A three-year survey of neonatal septicaemia (363 bacteriologically proven cases) in the University of Calabar Teaching Hospital, Calabar, has demonstrated that the dominant blood isolate was Staphylococcus aureus (53%) followed by unclassified Coliforms (20%), an unexpected Chromobacterium violaceum (5%). The incidence of neonatal septicaemia was 54.9 per 1000 live births for inborn infants. The predominant organisms were largely susceptible to gentamicin, ceftriazone and cefuroxime with a mortality rate of 19% with most (60.9%) of the fatalities being due to Gram-negative organisms.

We studied the prevalence of congenital malaria among neonates with suspected sepsis and its outcome at the University of Calabar Teaching Hospital, Calabar, Nigeria. All in-born neonates admitted to the newborn unit with clinical features suggestive of sepsis were recruited. They were screened for bacterial sepsis and malaria. The mothers of the neonates that had parasitaemia were further screened for malaria and anaemia. A total of 546 in-born neonates were admitted to the neonatal unit and 202 (37%) presented with clinical signs suggested of sepsis. Of these, 71 babies (35% of 202 or 13% of the total in-born nursery admissions) had congenital malaria and 14 also had sepsis. Sixty-three (88.7%) of the parasitaemic babies were delivered by mothers who received antenatal care at our centre. Eighty-six percent of the mothers of the 71 babies also had the malaria parasite in their blood. The majority (67%) of the 71 mothers were gravidae 2 and below. Thirty (42.3%) of the affected neonates were anaemic and 5 (7%) of them required a blood transfusion. Congenital malarial is not uncommon in Calabar among babies with suspected sepsis. It appears that the antenatal chemoprophylaxis with pyrimethamine (25 mg weekly) currently used for malaria in our centre no longer protects the mother and fetus. An alternative is needed in order to stem maternal, fetal and neonatal morbidity and wastage. Babies with features of sepsis should be routinely screened for malaria.

Introduction: Hepatitis E is a hepatotropic virus transmitted through the fecal-oral route and is prevalent in developing countries where sanitation is still a public health issue. There is no epidemiological data about this virus in Nigerian children. All the existing studies are hospital based, with obvious limitations. This study was conducted to establish the seroprevalence and predictors of viral hepatitis E antibody in children in Akpabuyo Local Government Area of Cross River State, Nigeria. Methodology: This was a community-based, cross-sectional study. A multi-staged sampling technique was used to select ten communities from which 406 children were recruited. The study period was April to June 2012. A structured interviewer-administered questionnaire was used for data collection. Blood samples were screened for anti-HEV IgG antibody using the enzyme-linked immunoassay technique. Multivariate logistic regression was used to identify factors that independently predicted the occurrence of the anti-HEV IgG antibody. A p value of < 0.05 was considered significant. Results: The seroprevalence rate of anti-HEV IgG antibody was 7.7% (95% CI = 5.1-10.3). The study population mainly (94.1%) comprised the lower social class. Levels of social amenities in these communities were generally poor, with virtually no piped water and modern sewage disposal systems. After multivariate analysis, the predictor of infection was the duration of residence in the study communities. Conclusions: HEV infection was prevalent in the study population. Educational campaigns and provision of good sewage disposal and piped water are of high necessity.

In a study of 149 cases of neonatal tetanus (NNT) admitted into the University of Calabar Teaching Hospital, 49 (33 per cent) were also found to have septicaemia. The dominant organisms were coliforms and Staphylococcus aureus. A comparison of the clinical features of the septicaemic and non-septicaemic neonates showed umbilical cord infection to be an indicator of septicaemia. There was no significant difference in the case fatality rates of the two groups of patients and the overall case fatality was low (37 per cent). This is attributable to early diagnosis and treatment of the septicaemia cases. It is suggested that paediatricians should have a high index of suspicion of septicaemia among cases of NNT as a means of reducing case fatality.

Background: The clinical features of hypoglycaemia and severe dehydration are similar, and these two can occur in a child presenting with acute diarrhoea. Hypoglycaemia occurring in a growing brain is deleterious and must be detected and treated. Objective: To determine the prevalence of hypoglycaemia among under-five children presenting with acute diarrhoea in UCTH, Calabar. Method: This was a prospective study of 150 children aged six weeks to five years presenting with acute diarrhoea in UCTH, Calabar from June 1st to October 31st 2008. Consecutive children who met the inclusion criteria were recruited into the study. Blood samples were collected for random blood sugar and serum electrotype estimation using One Touch Ultra Test Strips 2006 model and Flame photometry respectively. Results: The overall prevalence of hypoglycaemia in under-five children presenting with acute diarrhoea was 4%. There was no sex difference. It was commonest among children of the low socioeconomic class (83.3%). Risk factors to developing hypoglycaemia were longer duration of last feeds greater than five hours and severe dehydration, both reaching statistically significant differences (p=0.022 and 0.002; FET respectively). Forty percent of patients who died had hypoglycaemia constituting 33.3% of patients with hypoglycaemia. Conclusion: Children with diarrhoea complicated with severe dehydration are prone to developing hypoglycaemia. It causes high mortality and thus this parameter should be checked for and managed on time.

No abstract

No abstract

Neonatal intestinal obstruction is the most common surgical emergency in the newborn period. Prompt diagnosis and urgent management improve the chances of a favorable outcome. Aetiology and outcome may vary in different parts of the same country. Objective: To evaluate the aetiology and factors associated with mortality in neonates presenting with intestinal obstruction in University of Calabar Teaching Hospital, Calabar, Nigeria. Method: This was a retrospective study of clinical records of neonates presenting with features of intestinal obstruction over an eight year period. The biodata, diagnosis, management and outcome for the neonates were documented. Result: Forty neonates; 26(65%) males and 14(35.5%) females were studied. Imperforate anus was seen in 40% of subjects while Hirschsprung's disease and intestinal atresia each were seen in 10%. Aetiology could not be determined in about a fifth of the cases. Age less than one week at presentation was significantly associated with a poor outcome. No case had surgical intervention within twenty-four hours of presentation. The overall mortality was 30%, most of these 9 (75%) was due to anorectal malformations. Conclusion: The management and outcome of neonatal intestinal obstruction in our setting is poor. There is urgent need to upgrade our neonatal intensive care services to improve outcome in affected neonates. More Paediatric surgeons are required to reduce the gross inadequacy of expert as this would improve on the surgical intervention time as reported in this study.