Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of babies, delayed initiation of breastfeeding and inadequate knowledge among health workers. Low-tech facilities to prevent heat losses and provide warmth are available in sub-Saharan Africa and are thus recommended as well as continuous efforts at sensitizing caregivers on the thermal needs of newborns.

Low arginine bioavailability is associated with vaso‐occlusive painful crisis (VOC) severity in sickle cell anemia (SCA) and predicts need for pediatric hospitalization. Intravenous arginine therapy has opioid‐sparing effects and was found to significantly decrease pain scores in children hospitalized with SCA‐VOC in a phase‐two randomized placebo‐controlled trial (RCT). Efficacy of oral arginine is unknown. Our objective was to determine the safety and efficacy of oral arginine therapy in Nigerian children with SCA. A double‐blind RCT of oral L‐arginine‐hydrochloride (100 mg/kg TID) was conducted in children with SCA‐VOC, aged 5‐17 years, hospitalized at two Nigerian sites. The primary outcome measure was analgesic usage, quantified by difference in the mean Analgesic Medication Quantification Scale (MQS). Secondary outcomes included daily pain scores, time‐to‐crisis‐resolution and length‐of‐hospital‐stay. An intention‐to‐treat analysis was performed. Sixty‐eight children (age 5‐17 years, mean 10.6 ± 0.4 years; 56% male), were randomized to receive L‐arginine (35 patients) or placebo (33 patients). The mean total MQS for the arginine group was 73.4 (95% CI, 62.4‐84.3) vs 120.0 (96.7‐143.3) for placebo (P < .001). The mean rate of decline in worst pain scores was faster in the arginine arm vs placebo (1.50 [1.23‐1.77] vs 1.09 [0.94‐1.24] point/d, P = .009). Children receiving arginine had a shorter time‐to‐crisis‐resolution (P = .02), shorter hospital‐stay (P = .002) and experienced no serious adverse event. Pain control was more rapid, total analgesic requirement was significantly reduced, and most notably, time‐to‐crisis‐resolution and length‐of‐hospital‐stay were shorter in children with SCA‐VOC receiving arginine vs placebo. Given the established safety and low cost, oral arginine is a promising adjuvant therapy for SCA‐VOC management.

Background: Neurological diseases account for more than 20% of the world's disease burden with majority of affected people living in Africa. However there is a paucity of literature on neurological disease in Africa. Methods: A retrospective review of 114 children with neurological problem seen at a paediatric neurological clinic in a 2-year. Results: Delayed developmental milestone, convulsion and inability to walk were the 3 most common reasons for referral to our Paediatric neurology clinic. Cerebral palsy (55.3%), Seizure disorder (26.3%) and postmeningitic complications (6.2%) were the common neurological disorder seen at our neurology clinic. The Paediatric outpatient department (POPD) of our hospital was the main source of referral for most cases (83.2%) and 71.1% of all patients resides within Zaria metropolis. The default rate from follow-up was higher among children with cerebral palsy compared to children with seizure disorder (58.7% vs. 13.3%, P< 0.001). Conclusion: Lack of adequate facilities for proper rehabilitation of children with cerebral palsy could have been the main reason for the high default rate from follow-up. Key words: Children, neurological disordersRésumé Introduction: La maladie neurologique constitue plus de 20% de problème de la maladie mondiale avec la majorité du peuple impliqué vivant en Afrique. Méthodes: Une rétrospective de 114 enfants avec des problèmes neurologiques vus au centre médical neurologique pédiatrique pendant 2 ans. Résultats: Développement rétardé d'événement important, convulsion et l'impulssance de marcher étaient les trois raisons les plus ordinaires pour envoyer un malade dans un centre médical neurologique pédiatrique. Palsie cérébrale (55,3%), Trouble d'attaque (26,3%) et des complications postmeningitique (6,2%) étaient des troubles neurologiques ordinaires vus dans notre centre médical neurologique. Le service pédiatrique des consultation externes (SPCE) de notre hôpital était la source majeur de renvoy pour la plupart des cas (83,2%) et 71,1% de tous les patients qui habitent dans un rayon de la métropole du Zaria. Le taux de défaut à partir du soins post-hospitalier était élevé parmi des enfants avec la palsie cérébrale par rapport aux enfants avec le trouble d'attaque (58,7% Vs 13,3%, P < 0,001). Conclusion: La pénurie des aménagements adéquats pour une rééducation propre pour des enfants atteints de la palsie cérébrale pourrait être la raison majeure pour un faux de défaut élevé à partir des soins post-hospitalier.

Introduction: Neonatal tetanus is a highly debilitating disease with high mortality. Global efforts at eliminating the disease in developing countries are yielding results but slower than expected. The high case fatality of neonatal tetanus remains a therapeutic challenge to physicians and requires continuous evaluation. This study aimed to determine the incidence and outcome of neonatal tetanus in Zaria, northwestern Nigeria. Methodology: A retrospective study of neonatal tetanus was conducted at the Neonatal Unit of Ahmadu Bello University Teaching Hospital, Zaria, between January 2005 and December 2009. Data generated were analyzed using the Epi Info version 3.5.1 software and statistical significance was set at p < 0.05. Results: Of the 2,692 newborns admitted during the study period, 20 had tetanus, giving an overall prevalence of 0.7%. There were 14 males and 6 females (male to female ratio 2.3:1). The mean age and weight at presentation were 8.3 ± 4.0 days and 2.7 ± 0.3 kg, respectively. The mean incubation period was 3.2 ± 2.0 days. Four infants (20.0%) survived, one was discharged against medical advice and 15 (75.0%) died. Factors associated with mortality were presentation at less than seven days of life, low Hendrickse score at presentation (p = 0.0005) and hypoglycaemia (p = 0.0374). Conclusion: The incidence and the mortality rate of neonatal tetanus appear to be lower than those previously reported by our centre for the same region. Therefore, the ongoing global efforts for disease elimination and further improvements in the quality of care should be sustained.