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Background Although, the use of manual dipstick urinalysis for proteinuria has been a common practice, the Kidney Disease Improving Global Outcomes (KDIGO) guideline on screening for chronic renal disease least advocate it use. Besides, several studies have assessed the performance of dipstick urinary in screening for proteinuria to be inaccurate, unreliable with a poor predictive values. The goal of this study was to determine and compare the presence of significant proteinuria (SP) in high-risk African children using the spot urine protein creatinine ratio (UPr/UCr) as a primary screening tool besides dipstick proteinuria screening. Methods This cross-sectional study involved 1,316 apparently healthy children recruited through a multi-stage sampling technique in Ogbomoso land, Nigeria. We performed a dipstick urinalysis on early-morning urine samples. Urinary protein content was determined using a turbidimetric method and Jaffe’s reaction to measure the urinary creatinine concentration. Statistical analysis was performed using the IBM Statistical Package for Social Sciences (SPSS)TM, Version 23.0 for Windows. Results The prevalence of SP using spot UPr/UCr (≥ 0.2) and dipstick proteinuria screening (≥1+) were 18% and 0.8%, respectively (p

Background. Streptococcus pneumoniae remains a major cause of childhood morbidity and mortality in the world. The introduction of pneumococcal conjugate vaccine in developing countries will be facilitated by a clearer understanding of the disease burden for bacterial causes of pneumonia and meningitis and the prevalent serotypes of S. pneumoniae. Methods. We conducted a prospective, hospital-based surveillance for a 2-year period involving children aged 2-59 months at 3 urban hospitals in Ibadan, Nigeria, using standard microbiological methods with confirmation and further testing of isolates at the Medical Research Council Laboratories in The Gambia. Results. There were 1210 cases overall: 481 (39.8%) were meningitis, 399 (33.0%) were pneumonia, and 330 (27.2%) were bacteremia clinical syndromes. There were 24 cases of definite meningitis, of which 9 were caused by S. pneumoniae, 11 by Haemophilus influenzae type b, and 4 by Klebsiella species. Of the 90 culture-positive pneumonia cases, 9 were caused by S. pneumoniae, 2 by H. influenzae type b, and 79 by other species. Among cases of bacteremia, the pathogen isolation rate was 28.8% (95 of 330); the isolated species included S. pneumoniae (3 isolates), Staphylococcus aureus (20 isolates), Klebsiella species (13 isolates), Salmonella species (15 isolates), and Escherichia coli (6 isolates). Of the 23 S. pneumoniae isolates, 11 were serotyped; the serotypes found were 5 (5 isolates), 19F (3 isolates), and 4 (3 isolates), and 1 isolate was nontypeable. These isolates were all susceptible to penicillin. Eight of 9 patients with definite pneumococcal meningitis died, whereas all patients with pneumococcal pneumonia and septicemia survived. Conclusions. Of the pneumococcal serotypes identified, 55% were covered by the licensed 7-valent pneumococcal conjugate vaccine, whereas all are covered by the 10- and 13-valent vaccines.

Objectives : To evaluate the short term prognosis of childhood heart failure and highlight the factors that affect outcome among cases of heart failure admitted into the paediatric wards, University College Hospital, Ibadan. Background : Childhood heart failure remains a major cause of morbidity and mortality in the developing world. The advent of open heart surgery, use of better myocardial preservative techniques, and the introduction of newer, more effective drugs in the treatment of heart failure have greatly improved the outcome of children with heart failure in the developed world but the outlook of such children in the developing world however remains poor. Methods : One hundred consecutive cases of heart failure admitted into the Paediatric wards of the University College Hospital, Ibadan with a diagnosis of heart failure over a 10-month period were studied prospectively. Diagnosis of heart failure was based on the presence of at least three of the four cardinal signs of heart failure: tachypnoea, tachycardia, tender hepatomegaly and cardiomegaly. All cases were followed up daily till a definite outcome was determined. Results : The predominant underlying causes of heart failure were acute respiratory infections (36%), severe anaemia (28%), and congenital heart disease (25%). There was a case-fatality rate of 24% among the study population. Poor prognostic indices identified were age below one year or above 5years, presence of underlying acute respiratory infections, rheumatic heart disease and renal disorders. Conclusion : Heart failure in Nigerian children though mostly due to preventable causes, are associated with an unacceptably high mortality. Keywords : heart failure, children prognostic indices Resume Objectifs : Evaluer le prognostic a court terme du cardiaque d'enfance et souligner des facteurs qui touchent le resultat parmi les cas des cardiaques admis dans la salle d'hopital pediatrique, college hospitalier universitaire, Ibadan. Introduction : Le cardiaque d'enfance demeure une cause principale de la morbidite et mortalite dans les pays en voie de developpement. L'avenement de la chirurgie a coeur ouvert, l'utilisation de meilleurs techniques du preservateurs du myocarde, et l'arrivee de nouveau et des medicaments plus efficace dans la prise en charge du cardiaque sont fortement ameliore le resultat chez des enfants atteints du cardiaque dans les pays developpes malheureusement, le cas des enfants pareils dans les pays en voie de developpement demeure mauvais. Methodes : Cent cas consecutifs des cardiaques admis dans la salle d'hopital pediatrique du College hospitalier Universitaire, Ibadan avec un diagnostic du cardiaque au cours d'une periode de 10 mois ont ete etudie en perspective. Le diagnostic du cardiaque etait fonde sur la presence du moins, trois des quatre signes principaux du cardiaque: tachypnee, tachycardie, hepatomegalie tendre et cardiomegalie. Tous les cas ont ete suivi chaque jour jusqu' au moment ou on a pu decider un resultat bien arrete. Resultats : Les causes de base predominantes du cardiaque etaient infections respiratoire intense 36%, anemie grave 28%, et maladie congenitale du coeur 25%. Il y avait un taux de cas fatalite de 24% parmi la population d'etude. Signes prognostiques mauvais identifies etaient âges moins d'un an ou plus de 5 ans, presence des infections respiratoire grave de base, rhumatismal maladie du coeur et troubles renaux. Conclusion : Le cardiaque chez des enfants nigerians quoiqu'il soit principalement attribuable aux causes evitables sont lies a un niveau de la mortalite inadmissible. West African Journal of Medicine Vol. 24(1) 2005: 325-328