maternal TT vaccination status was also documented. Results. Thirty-eight (23.5%) mothers and 41 (25.3%) babies were seronegative, out of whom 8 mothers were HIV positive and 9 babies were HIV exposed. HIV infected mothers and HIV exposed infants were, respectively, 16.27 times (OR = 16.27, 95% CI = 3.28 to 80.61) and 33.75 times (OR = 33.75, 95% CI = 4.12 to 276.40) more likely to be seronegative for anti-tetanus antibody. Similarly, HIV positive mother-newborn pairs were 7.46 times more likely to have a poor transplacental transfer of tetanus antibodies (OR = 7.46, 95% CI = 1.96 to 28.41). Conclusions. Maternal HIV infection is associated with impaired maternofoetal transfer of anti-tetanus antibodies and seronegativity among mothers and their newborns. Hence, this may hinder efforts to eliminate neonatal tetanus.

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Background:Smaller substances <600 Daltons (Da) can transit human placenta while larger ones >1000 Da may not. This may not be consistent because maternal measles antibodies (MMA) are large immunoglobulin G molecules with molecular weight of 150,000 Da, could cross the placenta in mother-infant pairs.Aim:The objective was to assess the efficiency of placental transfer of MMA in mother-infant pairs at birth.Subjects and Methods:Sera collected from mother-infant pairs were analyzed for MMA using enzyme-linked immunosorbent assay. Gestational age (GA) of newborns was determined using the last menstrual period, ultrasound scan, and the Dubowitz criteria, whereas their birth weight (BW) was measured using the bassinet weighing scale.Results:Correlation coefficient (r) of MMA of mother-infant pairs at birth was significant (P < 0.01) and comparison of mean MMA for term and postterm deliveries were significant (P = 0.001) and (P = 0.007) respectively. Goodman and Kruskal's Gamma rank correlation of GA and BW was also significant (P< 0.001).Conclusion:Passage of MMA across placenta was efficient and newborn infants are protected from measles at birth.

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