Search

Background: Jaundice is the yellowish discoloration of the skin, sclera and mucous membranes resulting from deposition of bilirubin. Neonatal jaundice is a leading cause of neonatal admissions in the first week of life and risk factors such as sepsis, prematurity, glucose-6-phosphate dehydrogenase enzyme deficiencies, use of native herbs and contact with naphthalene balls contaminated clothes have been identified for neonatal jaundice. Objective: To determine the risk factors for neonatal jaundice at University of Benin Teaching Hospital, Benin City. Methods: This retrospective study was conducted at the Special Care Baby Unit of the University of Benin Teaching Hospital, Benin City. Case notes of babies admitted from January 2006 to December 2008 were retrieved and information on biodata, gestational age, anthropometric values, potential risk factors, level of serum bilirubin at presentation and discharge, mode of treatment and outcome were extracted. Results: Of the 1784 babies admitted during the period, 472 (26.5%) were admitted for neonatal jaudice. Fifty seven percent of the babies with neonatal jaundice were delivered in UBTH (in-born babies), while 202 (42.8%) of the babies were born before arrival (out-born babies) in UBTH. The Male: Female ratio was 1.02:1. The mean age at presentation with jaundice was 3.43 ± 3.76 days of life. Outborn babies tended to present at an older age (6.08 ± 5.19 days) than in -born babies (2.47 ± 2.48 days). The mean serum bilirubin value in out-born babies (14.00 ± 4.58 mg/ dL) was significantly higher than that observed among the in-born babies 9.35 ± 4.38 mg/dL: p = 0.000). The risk factors identified were use of mentholatum, naphthalene balls and native herbs in 40.0%, 16.7% and 7.0% respectively. ABO incompatibility was found in 7.6% of babies. No risk factor was identified in 36.3% of the babies. The case fatality rate in this study was relatively high particularly in association with sepsis, prematurity and asphyxia. Mortality was higher in out-born babies than in in-born babies (p= 0.00). Conclusion: Early presentation of babies and adequate management of sepsis and prematurity will reduce mortality associated with neonatal jaundice.

Neutropaenic enterocolitis (NE) is a life-threatening condition characterised by an inflammation of the colon and/or the small bowel in the background of chemotherapy-induced neutropaenia. A 16-year-old girl with acute myeloblastic leukaemia (AML) developed fever, right-sided abdominal pain and tenderness with severe neutropaenia. Initial ultrasound findings suggested acute appendicitis for which she had surgery. She developed recurrent symptoms 3 weeks later. Abdominal computed tomography (CT) scan showed features of NE, but she succumbed to the illness. Another 17-year-old boy with AML developed fever and severe right-sided lower abdominal pain and tenderness, following completion of induction chemotherapy. He was neutropaenic and abdominal CT was typical of NE. He was managed nonoperatively and symptoms resolved. The diagnosis of NE can be a dilemma. A high index of suspicion is needed to avoid a misdiagnosis of acute appendicitis., Competing Interests: None

Background: Accidental childhood poisoning contributes significantly to childhood morbidity and mortality worldwide. A review of the agents which cause poisoning in our locality from time to time is important in planning prevention strategies and treatment modalities., Objective: To document the pattern of accidental childhood poisoning at the Children Emergency Room (CHER) of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria., Methods: A retrospective study in which records of admissions as well as case notes of patients admitted because of ingestion of poisons from October 2011 to June 2014 were obtained. Demographic characteristics, type of poison, where poison was kept, route of poisoning and outcome were extracted from medical records of the patients., Results: Fifty-five (1.44%) patients were admitted for accidental poisoning of a total of 3,822 admissions. Thirty-nine (70.9%) were males while 16 (29.1%) were females. The median and modal age at presentation was two years (range of 0.5-7 years). Route of poisoning was by ingestion in 54 (98.2%) patients. The commonest agent of poisoning was kerosene (32.7%); followed by medicines (18.2%), insecticides (16.4%) and caustic soda (12.7%). Forty-nine (89.1%) patients were discharged home with fatality in one (1.8%)., Conclusion: Kerosene is still the major agent of poisoning in Benin City, although the prevalence has decreased. Alcohol poisoning has also decreased while ingestion of medicines has increased. The use of beverage and disposable water containers to store poisonous substances and keeping them in easily accessible areas in the home is still rampant. Measures to prevent access of children to these substances will greatly reduce the burden of accidental poisoning.

Background Sickle cell disease (SCD) is a major genetic disease that manifests early in life and may lead to significant morbidities. One of the health care services that have been effective in reducing the burden of SCD in developed countries is newborn screening (NBS) followed by pneumococcal vaccines, penicillin prophylaxis, and hydroxyurea treatment. Yet, in sub-Saharan African countries, where about 75% of annual affected babies worldwide are born, NBS programmes are largely unavailable. It is not clear whether this is due to technical challenges associated with setting up such programmes, or significant cultural and social barriers to its acceptance in such settings. Objective Our aim was to ascertain the attitudes to and acceptability of NBS in Nigeria among various socio-demographic groups including health professionals, undergraduate students, parents of children with SCD and SCD patients. Methods Data on socio-demographic characteristics, knowledge of SCD and attitude towards NBS were collected using a semi-structured pre-tested questionnaire from April to July 2014 across 15 health institutions and university campuses in Nigeria. Data were collected from 1,301 respondents across Nigeria. Results There was good knowledge of SCD as an inherited blood disorder. Although 86% of respondents (n = 1,119) supported NBS, there was a statistically significant relationship between support for NBS and age (p = 003), educational status (p = 000) and religion (p = 000). Conclusion This study suggests that there is a good acceptability of NBS across Nigeria. The main barriers to its use are likely to be financial and practical, rather than social or cultural., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2018, Nnodu et al.)

Background: Blood transfusion is a life-saving procedure in paediatric practice. It is important in replacing blood volume in cases of haemorrhage or providing specific blood components as required. However, the procedure carries some risks and complications. The decision to transfuse, frequency of transfusion and the availability of safe blood and blood products are essential determinants of the success of the procedure. Hence, knowledge of the indications and rate of transfusion is important to ensure that blood for transfusion is safe and made available as at when due., Objective: To determine the common indications for blood transfusion, the frequency of transfusion and outcome of transfused patients., Methods: Transfusion records of children admitted into the Children Emergency Room (CHER) of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria from January 2010 to December 2011 were retrieved. Information on the patients' biodata, indications for transfusion, type of blood product and outcome were documented., Results: Within the 24 months under review, a total of 4133 patients were admitted, out of which 655 (15.8%) were transfused. The age of the children ranged between one month and 17 years (median and modal age was 2 years). Commonest indications for transfusion were severe malaria (55.4%), sepsis (11.5%) and sickle cell anaemia [SCA] (4.0%). Whole blood constituted the highest type of blood product utilized (99.7%). Of the 655 patients transfused, 226 (34.5%) had multiple transfusions. The frequency of blood transfusion was 1.2 transfusions per day. Ninety two percent (605) of the patients were discharged from CHER while nine (1.4%) discharged against medical advice. Mortality amongst them was 6.2% (41 patients). The ages of the patients (p = 0.56, C.I. = 0.99, 1.01) and the number of blood transfusions (p = 0.66, C.I.= 0.48, 1.60) were not significant predictors of mortality., Conclusion and Recommendation: Majority of the patients were transfused following preventable disease conditions. Reduction of the burden of these conditions by good environmental hygiene, use of insecticide treated nets (ITN), indoor residual spraying (IRS), prompt hospital presentation and genetic counselling may greatly reduce the need for blood transfusion in the region.

Objective: To determine the pattern of care sought in cases of psychiatric emergency before presentation to a tertiary health care center., Method: Consecutive recruitment of 180 emergency psychiatric cases, which comprised a total of 156 patients, presenting to the accident and emergency unit of the University of Benin Teaching Hospital (UBTH), Edo State, Nigeria, was conducted from June 2008 to January 2009. A structured instrument was used to gather the patients' information including their sociodemographic characteristics, their care before presentation, and the relations accompanying them to the hospital., Results: The mean ± SD patient age was 33.82 ± 12.64 years, with an age range of 18-73 years and a modal age of 23 years. The male to female ratio was 1:1.05. Of the patients, 121 (77.6%) were not married, while 35 (22.4%) were married. Most identified as Christian (96.2%). The majority of the patients (70.0%) presented to the hospital through self-referral. Eighty (44.4%) of the patients had not sought any treatment before coming to UBTH. Forty-seven patients (26.1%) had sought care in churches, 39 (21.7%) had sought treatment in other hospitals, and 12 (6.7%) had sought traditional care before presenting to UBTH. Seventy-four patients (41.1%) were accompanied by parents and 44 (24.4%) were accompanied by siblings, while the spouse accompanied 23 (12.8%) patients., Conclusions: Most patients with psychiatric emergencies at UBTH prefer to present directly to the tertiary health care center in Benin City, and they are usually supported by their immediate family members.

Background: Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina which occurs in premature babies due to defective vasculogenesis. There are established screening guidelines to enhance its early identification and prompt treatment. The aim of the study was to determine the level of awareness of the screening protocols for retinopathy of prematurity (ROP) among paediatricians in Nigeria., Methods: A questionnaire was administered to paediatricians and residents in paediatrics attending a continuous professional development (CPD) course in Benin City, Nigeria. Information on their knowledge of risk factors, screening guidelines and treatment modalities for ROP was obtained., Results: There were a total of 48 participants. The mean age of the participants was 34.5 ± 4.5 years of which 25 (52.1%) were females. A majority, 46 (95.8%) knew some risk factors for ROP. Fourteen (29.2%) participants knew the ROP screening guidelines while 10 (20.8%) had partial knowledge of these guidelines. Knowledge on the use of laser as a treatment modality of ROP was shown by 18 (37.5%) participants. The major reason given for not screening for ROP was being unaware of a referral centre in Nigeria in 43 (89.6%) participants., Conclusion: The majority of paediatricians attending a CPD course in Nigeria though aware of retinopathy of prematurity, are currently poorly informed on the management of this condition and the need for screening. There is need to enlighten paediatricians in Nigeria on retinopathy of prematurity in order to prevent this treatable cause of blindness in children.

Objective: To determine the prevalence of RHD among primary school pupils in Egor Local Government Area (LGA) of Edo State of Nigeria., Design: A cross sectional study, Setting: The study was carried out among selected primary pupils in three public and six private schools in Egor LGA, (the smallest governmental unit) in mid-Western Nigeria., Subjects: Using a multistage sampling technique, pupils were selected from public and private primary schools in Egor LGA. They were clinically screened for evidence of RHD by auscultating for significant murmurs. The pupils with significant murmurs then had echocardiographic evaluation to confirm the presence of RHD., Main Outcomes: Pupils with significant murmurs and pupils with echocardiographically confirmed RHD., Results: Of the 1764 pupils recruited, 900 (51.02%) were females while 864 (48.98%) were males. The mean age of the pupils was 8.86 ± 2.14 years. 1065 (60.37%) and 699 (39.63%) respectively were recruited from public and private schools. Of the 1764 pupils, six (0.34%) had significant murmur. Only one of the six had RHD, giving a prevalence of 0.57/1000 pupils. The pupil with RHD was a male, from public school and in the low socioeconomic class., Conclusion: The prevalence of RHD in this study is low compared to similar studies conducted outside the country. The true prevalence may be underestimated since higher prevalence is obtained from echocardiographic based screening compared to clinical screening.