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Background: Prompt and effective healthcare practice is essential to reducing neonatal morbidity and mortality which is at a higher rate among low-income nations including Nigeria, especially in rural settings. Studies have identified some structural factors such as poverty and limited healthcare resources as major factors without giving adequate attention to the related intrinsic factors such as peoples‟ understanding and beliefs among other cultural factors that could encourage or hinder effective healthcare practices for the neonates which is the gap of this study intends to fill. Methods: First-hand data were collected during a six-month rapid ethnographic fieldwork at Akinlalu using various qualitative methods of data collection including observations, interviews, and discussion among others. The main focuses were the community's social life and activities and socio-cultural structures such as faith homes and healthcare as well as individuals (grandmothers, grandfathers, birth attendants, medical doctors, and childbearing fathers and mothers) involved in family and children's health in this community. Results: Findings reveal an array of neonatal illnesses and interestingly a high level of discordance between the perceived illnesses, causes, and treatment between local people and modern healthcare providers. Widely identified and considered the deadliest neonatal diseases are senukoto, oka, and yiyi (measles). Others mentioned are giri (convulsion), olo-inu, and jedi-jedi. Senukoto is believed to be caused by kokoro (bacteria/germs) and can kill the infected neonate within the first seven days after birth if not adequately treated. Oka, yiiyi, and olo-inu were also considered deadly, usually causing taboos violation while eating sweetening things during pregnancy or breastfeeding is the perceived cause of jedi-jedi. Conclusion: the study concludes that rural dwellers often cast doubt on orthodox medical practitioners in response to childhood illnesses and treatment which in most cases have implications for prompt healthcare seeking and non-adherence to the medically prescribed regimen.

Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres (8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive approach to policy formulations that support and protect patients with kidney disease in the continent, especially from the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for noncommunicable diseases, this paper proposes an African roadmap for optimal kidney care.

BackgroundWorldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5–10% of pregnancies. Sub-Saharan Africa is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce.MethodsWomen with HDPs (n=410) and normotensive women (n=78) were recruited at delivery and prospectively followed-up for one year. Serum creatinine was measured and the estimated glomerular filtration rates(eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR2 lasting for ≥ three months. Prevalence of CKD at six months and one year after delivery was estimated. Logistic regression analyses were conducted to evaluate predictors of CKD at six months and one year postpartum. ResultsWithin 24 hours of delivery, nine weeks and six months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12%, 5.7%, 4.3% versus 0%, 2% and 2.4%, respectively). The prevalence of CKD in HDPs at six months and one year postpartum was 6.1% and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age independently predicted occurrence of decreased eGFR at six months postpartum (aOR= 1.18/year; 95%CI 1.04-1.34).ConclusionPrior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

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 popul...