BackgroundChildren with acute febrile illness with no localizing signs often receive antibiotics empirically in most resource-poor settings. However, little is known about the burden of bacteremia in this category of patients, and an appraisal is thus warranted. This will guide clinical practice and promote rational antibiotics use.MethodsWe prospectively followed up 140 under-five children who presented with acute undifferentiated fever at the emergency/outpatient pediatric unit of a secondary healthcare facility. Baseline clinical and laboratory information was obtained and documented in a structured questionnaire. We compared baseline characteristics between participants with bacteremia and those without bacteremia. We further fitted a multivariable logistic regression model to identify factors predictive of bacteremia among the cohort.ResultThe prevalence of bacteremia was 17.1%, and Salmonella Typhi was the most frequently (40.9%) isolated pathogen. The majority (78.6%) of the study participants were managed as outpatients. The participants who required admission were four times more likely to have bacteremia when compared to those managed as outpatients (AOR 4.08, 95% CI 1.19 to 14.00). There is a four times likelihood of bacteremia (AOR 4.75, 95% CI 1.48 to 15.29) with a fever duration of beyond 7 days. Similarly, participants who were admitted with lethargy were six times more likely to have bacteremia (AOR 6.20, 95% CI 1.15 to 33.44). Other significant predictors were tachypnea and lymphopenia.ConclusionAmong under-five children with acute undifferentiated fever, longer duration of fever, lethargy, inpatient care, tachypnea, and lymphopenia were the significant predictors of bacteremia.
Background: The value of Cystatin C as a biomarker of Glomerular filtration rate (GFR) among African newborns is unknown, due to paucity of studies, restricting the measurement of GFR in this population of newborns to creatinine clearance despite its limitations. This study was therefore conducted to estimate GFR from serum Cystatin C in a population of Nigerian newborns and explored the relationship with anthropometrics. Methods: This was a cross-sectional, analytical study. A total of 60 healthy preterm and 30 healthy term babies were recruited at a tertiary hospital in North-central, Nigeria. Serum Cystatin C was determined using ELISA according to standard methods. Anthropometric measurements were done with standard methods. The GFR was estimated using Zappitelli's equation. Data were analyzed using SPSS Version 20, and p-value < 0.05 was considered significant. Results: Mean serum Cystatin C was 1.20 ± 0.33 (range 0.80-2.20) mg/L with comparable values in males and females (1.19 ± 0.35 vs 1.15 ± 0.31 mg/L, p = 0.481)). Mean serum Cystatin C among preterm babies were higher than term babies (1.31 ± 0.36 vs 1.01 ± 0.11 mg/L, p = < 0.001). Mean estimated GFR was 65.36 ± 16.9 ml/min/1.73 2 and was comparable in males and females (64.39 ± 17.95 vs 66.52 ± 15.76 ml/min/1.73 m 2 ,p = 0.555). Estimated GFR was lower among preterm than term babies (60.10 ± 17.53 vs 75.89 ± 9.1 ml/min/1.73 m 2 , p = < 0.001). Serum cystatin C and estimated GFR moderately correlated with gestational age and anthropometrics (length, occipitofrontal circumference and weight). Conclusions: Serum cystatin C as a biomarker GFR among newborns is low compared with most studies done out of Africa. The serum cystatin C and estimated GFR correlated with the gestational age and anthropometric parameters. The findings relationship between the serum Cystatin C, estimated GFR and anthropometrics among the newborns suggested a need for more studies. ARTICLE HISTORY
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