Incidence of acute kidney injury in asphyxiated babies in university of Uyo teaching hospital, Uyo, Nigeria

Background: Acute Kidney Injury (AKI) is a consequence of birth asphyxia. In resource poor countries like ours, birth asphyxia still contributes to the high rates of neonatal morbidity and mortality. A few studies have reported the incidence of AKI in birth asphyxia in Nigeria but none from Uyo, south-south region of Nigeria.Methods: A descriptive cross sectional study carried out in the Newborn Unit of the University of Uyo Teaching hospital, Uyo, Nigeria over a period of eight months. One hundred and four term neonates with provisional diagnosis of birth asphyxia using Apgar scoring were recruited. Blood sample was collected within six hours of life from each subject for serum creatinine estimation using modified Jaffe method. Urine output was assessed by application of plastic collection bag to the skin by adhesive patch. AKI was diagnosed when sCr >1.5mg/dl while oliguria was defined as urinary output <1.5ml/kg/hour.Results: Of the total of 104 asphyxiated neonates enrolled into the study, 56 (53.8%) were males while 48 (46.2%) were females giving a male/female ratio of 1.2:1. Twenty-eight (26.9%) of the subjects had severe birth asphyxia; 52 (50%) had moderate birth asphyxia while 24 (23.1%) were mildly asphyxiated. Incidence of AKI was 48 (46.1%), twelve (11.5%) had AKI based on serum creatinine criteria while 36 (34.6%) had AKI based on urinary output criteria. The mean urinary output (ml/kg/hr) for the subjects was 1.65±0.68 while the mean serum creatinine (mg/dl) was 0.88±0.46.Conclusions: The incidence of AKI among asphyxiated neonates in our locale is high at 46.1%.

Relationship between Serum C-reactive Protein Levels and Severity of Plasmodium falciparum Malaria in Children Seen in South-South Nigeria.

Aim: To determine the relationship between serum C-reactive protein levels and severity of malaria infection in children aged six months to five years in a malaria endemic setting. Study Design: A prospective cross-sectional study. Place and Duration of Study: This study was carried out in the Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunization Centre and main Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. It was conducted over a six month period. Methodology: We studied three hundred and sixty (360) children with microscopically confirmed Plasmodium falciparum malaria and three hundred and sixty (360) healthy controls matched for age and gender. Their serum C-reactive protein levels were measured using the highly sensitive Enzyme Linked Immunosorbent assay (ELISA). Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 17.0. Results: The serum C-reactive protein levels showed a positive correlation with the malaria parasite count (r = 0.55; p < 0.001). Children presenting with severe manifestations of malaria had significantly higher mean serum C-reactive protein levels (33.3± 6.88mg/l) than the 8.12±9.09mg/l obtained in those with uncomplicated malaria (t = -15.57; p = 0.001. Conclusion: This study shows that C-reactive protein levels are increased in children with malaria, especially in severe malaria. Its estimation therefore holds potential usefulness as an adjunct for assessment of malarial severity.