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53 Nigerian infants with neonatal meningitis were prospectively studied. The striking features were: (a) the higher predisposition (26.7-fold) of LBW infants to developing meningitis than has been previously reported in the literature; (b) the predominant role of E. coli and Staphylococcus aureus; and (c) the rarity of salmonella organisms and the conspicuous absence of group B streptococcus as aetiological pathogens. The outcome was related to the age of onset and type of micro-organism. The presence of neurological signs, particularly nuchal rigidity and bulging anterior fontanelle, carried a poor prognosis. The overall mortality was 37.7%.

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A prospective study of 55 infants with neonatal seizures admitted to the Special Care Baby Unit of the University of Benin Teaching Hospital over a 5.5-year period revealed that perinatal asphyxia and hypoglycemia were the principal aetiologic factors in about 71% of the cases. The most frequently encountered seizure types were unilateral clonic (51.5%). Generalized clonic and massive generalized myoclonic seizures were found in 14 (25.5%) and seven (12.7%) cases, respectively, and subtle seizures in three. The overall incidence was 3.5/1000 live births, with a preponderance of male infants in the seizure population, among whom preterm infants were significantly more common. The mortality, (34.5%) was closely related to the etiology. Since the associated adverse perinatal events are largely preventable, improved prenatal and perinatal health care delivery should lead to a decline in the frequency of neonatal seizures.

The present study assessed the prevalence of cardiovascular risk factors in 65 Nigerian medical students attending the University of Benin, Benin City, Nigeria. Their ages ranged from 17 to 28 years with a mean age for men of 20.9 years and for women of 18.8 years. Approximately 8% of the men and 0% of the women were current cigarette smokers, whereas alcohol use was observed in 14.6% of the men and in 0% of the women. The Nigerian men had significantly higher diastolic blood pressures than did American black and white men. Compared to American black men, the Nigerian men had considerably lower total cholesterol and triglyceride concentrations. The Nigerian women did not differ from American black women with respect to total cholesterol, but had significantly lower triglyceride concentrations. T he studies of the determinants of differences in the distribution of risk factors and disease among populations can often be evaluated by comparisons across geographic areas. Cross-cultural studies, including the Japanese-American comparisons, 1 studies of migrants in Israel, 2 and the Irish-Boston Study 3 have been successful in determining the influence of environmental and genetic factors on chronic diseases. There have been few attempts to compare the distribution of risk factors in American blacks to those in African blacks because of methodological issues, including nonstandardized procedures and incomplete sampling frames.46 Also, the selection of a healthy African population, in spite of the increased prevalence of infectious diseases (especially parasitic diseases) and the high prevalence of malnutrition, is an important consideration in cross-cultural comparisons. 678 The studies of risk factors and disease in Africans who are healthy (i.e., well-nourished and having minimal problems associated with serious infectious diseases as compared to the United States) may be of considerable interest in understanding the determinants of risk factors in Americans and in providing insight into future potential risks among blacks in Africa.In the United States, the study of black-white differences, risk factors, and disease is often confounded by socioeconomic status. It is hypothesized that socioeconomic level may determine variations in health habits or utilization of medical services. For example, among upper income and better educated American blacks, lower rates of adverse risk factors, such as cigarette smoking, alcohol intake, obesity, noninsulin dependent diabetes, and a Received April 4, 1986; revision accepted June 8, 1988. history of selected chronic diseases are found, compared to lower income and less well-educated blacks. 910 An increased prevalence of these adverse risk factors has been associated with a higher risk of heart attack, which is a leading cause of morbidity and mortality in American blacks. However, information concerning the prevalence of these risk factors in relation to socioeconomic status and the impact on chronic diseases, particularly cardiovascular diseases, is not available for b...