African Journals OnLine
Nigerian Journal of Paediatrics

Vol. 29. No. 4. October 2002
CONTENTS

Chukwudi NK, Ejike O, Adimora GN, Ibe BC.  Influence of Biosocial Factors on the Incidence of Low Birth Weight Babies in Enugu.  Nigerian Journal of Paediatrics 2002; 29:99.  A retrospective review of 2,216 deliveries at the labour  ward of the University of Nigeria Teaching Hospital, Enugu was carried out for the period January 1, 1995 to December 31, 1996.  The relationship between various maternal and neonatal biosocial factors and low birth weight incidence was examined.  The incidence of LBW for the period was 12.64 percent with female preponderance  [male: female ratio 1:1.33 (p <0.01)].  Maternal ages <20 years and ³35 years were associated with relatively high incidences of LBW.  Other factors identified as risk factors for the delivery of LBW infants, included lack of antenatal care (p<0.001), female gender, grand multiparity and multiple gestation.

Ibeziako SN, Ibekwe RC.  Pattern and Outcome of Admissions in the Children’s Emergency Room of the University of Nigeria Teaching Hospital, Enugu. Nigerian Journal of Paediatrics 2002; 29: 103. A five-year review of the pattern and outcome of paediatric admissions in the Children Emergency Room (CHER) of the University of Nigeria Teaching Hospital (UNTH) Enugu, showed a total of 10,267 admissions, a discharge rate of 50.4 percent, a transfer-out rate of 44.3 percent, and a mortality of 5.1 percent. The commonest causes of admission were febrile convulsions (21.5 percent), severe malaria with anaemic heart failure (18.4 percent), acute lower respiratory tract infections (ALRTI) in 16.1 percent, diarrhoeal diseases (12.3 percent), complications of sickle cell anaemia (7.6 percent), acute neurological conditions (7.6 percent), acute asthma (5.2 percent) and neonatal conditions (4.8 percent). Surgical emergencies constituted 6.1 percent of all admissions while chronic medical conditions were only 0.4 percent. Among those that died, neonatal deaths involving mainly out-born babies accounted for 10.4 percent, while the leading causes of mortality beyond the neonatal period were severe malaria with severe anaemia in 30.0 percent, ALRTI in 19.3 percent and severe dehydration with shock in 10.9 percent. The majority of deaths (73.5 percent) in children under five years of age occurred in those aged two years and below with a peak in the age group, 7- 12 months. The vulnerability of our children to communicable but preventable diseases is highlighted. The provision of Children’s Emergency Units is recommended where they do not exist. A cleaner environment, sustained health education and disease surveillance among the under-five for early detection of ill health and appropriate intervention will most likely reduce the burden of paediatric emergencies. At the appropriate level of care, facilities to ensure prompt response by blood transfusion services should be ensured.

BN Tagbo, AC Ude, BC Ibe.  Predictive Value of Respiratory Rate Thresholds in Pneumonia among Preschool Children in Enugu, Nigeria.  Nigerian Journal of Paediatrics  2002; 29: 108.  A study was carried out to determine the predictive value of respiratory rate in the clinical diagnosis of pneumonia in 101 children with respiratory symptoms of <28 days duration. Clinical, demographic and anthropometric variables were obtained at presentation while confirmation of the diagnosis was by a chest x-ray in each subject. Fifty-two of the subjects had radiological pneumonia; 42(80 percent) of them were less than three years old including 22 (42 percent) less than one year. The male to female ratio was 1.3:1. Of the 52 children with pneumonia, 38 (73 percent) had respiratory rate ³50/minute, while 43 (83 percent) had respiratory rate ³40/min. When all age groups are considered, subjects with pneumonia had significantly higher respiratory rates. Respiratory rate was found to be least reliable as an indicator of pneumonia in children aged 2-11 months in whom the widest variation of respiratory rate was identified. For children aged 12-35 months, a respiratory rate of ³50/min was a good predictor of pneumonia while a respiratory rate of ³35/min was highly sensitive in children ³36 months old. The current data suggest that the age specific respiratory rate cut off recommended by WHO programme for the control of acute respiratory infections need to be reviewed.

Key Words: Predictive value, Respiratory rate, Pneumonia, Pre-school children.

Oyedeji GA,  Ajibola AJ,  Oyedeji AO. Are the Mothers of Hospitalized Socially Disadvantaged Children worse Care Givers than those of Non-disadvantaged Children? Nigerian Journal of Paediatrics 2002; 29:113.The level of general hygiene, duration of breastfeeding and number of doses of scheduled immunizations received by 207 socially disadvantaged and 237 non-disadvantaged controls, mostly under five-year old children, admitted to the Wesley Guild Hospital, Ilesa, over a six-month period, were studied through physical inspection and administration of questionnaire. Compared with controls, higher percentages of disadvantaged children received none or incomplete doses of scheduled vaccinations (p<0.001), were breastfed for a total of less than 18 months (p <0.05) and were kept below average standard of hygiene (p<0.001). The findings suggest that there is need to further define the factors of social disadvantage prevalent in our communities and their effects on the health of children in order to effectively reduce the incidence and ill effects of such social disadvantages.

Key words:  Mothers, Social, Disadvantage, Care givers

Ogisi  FO. Cancrum Auris in Children: Report of Two Cases. Nigerian Journal of Paediatrics 2002; 29:119.  Two cases of necrotising otitis externa (cancrum auris) associated with malnutrition in very young children are presented.  Pseudomonas aeruginosa and Klebsiella spp were isolated from one of the children while P. aeruginosa and coliforms were cultured from swabs of the wound in the second case. Management consisted of wound debridement under local anaesthesia with application of both local and systemic antibiotics. Follow up showed good healing in one case and improvement in the other which was however, complicated by fibrosis and meatal stenosis. Malnutrition was most probably a predisposing factor in both cases.

Lagunju IA, Omokhodion SI, Brown BJ, Adeniyi OF. Camptomelic Dysplasia in One of Twins – A Case Report. Nigerian Journal of Paediatrics 2002; 29:122.  Camptomelic dysplasia, a very rare and lethal form of skeletal dysplasia is reported in one of a set of twins. He presented on the second day of life with short, deformed lower limbs and respiratory distress from birth and died on the fifth day of life. This report highlights the features of camptomelic dysplasia and draws attention to its occurrence in a Nigerian child. With advances in neonatal life support, there is need to proffer solutions to the problems that presently make the prognosis of camptomelic dysplasia, poor.