African Journals OnLine
Nigerian Journal of Paediatrics

Vol. 29, No. 2, April 2002
Abstracts

Orogade AA, Ogala WN, Aikhionbare HA. Asymptomatic Malaria Parasitaemia - A suitable index for evaluation of Malaria Vector Control Measures. Nigerian Journal of Paediatrics 2002; 29:23. To evaluate the impact of malaria vector control measures which form an integral part of the National guidelines for malaria control, 1224 and 940 healthy primary school children in Kaduna, were assessed for malaria parasitaemia at peak wet (maximal malaria transmission) and peak dry (minimal malaria transmission) seasons, respectively. Possible association between asymptomatic malaria parasitaemia (ASMP) and utilization of vector control measures were analyzed. The overall ASMP prevalences were 22.5 per cent and 14.9 per cent at maximal and minimal transmission periods, respectively. Vector control measure utilization was strongly related and inversely associated with the rates of ASMP. The estimation of ASMP is therefore recommended for use as an index for evaluation of malaria vector control programmes.

Adegboye VO, Ogunkunle O, Omokhodion SI, Brimmo AI, Adebo OA, Ogunseyinde OO, Obajimi MO. Coarctation of the Aorta: Experience at the University College Hospital, Ibadan. Nigerian Journal of Paediatrics 2002;29:27. Between May 1977 and June 1998, 697 patients with congenital heart diseases were admitted to the cardiothoracic surgical unit (CTSU) at the University College Hospital, Ibadan. Eighteen (2.6 per cent) of the patients with 19 coarctations of the aorta (CoA) were retrospectively studied. The age range of all the patients with CoA was 18 days to 30 years (mean 7.2±8.2 years), but for the 15 patients who underwent surgery, it was one month to 30 years (mean 8.6±8.3 years). Three patients died preoperatively of congenital cardiac anomalies associated with infantile CoA. There were 16 thoracic and two abdominal CoA, while one patient had recurrent CoA. Resection and end-to-end anastomosis was performed in four patients, dacron tube interposition graft in three, and dacron patch graft in four patients. Other procedures were employed in five patients. Operative mortality was 25 per cent. Operative deaths occurred in two infants with isolated CoA, a neonate who had associated pulmonary hypertension and a 17-year old who had surgery for re-coarctation. Complications of surgery included post-operative haemorrhage in two patients, intra-operative hemorrhage in one and hoarseness of the voice in four patients. Paradoxical hypertension occurred in three patients, graft occlusion and wound dehiscence occurred together in one patient and two patients had chylothorax. It is concluded that CoA is a surgically correctable congenital anomaly which is probably less frequently diagnosed locally.

Ikefuna AN, Iloeje SO. Evaluation of Factors that Influence School Readiness Among Nursery School Children in Enugu. Nigerian Journal of Paediatrics 2002; 29: 34. The preschool child is often confronted with adverse environmental influences that may affect his/her development and hence his readiness for schooling. The factors that affect school readiness were evaluated in 532 nursery school pupils using a proforma on perinatal problems and gross motor development of the pupils. Their nutritional status, neurodevelopment status, and their performance on the Draw-A-Person Test were assessed. Sixty (11.3 per cent) of the 532 children were unready for schooling. Factors that are responsible for this included malnutrition, adverse perinatal period and a younger age at school entry. The need for the establishment of the preschool health unit in the Local Government as well as routine medical examination of nursery school pupils is emphasized.

Adegboye VO , Omokhodion SI , Ogunkunle O , Obajimi MO, Brimmo AI, Adebo OA. Experience with the Management of Congenital Diaphragmatic Hernia at the University College Hospital, Ibadan. Nigerian Journal of Paediatrics 2002;29:40. A retrospective review of 44 cases of congenital diaphragmatic hernia (CDH) treated at the Cardiothoracic Surgical Unit, University College Hospital (UCH), Ibadan, between August 1976 and May 1999, was carried out. Thirty (68.2 per cent) of the 44 were males and 14 (13.8 per cent) were females. The patients were analysed in three groups: 31 patients who underwent surgery were analysed as two groups: inborn (born within UCH), 10 patients, and outborn (born elsewhere), 21 patients; the third group consisted of 13 patients who were not operated upon. All the inborn patients and 18 (85.7 per cent) of the outborn had left-sided defects; the remaining three of the outborn had right-sided defects. Eleven (84.6 per cent) of those who didn't undergo surgery, had left-sided defects while the remaining 15.4 per cent had bilateral defects. The three groups had comparable gestational ages (inborn vs outborn, p> 0.05; inborn vs unoperated, p> 0.05; outborn vs unoperated, p>0.05) and birth weights ( inborn vs outborn, p>0.05; inborn vs unoperated, p>0.05; outborn vs unoperated, p> 0.05). Those who did not undergo surgery had lower Apgar scores and higher incidence of associated congenital malformations than the patients who underwent surgical repairs. The differences in the mean of 5 minute Apgar scores among the three groups were not statistically significant (p> 0.05). Age at surgery was higher in the outborn (mean 55.5 ± 42.2 hours) than the inborn (mean 9.2 ± 3.9 hours) patients. The difference between the mean age at surgery was statistically significant (p< 0.05). Majority of those requiring operation (24 patients, 77.4 per cent) had repair by thoracotomy, while the remaining seven (22.6 per cent) had repair by the abdominal approach. Most of the patients had primary repair while two required diaphragmatic patches with dacron. Sixty per cent of the inborn patients required post-operative ventilation compared with only 23.8 per cent of the outborn. Survival was 71.4 per cent for the outborn and 40 per cent for the inborn. It is concluded that CDH is a disease with a range of severity. The higher survival rate among the more mature outborns suggest a natural selection of those with minimum respiratory impairment.

Keywords: Congenital, Diaphragmatic hernia.

Onabolu OO. Pattern of Paediatric Ophthalmic Admissions into the Ogun State University Teaching Hospital, Sagamu. Nigerian Journal of Paediatrics 2002; 29:47. Visual impairment in childhood is an impediment to learning and social development.

A study of paediatric ophthalmic admissions into the Ogun State University Teaching Hospital, Sagamu, was conducted to establish the main causes of admission, and the visual outcome after treatment. Of the 89 eyes in 67 patients whose case notes were analysed, infection (38 per cent), trauma (30 per cent), congenital diseases (17 per cent) and tumours (15 per cent) were the four main groups of ocular diseases seen. Measles infection was the major blinding disease. Trauma was associated with the worst visual prognosis in spite of treatment. Congenital cataract was the commonest congenital ocular disease. Although the visual outcome after cataract surgery was fair, the development of amblyopia prevented maximal visual recovery. The possibility of rubella aetiology of the cataract could not be ruled out in these patients. There is a need for sustained commitment to immunization. The availability of ophthalmic microsurgical instruments will improve the surgical care of patients with a view to better visual outcome.