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Introduction: Brainstem Auditory Evoked Response (BAER) is an effective and objective hearing screening method in new-borns, especially those with Bilirubin Encephalopathy (BE). The most common and earliest manifestation of bilirubin neurotoxicity is involvement of the auditory nerve. This, often ‘silent’ sequel is sometimes missed, but can be detected early using BAER. The Bilirubin Induced Neurologic Dysfunction (BIND) score has been proposed to facilitate the clinical diagnosis of this disorder. Aim: To determine the effectiveness of BAER and BIND score in detecting Acute Bilirubin Encephalopathy (ABE) amongst neonates with hyperbilirubinaemia. Materials and Methods: A cross-sectional study involving 132 consecutive term neonates (66 neonates with Total Serum Bilirubin (TSB) ≥10.0 mg/dL and 66 age and sex matched controls) was conducted. Eligible neonates were subjected to BAER immediately after sample for bilirubin was taken and BIND scoring was done. The data was analysed with SPSS version 21. The mean, standard deviation and t-test was calculated for continuous data, while percentages and Chi-square test or fisher’s-exact test (where applicable) were computed for categorical variables. The sensitivity, specificity, predictive values of the BIND score relative to BAER and Receiver Operator Characteristic (ROC) curve analysis were also calculated. The level of statistical significance was set at p≤0.05. Results: The mean gestational age at birth of cases was 39.1±0.8 weeks, and 39.1±0.7 weeks for healthy controls. The age range of the neonates at presentation was between 24 hours to 15 days, with the mean age of neonates with hyperbilirubinaemia was 5.17±2.1 days while that of the healthy controls was 5.98±2.8. Thirty-six (54.5%) males and 30 (45.5%) females with hyperbilirubinaemia were enrolled (M:F 1.2:1), similar to 35 (53%) females and 31 (47%) males amongst the control group (M:F=1:1.1). The sensitivity and specificity of the BIND score relative to BAER was 93.8% and 90% respectively, with an area of 0.96 by ROC analysis. The BIND score had a positive predictive value of 75%, negative predictive value of 97.8% and an overall diagnostic accuracy of 90.9%. Conclusion: BAER audiometry and BIND score are useful diagnostic tools in detecting ABE. The BIND score is a reliable surrogate where BAER is not available to detect ABE.

Background HIV has emerged as one of the leading causes of childhood mortality and morbidity in sub Saharan Africa Antiretroviral therapy ART in children in Africa has resulted in dramatically improved survival However excellent adherence is one of the most important factors in determining treatment success and preventing viral resistance While studies of African adults showed that good adherence to ART is possible despite poor social circumstances there are limited data on ART adherence among African children and hence the need for the current study This study determined factors associated with adherence to highly active antiretroviral therapy HAART among HIV infected children in Kano Nigeria Method A cross sectional study was conducted at the Special Treatment Clinic STC of Aminu Kano Teaching Hospital Kano Nigeria The study population comprised HIV infected children taking ARV medications which accessed care at the Clinic between June and August and met the eligibility criteria A list of all children who were on HAART and had a clinic appointment within the study period was generated From this list participants were randomly selected using a computer based random number generator Caregivers were interviewed at the clinic using a structured questionnaire Results A total of children males out of contacted whose caregivers provided consent were recruited into the study The median age of the study children was years IQR to years A total of children were adherent to the prescribed antiretroviral drugs for the days preceding the interview Non adherence was found to be significantly associated with caregiver rsquo s report of missing at least one clinic appointment in the last six months p value and children on second line HAART regimen p value However children whose caregivers were older than years p value were more likely to be adherent than their respective counterparts Conclusion Adherence to HAART in children in Kano Nigeria was similar to reported adherence levels from other sub Saharan African countries Keeping clinic appointments was strong predictor of good adherence to HAART