African Journals OnLine
Nigerian Journal of Paediatrics

Volume 28 No 2 April 2001
Abstracts

Johnson AOK. Conjugated Hyperbilirubinaemia in Early Infancy. Nigerian Journal of Paediatrics 2001; 28: 29. 

Conjugated hyperbilirubinaemia exists when the conjugated serum bilirubin level is more than 2 mg/dl or more than 20 per cent of the total serum bilirubin. It is always pathological in early infancy. The causes are many and diverse and most result in cholestasis. Initial diagnostic tests should include tests of liver function, blood and viral cultures, abdominal sonogram, hepatobiliary radionuclide test or duodenal aspiration test to detect the presence of bile in the gut, metabolic screen, and liver biopsy. When carried out early in the course of the disease, these tests will often differentiate between idiopathic neonatal hepatitis and congenital biliary atresia, the two most common causes of conjugated hyperbilirubinaemia in early infancy. While neonatal hepatitis generally requires only supportive therapy, biliary atresia and other mechanical obstructions of the hepatobiliary tree require surgery. Unrelieved chronic cholestasis results in fat malabsorption and growth failure, as well as biliary cirrhosis and ultimate liver failure.

Fatunde OJ, Familusi JB. Post-neonatal Tetanus in Nigeria: A Need for Booster Doses of Tetanus Toxoid. Nigerian Journal of Paediatrics 2001; 28:35. 

Eighty-two (87 per cent) of the 94 cases of post-neonatal tetanus patients seen in the department of paediatrics, University College Hospital, Ibadan, over an 11-year period were aged five years and above. Persistent occurrence of this preventable condition for which an effective vaccine is available indicates deficiencies in the health system of the country. Although, a case fatality rate of 12 per cent compared favourably with those of centres employing more sophisticated treatment modalities, morbidity was high with patients spending an average of 23 days (range 3 to 76 days) in hospital. Although no reliable record of tetanus immunization was obtained in 37 of the patients, 34, 8 and 15 patients received doses of DPT immunization of 0, 1 - 2 and 3, respectively, during infancy. No patient had tetanus toxoid (TT) administered after infancy. The findings indicate that the current Expanded Programme on Immunisation (EPI) recommended by the WHO for developing countries of which three doses of DPT are given during infancy with no provision for booster doses, is inadequate for tetanus prevention during childhood. It is suggested that a clause be added to the EPI schedule, advising two extra doses of TT between ages four to six years and 11 to 12 years (entry into primary school and secondary school, respectively) for all children. In order to ensure compliance, these booster doses of TT could be made prerequisites for entry into these schools.


Anochie IC, Nkanginieme KEO, Eke F. The Influence of Instruction about the Method of Urine Collection and Storage on the Prevalence of Urinary Tract Infection. Nigerian Journal of Paediatrics 2001; 28:39. 

A study of 66 children, including 46 (69.7 percent) females and aged between four weeks and 15 years with significant bacteriuria was undertaken over a four-month period to determine the effects of instructions received about the methods of urine collection and storage on the prevalence of urinary tract infection. The commonest clinical presentation was fever (65.2 per cent). Only 23(35.1 per cent) of the patients had specific symptoms suggestive of urinary tract infection(UTI). The method of urine collection was explained to 68.2 per cent of the patients and/or their relations. This instruction was given mostly by the attending physicians (80.0 per cent). Despite the explanation, 14 (21.2 per cent) of the patients collected the urine samples wrongly and 48 (72.7 per cent) stored the samples longer than one hour. Significant bacteriuria was more prevalent in 72.7 per cent of patients who submitted their urine samples to the laboratory later than one hour after collection. There is a need for health care workers to effectively educate patients and/or their relations on the proper methods of urine collection and storage in order to reduce the frequency of making a false diagnosis of UTI with its consequent financial wastage.


Ogunseyinde AO, Familusi JB. Atypical Presentation of Lymphoma in an HIV-seropositive Child. Nigerian Journal of Paediatrics 2001;28:43. 

A case of lymphoma in an HIV sero-positive child whose parents also tested positive for the HIV infection is presented. He was initially being managed for meningitis in a private clinic. The rapid progression and dissemination of the disease to other parts of the body was no doubt, due to the HIV infection. It is important that health workers become more aware of the protean clinical manifestations of HIV infection in this environment where other childhood diseases share some of the clinical features and it should be considered in patients with lymphoma and rapid progression of the disease 


Adedoyin OT, Adeniyi A. Preventive Nephrology - A Proposed Option in Childhood Nephropathy. Nigerian Journal of Paediatrics 2001; 28:46. 

Three children with renal disorders managed at the University of Ilorin Teaching Hospital are reported as case studies to underscore the need for preventive nephrology . The first case illustrates the inevitability of rapidly progressive renal failure when remedial management desired in the early stages of the nephropathy is not offered or available. Subsequent efforts to help the child were inadequate, too late and foreclosed by extreme poverty of the family. The second case typifies the acute on chronic nephropathy complicated by hypertension and again, extreme poverty of the family. The prognoses in such cases are uniformly bad. The third case represents an important group with relapsing type of nephrotic syndrome, which is amenable to remedial management, and a fair chance of a good span of life. A long term follow-up and attention to possible trigger factors that might lead to relapse is called for. In the three cases, it was posited that primary, secondary or tertiary preventive strategies would have been useful or was useful.


Ernest SK, Mokuolu O, Adeniyi A. Evaluation of Sodium Sulphacetamide drops in the Treatment of Ophthalmia Neonatorum. Nigerian Journal of Paediatrics 2001;28:50. 

Sodium sulphacetamide eye drops had been used successfully in the past in the treatment of ophthalmia neonatorium (ON) but its use has decreased remarkably in recent time. The efficacy of 10 percent sodium sulphacetamide eye drops in the treatment of ON was prospectively evaluated in 68 neonates seen in our Neonatal Intensive Care Unit over a period of six months. Excluded from the study were babies with suspected gonococcal ON, and those who required systemic antibiotics for the treatment of associated sepsis. The eye drops were instilled for one week if by 72 hours of use, clinical response was achieved, otherwise another ophthalmic agent was used. Seventy seven percent of the neonates had clinical cure. It is concluded that sodium sulphacetamide drops may be a useful first line eye drop in the treatment of ON.