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Mary Slessor Journal of Medicine

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Volume 3 Number 1,  2003
CONTENTS

The Biochemical Composition of the Breast Milk of Nigerian Mothers.

I.S.I Ogbu

Department of Medical Laboratory Science,
Faculty of Health Science and Technology,
College of Medicine, University of Nigeria,
Enugu Campus, Nigeria.

A study was conducted to determine the biochemical composition of the breast milk of Nigerian mothers of Igbo ethnic group. Apparently healthy nursing mothers (157) aged between 20-40 yeas with parities 1-5 who were attending the 6-week postnatal clinics of the University of Nigeria Teaching Hospital Enugu, Southeastern Nigeria were systematically sampled for breast milk. The samples collected after their babies had been fed for a while where analysed for 13-biochemical parameter using standard methods. The mean and range of values were calculated and compared with reported values. The values obtained for vitamin C,

3.0-6.0 (mean 5.1) mg/dl, sodium 12.0-36.0 mmol/l, urea, 3.0-8.0 mmol/l (mean 7.0) are higher while values for sugar, 35-64mmol/l (mean 52.0), triglycerides 0.36-0.95 mmol/l (mean 0.63), creatinine 159-364µol/l (mean 239), chloride, 4.4-10.6 mmol/l (mean 3.5) were lower than published values. The values for total protein are most consistent with published figures, while potassium and cholesterol values 12.7 and 4.0mmol/l respectively are similar to published values. The breast milk of Nigerian mothers of Igbo ethnic extraction may not be said to be richer or poorer in biochemical content than those of mothers elsewhere. Surely the milk is good enough for the nourishment of their infants.

Key Words: Biochemical composition, Breast milk, Mothers, Nigeria

 

The Epidemiology of Pulmonary Paragonimiasis in Cross River Basin in Nigeria: Update on infection prevalence and distribution of the snail and crab intermediate hosts.              

Asor, J.E 1.  Ibanga, E.S 2 and Arene, F.O. I 3

1Department of Biological Sciences, University of   Calabar, Calabar, Nigeria

2 Department of Zoology, University of Uyo, Akwa Ibom State, Nigeria.

3 Department of Zoology, University of Port Harcourt, Port Harcourt, Nigeria.

Abstract

Deep sputum samples from 2400 school children aged 5-14 years old, in eight districts in Cross river basin, Nigeria were examined for Paragonimus ova. A total of 246 sites along streams and rivers including the Cross River itself were also surveyed for snail and crab intermediate hosts of Paragonimus, and their infection rates were determined. The overall prevalence of pulmonary Paragonimus infection in schoolchildren in the area was 14.4% (346/2400). Six foci of the infection were identified at Oban, Ugep, Ikom, Obubra, Yala, and Ogoja districts. The intensity of the infections (number of ova per 5ml. Sputum) were generally low. Of the 346 infected school children, 249 (72.0%) had less than 50 ova of Paragonimus in 5ml sputum, and 74 (21.4%) had between 50 and 100 ova of Paragonimus in 5ml sputum, while 23 (6.6%) had over 100 ova of Paragonimus in 5ml sputum. Two snail hosts of Paragonimus were encountered in our survey. These were Potadoma freethii and Afropomus balanoides. P. freethii was more widely distributed than A. balanoides and was the only snail species naturally infected with Paragonimus (6.1%). Three crab species associated with Paragonimiasis transmission were also collected. These were Sudanonautes aubryi, Sudanonautes africanus and Sudanonautes pelli. These three crab species were widely distributed in the basin. However, only  S. africanus  (5.0%) was found to harbour Paragonimus infection. The results of this study indicate the growing public health threat posed by Paragonimiasis in Cross River basin in Nigeria. A combination of chemotherapy, to bring relief to persons already afflicted by the disease, and public health education related to Paragonimiasis transmission to increase awareness of the infection in the area is recommended as the best approach   to check the infection in the basin.

 Key Words: Pulmonary Paragonimiasis, Cross River Basin, Distribution, Intermediate Hosts,  Prevalence

 

The National Health Insurance Scheme (NHIS) and Information Management.  

O.O. Lawal

The University library
University of Calabar, Calabar.

Abstract

This paper examines the establishment of the Nigerian National Health Insurance Scheme

(NHIS) in response to expressed need for improvement in Primary health care delivery. The role of international agencies such as the World Health Organization (WHO) and United Nations Development Programme (UNDP) in providing support for the implementation of the NHIS objectives was also analysed. Te study concludes by focusing on aspects of information management on health services especially within the construct of Health Insurance Scheme.

Key Words: Health Information Management, Health Insurance, Social Health System

 

 

Association of Pulmonary Paragonimiasis with Active Pulmonary Tuberculosis in Rural Yakurr Community in Cross River Basin, Nigeria.  

Ibanga, E.S.1   Arene, F.O.I 2  and Asor, J.E. 3  

1Department of Zoology, University of Uyo, Uyo, Nigeria

2Department of Zoology, University of Port Harcourt, Port Harcourt, Nigeria.

3Department of Biological Sciences, University of Calabar, Calabar, Nigeria.

Abstract

Pulmonary tuberculosis and human Paragonimiasis coexist in communities in Cross River Basin in Nigeria. In 1997, our unit surveyed the Yakurr community in the basin to ascertain the prevalence of both Paragonimiasis and active pulmonary tuberculosis in the community, and to investigate whether there was association of Paragonimiasis with tuberculosis in the community. Deep sputum samples from 1100 subjects of the community were examined for prevalence of Paragonimus eggs by the concentration method, as well as for Mycobacterium tuberculosis by the Ziehl-Neelsen method.

The subjects ranged in age between 5-68 years old, and were categorized into eleven age groups (5-10, 11-16, 17-22, 23-28, 29-34, 35-40, 41-46, 47-52, 53-58, 59-64, and  > 64). Both sexes were represented. Three sputum samples collected in three consecutive days were examined. Mean prevalence rate of Paragonimiasis in the community was 9.36% (203/1100). Highest prevalence of the infection (19.00%) occurred in the 11-16 years age group. Thereafter prevalence of the infection decreased to lower levels in the older age group. Intensity of the infections were generally low (< 20 eggs per 5ml sputum). Active pulmonary tuberculosis was recorded in 20 (1.18%) of the 100 subjects investigated, with peak prevalence (3.00%) among subjects between the age of 23 and 34 years old. Paragonimus eggs and Mycobacterium tuberculosis occurred concomitantly in 10 (0.91%) of the 1100 sputum samples examined. There was no significant association of Paragonimiasis with tuberculosis in the community.

 

Key Words: Paragonimiasis, Tuberculosis, and Yakurr Community, Cross River Basin, Nigeria

 

 

Paragonimus uterobilateralis: Peak Period of Egg Output in Sputum of Infected Subjects in Cross River Basin, Nigeria.

Asor, J.E.1 , Ibanga, E.S. 2, and Arene, F.O.I.3   

1Department of Biological Sciences, University of Calabar, Calabar, Nigeria

2Department of Zoology, University of Uyo, Uyo, Nigeria

3Department of Zoology, University of Port Harcourt, Port Harcourt, Nigeria.

Abstract

This study was designed to determine the peak period of excretion of eggs of Paragonimus uterobilateralis in sputum of infected subjects in the Cross River Basin in Nigeria. 120 subjects infected with P .uterobilateralis from the basin where investigated. The subjects ranged from 5-56 years old and were categorized into 5 age groups. (5-10; 11-20; 21-30; 31-40; >40 years old ) Both sexes were represented. Twenty four-hour sputum, collected at twenty four-hour intervals for three consecutive days was examined microscopically for egg of Paragonimus.  It was found that quantity of egg in sputum of infected persons was significantly higher between the hours of 5am to 9am than other times. This was true in both males and females of all ages. The finding suggests that sputum collected between this time range (05 hours - 09hours) will be meaningful in evaluating status of Paragonimus infections in the area.

 

Key Words: Paragonimus uterobilateralis; Cross River Basin; Nigeria; peak period, egg output; sputum.

 

Urinary Schistosomiasis in Two Endemic Communities of Cross River Basin: Prevalence, Intensity, and Treatment

K.N. Opara1, H.C. Mbagwu2 , U.F. Ekpo3

1Department of Zoology, University of Uyo, Uyo

2Department of Pharmacology and Toxicology, University of Uyo, Uyo

3Department of Biological Sciences, Federal University of Agriculture, Abeokuta

 Abstract

We diagnosed schistosomiasis due to S. haematobium in Obudu and Biase Local Government Areas of Cross River State, Nigeria, using the membrane filtration technique. Altogether, 1,326 urine samples where screened. Of the 722 individual urine screened in Biase, 444 (61.5%) were positive cases, while in Obudu 354 (58.6%) were positive out of the 604 subjects screened. Males from both communities had a higher prevalence and intensity rate (P< 0.05) than Females. The relative index of potential infection (RIPI) of each age group shows that 6-20 yeas of age contributed 84.22% and 87.4% of total contamination of the environment with S. haematobium eggs in Biase and Obudu respectively. Treatment with praziquantel (40mgkg-1)  of 80 randomly selected positive cases from both communities showed a cure rate of 57.1-100% at 7-56 days after treatment.

Key Words: Schistosoma haematobium,  Cross River Basin, Prevalence, Intensity, Praziquantel.

 

 

Chronic Suppurative Osteomyelitis of the Jaws

A.E Obiechina and A.O. Fasola

Department of Oral and Maxillofacial Surgery
University College Hospital
P.M.B 5116. Ibadan, Nigeria.

Abstract

Sixty-four patients treated at the University College Hospital, Ibadan were analysed. The objective was to evaluate the effect of the duration and sight distribution of CSO on the out come of treatment. The commonest aetiological was dental abscess.  A total of 53 (82.8%) of the teeth associated with the aetiology of CSO wee molar teeth. The duration of CSO ranged from 2 to 96months with a mean of 25.8, standard deviation 20.8 and median of 20. The mandible was involved in 59 (92.2%) and the maxilla in (5) 7.8% patients. The result suggest that the longer the duration of the lesion, the greater the segments of the jaws to be affected (P<0.05). It also implied that previous treatment received by the patients were either inadequate or ineffective in inhibiting the disease. Forty-seven (73.5%) of the site distribution were in segments bearing the molar teeth or the segment of closest proximity. Teeth- related aetiological factors were the major causes of CSO. The types of surgery performed were sequestrectomy 26 (40.6%) and 38 (59.4%) had decortication and saucerisation. In conclusion, the duration of CSO and the site distribution affected treatment outcome. The longer the duration of the lesion, the greater the probability of a less favorable outcome of treatment. Furthermore, CSO affecting multiple segments of the jaw was more difficult to treat than when a single segment of the jaw was involved.

 

Key Words: Osteomyelitis; Suppurative, Chronic; Mandible; Maxilla; Jaw.

 

Penile Cancer in North- Eastern Nigeria

E.U Ajuluchukwu and Mustapha I. Khalil

Department of Surgery and Pathology, College of Medical Sciences, University of Maiduguri, Borno State

Abstract

Penile cancer is a rare disease in Europe and America. In 1979, it formed just 0.1% of Genito-Urinary Tract cancers in the Cancer Registry of the University College Hospital Ibadan. A retrospective study was carried out to analyze cases of carcinoma of the penis that was presented at the University of Maiduguri Teaching Hospital (UMTH) from 1991 to 1999. There were 19 cases, aged 25 – 90 years, with a mean of 62.7 years. Almost all were in circumcised patients. The average age at circumcision was 10.8 years. The average number of wives was 18.6. All has multiple sex partners apart from their many wives. Venereal diseases were common among the sufferers. The duration of the ailments was 3 months to 8 years. All but 2 tried concoctions from traditional medicine men prior to a visit to our hospital. Ulcerated penile masses of varied sizes, some mobile, some fungating and fixed, were the main presenting complains. Some had excisional biopsies, some partial or total penectomies, while the others had both penectomies and orchidectomes. Histopathological reports confirmed squamous cell carcinoma in all the cases. The postoperative results were good to very good. The follow-up period was 2 to 12 months. Two had recurrence, one almost immediately and the other 8 months post surgery. Only one (5.3%), of the cases was not circumcised. Therefore, the cause of the cancer must be sought in the multiple sex partners with antecedent recurrent venereal diseases e.g. human Papilomavirus  (HPV). Due to some factors such as embarrassment of the problem and low socio-economic conditions, a good number of penile cancers might go unreported.

Key Words: Penis, Circumcision, Sexual Promiscuity

 

Sexual Behaviour, Knowledge, and Information Sources about Sexually Transmitted Diseases: Cases Study of Students in Ambrose Alli University Ekpoma

R.I. Ogbimi and N.N. Ajodi

Institute of Public Administration and Extension Services, Ekehuan Campus, University of Benin, Benin City

Abstract

A Survey of 202 final year students (114 females, 88 males) of Ambrose Alli University, Ekpoma was conducted to determine gender-specific differences in their knowledge of sexually transmitted diseases (STDs), sources of knowledge and sexual behaviours. Random sampling procedures were used to select students from departments within the various faculties. A pre-tested questionnaire was used to determine their knowledge (symptoms and modes of transmission) of syphilis, gonorrhea, and AIDS, their sexual experience with single or multiple partners and the us of condoms. Sources of information evaluated included the school system, mass media, religious groups, and the family. Except for the increased level of awareness of gonorrhea among males, respondents had inadequate knowledge of other STDs. The prevalence of sexual experience was comparable in males (84.1%) and females 81.6% (P<0.05); the frequency of condom use by them was low (34.3%). Intensified health education through their favourite information sources is recommended.

Key Words: Sexual behaviours, students, knowledge, sexually transmitted diseases.

     

Prevalence of Bacteria in Diabetics and Non-Diabetics

N. Frank-Peterside and M.B.O Ayodele

Department of Microbiology, Faculty of Science, University of Port-Harcourt, P.M.B 5323, Choba, Rivers State

Abstract

The study was carried out to determine the prevalence of bacteriuria in diabetic and non-diabetic patients attending the University of Port-Harcourt Teaching Hospital and the Diabetic Association of Nigeria, Rivers State Chapter. A total of 257 (132 diabetic and 125 non-diabetic) mid-stream urine samples were collected and cultured on cystine lactose electrolyte deficient (CLED) agar medium using the standard wire loop technique. Forty-nine (37.2%) of the non-diabetics had significant bacteriuria. Among diabetics 32 (65.31%) females and 17 (34.69%) males had significant bacteriuria while 15 (68.25%) females and 7 (31.75%) males in non-diabetics had significant bacteriuria .In both groups studied, the incidence of significant bacteriuria was highest in the age range of 18-39 years for both groups, 55.11% in the diabetics and 68.25% in non-diabetics. Escherichia coli and Staphylococcus aureus were the most frequently isolated bacteria in the two groups, statistical analysis showed a significant prevalence of bacteriuria in diabetics compared with non-diabetics (P<0.05).

Key words: Bacteriuria, Diabetics, Non-Diabetics, Age, Sex

 

A-V Fistulae from Arrow Injuries: A Report of Two Cases

E.U. Ajuluchukwu, M.I. Khalil, & I.M. Umar

Department of Surgery, Pathology, and Radiology, College of Medical Sciences, University of Maiduguri Teaching Hospital, University of Maiduguri, Maiduguri, Nigeria

  Abstract

Feathered arrows, representing some of the primeval weapons of man are still being used as violent weapons for settling disputes. Seventeen various cases of cardio-vascular injuries caused by arrow shots were recorded at the University of Maiduguri Teaching Hospital (UMTH) from 1994 to 1998. Of these, one involved the temporal vessels, which led to a temporo-temporal A-V fistula causing the patient continuous noisy headache. The late complication was only recognized about two years post injury. Another arrow shot injury involved femoral vessels and resulted in femoro-femoral A-V fistula, which came to be recognized four yeas post injury. The thigh fistula caused cardio-pulmonary decompensation.

The two patients had undergone alternative treatments between orthodox medical practitioners and medicine men both in Nigeria and some other West African countries, prior to presentation at UMTH. Successful surgical vascular repairs restored normal health conditions to the patients. Vascular complications of any missile injury should be recognized early so as to prevent serious complications. 

Key Words: Arrow, Cardio-vascular, A-V Fistula

 

Molecular Identification of Anopheles gambiae Complex Found in Calabar, Using the Polymerase Chain Reaction Technique

Alaribe, A.A.A. 1, G.C Ejezie 2 and E.N.U. Ezedinachi 3

1,2Department of Microbiology/Parasitology, University of Calabar, Calabar, Nigeria

3Department of Medicine, University of Calabar

Abstract

Fifty-three Anopheles species identified morphologically were subjected to the polymerase chain reaction (PCR) analysis for species differentiation within the Anopheles gambiae complex, using five primers in the PCR mix. Thirty-three of these were identified as members of  An. gambiae complex. Out of this number 31 (93.9%) were identified as An. gambiae s.s while 2 (6.1%) were identified as An. arabiensis. The high numbers of unidentified species 20 (37.7%) show that the non-gambiae species in the environment is relatively high. This work has shown that An. gambiae is the predominant species of malaria vector in the Calabar area of the country.

Key Words: Sibling species, An gambiae complex, polymerase chain reaction

 

Blood Concentrations of Methaemoglobin, Carboxyhaemoglobin and some Haematological parameters in Petrol Station Attendants in Enugu Metropolis.

 S.O. Ureme 1, I.G. Maduka 2 & G.A Azubuike 3

  1 Dept. of Medical Lab Science College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria

  2  Dept. of Chemical Pathology, University of Nigeria Teaching Hospital Enugu, Nigeria

  3 Dept. of Haematology and Immunology University of Nigeria Teaching Hospital Enugu, Nigeria

 Abstract

Concentration of methaemoglobin and carboxyhaemoglobin in blood and some haematological parameters wee studied in fifty petroleum attendants in Enugu metropolis. The age range of the subjects (30 males and 20 females) and controls (12 males and 10 females) was 23-60 years. The purpose of the study was to determine if exposure to petrol fumes has any adverse effect on haemoglobin metabolism and haematological parameter. Methaemoglobin and carboxy-haemoglobin were determined by the method of Dacie and Lewis (1994) while the method of Bain (1994) was adopted for haemoglobin parameters. The mean results showed no significant difference in methaemoglobin, haemoglobin, packed cell volume and reticulocyte count (P>0.05) while a significant difference (P>0.05) was recorded in carboxyhaemoglobin of test and control subjects. The results suggest that exposure to petrol fumes may increase blood concentration of carboxyhaemoglobin but may affect methaemoglobin and haematological parameters.

Key words: Methaemoglobin, carboxyhaemoglobin, haematological parameters

 

Safety Considerations in the Management Of Hospital-Generated Wastes in University of Calabar Teaching Hospital, Calabar.

 1Asuquo, A.E., 1Epoke J., 1Kalu N.M. and 2Aniah E.J.

1Department of Medical Microbiology,
University of Calabar Teaching Hospital

2Environmental Protection and Resource Management Programme,
University of Calabar, Nigeria

Abstract

One hundred and twenty one hospital workers were studied to assess their compliance with standard methods of handling and disposing hospital generated wastes. One group comprised of 20 doctors, 22 nurses and 16 laboratory scientists who made up 58 waste generators.

Another group included 30 ward orderlies and 33 cleaners making up 63 workers who serve as waste managers. Questionnaires, random personal observation and brief intercept studies were  used to assess compliance. The study revealed that 30.6% of the workers studied did not wear any form of protective clothing during work. Neither waste generators nor managers segregated wastes into infectious and non-infectious components while sterilization of waste material was not done before disposal. More enlightenment and greater supervision of hospital waste managers is hereby advocated. This will reduce nosocomial infections for health personnel and save the general public from environmental health hazard emanating from improperly managed infectious wastes.

Key Words: Hospital-generated wastes, Management, Safety considerations

 

Antibiotic Misuse among High School Students in Calabar Nigeria

Asuquo, A.E., Epoke J., and Asuquo E.E.

Department of Medical Microbiology and Parasitology
College of Medical Sciences, University of Calabar
Calabar Nigeria.

 Abstract

Five hundred and sixty high school students from five secondary schools in Calabar, Nigeria were studied for antibiotic usage. Questionnaires where administered to determine the following parameters: Knowledge of antibiotics, types of infections for which antibiotics were taken, sources of prescription and procurement of antibiotics, antibiotic dosage and first part of call on taking ill. Analysis of responses using Chi Square showed that the most patronized sources of antibiotics where patent medicine dealers (36%) and friends/relations (32.5%). Procurement of antibiotics from these sources was significantly higher than procurement from hospitals, clinics, and pharmacies (P=0.05). Antibiotic usage by today’s high school students portends gross misuse with consequent great public health threats in the future. There is need for urgent measures to stem the trend. Definite antibiotic policies  must be established to prevent the great ease of procuring antibiotics without prescription from unqualified medical personnel.

Key Words:  Antibiotics, Misuse, Students

 

 

The Prevalence of Filariasis in Awi, Akamkpa Local Government Area of Cross River State-Nigeria.

S.S Akpan1 and G.C Ejezie2

1Department of Microbiology and Parasitology
University of Calabar Teaching Hospital
P.M.B 1278, Calabar-Nigeria

2Department of Microbiology and Parasitology
College of Medical Sciences, University of Calabar
P.M.B. 1115, Calabar-Nigeria.

Abstract

The prevalence of Filariasis in Awi, Akamkpa Local Government Area, was studied among 303 residents of the community between July 2000 and June 2001. Venous blood specimens collected from the residents after a Mazzotti test, were examined using standard parasitological

techniques for the presence of microfilariae. A questionnaire, which set out to test the perception and rapid epidemiological assessment of Filariasis in the area was administered to the study population. The overall prevalence rate for filaraemia was 25.7%. Two species of microfilariae, viz Mansonella perstans and Loa loa were detected, with prevalence rates of 96.2% and 3.8% respectively. Filaraemia was higher in males 33.9% (61:180) than in females 13.8% (17:123). However the difference was not statistically significant (x2 =0.75 <6.64; P>0.01). Only 41(13.5%) of the respondents knew of Filariasis as a parasitic disease, but none of them had knowledge of the causative agents and the insect vectors involved in the transmission of the disease. A total 495 female Culicoides (midges), 800 anopheline and 1772 culicine mosquitoes where caught and dissected for the third stage lava of filarial worms. The disease transmission occurred through out the year with an abundance of Culicoides (midges) recorded in June, when the peak transmission of Filariasis (mansonelliasis) also occurred. Although the pathogenicity of Mansonella perstans is still doubtful, the presence of Loa loa in Awi makes the community epidemiologically important as a focus for the spread of infection to Calabar.   Treatment of properly diagnosed cases, medical education, provision of insecticide, treated bed net and improved housing will help to curtail the transmission of Filariasis in the area.

Key Words: Filariasis, Prevalence, Mansonelliasis, Loiasis.

 

Masses in the Neck: A Histopathological Analysis of 213 Cases In South Eastern, Nigeria

I.A. Ekanem1, and B.A. Abimiku2

1Department of Pathology
University of Calabar Teaching Hospital and
College of Medical Sciences, University of Calabar
Calabar, Nigeria.

Abstract

Fifty nine percent of the neck masses in the University of Calabar Teaching Hospital, Calabar, Nigeria are caused by lymphoid tissues. Thyroid masses and congenital cysts account for the remaining 41%. Under the age of 20, malignant lymphomas (particularly Hodgkin’s disease) are common while those aged over 20 years, metastatic tumors are more frequent. Malignancies account for 25% of neck masses diagnosed histologically. Childhood tuberculosis remains the commonest cause of lymphadenopathy in this age group. 9% of patients with neck swellings in their adolescent and early adulthood suffered from tuberculosis. The reason for this unusual presentation in an area of high prevalence rate of tuberculosis is not clear and is worthy of further investigation. It may well represent an upsurge of the fatal human immunodeficiency syndrome (HIV) infection in its prodromal stage. Goitres and adenomas still remain the exclusive diseases of he adult females while in males malignant thyroid epithelial tumors are more common than benign tumors. Non-specific

Reactive lymphoid changes are not as common as earlier reported in Ibadan. This original study from South Eastern Nigeria hopes to be of both clinical and epidemiological relevance in patient management.

Key Words: Neck swellings, Histopathology, Diagnosis.

 

 

Restoration of Functions in Children after Ano-Rectal Surgery

A.E Archibong

Pediatric Surgery Unit, Department of Surgery
College of Medical Sciences
University of Calabar
Calabar, Nigeria

Abstract

Operations on congenital anomaly in early childhood frequently cause complications leading to functional disturbances such as faecal incontinence, constipation, and anal stenosis. The age of maximum presentation was within the 6-10 years age bracket, when the children are away from the home environment apparently because of societal embarrassment. Boys and girls are afflicted in equal proportions. Complications form anal agenesis operations accounted for the majority of patients 45 children (54%) while aganglionic megacolon accounted for 39 patients (46%). Treatment in all cases started conservatively with diet manipulations, enema and physiotherapeutic training. However, with non-improvement in faecal soilage, a simple repair involving a narrowing at the ano-rectal junction was carried out. In a follow up period of between 6-12months, 45 children had satisfactory clinical conditions while in 27 children their general condition had improved.

Key Words: Complications, Ano-Rectal, Abnormalities, Operation.