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Introduction: Chronic kidney disease (CKD) among children is on the rise, both locally and globally. The burden of managing CKD in children from resource-poor centers and the developing nations as a whole is quite challenging. Pediatric CKD has remained a death sentence in many poor nations of the world, including Nigeria. Chronic kidney disease is asymptomatic in its earliest stages, although urinalysis findings or blood pressure may be abnormal. As CKD progresses to more advanced stages, signs and symptoms greatly increase, making the diagnosis of CKD more obvious. Case Report: We hereby report a rare presentation of only headache, sudden blindness, hypertension, and retinal detachment as the only pointer to end stage kidney disease (ESKD) in a 15-year-old girl. Conclusion: There is need for nephro-prevention in children, and a higher index of suspicion for CKD, with the intention of reducing or halting disease progression at earlier stages of the disease.

Introduction Chronic renal failure (CRF) is a multi-systemic disease affecting different organ systems of the body. Ocular manifestations of chronic renal disease include squint, subconjunctival hemorrhage, vitreous hemorrhage, neovascular glaucoma, cataracts and retinal detachment. These result in visual impairment or blindness. In this article, a case of bilateral exudative retinal detachment (ERD) in a pediatric patient with CRF and hypertension is presented. Methods The patient is a 16-year-old girl with CRF, grade 3 hypertension, and bilateral ERD. Detailed ophthalmic evaluation including visual acuity, anterior and posterior segments evaluation with +78 DS super field lens and digital slit lamp, intraocular pressure (IOP) measurement using a non-contact tonometer. B-mode ocular and renal ultrasounds scan were done. Results With the management of systemic hypertension, and hemodialysis, a slight improvement of vision was noted but this was not sustained as renal replacement therapy was not continued due to financial constraints. Conclusion Ocular disturbances may be the pointer to renal compromise. There is a need for thorough systemic review in patients with ocular symptoms and ocular evaluation in all patients with CRF and hypertension.

Background: Childhood malaria has remained a major public health burden. It severely affects children aged under-5 years, particularly in Sub-Saharan Africa. Curbing the prevalence of malaria begins with determining the prevalence and related factors of the disease in the community. Objective: The objective of the study was to determine the prevalence and related factors of malaria in children at Aba, Southeast Nigeria. Materials and Methods: In this retrospective study, 275 case files of children admitted with malaria in the Department of Paediatrics of the Abia State University Teaching Hospital from January 1, 2016, to December 31, 2016, were analyzed. Results: During the study period, among the 440 overall admission, 275 children were diagnosed with malaria. The prevalence of malaria in our study was 62.5%. The male:female ratio was 1:1.2. We found, 234 (85.1%) children were 11 and 16 years. The highest prevalence of malaria 40 (14.4%) occurred in September while the least 10 (3.6%) occurred in April. Around 247 (89.8%) patients were discharged home, 18 (6.5%) patients succumbed to death, and 6 (2.1%) patients were discharged against medical advice. Conclusion: The prevalence and mortality rates of malaria are high. To curb the trend of this disease, good environmental sanitation, prevention of the anophelene mosquito blood meal on humans, and early diagnosis and treatment of malaria should all be enhanced.

Background: The chronic course of nephrotic syndrome (NS), it is racial/regional variations, and associated risk of end-stage renal disease is of great pediatric importance. This underscores the need to study the characteristics of this cohort of patients in every nephrology setting. Objective: This study was aimed at documenting the characteristics of children presenting with NS in our hospital. Materials and Methods: This was a cross-sectional descriptive study of children aged 29 days–16 years admitted and managed for NS over 5 years at the Pediatric Nephrology Unit of the Abia State University Teaching Hospital, Nigeria. Children diagnosed with NS in our setting were consecutively enrolled in the study. The parameters documented and analyzed for each patient with NS included Biodata, presenting complaints, duration of illness before the presentation, intake of herbal concoctions, results of investigations done, response to the steroids, duration of treatment before remission, and outcome of admission. Steroid sensitive NS was followed up for a median (range) period of 18.2 (12.0–24.0) months to monitor remission and relapse. Results: A total of 6108 children were admitted into the pediatric wards during the study period, of which 104 were renal disorders. NS accounted for 0.8% of all the pediatric admissions and 49 (47.1%) of the admitted renal disorders. Male:female ratio was 2.3:1. The mean age was 8.35±3.99 years, with peak ages between 7 and 9 years. The major clinical features at first presentation were pedal edema (93.9%) and oliguria (87.8%). A total of 19 patients (38.9%) took herbal concoctions before the presentation (p

Background: Diarrhea is a major cause of childhood morbidity and mortality worldwide, particularly in low resource nations. To achieve the Sustainable Developmental Goal 3.2, effective steps should be taken to stem the tide of childhood diarrhea and its associated mortality. Objective: The objective of the study was to determine the prevalence of diarrhea and its associated risk factors in children aged 1–60 months presenting to our health facility. Materials and Methods: In the present retrospective study, we reviewed medical records of children aged 1–60 months with diarrhea admitted to the Children Emergency Room and Pediatric Medical Wards of the Abia State University Teaching Hospital, Aba, from January 1, 2015 to December 31, 2016. Results: The prevalence of diarrhea was 11.2%. The study consisted of 68 males and 32 females with male:female ratio of 2.1:1. Around half (53%) of the children belonged to the age group of 1–12 months, 40% in the age group of 13–36 months, and 7% children belonged to the age group of 37–60 months. Most of the cases (88%) reported of acute watery diarrhea. The greatest monthly prevalence was in February (47%). Mortality rate was 22% which was significantly more among the infants, than among the age groups of 13–24 months and 25–36 months, respectively (p=0.019). Conclusion: The prevalence and mortality rates of diarrhea in this study were high. The mortality was significantly more among infants. Curbing the mortality of diarrhea in the under-five age group requires adopting specific measures to prevent and manage diarrhea, with special focus on infants.

Background: Potable water, good sanitary conditions, and good hygienic practices are essential for the survival and development of children. Objective: The study aimed to determine the demographic and socioeconomic effect of water, sanitation, and hygiene (WASH) in the occurrence of diarrheal disease among pediatric age group in Aba, Abia State. Materials and Methods: The study adopted a descriptive cross-sectional survey design to assess the environmental sanitation in the selected study areas. The survey was designed with the use of questionnaire which was administered to a sample size of 360 participants. The collected data were entered into computer software called Statistical Package for the Social Sciences (SPSS) Version 20.0 and analyzed using descriptive statistical analysis. Results: The results were displayed in frequency tables and charts. The relation between variables was determined with Fisher’s exact test and the findings showed that 267 (74.1%) of the participants reported with 1–5 times episodes of diarrhea/year and 204 (56.7%) participants had available water supply and the major source of water supply was borehole in 227 (63.1%) participants. In terms of water treatment, 255 (70.8%) reported of not boiling water before use; 100 (27.7%) did not wash hands after defecation, 225 (62.5%) did not wash hands after touching pet animals, and only 32 (8.8%) reported of not washing fruits/vegetables before eating or cooking. A total of 264 (73.3%) had the knowledge of treating children with diarrhea at health center. Conclusion: WASH had impact in the occurrence of diarrheal disease among pediatric age group in relation to demographic and socioeconomic factors. However, the available and functional sanitary facilities do not meet the required standards. Therefore, awareness should be generated on the importance of WASH practices in all local governments in Abia State.

Background: HIV infection significantly increases depression risk in the caregivers of HIV-infected children. Our study is aimed at determining the depression prevalence and severity in caregivers of children who are infected with HIV. Materials and Methods: This was a hospital-based, cross-sectional, and comparative study. Study participants who met the inclusion criteria were enrolled consecutively to achieve the calculated sample size. Their sociodemographic variables were obtained, and the Zung Self-rating Depression Scale was used to assess the prevalence and severity of depression in the caregivers. Results: There were 352 study participants which comprised 176 caregivers of children infected with HIV, who served as cases and 176 caregivers of HIV-negative children, who served as controls. One hundred and fifty-five (88.1%) of the cases were the biologic caregivers, whereas the biologic caregivers comprised of 133 (75.6%) for the controls. Furthermore, 43 (24.4%) and 133 (75.6%) of the cases were males and females, respectively, whereas 47 (26.7%) and 129 (73.3%) of the controls were, respectively, males and females. The prevalence of depression among the cases and controls was 43.2% and 6.8%, respectively (P < 0.001; odds ratio [OR]: 10.39). Among the cases with depression, 73 (47.1%) were the biological caregivers, whereas 3 (14.3%) were the nonbiological caregivers. This was statistically significant (P = 0.009; OR = 5.341). The severity of depression among the cases was mild depression (52.6%), moderate depression (30.3%), and severe depression (17.1%). Conclusions: There is a high prevalence of depression among the caregivers of children infected with HIV and the biologic caregivers of these children tend to have a higher depression burden than their nonbiologic counterparts.

Background: Pediatric injuries constitute a significant health burden, particularly in developing countries, including Nigeria. Comprehensive and case-specific management including a good database is largely unavailable in these countries. Aim: This study aims to determine the causes and associated factors of pediatric injury (PI) in Aba, Southeast Nigeria. Materials and Methods: This was a retrospective study conducted for a period of 3 years (January 1, 2015–December 31, 2017) in a Mission Hospital in Aba. Data were obtained from the case notes of children aged 16 years and below, who were seen for injuries at the accident and emergency department (AED). Information extracted from the case files included the sex, age, nature of injury, venue of injury, body areas involved, and outcome of treatment. Results: PI constituted 13% of all trauma cases seen in the AED during the study period. There were 54 males and 39 females, giving a male:female ratio of 1.4:1. The leading mechanisms of injury were road traffic accident (RTA), 36 (38.7%) and domestic accidents, 27 (29%), while gunshot wounds 3 (3.3%) constitute the least. RTA occurred most frequently in the age groups of 6–15 years, 24 (25.8%). Again, 91.7% of RTA occurred in the urban area and involved mostly pedestrians crossing the road (55.6%). Children aged 0–5 years, 34 (36.6%) were the most frequently involved in PI. Leading mechanisms of injury in this age group were domestic accidents, falls, and burns. There was a statistically significant association between age and mechanism of injury (p=0.000). Mortality rate was 2%. Conclusion: Pediatric injuries constituted 13% of all trauma cases in this study. Children aged 0–5 years were the most frequently involved in PI. RTA and domestic accidents were the leading causes of PI. Very young children at home and older children crossing the road were vulnerable to pediatric injuries.

Introduction: A regular reappraisal of the morbidity and mortality pattern in our children emergency rooms will go a long way in policy makings that will help in achieving the sustainable development goal (SGD)-3. With such evidence-based policies, childhood morbidity and mortality will surely reduce.Objective: This study was aimed at re-appraising the morbidity and mortality pattern in our children emergency room (CHER), after the initial audit 10 years ago.Methods :This was a retrospective descriptive study over a 7-year period. The study population comprised of all children aged 1 month to 16 years that presented to the CHER of the Abia State University Teaching Hospital, Aba, Nigeria, from January 2011 to December 2017. The age, gender, duration of illness before presentation, diagnoses and disease outcome of these patients, were all retrieved from the CHER register and hospital medical records.Results: Six thousand eight hundred and twenty-five (6825) patients were seen over the study period. There were 4075 males and 2750 females, giving a Male: Female ratio of 1.5:1. Majority (>90%) of these patients were aged =5 years. Severe malaria (24.5%), Gastroenteritis (20.9%), bronchopneumonia (20.1%) and septicaemia (14.7%) were the leading causes of admission into CHER. Mortality rate was 6.2%, with >80.0% of this death occurring in children aged =5 years. Mortality was significantly associated with age and sex. Bronchopneumonia (37.0%) and severe malaria (33.0%) were the leading causes of death. A total of 5.1% of the patients were discharged against medical advice (DAMA).Conclusion: There was an increase in our patient load, and significant reduction in child mortality at our CHER. Infections and malaria remained the leading causes of morbidity and death. Improvement in human and material resources in the CHER is inevitable in achieving SDG-3.Keywords: Morbidity, Mortality, SDG, Children Emergency Room, Re-appraisal.Running title: Childhood Morbidity and Mortality at the Children Emergency Room of a Tertiary Institution.

Background: Urinary tract infection (UTI) is commoner in children with Congenital anomalies of the kidney and urinary tract (CAKUT) than in the general paediatric population. Recurrent UTI as a result of CAKUT may predispose children to renal scarring, hypertension and CKD. Prevention of UTI in this group of patients is advocated, but achieving this has become a medical challenge in view of the controversy surrounding use of prophylactic antibiotic. Methods: This was a 10 year retrospective review of Children with CAKUT who were placed on prophylactic antibiotics over a certain period, at an Academic Hospital in Johannesburg. The rate of UTI, the types of causative organisms isolated and the efficacy of prophylactic antibiotics in preventing UTI were documented. Results: One hundred and thirty four (134) patients with CAKUT were analyzed. Thirty six (36) of them had been started on prophylactic antibiotics after the diagnosis of CAKUT was made. There was a statistically significant association between the use of prophylactic antibiotics and the rate of UTI (p < 0.001). Patients who were not on a prophylactic antibiotic were five times more likely to have a UTI than those who were on a prophylactic antibiotic (OR = 5.21, P = 0.001, 95% CI: 1.9906 – 13.6277). Patients who were on prophylactic antibiotics showed an altered pattern of isolated bacteria, with Klebsiella pneumoniae being the most common organism isolated, rather than E. coli, when compared to the group that were not on prophylactic antibiotics. There was a statistically significant association between the type of bacteria isolated and the use of antibiotic prophylaxis (p= 0.031). Conclusion: Antibiotic prophylaxis was very effective in decreasing the rate of UTI in our cohort of patients with CAKUT.

Background: Oedema, a constant feature of childhood nephrotic syndrome can be severe, enough to cause respiratory embarrassment. It can also be refractory to diuretic monotherapy. In such cases, combination of salt poor albumin (SPA) infusion and diuretics has remained the best treatment option. However, the cost of SPA has made it practically unavailable in resource-poor settings. It becomes a therapeutic dilemma when nephrotic syndrome patients of financially-constrained caregivers present with refractory anasarca in a resource-poor settings. Case review: We present a seven-year-old boy with relapsed steroid sensitive nephrotic syndrome who presented to Abia State University Teaching Hospital Aba, in respiratory distress with anasarca and a weight of 58 kilograms. SPA could not be accessed due to financial constraints. A decision to use fresh whole blood in the place of SPA, in combination with frusemide, achieved a lifesaving diuresis and regression of the anasarca. Conclusion: Whole blood is a good alternative for the treatment of refractory oedema in children with nephrotic syndrome in resource poor settings.

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a well-documented risk factor for the development of urinary tract infection (UTI) in children. Prevention of UTI in this group of patients is advocated due to their increased risk of renal scarring, hypertension and end stage kidney failure. Methods: A 10-year retrospective review of CAKUT patients at the Johannesburg Academic Hospital, who were placed on prophylactic antibiotics over a certain period was done. The rate of UTI, the types of causative organisms isolated and the efficacy of prophylactic antibiotics in preventing UTI were documented. Results: Thirty-six (36) out of 134 patients had been started on prophylactic antibiotics after the diagnosis of CAKUT was made. There was a statistically significant association between the use of prophylactic antibiotics and the rate of UTI (p Conclusion: Antibiotic prophylaxis was very effective in decreasing the rate of UTI in our cohort of patients with CAKUT.

We report this case of a 15-year-old male who presented to the children outpatient clinic (CHOP) of Abia State University Teaching Hospital (ABSUTH), Aba on the 5th of November 2015. He had tuberculosis (TB) of the skin (scrofuloderma) which was not diagnosed and had received treatment other than anti-TB medication. He now presented 9 years after with multiple body discharging sinuses, cicatricial skin lesions, tuberculosis of the spine (L5, S1) with contracture of the Achilles Tendon and genital warts. Subsequent treatment with full anti-TB drugs led to resolution of his illness. A higher index of suspicion is required for early diagnosis of extrapulmonary TB. Prompt and adequate treatment with anti-TB medication ensures cure in such cases. Appropriate control program is also known to improve the outcome and reduce sequelae.

Background: Pneumonia has been reported to be a leading cause of mortality in children aged less than 5 years worldwide particularly in low resource nations. To achieve the Sustainable Developmental Goal (SDG) 3.2 which aims at reducing neonatal mortality and under five mortality, effective steps should be taken to stem the prevalence and mortality from childhood pneumonia. Aim: To determine the prevalence, monthly variations and mortality from pneumonia in children aged 1 month to 16 years at the department of Paediatrics of the Abia State University Teaching Hospital, Aba. Patients and methods: This was a retrospective review of the medical records of children aged 1 month to 16 years, diagnosed with pneumonia, at the department of Paediatrics of the Abia State University Teaching Hospital, Aba. Relevant information were extracted from case files of qualified subjects and subsequently analyzed using SPSS version 24. Result: There was a total of 440 admissions out of which 74 had a diagnosis of pneumonia, giving a prevalence of 16.8%. Six of the cases had inadequate data and were discarded. Sixty eight (68) were used for subsequent analysis. Forty five (45) were males, while 23 were females, giving a male: female ratio of 1.8: 1. Approximately 88% of the cases occurred in children aged ≤ 5 years with 61.8% of the patients aged less than one year. The greatest monthly prevalence, 25%; was in January and February. Mortality rate was 4.4%. Conclusion: The prevalence of childhood pneumonia is high. Children below 5 years are very vulnerable. Effective steps to reduce childhood pneumonia will drastically reduce under-5 mortality and achieve SDG 3.2.

Blood is an essential component of paediatric care worldwide. Blood and blood products are scarce and expensive and may be associated with health hazards post-transfusion. This study aims at determining the prevalence, indications and associated factors of blood transfusion in children in an academic hospital. Materials and Methods: This was a retrospectively review of all records of blood transfusions conducted at the Children’s Emergency and Paediatrics wards of the State University Teaching Hospital, Southeast Nigeria; from 1st January 2016 to 31st December 2017. Results: The prevalence of blood transfusion was 7%. Total number of transfusions was 56. Male: female ratio was 0.8: 1. Median age of transfused children was 5 years (range 2 months to 12 years). Forty one (73.3%) of the transfused children were aged

Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive ciliopathy characterized by obesity, post-axial polydactyly, renal abnormalities, mental retardation, pigmentary retinopathy and hypogenitalism. Diagnosis is rare in early childhood, and only few of the features are present at that age. This is because the disease is slow evolving. However, it is possible to find majority of the component of this syndrome in very young children. A 3-year old very obese male presented with clinical features of sepsis and congestive cardiac failure. He is a product of non-consanguineous marriage with unremarkable family history. Both parents are of the Ibo tribe in Nigeria. Polydactyly was noticed at birth. There was delay in some aspects of his developmental milestone. Examination revealed mild hypertelorism and retrognathia, polydactyly of both feet with syndactyly of the big and second toes. Other findings were short broad hands, mottled pigments on the retina, moderate mental retardation, hypogenitalism, nephrotic syndrome, renal tubulopathy, hyperglycaemia and hypopigmented skin lesions. A case of BBS with all the primary features and some secondary manifestations in a very young child is hereby reported. A high index of suspicion for BBS should be shown in any young child with at least one of the features of this syndrome. This will enhance earlier diagnosis and improve disease outcome.

Background: Renal diseases are currently posing a great health concern worldwide. Proper documentation, knowledge of renal disease burdens, and established renal registries will provide data to guide stake-holders in future planning and resource allocation. This study aims at documenting the pattern and outcome of childhood renal diseases admitted at our centre. Methods: This was a prospective study of all childhood renal diseases admitted into the pediatrics wards of the Abia State University Teaching Hospital, Aba, from October 2013 to October 2018. The demographic characteristics of the patients, ingestion of herbal concoctions, clinical presentation, laboratory investigations, diagnosis and management outcomes were documented, and analysed. Result: A total of 6108 children were admitted into the paediatric wards during the study period. One hundred and four (104) of them had renal diseases, accounting for 1.7% of paediatric admissions. There was male preponderance (55.8%) with a Male: Female ratio of 1.3:1. Sex had significant association with renal diseases (p-Value=0.025). The age range was 0.5 – 16 years with a mean age of 7.9±4.5 years. Majority (40.4%) of the patients were aged 5-10 years (p-Value 0.021). Nephrotic Syndrome (47.1%), Acute Kidney Injury (10.6%) and Acute Glomerular Nephritis (10.6%) were the commonest causes of admission. Proteinuria (39.4%), Oedema (39.4%) and Oliguria (26.9%) were the most frequent clinical presentations. Progressive increase in yearly diagnosis of renal diseases was observed. More than 90% of the patients took herbal remedies before presentation (p-Value=0.001). Mortality rate was 4.8%. Causes of death were Chronic Kidney Disease (40%), Acute Kidney Injury (20%), Wilms tumour (20%), and HIVAN (20%). Conclusion: The prevalence of childhood renal diseases in Aba is 1.7%. Nephrotic syndrome is the commonest cause of renal admission in our centre. Ingestion of herbal concoctions by our cohort was high. There was an annual increment in the number of renal disorders in our centre. Preventive nephrology should be adopted to curb the morbidity and mortality from renal diseases worldwide.

Introduction:there is a decline in child mortality rate globally, courtesy of the erstwhile Millennium Development Goals. However, under-five mortality is still high in the African sub-regions. The need to review the morbidity and mortality pattern among children admitted into private health settings, where 60% of the medical conditions of the masses are being attended to in the sub-regions, cannot be overemphasized. This study aimed at documenting the morbidity pattern and outcomes of admissions among children admitted into the Living Word Mission Hospital (LWMH), Aba, Nigeria. Methods:this was a retrospective descriptive study over a 3 year period. The study population comprised of all children aged 1 month to 15 years that were admitted into the paediatric wards of the Living Word Mission Hospital, Aba, Nigeria. The age, gender, diagnoses and disease outcome of these patients, were all retrieved from the paediatric ward registers and hospital medical records. The data were analyzed using SPSS, version 20.0. Results:there were 2278 paediatric medical cases admitted over the study period. Males were 1364 and females were 914, giving a male: female ratio of 1.5:1. More than 90% of these patients were aged < less than 5 years. Severe malaria (31.1%), septicaemia (16.6%), bronchopneumonia (15.4%), uncomplicated malaria (11.9%), acute watery diarrhea (10.5%) and meningitis (3.7%) were the leading causes of admission. Mortality rate was 5.7%, with 87.5% of these deaths occurring in under-fives. Septicaemia (34.6%) and Severe malaria (23.2%) were the leading causes of death. Conclusion:there is a high rate of paediatric admissions at Living Word Hospital, Aba. The under-five population remains a vulnerable group to both childhood morbidity and mortality. Septicaemia, malaria, bronchopnuemonia and acute watery diarrhoea were the leading causes of morbidity and mortality. Childhood mortality at LWMH is lower than observed in most government hospitals in Nigeria.

Background: Trauma is a leading cause of morbidity and mortality in children. The incidence has been on the increase in our sub-region in recent years. The aim of this study is to present the clinical presentation, management and outcome of children involved in trauma in at the Abia State University Teaching Hospital. Methods: A prospective study of children managed for trauma in our centre from January 2018 to December 2018. A Proforma was designed to include demographic data, clinical presentation, investigation, treatment and outcome. These data was collated and analysed using SPSS version 17.0. Results: A total of 300 patients presented to our trauma centre during the study period. There were 200 boys and 100 girls. The median age was 6 years (range 1 month to 15 years). The median duration of presentation was 4 hours (40 minutes to 7 days). 100 patients presented between 12 am and 7pm while 200 patients were seen between 7pm and 12 midnight. At presentation 250 patients were in pain, 150 bleeding, 120 had a swelling of part of the body, 20 were unconscious, and 10 had polytrauma. The cause of the trauma were Tricycle accident 100, motor vehicle 80 patients, burns 40, fall from height 20, gunshot injuries 10and others 10. The investigations include X-rays, FAST, CT-scan, haematological and biochemical test. The diagnosis at presentation revealed; 40 head injury, 100 lacerations, 10chest injuries, 30 blunt abdominal injuries, 20 pelvic injuries, 40 burns, 40 limb fractures, 20 poly-traumatised patients. There were 30 (10%) mortalities. Conclusion: The result in this series shows good outcome in children managed for trauma in our centre. There may therefore be the need for training, procurement of equipment and the establishment of paediatric trauma centres in the various sub-regions in the country. This will help in reducing morbidity and mortality.

Background: Neonatal surgery is still a challenge in developing country due to lack of appropriate equipment, inadequate work force and lack of political will by hospital management. However, there has been significant improvement in outcome over the last century. Objective: This study evaluates neonatal surgery in commercial city of Aba South East Nigeria with emphasis on challenges and management outcome. Methods: Prospective analysis of sixty neonates who had operative treatment at Abia State University Teaching Hospital Aba from October 2016 to July 2018. Proforma was opened for sex, weight, prenatal care, age at presentation, duration of symptoms prior to presentation, surgical pathology, treatment offered, associated congenital anomaly, evidence of prenatal diagnosis, complications and outcome. Results: There were 40 males and 20 females, male to female ratio of 2:1. The mean weight of the neonates was 2.5kg (range1.1-4.3kg). The average age at operation was 3 days (1-15days), the mean duration of symptoms before presentation was 3.5days. The major indication for operation was anorectal malformation 32 patients {53.3%} anterior abdominal wall defect 8 patients {13.3%}, Intestinal atresia 8 patients {13.3%}, intestinal perforation 8 patients {13.3%}, obstructed hernia 4 patient {6.6%}/There was associated congenital abnormality in 5 patients {8.3%} and prenatal diagnoses was made in 10 cases {16.6%}. During a mean follow up of 3months {1week to 9months, procedure related complications in 16 patients {26.6%} and 8patients died {mortality of 13.3%}. Conclusion: Surgical care of the neonate with a wide range of pathologies is still major challenge in our setting. Good political will, capacity building in form of manpower development and procurement of appropriate equipment will enhance the outcome.