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Aims: To determine the incidence and severity of zidovudine-induced anaemia in HIVinfected children initiated on anti-retroviral therapy in Jos, Nigeria. Study Design: This was an observational cohort study.

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Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling  the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality. Key words: Neonate, Morbidity, Mortality, Nigeria

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Perinatal asphyxia is a global neonatal problem, which significantly contributes to both neonatal morbidity and mortality. This study was therefore undertaken to determine the prevalence, risk factors and outcomes of perinatal asphyxia in Makurdi, Nigeria. A retrospective review of clinical data of all newborns managed at the Special Care Baby Unit of the Benue State University Teaching Hospital over a 5 year period (January 2015-December 2019) was carried out using the research clinical data form. Maternal information including biodata, obstetric history, perinatal events as well as neonates' presentation and outcomes were reviewed. All inborn neonates with Apgar scores <7 at 5 min or out-born neonates with no recorded Apgar scores but with history of poor cry/inability to cry at birth were classified as asphyxiated. Out of the 1142 neonates admitted during the study period, 127 neonates had perinatal asphyxia with prevalence of 11.1%. Eighty-four (66.1%) of the newborns were males, while 43(33.9%) were females with male to female ratio of 1.95:1 Majority of the newborns(89.1%) were managed and discharged without early neurologic complications; eight survived with early neurologic complications, eight were discharged against medical advice, while 7 newborns died, giving a case fatality rate of 5.5%.Risk factors significantly associated were Meconium-stained amniotic fluid(P=0.002) ,fetal presentation (P=0.030),and birth attendants (P=0.001). The burden of perinatal asphyxia still persists in our environment. Associated factors in this study were meconium-stained liquor and unskilled birth attendants. Hence pregnant women should be encouraged to attend antenatal care and should ensure skilled birth attendants attend delivery with capacity to conduct safe delivery and institute neonatal resuscitation when necessary.

The main objective of this study was to determine the prevalence of preterm births, risk factors and the outcome in a Tertiary Hospital in North Central Nigeria. Setting and Methods: The study was based on the data of records of all preterm admissions over a three-year period at Benue State University Teaching Hospital (BSUTH), Makurdi, Benue State. Results: During this period, a total of 778 neonates were admitted out of which 95 (12.0%) were preterm with gestational ages ranging from 21 -36 weeks with an average mean gestational age 31.27 weeks (±3.2) and birth weights from 500 -2490 g with a mean of 1440 g (±0.45). There were 48 males and 47 females (M: F 1.02). 76 (80.0%) were delivered by spontaneous vaginal delivery while 19 (20.0%) were delivered by caesarean section. 37 (39.0%) were delivered in BSUTH while 58 (61.0%) were delivered elsewhere and referred or brought into Special Care Baby Unit (SCBU). The duration of hospital stay ranged from 1 -90 days, with a mean duration of 17 days (±15.2 days). The commonest risk factor for prematurity was premature rupture of membrane followed by multiple pregnancy and lack of Ante natal care (ANC). The commonest morbidity in the patients in the present study was sepsis followed by respiratory problems and jaundice. Of the 95 preterm, 60 (63.2%) were discharged, 27 (28.4%) died, while 8 (8.4%) were discharged against medical advice (DAMA). Conclusion: Prematurity remains a major cause of morbidity and mortality in our SCBU. There is urgent need for the establishment of a neonatal intensive care unit with adequate manpower and appropriate equipment so as to improve the survival rates of this vulnerable group of patients.

Background:Interrupting anti-retroviral therapy (ART) for any number of reasons is an indication of a compromised adherence to ART. Several factors, including the pill burden from other drugs used in treating co-infections in children with human immunodeficiency virus (HIV), may influence ART adherence. The aim of this study was to identify the factors associated with ART interruption in HIV-1-infected children.Materials and Methods:A retrospective cohort study analysing data on 580 children consecutively enrolled on ART between February 2006 and December 2010 at the paediatric HIV clinic of Jos University Teaching Hospital (JUTH), Jos. Subjects were children aged 2 months — 15 years diagnosed with HIV-1 infection and on first-line ART. Cotrimoxazole prophylaxis was usually commenced at diagnosis while awaiting ART commencement. Children diagnosed with tuberculosis (TB) were also placed on multiple individual anti-TB drugs.Statistical analysis used:A comparison of the data on children with and without ART interruption was made. Variables associated with ART interruption in a univariate analysis were fit in a multivariate logistic model to determine the factors that were associated with ART interruption.Results:Children on anti-TB drugs were twice more likely to interrupt ART compared to those who were not, (adjusted odds ratio, AOR = 1.84 (1.03-3.28); P = 0.04). But children on cotrimoxazole prophylaxis had a 57% reduction in the odds of interrupting ART compared to those who were not, (AOR = 0.43 (0.20-0.93); P = 0.03).Conclusion:Children on ART and also taking multiple individual anti-TB drugs should be monitored closely for ART adherence. Cotrimoxazole prophylaxis should be encouraged in children diagnosed with HIV while awaiting ART commencement as this may prime them for a better ART adherence.