Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive ciliopathy characterized by obesity, post-axial polydactyly, renal abnormalities, mental retardation, pigmentary retinopathy and hypogenitalism. Diagnosis is rare in early childhood, and only few of the features are present at that age. This is because the disease is slow evolving. However, it is possible to find majority of the component of this syndrome in very young children. A 3-year old very obese male presented with clinical features of sepsis and congestive cardiac failure. He is a product of non-consanguineous marriage with unremarkable family history. Both parents are of the Ibo tribe in Nigeria. Polydactyly was noticed at birth. There was delay in some aspects of his developmental milestone. Examination revealed mild hypertelorism and retrognathia, polydactyly of both feet with syndactyly of the big and second toes. Other findings were short broad hands, mottled pigments on the retina, moderate mental retardation, hypogenitalism, nephrotic syndrome, renal tubulopathy, hyperglycaemia and hypopigmented skin lesions. A case of BBS with all the primary features and some secondary manifestations in a very young child is hereby reported. A high index of suspicion for BBS should be shown in any young child with at least one of the features of this syndrome. This will enhance earlier diagnosis and improve disease outcome.

IntroductionThere is a decline in child mortality rate globally, courtesy of the erstwhile Millennium Development Goals. However, under-five mortality is still high in the African sub-regions. The need to review the morbidity and mortality pattern among children admitted into private health settings, where 60% of the medical conditions of the masses are being attended to in the sub-regions, cannot be overemphasized. This study aimed at documenting the morbidity pattern and outcomes of admissions among children admitted into the Living Word Mission Hospital (LWMH), Aba, Nigeria.MethodsThis was a retrospective descriptive study over a 3 year period. The study population comprised of all children aged 1 month to 15 years that were admitted into the pediatric wards of the Living Word Mission Hospital, Aba, Nigeria. The age, gender, diagnoses and disease outcome of these patients, were all retrieved from the pediatric ward registers and hospital medical records. The data were analyzed using SPSS, version 20.0.ResultsThere were 2278 pediatric medical cases admitted over the study period. Males were 1364 and females were 914, giving a male: female ratio of 1.5:1. More than 90% of these patients were aged < less than 5 years. Severe malaria (31.1%), septicaemia (16.6%), bronchopneumonia (15.4%), uncomplicated malaria (11.9%), acute watery diarrhea (10.5%) and meningitis (3.7%) were the leading causes of admission. Mortality rate was 5.7%, with 87.5% of these deaths occurring in under-fives. Septicaemia (34.6%) and Severe malaria (23.2%) were the leading causes of death.ConclusionThere is a high rate of paediatric admissions at Living Word Hospital, Aba. The under-five population remains a vulnerable group to both childhood morbidity and mortality. Septicaemia, malaria, bronchopnuemonia and acute watery diarrhoea were the leading causes of morbidity and mortality. Childhood mortality at LWMH is lower than observed in most government hospitals in Nigeria.

Background: Diarrhea is a major cause of childhood morbidity and mortality worldwide, particularly in low resource nations. To achieve the Sustainable Developmental Goal 3.2, effective steps should be taken to stem the tide of childhood diarrhea and its associated mortality. Objective: The objective of the study was to determine the prevalence of diarrhea and its associated risk factors in children aged 1-60 months presenting to our health facility. Materials and Methods: In the present retrospective study, we reviewed medical records of children aged 1-60 months with diarrhea admitted to the Children Emergency Room and Pediatric Medical Wards of the

Background: Childhood malaria has remained a major public health burden. It severely affects children aged under-5 years, particularly in Sub-Saharan Africa. Curbing the prevalence of malaria begins with determining the prevalence and related factors of the disease in the community. Objective: The objective of the study was to determine the prevalence and related factors of malaria in children at Aba, Southeast Nigeria. Materials and Methods: In this retrospective study, 275 case files of children admitted with malaria in the Department of Paediatrics of the Abia State University Teaching Hospital from January 1, 2016, to December 31, 2016, were analyzed. Results: During the study period, among the 440 overall admission, 275 children were diagnosed with malaria. The prevalence of malaria in our study was 62.5%. The male:female ratio was 1:1.2. We found, 234 (85.1%) children were <5 years of age, 23 (8.2%) belonged to the age group of 5-11 years, and 18 (6.7%) were aged between >11 and 16 years. The highest prevalence of malaria 40 (14.4%) occurred in September while the least 10 (3.6%) occurred in April. Around 247 (89.8%) patients were discharged home, 18 (6.5%) patients succumbed to death, and 6 (2.1%) patients were discharged against medical advice. Conclusion: The prevalence and mortality rates of malaria are high. To curb the trend of this disease, good environmental sanitation, prevention of the anophelene mosquito blood meal on humans, and early diagnosis and treatment of malaria should all be enhanced.

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Introduction: The first two years of life are particularly important as optimal nutrition and care during this period lowers morbidity and mortality. Much has been documented on morbidity and mortality among children aged under-5 years. This study was aimed at evaluating the contribution of morbidity and mortality in the first 2 years of post-neonatal life to under-5 morbidity and mortality. Results: The total number of children aged 29 days to 5 years, admitted over the study period was 480, out of which those aged 29 days-2years were 346 (72.1%). There were 300 males and 180 females giving male: female ratio of 1.7:1. Malaria, acute watery diarrhea and sepsis (35.6%, 21.3%, and 18.5% respectively) were the leading morbidities in those aged 29 days-5 years. Morbidity was significantly more in the 29 days-2years age bracket, P=0.042. Monthly morbidity was significantly more in the 29 days-2years age group, than the 29 days-5years age bracket. P=0.000. Two hundred and eighty-eight (83.2%) of those aged 29 days-2 years and 412(85.5%) of those aged 29 days-5years, respectively, were discharged; while their case fatalities were 12.4% and 9.8% respectively with no significant difference in their admission outcome. P = 0.081. Conclusions: The contribution of morbidity in the 29 days-2years age group is significantly high in the overall 29 days-5years age group morbidity. Measures taken to curb morbidity in the under-2 age group could impact positively on the health status of all children. Methods: This was a retrospective analysis of all the children aged 29 days to 5 years, admitted into the department of Paediatrics of the Abia State University Teaching Hospital, Aba, over a one-year period.

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