ABSTRACT
It is not known at which size a congenital Patent ductus arteriosus (PDA) in children becomes associated with a resultant severe malnutrition in children. Furthermore, the effect of ductal size on anthropometry of children with PDA is yet to be determined. Objectives This study was aimed to asses if the ductal size had any effect on anthropometry of children with PDA and at which size evidence of severe malnutrition ensues Methods This was a five-year observational cross-sectional study of children who presented at three tertiary institutions with PDA. Results There was a negative non-significant correlation between the size of PDA and the weight of patients, (Pearson correlation coefficient = -0.1, p = 0.7). There was also a negative non-significant correlation between the size of PDA and patient’s height/length, (correlation coefficient = -0.1, p = 0.5). The association between the size of PDA and the severity of malnutrition revealed greater proportion of 35.3% (6/17) for wasting and stunting in patients who had large PDA sizes of >7mm, when compared with fewer proportions in those with PDA sizes of 3- 6mm (26.1% (6/23) and those with tiny PDA of <3mm (33.3% (10/30); (?2 = 10.21, p = 0.8). There was a positive correlation between ductal size and nutritional status of patients, and severe malnutrition ensued from ductal size of 3.2mm; with ETA square of 0.072. The majority of children with PDA presented with severe forms of malnutrition (wasting and stunting). Conclusion: Severe malnutrition ensues when ductal size is 3.2mm. The size of PDA has no effect on weight and height of children with PDA.
ABSTRACT
Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis. AimTo determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype. Method This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment. Results The median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001). Conclusion Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state