The study showed an unacceptably high rate of stillbirth in rural Nigeria. Early recognition of complications and prompt referral may reduce stillbirth rate.

Background. Soil-transmitted helminthic infection is a common public health challenge of primary school children in resource challenged and developing countries. Our aim was to determine the prevalence and pattern of soil-transmitted helminthic infection among primary school children in a rural community in Imo State, Nigeria. Method. The study involved a cross-sectional survey of 284 primary school children in a rural community. Results. The overall prevalence of soil-transmitted helminthic infection (STHI) was 30.3%. Of all STHIs, hookworm was the commonest geohelminth observed, 81 (94.2%). The prevalence of soil-transmitted helminthic infection was more in males, 58 (38.4%), than in females, 28 (21.1%). This difference was statistically significant (P = 0.001). Conclusion. The high prevalence rate of soil-transmitted helminthic infection amongst the study population is worrisome. There is need for organized and routine deworming among school children in the community.

Background. Adherence is the strongest predictor of successful treatment outcome among children infected with HIV. Our aim was to assess the antiretroviral drugs adherence status of HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria. Method. The study involved a cross-sectional survey of 210 HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria using self-report method of assessment. Optimal ART adherence is defined as patient taking not missing more than 1 dose of combined antiretroviral therapy medication in the preceding 2 weeks prior to the study. Result. A majority of the subjects 191 (91%) had good adherence. There was a significant relationship between adherence and patient educational level (p = 0.004), duration of treatment (p = 0.001), drug administrator (p = 0.005), and orphan status (p = 0.001). The motivating factor for adherence was “not falling sick as before” while stigma was the most discouraging factor. Conclusion. The adherence level in this study was good. Stigma was an important reason given by patient/caregivers for nonadherence. There is need for concerted effort in addressing this barrier to improve adherence and prevent the emergence of drug resistance and treatment failure.

Background: Congenital malformations (CM) are significant causes of childhood morbidity and mortality impacting negatively on the affected family’s emotional and financial life. It also results in an enormous burden on a nation’s health and socio-economic systems. However, few studies on CM have emanated from developing countries including Nigeria and specifically from Yenagoa, Bayelsa State which is located in the oil rich Niger Delta region. We therefore analyzed the prevalence, pattern and outcome of management of babies with CM seen at the Neonatal unit (SCBU) of the Federal Medical Centre, Yenagoa. This could be used as evidence for policy makers to develop and implement CM surveillance, prevention and supportive programs. Methods: This was a descriptive observational study of all neonates with CM admitted into the Special Care Baby Unit (SCBU) over a one year period from 1st February 2017 to 31st January 2018. Identification and confirmation of congenital anomalies was done by physical examination, diagnostic investigations and surgical interventions. The conditions were classified organ and system-wise except for the chromosomal abnormalities. The prevalence and pattern of defects were determined, while factors related to the outcome of the anomalies were calculated with odds ratio and 95% confidence interval. Data entry and analysis were performed using excel and SPSS version 22. Results: Among the 502 newborn admissions during the study period, congenital anomalies were found in 61 newborns, giving a prevalence rate of 12.2% with a female preponderance of 55.7%. The commonest CM were those related to the cardiovascular system (47.5%) followed by the digestive system (32.8%) then musculoskeletal system (19.7%). The mean duration of care was 9.7± 9.0 days with mortality of 30.5% recorded at that period. Babies with CM affecting the cardiovascular system and chromosomal anomalies were less likely to survive although these relationships were not statistically significant (p > 0.05). However, duration of care showed a statistically significant relationship with outcome as babies who spent one day and less in the neonatal unit  had  reduced odds of a favourable outcome (OR – 0.07). An increased odd of survival (OR – 2.09) was seen in babies with only one congenital birth defect. Conclusion: A high prevalence of Congenital malformations in newborns was demonstrated in this study. This has highlighted the need for a well-designed surveillance, prevention and supportive hospital, State and National programme for affected babies and their families.

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Duchenne muscular dystrophy is a progressive genetic disease with no cure at present. Children suffering from this disease eventually become wheelchair bound and die in their late teens. Paediatricians caring for the child with Duchenne Muscular Dystrophy in resource poor settings face a lot challenges. These challenges include: poverty, inadequate multidisciplinary care, emotional burn-out of parents and lack of facilities for dystrophin assay or genetic testing.

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Background: Malaria is a major cause of fever in endemic countries, although the prevalence of malaria has been declining across Sub-Saharan Africa, the proportion of clinical presentation attributable to febrile illness due to malaria to febrile illnesses have remained high. It is therefore important to determine the proportion of fever cases attributable to malaria. Methods: A descriptive cross sectional study was conducted among children aged 1-72 months presenting at a tertiary facility in Imo state Nigeria from 1st March, 2014 to 31st October, 2015. Children between 1-72 months of age with documented fever at presentation or history of fever in the last 24 hours without signs of severe malaria and those without any history of anti-malarial drugs administration were considered eligible. Fever was regarded as axillary temperature of ≥37.5°C. For all subjects (febrile and afebrile), the presence of Plasmodium falciparum was assessed microscopically by a WHO Certified malaria microscopist. Malaria parasite density was grouped as 1-1000, 1001–10000, and >10,000 parasites/µl respectively according to World Health Organization guidelines for grouping malaria parasitamae while data was analysed using SPSS 20.1v. Results: Overall malaria prevalence of both febrile and afebrile at point of assessment but with history of fever in the last 24 hours was 24.3%. Prevalence by microscopy was 26% among the 289 children who were febrile as at point of examination. There was no significant difference (p>0.05) between malaria prevalence in males as against females. Age group 49-72 months had the highest prevalence (42.6%), while age groups 25-48 and 1-24 months recorded prevalence of 35.7% and 25%, respectively (P<0.05). About 22.5% of afebrile patients had positive Plasmodium parasitaemia. The Geo-mean (range) of parasitaemia was 1427(8-180,000) parasite/µl while mean body temperature ± SD was 37.0±0.9°C. About 8% of the children had high parasite density. Conclusion: Plasmodium falciparum although linked with majority of fever is not the cause of fever in all instances. Healthcare providers should make more effort to correctly diagnose non-malaria febrile cases so as to optimize clinical outcomes for the patients and minimize possible over diagnosis and overtreatment of malaria.