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MUSTAPHA BELLO

University of Maiduguri, Paediatrics, Department Member

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Phone: 08033734343
Address: DEPARTMENT OF PAEDIATRICS, UNIVERSITY OF MAIDUGURI, MAIDUGURI, BORNO STATE, NIGERIA

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Eric S . Kim (UBC)

University of British Columbia

Muhammad Waziri

University of Maiduguri

Ertuğrul Murat Özgür

Ankara University

Washington Center for Consciousness Studies

Garumma T Feyissa

Drexel University

Oladosu A Ojengbede

University of Ibadan Nigeria

University of KwaZulu-Natal

Neda Laiteerapong

University of Chicago

Cristina Campoy

University of Granada

University of Nigeria, Nsukka

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Papers by MUSTAPHA BELLO

Evaluation of the Nitrite Test in Screening for Urinary Tract Infection in Febrile Children with Sickle Cell Anaemia in Maiduguri- Nigeria

PubMed, 2011

BACKGROUND: Urinary tract infection is a significant cause of morbidity in children with sickle c... more BACKGROUND: Urinary tract infection is a significant cause of morbidity in children with sickle cell anaemia (SCA). Individuals with SCA have increased risk of urinary tract infection (UTI). Facilities for urine culture may not be available in most rural and even some urban areas in most developing countries like Nigeria. It will therefore be useful to have a simple means of screening such children for UTI with the intent of prompt treatment. MATERIALS AND METHODS: The study will evaluate the usefulness of the nitrite test in detecting UTI in febrile SCA children. This study was carried out in the Department of Paediatrics University of Maiduguri Teaching Hospital and State Specialist Hospital Maiduguri. RESULTS: The study consisted of 250 children aged 6 months to 15 years with SCA presenting with fever (temperature ≥ 37. 5°C). Midstream urine specimen was collected from older children and suprapubic bladder aspiration of urine specimen was collected from infants. Samples were subjected to nitrite test, culture and sensitivity. There was significant bacteriuria in 65 (26+) children with SCA. A positive test for nitrite was obtained in 43 of the 65 (66.2+) children. The nitrite test has a specificity of 93.5+ in detecting bacteriuria, a sensitivity of 66.2+, a positive predictive value of 78.2+ and a negative predictive value of 93.5+. A positive nitrite test was significantly associated with bacteriuria, while a negative test was also significantly associated with an absence of bacteriuria. CONCLUSIONS: From this study, the nitrite test is useful as a screening test for UTI in SCA children. However in sick children with SCA, microscopy, culture and sensitivity should still be done in spite of a negative nitrite test.

Neonatal Septicaemia in Poor Resource Settings

Pediatric infectious diseases: open access, 2017

Neonatal septicaemia despite recent advances in hygiene and introduction of potent antibiotics ha... more Neonatal septicaemia despite recent advances in hygiene and introduction of potent antibiotics has remained a major cause of morbidity and mortality worldwide. The developing countries worse as the incidence is as 56.9/1000 live birth in Nigeria. In our environment, the risk factors were low socioeconomic factors, delivery at home, maternal fever and use of traditional concoctions were the common finding and late presentation was another problem. In neonatal period, child immune defense mechanism is very low as the neonate whether term or preterm, have qualitative and quantitative deficiencies in cellular and humoral immunity compared to adults. When bacterial pathogens invade neonatal blood system, pro-inflammatory cytokines such as TNF-α, TNF-γ, interleukins a response followed rapidly by a surge of anti-inflammatory cytokines which include IL-10, IL-1RA, IL-13, IL-14, etc. Early presentation and prompt treatment with potent antibiotics improve the outcomes as most of those babies that presented early to our health facility and had treatment instituted early recovered well with no residual complication. Conclusion: Therefore counselling and empowerment of mother of sick neonates play an important role in the mother to present such ill neonate whom may turn out to be a septicaemic neonate. This means early presentation to health facility, early diagnosis and early appropriate treatment thereby saving the neonate.

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Nigerian Medical Journal, 2013

goal yet. 4 Available data indicates that 18 states (out of 37) are at risk for maternal and neon... more goal yet. 4 Available data indicates that 18 states (out of 37) are at risk for maternal and neonatal tetanus. 4 Many hospital based studies have identified neonatal tetanus as a problem of high magnitude in Nigeria. 5-8 Maternal immunization and improved obstetric and neonatal care are the main strategies in Nigeria for improving protection against neonatal tetanus. 4 Recently, the high-risk approach of conducting tetanus toxoid (TT) Supplementary Immunization Activities (SIAs) targeting women of reproductive age was conducted in three states of the federation and selected Local Government Areas (LGAs) in 5 other states including Borno. Health education to modify harmful cultural practices that directly encourage the risk of acquisition of tetanus is also useful. 9,10 Nigeria plans to achieve elimination in a phased manner by focusing on two zones (South-east and Southwest) in 2013-2014 followed by the remaining four zones. The bulk of African Countries, Nigeria inclusive, have a very young population with more women in reproductive age group. 11 This further underscores the need for increase action towards maternal tetanus immunization of women of child-bearing age if the scourge is to be controlled.

Congenital Birth Defects , Its Incidence and Management Challenges in a Poor Resource Health Facility : A Scenario from North-Eastern Nigeria

Birth defects also known as congenital anomalies, congenital malformations or congenital disorder... more Birth defects also known as congenital anomalies, congenital malformations or congenital disorders are structural or functional anomalies that occur during intrauterine life. They are important cause for neonatal morbidity and mortality and larger percentage of stillbirth.. A mother who gives birth to an abnormal baby is seen as a reproductive failure and may be saddled with the high cost of taking care of such a child. The aim of the study was to determine the incidence and pattern of congenital malformations in UMTH, identify subgroups that are affected and challenge associated with management, provide information that can be used for prevention and counseling. This cross-sectional descriptive study was carried out at the Special Care Baby Unit (SCBU) of the Department of Paediatrics in association with the labour ward of the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital, Maiduguri (UMTH), over 18 month period from 1st January 2017-30th ...

Evaluation of the Nitrite Test in Screening for Urinary Tract Infection in Febrile Children with Sickle Cell Anaemia

Nigerian Journal of Paediatrics, 2005

Management of chylous ascites with surgery and frusemide in a new born

African Journal of Paediatric Surgery

IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 2... more IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 20,000-1 in 187,000 admissions has been reported in a large tertiary hospital. [2,3] Most reports showed a slight male preponderance, ratio of 1.8:1 M˃F. [4] The first report of chylous ascites was in a 2-year-old boy with tuberculosis by Morton in 1683. [5] Many aetiological factors have been described in adults, but the predominant cause in children is mainly due to congenital developmental disorders of the lymphatic channels, which is usually a hyperplasia or hypoplasia of the lymphatic channels. [6] Of which, hyperplasia of the primary lymphatic channels is responsible for majority of the congenital malformations. Rarely, chylous ascites may follow birth trauma, malignancy, surgery and cardiovascular diseases in children. And sometimes, it can also follow certain genetic syndromes like Turner syndrome, yellow nail syndrome and Klippel-Trenaunay-Weber syndrome.

Comparative outcome of overhead and total body phototherapy for treatment of severe neonatal jaundice in Nigeria

Paediatrics and International Child Health, 2019

Background: In Nigeria, neonatal jaundice is commonly treated by overhead phototherapy with neona... more Background: In Nigeria, neonatal jaundice is commonly treated by overhead phototherapy with neonates lying supine, often with effective exposure of less than one half of the body surface. Total body exposure in phototherapy has been in use for less than 2 years in Nigeria, but is available in only five neonatal centres. Aim: To compare the effectiveness of total body exposure (TBPE) with the conventional partial exposure (COPT) for treatment of hyperbilirubinaemia. Methods: Eleven datasets from 10 neonatal units across Nigeria were retrieved. They included neonates with severe hyperbilirubinaemia treated with TBPE using the Firefly® device (MTTS Asia) as a test group. The remainder of the patients, the controls, were treated with COPT. Any requirement for exchange blood transfusion (EBT) in either group was documented. Total serum bilirubin (TSB) >213.8 μmol/L (12.5 mg/dL) was treated as severe hyperbilirubinaemia. The efficiency of the intervention was determined according to the time taken for a severe case to be downgraded to mild at ≤213.8 μmol/L. Results: A total of 486 patients were studied, 343 controls and 143 cases. Mean (SD) postnatal age was 6 days (0.7) for cases and 5 (0.9) for controls, for gestational age (GA) in completed weeks was 36 (0.5) for cases and 37 (0.7) for controls and for birthweight was 2.7 kg (0.25) for cases and 2.7 (0.22) for controls. Mean (SD) pre-intervention TSB was 299.3 (35.7) μmol/L for cases and 327.3 (13.9) for controls. Severity downgrade day was Day 2 (0.4) for cases and Day 5 (1.1) for controls. Overall relative EBT rate was 6% for cases and 55% for controls (p= 0.0001), and early preterm relative EBT rate was 0% for cases and 68% for controls (p < 0.01). Conclusion: TBPE was quicker and safer for reduction of hyperbilirubinaemia and patients rarely required EBT. TBPE is recommended for rapid reduction of serum bilirubin levels and the reduction of treatment costs, morbidity and mortality in low-and middle-income countries.

Antimicrobial sensitivity pattern of organisms causing urinary tract infection in children with sickle cell anemia in Maiduguri, Nigeria

Nigerian Journal of Clinical Practice, 2012

Background: Patients with sickle cell disease have increased tendency to develop frequent and sev... more Background: Patients with sickle cell disease have increased tendency to develop frequent and severe infections, especially of bones and urinary tract. Objective: The knowledge of antimicrobial sensitivity pattern of common etiological agents will serve as a guide to empiric treatment while results of urine culture and sensitivity are being awaited. Materials and Methods: Antimicrobial sensitivity test was carried out on bacterial isolates from the urine of febrile children with sickle cell anemia (SCA) and children with HbAA in Maiduguri. Urine specimens were collected and cultured by standard methods. Sensitivity to 15 antimicrobials (based on availability of sensitivity disc) was tested using the disc-diffusion technique of stokes. Results: Significant bacteriuria was obtained from 65 (26%) of the 250 children with SCA and 51 (20.4%) of the 250 controls. The isolates were E. coli, Klebsiella, Coliforms, Proteus, Staph aureus and Salmonella. Sensitivity was highest to 3 rd generation cephalosporins, followed by the quinolones: ciprofloxacin (86.2%), ofloxacin (83.1%), and peflacine (73.8%). Sensitivity of the organisms to some of the commonly used antibiotics like ampicillin, cotrimoxazole, and nalidixic acid was generally low. In general, the pattern of bacteriuria and their sensitivity in the SCA group was similar to the pattern in the control group. Conclusion: Etiological agents of childhood urinary tract infections (UTI) in this environment are resistant to most of the drugs commonly recommended for its treatment. Amoxicillin/clavulanic acid, cefuroxime, and gentamicin, are recommended as first-line drugs for treatment of UTI while awaiting results of culture and sensitivity. Ceftriaxone and ceftazidime should be reserved for case of non response to first-line drugs and severe infections.

Prevalence of exchange blood transfusion in severe hyperbilirubinaemia and outcome at the University of Maiduguri Teaching Hospital Maiduguri, Northeastern Nigeria

Nigerian Journal of Paediatrics

Background: Exchange blood transfusion (EBT) is carried out for the treatment of conditions prese... more Background: Exchange blood transfusion (EBT) is carried out for the treatment of conditions presenting with severe hyperbilirubinaemia and anaemia, such as ABO incompatibility, sepsis, prematurity and birth trauma among others. While it is fast being abandoned as treatment modality for severe neonatal jaundice in the resource rich countries, it is still a backbone of treatment for severe neonatal jaundice in resource limited settings. Since such a study has not been done in this centre before now, we decided to study the positive effects of exchange blood transfusion in Maiduguri, North-Eastern Nigeria.Objective: To determine the prevalence, indications and outcome of exchange blood transfusion at the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maiduguri.Methods: This is a retrospective study which examined the records of babies admitted into the SCBU between 1st January to December 31st 2014 with the aim of determining the prevalence of EBT at the Speci...

Causes of deaths in neonates and children aged 1-59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study

mustapha bello, 2022

Background: Nigeria has one of the highest under-five mortality rates in the world. Identifying t... more Background: Nigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013-2018 periods. Methods: We conducted retrospective inquiries into the cause of deaths of 948 neonates and 2,127 children aged 1-59 months as identified in the 2018 Nigeria Demographic and Health Survey (NDHS). The verbal autopsy asked about signs and symptoms during the final illness. The Physician Coded Verbal Autopsy (PCVA) and Expert Algorithm Verbal Autopsy (EAVA) methods were employed to assign the immediate and underlying cause of deaths to all cases. Result: For the analysis, sampling weights were applied to accommodate non-proportional allocation. Boys accounted for 56 percent of neonatal deaths and 51.5 percent of the 1-59-months old deaths. About one-quarter of under-5 mortality was attributed to neonatal deaths, and 50 percent of these neonatal deaths were recorded within 48 h of delivery. Overall, 84 percent of the under-5 deaths were in the northern geopolitical zones. Based on the two methods for case analysis, neonatal infections (sepsis, pneumonia, and meningitis) were responsible for 44 percent of the neonatal deaths, followed by intrapartum injury (PCVA: 21 percent vs. EAVA: 29 percent). The three main causes of death in children aged 1-59 months were malaria (PCVA: 23 percent vs. EAVA: 35 percent), diarrhoea (PCVA: 17 percent vs. EAVA: 23 percent), and pneumonia (PCVA: 10 percent vs. EAVA: 12 percent). In the North West, where the majority of under-5 (1-59 months) deaths were recorded, diarrhoea was the main cause of death (PCVA: 24.3 percent vs. EAVA: 30 percent). Conclusion: The causes of neonatal and children aged 1-59 months deaths vary across the northern and southern regions. By homing on the specific causes of mortality by region, the study provides crucial information that may be useful in planning appropriately tailored interventions to significantly reduce under-five deaths in Nigeria.

Management of Chylous Ascites with Surgery and Frusemide in a New Born

Mustapha Bello, 2022

IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 2... more IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 20,000-1 in 187,000 admissions has been reported in a large tertiary hospital. [2,3] Most reports showed a slight male preponderance, ratio of 1.8:1 M˃F. [4] The first report of chylous ascites was in a 2-year-old boy with tuberculosis by Morton in 1683. [5] Many aetiological factors have been described in adults, but the predominant cause in children is mainly due to congenital developmental disorders of the lymphatic channels, which is usually a hyperplasia or hypoplasia of the lymphatic channels. [6] Of which, hyperplasia of the primary lymphatic channels is responsible for majority of the congenital malformations. Rarely, chylous ascites may follow birth trauma, malignancy, surgery and cardiovascular diseases in children. And sometimes, it can also follow certain genetic syndromes like Turner syndrome, yellow nail syndrome and Klippel-Trenaunay-Weber syndrome.

Intrauterine Growth Standards: A Cross-Sectional Study in A Population of Nigerian Newborns

Pediatric Reports, 2012

The aim of the study was to define an intrauterine growth curve for a population of Nigerian newb... more The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA) of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the ...

Acute renal failure in the newborn: Incidence and outcome

Journal of Paediatrics and Child Health, 1997

To describe an experience from a developing country of newborn renal disease particularly those w... more To describe an experience from a developing country of newborn renal disease particularly those without advanced neonatal care. Prospective evaluation from a referral hospital, North-East of Nigeria between 1 July 1990 and 30 June 1994. Babies admitted for any morbidities who were diagnosed as being in acute renal failure (ARF) during the study period (non-oliguric inclusive). Onset of ARF; day on which oliguria or anuria detected, or serum urea first exceeded 10 mmol/L. Urine output quantitated from carefully bagged urine and suprapubic bladder aspiration, and venous blood regularly obtained for serum electrolytes, urea and creatinine. Fractional excretion of sodium (FE(Na)) and renal failure index (RFI) were determined on some babies. Forty-three neonates (M:F; 3.3:1) with ARF, the majority (27) of whom were out-born, and 14, 26 and three were preterm, full-term and post term, respectively. Encountered incidence was 3.9/1000 live births with a high prevalence rate; 34.5/1000 admissions. A significantly greater incidence was seen in the latter half of study; 10.7 vs 53.7/1000, P &lt; 0.05. Early ARF occurrence (aged; 0-5 days) in 33 (77%) of babies. The aetiology was comprised of perinatal asphyxia, sepsis, obstructive uropathy and miscellaneous in 53.4%, 32.6%, 9.3% and 4.7%, respectively. Twenty-two (51.2%) deaths occurred; however, the exact causes were indeterminable. Fractional excretion of sodium (FE(Na)) and renal failure index (RFI) were of &lt; 1.75% and &lt; or = 2.0, respectively, significantly differentiated sepsis (intrinsic) from perinatal asphyxial (pre-renal) ARF; P &lt; 0.01. No case of persistent renal failure occurred. Our FE(Na) value (although less than reported in previous literature from affluent societies) remained sensitive (along with RFI) in differentiating aetiological group of ARF. Our data and medical management outcome, despite absence of level-III care, support the need for good resuscitation, careful monitoring and constant re-evaluation. The effect of salbutamol on hyperkalaemia is emphasized.

Causes of deaths in neonates and children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study

BMC Public Health

Background Nigeria has one of the highest under-five mortality rates in the world. Identifying th... more Background Nigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013–2018 periods. Methods We conducted retrospective inquiries into the cause of deaths of 948 neonates and 2,127 children aged 1–59 months as identified in the 2018 Nigeria Demographic and Health Survey (NDHS). The verbal autopsy asked about signs and symptoms during the final illness. The Physician Coded Verbal Autopsy (PCVA) and Expert Algorithm Verbal Autopsy (EAVA) methods were employed to assign the immediate and underlying cause of deaths to all cases. Result For the analysis, sampling weights were applied to accommodate non-proportional allocation. Boys accounted for 56 percent of neonatal deaths and 51.5 percent o...

Preterm Babies: Management and Challenges Associated with Survival in a Resource-Limited Setting

West African journal of medicine, 2020

BACKGROUND Preterm babies have constituted a major constraints on human and material resources du... more BACKGROUND Preterm babies have constituted a major constraints on human and material resources due to early mortality and long term disability among survivors. Rates of disability among survivors have increased over the period, with high rates of broncho-pulmonary dysplasia. OBJECTIVE To determine the survival and management challenges of preterm babies in University of Maiduguri Teaching Hospital, Maiduguri Borno State REUSLTS: Of the 1129 preterm babies managed in the Special Care Baby Unit (SCBU), 714 cases notes were retrieved and analyzed giving a retrieval rate of 63%. There were 256 (35.9%) preterm babies as in-born, while 458 (64.1%) were out-born. Male preterm babies were 372 (52.1%), while female preterm babies were 342 (47.9%); with female to male ratio of 1.08:1. Extreme low birth weight (<1000grams) were 17 (2.3%), very low birth weight (1000-1499 grams) were 288 (40.3%) while low birth weight (1500-2499 grams) were 406 (56.9%). We also documented 3 preterm babies wh...

Birth Injuries, Risk Factors and Predictors of Outcome in Maiduguri North-eastern Nigeria

Journal of Advances in Medicine and Medical Research, 2018

Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at bi... more Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at birth which can be avoidable and unavoidable. Despite advances in prenatal care, birth injuries occurs especially in prolonged and difficult labour /deliveries. Objectives: The study aimed to determine the risk factors and predictors of outcome at Special Care Baby Unit of the University of Maiduguri Teaching Hospital Maiduguri, NorthEastern Nigeria. Patients and Methods: This was a prospective cross-sectional studies conducted over 12 months from 1 st January to 31 st December 2016. Patients who met the inclusion criteria after obtaining ethical clearance were evaluated after consenting to participate in the study. Results: Sixty one (5.7%) out of 1078 neonates admitted to Special Care Baby Unit (SCBU) with birth injuries were recruited into the study. The common risk factors identified were primiparity 25/61 (40.7%) p=0.017, mode of delivery spontaneous vaginal delivery 36/61 (58.8%). Deliver at tertiary centre was high 38/61 (62.3%), though not statistically significant. When compared neonates with one-two birth injuries compared to those greater than 2 birth injuries delivery by Original Research Article Pius et al.; JAMMR, 25(10): 1-8, 2018; Article no.JAMMR.40276 2 non-obstetrician was associated with higher risk of birth injury p=0.001. Facial nerve palsy, Erb&#39;s palsy was the common central nervous system injury; perinatal asphyxia was higher 24/61 (39.1%). Soft tissue injury constituted the majority; Facial and skin bruises 37/61 (60.7%), sub-conjunctival haemorrhage 25/61 (40.1%) cephalhaematoma and subgaleal haemorrhage was 10/61 (16.4%) and 8/61 (13.1%) respectively. Clavicular fracture was the commonest 5/61 (8.2%), followed by humerus 4/61 (6.6%). Two patients with liver and splenic rupture died within 2 days of admission. Conclusion: The risk factors and predictors of birth injuries are intertwined; largely birth injury is avoidable with good antenatal care and prompt management of labour processes by trained personnel.

Achondrogenesis Type II in a Live Term Newborn Infant: A Case Report

Open Journal of Pediatrics, 2018

Background: Achondrogenesis type II is a lethal form of osteochondrodysplasia characterized by sh... more Background: Achondrogenesis type II is a lethal form of osteochondrodysplasia characterized by short trunk, disproportionately large head, prominent forehead, micrognathia, extreme micromelia, anasarca, large abdomen and poor ossification of the bones. The children with achondrogenesis are usually born premature, or die in the neonatal period mostly from respiratory failure. We report the case of a live term newborn infant with achondrogenesis type II who died shortly after birth. Methods: We report a case of achondrogenesis type II in a live male newborn. Results: We report the case of a term male infant delivered to a 24-year-old woman with a chondrogenesis type II confirmed radiologically but died at age 5 days. Conclusion: Whenever a skeletal dysplasia in a fetal dwarfism is suspected, a proper work-up plan should be done to evaluate family history. A clinical, radiographic and histopathologic examination, should be done and confirmed by genetic study. Following evidence-based diagnosis, patients could be offered termination of pregnancy after counseling.

Characteristics and predictors of outcome of care of preterm newborns in resource constraints setting, Maiduguri, Northeastern Nigeria

Journal of Clinical Neonatology, 2019

Background: Currently, prematurity has been noted to be the commonest cause of under-five mortali... more Background: Currently, prematurity has been noted to be the commonest cause of under-five mortality globally, well above pneumonias and malaria. The survival chances of babies born preterm in the resource constraints settings is unacceptably low though vary significantly depending on where they are born. Objective: The aim of the study was to determine the characteristics and predictors of survival of preterm babies at the

The Influence of Gestational Age on the Loss of Maternal Measles Antibodies in Newborn Infants in North-Eastern Nigeria: A Call for a Review of Measles Immunization Schedule

African Journal of Clinical and Experimental Microbiology, 2012

Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs dur... more Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs during third trimester of pregnancy. Gestational age (GA) affects the levels of MMA such that longer GA may result in infants starting out with high levels of MMA. Objective: To determine the influence of GA on the loss of MMA in newborn infants in North-Eastern Nigeria. Method: A prospective study was conducted on newborn infants at Maiduguri; sera were collected at birth and at six months of age. Enzyme linked immunosorbent assay (ELISA) was used to measure MMA while GA was determined using the last menstrual period, ultrasound scan reports and the Dubowitz criteria. Results: Seventy eight newborn infants were enrolled. Seventeen (89.5 %) preterm, 43 (95.6 %) term and 14 (100 %) postterm had protective levels of MMA at birth. Two (10.5 %) preterm, nine (20.0%) term and two (14.3 %) postterm had protective MMA at six months of age. Comparison of mean MMA at birth and at six months of age was significant (p = 0.005), however, it was independent of GA of the newborn infants. Conclusion: Significant decline of mean MMA levels was seen in these infants at six months of age, which was independent of their GA. These infants may be prone to measles at an earlier age (less than six months). Therefore, the current recommendation of measles immunization to infants at nine months of age may require reconsideration.

Frontonasal dysplasia Sequence : A case report

Nigerian Journal of Paediatrics, 2014

Frontonasal dysplasia (FND) is a very rare congenital abnormality in which the mid face does not ... more Frontonasal dysplasia (FND) is a very rare congenital abnormality in which the mid face does not develop normally. It affects mainly the head and face. Cause is unknown but may be sporadic or familial. We report a rare case of a full term baby who presented with classical features of FND in Maiduguri, Nigeria. Management difficulty in resource limited setting is highlighted.

Evaluation of the Nitrite Test in Screening for Urinary Tract Infection in Febrile Children with Sickle Cell Anaemia in Maiduguri- Nigeria

PubMed, 2011

BACKGROUND: Urinary tract infection is a significant cause of morbidity in children with sickle c... more BACKGROUND: Urinary tract infection is a significant cause of morbidity in children with sickle cell anaemia (SCA). Individuals with SCA have increased risk of urinary tract infection (UTI). Facilities for urine culture may not be available in most rural and even some urban areas in most developing countries like Nigeria. It will therefore be useful to have a simple means of screening such children for UTI with the intent of prompt treatment. MATERIALS AND METHODS: The study will evaluate the usefulness of the nitrite test in detecting UTI in febrile SCA children. This study was carried out in the Department of Paediatrics University of Maiduguri Teaching Hospital and State Specialist Hospital Maiduguri. RESULTS: The study consisted of 250 children aged 6 months to 15 years with SCA presenting with fever (temperature ≥ 37. 5°C). Midstream urine specimen was collected from older children and suprapubic bladder aspiration of urine specimen was collected from infants. Samples were subjected to nitrite test, culture and sensitivity. There was significant bacteriuria in 65 (26+) children with SCA. A positive test for nitrite was obtained in 43 of the 65 (66.2+) children. The nitrite test has a specificity of 93.5+ in detecting bacteriuria, a sensitivity of 66.2+, a positive predictive value of 78.2+ and a negative predictive value of 93.5+. A positive nitrite test was significantly associated with bacteriuria, while a negative test was also significantly associated with an absence of bacteriuria. CONCLUSIONS: From this study, the nitrite test is useful as a screening test for UTI in SCA children. However in sick children with SCA, microscopy, culture and sensitivity should still be done in spite of a negative nitrite test.

Neonatal Septicaemia in Poor Resource Settings

Pediatric infectious diseases: open access, 2017

Neonatal septicaemia despite recent advances in hygiene and introduction of potent antibiotics ha... more Neonatal septicaemia despite recent advances in hygiene and introduction of potent antibiotics has remained a major cause of morbidity and mortality worldwide. The developing countries worse as the incidence is as 56.9/1000 live birth in Nigeria. In our environment, the risk factors were low socioeconomic factors, delivery at home, maternal fever and use of traditional concoctions were the common finding and late presentation was another problem. In neonatal period, child immune defense mechanism is very low as the neonate whether term or preterm, have qualitative and quantitative deficiencies in cellular and humoral immunity compared to adults. When bacterial pathogens invade neonatal blood system, pro-inflammatory cytokines such as TNF-α, TNF-γ, interleukins a response followed rapidly by a surge of anti-inflammatory cytokines which include IL-10, IL-1RA, IL-13, IL-14, etc. Early presentation and prompt treatment with potent antibiotics improve the outcomes as most of those babies that presented early to our health facility and had treatment instituted early recovered well with no residual complication. Conclusion: Therefore counselling and empowerment of mother of sick neonates play an important role in the mother to present such ill neonate whom may turn out to be a septicaemic neonate. This means early presentation to health facility, early diagnosis and early appropriate treatment thereby saving the neonate.

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Nigerian Medical Journal, 2013

goal yet. 4 Available data indicates that 18 states (out of 37) are at risk for maternal and neon... more goal yet. 4 Available data indicates that 18 states (out of 37) are at risk for maternal and neonatal tetanus. 4 Many hospital based studies have identified neonatal tetanus as a problem of high magnitude in Nigeria. 5-8 Maternal immunization and improved obstetric and neonatal care are the main strategies in Nigeria for improving protection against neonatal tetanus. 4 Recently, the high-risk approach of conducting tetanus toxoid (TT) Supplementary Immunization Activities (SIAs) targeting women of reproductive age was conducted in three states of the federation and selected Local Government Areas (LGAs) in 5 other states including Borno. Health education to modify harmful cultural practices that directly encourage the risk of acquisition of tetanus is also useful. 9,10 Nigeria plans to achieve elimination in a phased manner by focusing on two zones (South-east and Southwest) in 2013-2014 followed by the remaining four zones. The bulk of African Countries, Nigeria inclusive, have a very young population with more women in reproductive age group. 11 This further underscores the need for increase action towards maternal tetanus immunization of women of child-bearing age if the scourge is to be controlled.

Congenital Birth Defects , Its Incidence and Management Challenges in a Poor Resource Health Facility : A Scenario from North-Eastern Nigeria

Birth defects also known as congenital anomalies, congenital malformations or congenital disorder... more Birth defects also known as congenital anomalies, congenital malformations or congenital disorders are structural or functional anomalies that occur during intrauterine life. They are important cause for neonatal morbidity and mortality and larger percentage of stillbirth.. A mother who gives birth to an abnormal baby is seen as a reproductive failure and may be saddled with the high cost of taking care of such a child. The aim of the study was to determine the incidence and pattern of congenital malformations in UMTH, identify subgroups that are affected and challenge associated with management, provide information that can be used for prevention and counseling. This cross-sectional descriptive study was carried out at the Special Care Baby Unit (SCBU) of the Department of Paediatrics in association with the labour ward of the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital, Maiduguri (UMTH), over 18 month period from 1st January 2017-30th ...

Evaluation of the Nitrite Test in Screening for Urinary Tract Infection in Febrile Children with Sickle Cell Anaemia

Nigerian Journal of Paediatrics, 2005

Management of chylous ascites with surgery and frusemide in a new born

African Journal of Paediatric Surgery

IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 2... more IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 20,000-1 in 187,000 admissions has been reported in a large tertiary hospital. [2,3] Most reports showed a slight male preponderance, ratio of 1.8:1 M˃F. [4] The first report of chylous ascites was in a 2-year-old boy with tuberculosis by Morton in 1683. [5] Many aetiological factors have been described in adults, but the predominant cause in children is mainly due to congenital developmental disorders of the lymphatic channels, which is usually a hyperplasia or hypoplasia of the lymphatic channels. [6] Of which, hyperplasia of the primary lymphatic channels is responsible for majority of the congenital malformations. Rarely, chylous ascites may follow birth trauma, malignancy, surgery and cardiovascular diseases in children. And sometimes, it can also follow certain genetic syndromes like Turner syndrome, yellow nail syndrome and Klippel-Trenaunay-Weber syndrome.

Comparative outcome of overhead and total body phototherapy for treatment of severe neonatal jaundice in Nigeria

Paediatrics and International Child Health, 2019

Background: In Nigeria, neonatal jaundice is commonly treated by overhead phototherapy with neona... more Background: In Nigeria, neonatal jaundice is commonly treated by overhead phototherapy with neonates lying supine, often with effective exposure of less than one half of the body surface. Total body exposure in phototherapy has been in use for less than 2 years in Nigeria, but is available in only five neonatal centres. Aim: To compare the effectiveness of total body exposure (TBPE) with the conventional partial exposure (COPT) for treatment of hyperbilirubinaemia. Methods: Eleven datasets from 10 neonatal units across Nigeria were retrieved. They included neonates with severe hyperbilirubinaemia treated with TBPE using the Firefly® device (MTTS Asia) as a test group. The remainder of the patients, the controls, were treated with COPT. Any requirement for exchange blood transfusion (EBT) in either group was documented. Total serum bilirubin (TSB) >213.8 μmol/L (12.5 mg/dL) was treated as severe hyperbilirubinaemia. The efficiency of the intervention was determined according to the time taken for a severe case to be downgraded to mild at ≤213.8 μmol/L. Results: A total of 486 patients were studied, 343 controls and 143 cases. Mean (SD) postnatal age was 6 days (0.7) for cases and 5 (0.9) for controls, for gestational age (GA) in completed weeks was 36 (0.5) for cases and 37 (0.7) for controls and for birthweight was 2.7 kg (0.25) for cases and 2.7 (0.22) for controls. Mean (SD) pre-intervention TSB was 299.3 (35.7) μmol/L for cases and 327.3 (13.9) for controls. Severity downgrade day was Day 2 (0.4) for cases and Day 5 (1.1) for controls. Overall relative EBT rate was 6% for cases and 55% for controls (p= 0.0001), and early preterm relative EBT rate was 0% for cases and 68% for controls (p < 0.01). Conclusion: TBPE was quicker and safer for reduction of hyperbilirubinaemia and patients rarely required EBT. TBPE is recommended for rapid reduction of serum bilirubin levels and the reduction of treatment costs, morbidity and mortality in low-and middle-income countries.

Antimicrobial sensitivity pattern of organisms causing urinary tract infection in children with sickle cell anemia in Maiduguri, Nigeria

Nigerian Journal of Clinical Practice, 2012

Background: Patients with sickle cell disease have increased tendency to develop frequent and sev... more Background: Patients with sickle cell disease have increased tendency to develop frequent and severe infections, especially of bones and urinary tract. Objective: The knowledge of antimicrobial sensitivity pattern of common etiological agents will serve as a guide to empiric treatment while results of urine culture and sensitivity are being awaited. Materials and Methods: Antimicrobial sensitivity test was carried out on bacterial isolates from the urine of febrile children with sickle cell anemia (SCA) and children with HbAA in Maiduguri. Urine specimens were collected and cultured by standard methods. Sensitivity to 15 antimicrobials (based on availability of sensitivity disc) was tested using the disc-diffusion technique of stokes. Results: Significant bacteriuria was obtained from 65 (26%) of the 250 children with SCA and 51 (20.4%) of the 250 controls. The isolates were E. coli, Klebsiella, Coliforms, Proteus, Staph aureus and Salmonella. Sensitivity was highest to 3 rd generation cephalosporins, followed by the quinolones: ciprofloxacin (86.2%), ofloxacin (83.1%), and peflacine (73.8%). Sensitivity of the organisms to some of the commonly used antibiotics like ampicillin, cotrimoxazole, and nalidixic acid was generally low. In general, the pattern of bacteriuria and their sensitivity in the SCA group was similar to the pattern in the control group. Conclusion: Etiological agents of childhood urinary tract infections (UTI) in this environment are resistant to most of the drugs commonly recommended for its treatment. Amoxicillin/clavulanic acid, cefuroxime, and gentamicin, are recommended as first-line drugs for treatment of UTI while awaiting results of culture and sensitivity. Ceftriaxone and ceftazidime should be reserved for case of non response to first-line drugs and severe infections.

Prevalence of exchange blood transfusion in severe hyperbilirubinaemia and outcome at the University of Maiduguri Teaching Hospital Maiduguri, Northeastern Nigeria

Nigerian Journal of Paediatrics

Background: Exchange blood transfusion (EBT) is carried out for the treatment of conditions prese... more Background: Exchange blood transfusion (EBT) is carried out for the treatment of conditions presenting with severe hyperbilirubinaemia and anaemia, such as ABO incompatibility, sepsis, prematurity and birth trauma among others. While it is fast being abandoned as treatment modality for severe neonatal jaundice in the resource rich countries, it is still a backbone of treatment for severe neonatal jaundice in resource limited settings. Since such a study has not been done in this centre before now, we decided to study the positive effects of exchange blood transfusion in Maiduguri, North-Eastern Nigeria.Objective: To determine the prevalence, indications and outcome of exchange blood transfusion at the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maiduguri.Methods: This is a retrospective study which examined the records of babies admitted into the SCBU between 1st January to December 31st 2014 with the aim of determining the prevalence of EBT at the Speci...

Causes of deaths in neonates and children aged 1-59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study

mustapha bello, 2022

Background: Nigeria has one of the highest under-five mortality rates in the world. Identifying t... more Background: Nigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013-2018 periods. Methods: We conducted retrospective inquiries into the cause of deaths of 948 neonates and 2,127 children aged 1-59 months as identified in the 2018 Nigeria Demographic and Health Survey (NDHS). The verbal autopsy asked about signs and symptoms during the final illness. The Physician Coded Verbal Autopsy (PCVA) and Expert Algorithm Verbal Autopsy (EAVA) methods were employed to assign the immediate and underlying cause of deaths to all cases. Result: For the analysis, sampling weights were applied to accommodate non-proportional allocation. Boys accounted for 56 percent of neonatal deaths and 51.5 percent of the 1-59-months old deaths. About one-quarter of under-5 mortality was attributed to neonatal deaths, and 50 percent of these neonatal deaths were recorded within 48 h of delivery. Overall, 84 percent of the under-5 deaths were in the northern geopolitical zones. Based on the two methods for case analysis, neonatal infections (sepsis, pneumonia, and meningitis) were responsible for 44 percent of the neonatal deaths, followed by intrapartum injury (PCVA: 21 percent vs. EAVA: 29 percent). The three main causes of death in children aged 1-59 months were malaria (PCVA: 23 percent vs. EAVA: 35 percent), diarrhoea (PCVA: 17 percent vs. EAVA: 23 percent), and pneumonia (PCVA: 10 percent vs. EAVA: 12 percent). In the North West, where the majority of under-5 (1-59 months) deaths were recorded, diarrhoea was the main cause of death (PCVA: 24.3 percent vs. EAVA: 30 percent). Conclusion: The causes of neonatal and children aged 1-59 months deaths vary across the northern and southern regions. By homing on the specific causes of mortality by region, the study provides crucial information that may be useful in planning appropriately tailored interventions to significantly reduce under-five deaths in Nigeria.

Management of Chylous Ascites with Surgery and Frusemide in a New Born

Mustapha Bello, 2022

IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 2... more IntroductIon Chylous ascites is a rare clinical entity in children. [1] Incidence of about 1 in 20,000-1 in 187,000 admissions has been reported in a large tertiary hospital. [2,3] Most reports showed a slight male preponderance, ratio of 1.8:1 M˃F. [4] The first report of chylous ascites was in a 2-year-old boy with tuberculosis by Morton in 1683. [5] Many aetiological factors have been described in adults, but the predominant cause in children is mainly due to congenital developmental disorders of the lymphatic channels, which is usually a hyperplasia or hypoplasia of the lymphatic channels. [6] Of which, hyperplasia of the primary lymphatic channels is responsible for majority of the congenital malformations. Rarely, chylous ascites may follow birth trauma, malignancy, surgery and cardiovascular diseases in children. And sometimes, it can also follow certain genetic syndromes like Turner syndrome, yellow nail syndrome and Klippel-Trenaunay-Weber syndrome.

Intrauterine Growth Standards: A Cross-Sectional Study in A Population of Nigerian Newborns

Pediatric Reports, 2012

The aim of the study was to define an intrauterine growth curve for a population of Nigerian newb... more The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA) of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the ...

Acute renal failure in the newborn: Incidence and outcome

Journal of Paediatrics and Child Health, 1997

To describe an experience from a developing country of newborn renal disease particularly those w... more To describe an experience from a developing country of newborn renal disease particularly those without advanced neonatal care. Prospective evaluation from a referral hospital, North-East of Nigeria between 1 July 1990 and 30 June 1994. Babies admitted for any morbidities who were diagnosed as being in acute renal failure (ARF) during the study period (non-oliguric inclusive). Onset of ARF; day on which oliguria or anuria detected, or serum urea first exceeded 10 mmol/L. Urine output quantitated from carefully bagged urine and suprapubic bladder aspiration, and venous blood regularly obtained for serum electrolytes, urea and creatinine. Fractional excretion of sodium (FE(Na)) and renal failure index (RFI) were determined on some babies. Forty-three neonates (M:F; 3.3:1) with ARF, the majority (27) of whom were out-born, and 14, 26 and three were preterm, full-term and post term, respectively. Encountered incidence was 3.9/1000 live births with a high prevalence rate; 34.5/1000 admissions. A significantly greater incidence was seen in the latter half of study; 10.7 vs 53.7/1000, P &lt; 0.05. Early ARF occurrence (aged; 0-5 days) in 33 (77%) of babies. The aetiology was comprised of perinatal asphyxia, sepsis, obstructive uropathy and miscellaneous in 53.4%, 32.6%, 9.3% and 4.7%, respectively. Twenty-two (51.2%) deaths occurred; however, the exact causes were indeterminable. Fractional excretion of sodium (FE(Na)) and renal failure index (RFI) were of &lt; 1.75% and &lt; or = 2.0, respectively, significantly differentiated sepsis (intrinsic) from perinatal asphyxial (pre-renal) ARF; P &lt; 0.01. No case of persistent renal failure occurred. Our FE(Na) value (although less than reported in previous literature from affluent societies) remained sensitive (along with RFI) in differentiating aetiological group of ARF. Our data and medical management outcome, despite absence of level-III care, support the need for good resuscitation, careful monitoring and constant re-evaluation. The effect of salbutamol on hyperkalaemia is emphasized.

Causes of deaths in neonates and children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study

BMC Public Health

Background Nigeria has one of the highest under-five mortality rates in the world. Identifying th... more Background Nigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013–2018 periods. Methods We conducted retrospective inquiries into the cause of deaths of 948 neonates and 2,127 children aged 1–59 months as identified in the 2018 Nigeria Demographic and Health Survey (NDHS). The verbal autopsy asked about signs and symptoms during the final illness. The Physician Coded Verbal Autopsy (PCVA) and Expert Algorithm Verbal Autopsy (EAVA) methods were employed to assign the immediate and underlying cause of deaths to all cases. Result For the analysis, sampling weights were applied to accommodate non-proportional allocation. Boys accounted for 56 percent of neonatal deaths and 51.5 percent o...

Preterm Babies: Management and Challenges Associated with Survival in a Resource-Limited Setting

West African journal of medicine, 2020

BACKGROUND Preterm babies have constituted a major constraints on human and material resources du... more BACKGROUND Preterm babies have constituted a major constraints on human and material resources due to early mortality and long term disability among survivors. Rates of disability among survivors have increased over the period, with high rates of broncho-pulmonary dysplasia. OBJECTIVE To determine the survival and management challenges of preterm babies in University of Maiduguri Teaching Hospital, Maiduguri Borno State REUSLTS: Of the 1129 preterm babies managed in the Special Care Baby Unit (SCBU), 714 cases notes were retrieved and analyzed giving a retrieval rate of 63%. There were 256 (35.9%) preterm babies as in-born, while 458 (64.1%) were out-born. Male preterm babies were 372 (52.1%), while female preterm babies were 342 (47.9%); with female to male ratio of 1.08:1. Extreme low birth weight (<1000grams) were 17 (2.3%), very low birth weight (1000-1499 grams) were 288 (40.3%) while low birth weight (1500-2499 grams) were 406 (56.9%). We also documented 3 preterm babies wh...

Birth Injuries, Risk Factors and Predictors of Outcome in Maiduguri North-eastern Nigeria

Journal of Advances in Medicine and Medical Research, 2018

Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at bi... more Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at birth which can be avoidable and unavoidable. Despite advances in prenatal care, birth injuries occurs especially in prolonged and difficult labour /deliveries. Objectives: The study aimed to determine the risk factors and predictors of outcome at Special Care Baby Unit of the University of Maiduguri Teaching Hospital Maiduguri, NorthEastern Nigeria. Patients and Methods: This was a prospective cross-sectional studies conducted over 12 months from 1 st January to 31 st December 2016. Patients who met the inclusion criteria after obtaining ethical clearance were evaluated after consenting to participate in the study. Results: Sixty one (5.7%) out of 1078 neonates admitted to Special Care Baby Unit (SCBU) with birth injuries were recruited into the study. The common risk factors identified were primiparity 25/61 (40.7%) p=0.017, mode of delivery spontaneous vaginal delivery 36/61 (58.8%). Deliver at tertiary centre was high 38/61 (62.3%), though not statistically significant. When compared neonates with one-two birth injuries compared to those greater than 2 birth injuries delivery by Original Research Article Pius et al.; JAMMR, 25(10): 1-8, 2018; Article no.JAMMR.40276 2 non-obstetrician was associated with higher risk of birth injury p=0.001. Facial nerve palsy, Erb&#39;s palsy was the common central nervous system injury; perinatal asphyxia was higher 24/61 (39.1%). Soft tissue injury constituted the majority; Facial and skin bruises 37/61 (60.7%), sub-conjunctival haemorrhage 25/61 (40.1%) cephalhaematoma and subgaleal haemorrhage was 10/61 (16.4%) and 8/61 (13.1%) respectively. Clavicular fracture was the commonest 5/61 (8.2%), followed by humerus 4/61 (6.6%). Two patients with liver and splenic rupture died within 2 days of admission. Conclusion: The risk factors and predictors of birth injuries are intertwined; largely birth injury is avoidable with good antenatal care and prompt management of labour processes by trained personnel.

Achondrogenesis Type II in a Live Term Newborn Infant: A Case Report

Open Journal of Pediatrics, 2018

Background: Achondrogenesis type II is a lethal form of osteochondrodysplasia characterized by sh... more Background: Achondrogenesis type II is a lethal form of osteochondrodysplasia characterized by short trunk, disproportionately large head, prominent forehead, micrognathia, extreme micromelia, anasarca, large abdomen and poor ossification of the bones. The children with achondrogenesis are usually born premature, or die in the neonatal period mostly from respiratory failure. We report the case of a live term newborn infant with achondrogenesis type II who died shortly after birth. Methods: We report a case of achondrogenesis type II in a live male newborn. Results: We report the case of a term male infant delivered to a 24-year-old woman with a chondrogenesis type II confirmed radiologically but died at age 5 days. Conclusion: Whenever a skeletal dysplasia in a fetal dwarfism is suspected, a proper work-up plan should be done to evaluate family history. A clinical, radiographic and histopathologic examination, should be done and confirmed by genetic study. Following evidence-based diagnosis, patients could be offered termination of pregnancy after counseling.

Characteristics and predictors of outcome of care of preterm newborns in resource constraints setting, Maiduguri, Northeastern Nigeria

Journal of Clinical Neonatology, 2019

Background: Currently, prematurity has been noted to be the commonest cause of under-five mortali... more Background: Currently, prematurity has been noted to be the commonest cause of under-five mortality globally, well above pneumonias and malaria. The survival chances of babies born preterm in the resource constraints settings is unacceptably low though vary significantly depending on where they are born. Objective: The aim of the study was to determine the characteristics and predictors of survival of preterm babies at the

The Influence of Gestational Age on the Loss of Maternal Measles Antibodies in Newborn Infants in North-Eastern Nigeria: A Call for a Review of Measles Immunization Schedule

African Journal of Clinical and Experimental Microbiology, 2012

Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs dur... more Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs during third trimester of pregnancy. Gestational age (GA) affects the levels of MMA such that longer GA may result in infants starting out with high levels of MMA. Objective: To determine the influence of GA on the loss of MMA in newborn infants in North-Eastern Nigeria. Method: A prospective study was conducted on newborn infants at Maiduguri; sera were collected at birth and at six months of age. Enzyme linked immunosorbent assay (ELISA) was used to measure MMA while GA was determined using the last menstrual period, ultrasound scan reports and the Dubowitz criteria. Results: Seventy eight newborn infants were enrolled. Seventeen (89.5 %) preterm, 43 (95.6 %) term and 14 (100 %) postterm had protective levels of MMA at birth. Two (10.5 %) preterm, nine (20.0%) term and two (14.3 %) postterm had protective MMA at six months of age. Comparison of mean MMA at birth and at six months of age was significant (p = 0.005), however, it was independent of GA of the newborn infants. Conclusion: Significant decline of mean MMA levels was seen in these infants at six months of age, which was independent of their GA. These infants may be prone to measles at an earlier age (less than six months). Therefore, the current recommendation of measles immunization to infants at nine months of age may require reconsideration.

Frontonasal dysplasia Sequence : A case report

Nigerian Journal of Paediatrics, 2014

Frontonasal dysplasia (FND) is a very rare congenital abnormality in which the mid face does not ... more Frontonasal dysplasia (FND) is a very rare congenital abnormality in which the mid face does not develop normally. It affects mainly the head and face. Cause is unknown but may be sporadic or familial. We report a rare case of a full term baby who presented with classical features of FND in Maiduguri, Nigeria. Management difficulty in resource limited setting is highlighted.