Congenital Heart Disease in the Niger Delta region of Nigeria : a Four-Year Prospective Echocardiographic Analysis : Cardiovascular Topic

Introduction : Echocardiographic evaluation remains the gold standard for the diagnosis of structural cardiac disease. No previous prospective studies have been done on the prevalence of congenital heart disease (CHD) in the Niger Delta area. This study was done to determine the frequency and pattern of congenital heart disease; using echocardiography as a diagnostic tool. Methods : All patients presenting to the Paediatric Cardiology clinics of two centres; the University of Port Harcourt Teaching Hospital and the Paediatric Care Hospital between April 2009 and March 2013; were recruited and all had echocardiography performed.Results : Prevalence of CHD in this study was 14.4 per 1 000 children; 277 (83.4) of the patients had acyanotic CHD and 55 (16.6) had cyanotic CHD. Ventricular septal defect and tetralogy of Fallot were the commonest acyanotic and cyanotic heart defects; respectively.Conclusion : The high prevalence of CHD in this study is the highest in the country and Africa; and may be attributable to the increased oil spillage and gas flaring from petroleum exploitation in this region

Anaemia in Critically Ill Children- A Case Study from Nigeria.

Background and Aim: Anaemia is a common cause of morbidity and mortality in the tropics. World Health Organization estimated that anaemia affects one-quarter of the world's population and is concentrated within preschool age children and in resource-poor countries like ours. The aim of this study was to evaluate the prevalence and severity of anaemia in critically ill children presenting at the Children Emergency Ward of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Materials and Methods: This was a retrospective study of anaemic children (1 month to 16 years) admitted into the Children Emergency Ward of the UPTH from January to December 2010. Medical case notes of the patients were reviewed. Information obtained included age, gender, presenting complaints, diagnosis, packed cell volume (PCV), blood transfusion and outcome. The PCV was determined by microhaemtocrit method. Data generated were analysed using SPSS for widow, version 12.0 (SPSS Inc, Chicago Illinois, USA). Descriptive statistics in the form of the frequency and percentage were used. Results: There were a total of 1581 children admitted into the Children Emergency Ward of the UPTH during the period of study. Four hundred and twenty three were confirmed to have anaemia of varying degree giving a prevalence of 26.8%. Most 295(69.7%) of the mothers were poorly educated and live in the urban slums. There were more males 418(67.1%) than females 205(32.9%). Fever, vomiting and weakness were the main presenting features. Ninety two patients (6.3%) had mild anaemia, 102 patients (6.5%) had moderate anaemia and 229 patients (14.5%) had severe anaemia. Two hundred and twelve of the critically ill children (50.1%) were transfused on account of severe anaemia. Malaria and septiicaemia were the commonest associated morbid conditions. Twenty five deaths were recorded. Severe anaemia accounted for 13(52.0%) of the total deaths. Conclusion: Anaemia is prevalent among Nigerian children in critical condition. Severe anemia is common and associated with increased risk of clinically relevant outcomes such as hospitalization and mortality.

Growth pattern of exclusively breastfed infants in the first six months of life: a study of babies delivered at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

BACKGROUND: Some authors demonstrate that exclusively breastfed infants have growth patterns comparable with the NCHS standards while others conclude that exclusively breastfed infants grow slower. These conflicting results informed the need for this study to aid the paediatricians and health workers to justify or condemn the recommendation of exclusive breastfeeding for six months. This was a prospective longitudinal study carried out to determine the growth pattern of exclusively breastfed infants in the first 6 months of life and compare them with the International, National Centre for Health Statistics (NCHS/WHO) reference and the Local, Janes' Elite Standards. METHODS:Using weight, length and occipito-frontal circumference as indices, 530 infants were recruited consecutively by convenience sampling over 17 months. Measurements were taken at birth, 2 weeks, 6 weeks, 2 months and subsequently monthly until the end of the 6th month.RESULTS: The exclusively breastfed infants doubled their birth weights at 3 months. The mean weight, OFC and length gains were maximal at 2 months, 2 weeks and 2 months respectively. The growth of exclusively breastfed infants compared favourably with the NCHS/WHO reference group and also compared favourably with the Janes' 'Elite' reference group. CONCLUSION:It is concluded that the growth in weight, length and OFC of exclusively breastfed infants appears adequate for the first 6 months of life

The Profile of Non-Communicable Disease in Patients Admitted into the Children's Medical Ward of the University of Port Harcourt Teaching Hospital

Background: The prevalence of non-communicable diseases (NCD) is increasing in recent years in low income countries in sub-Saharan Africa because of changing disease patterns following socioeconomic development. Nevertheless; communicable diseases (CD) still remain the predominant health problem. At present; non-communicable diseases are not a high priority in sub-Saharan Africa but the probability of death from a NCD is higher in sub-Saharan Africa than in the developed world. It is therefore important to know the existing disease burden due to NCD with a view to alerting policy makers and health workers of the trend of disease in our environment. Objectives: To determine the pattern of admission of paediatric patients seen at the children's ward of the University of Port Harcourt Teaching Hospital (UPTH) and ascertain the pattern of non communi- cable diseases. Methods: The study was retrospective and involved analysis of data from the admission records of the children's wards of the UPTH from February 2004-November 2005. Patients with non-communicable diseases were analysed for this study. Results: A total of two thousand four hundred and fourteen (2414) children were admitted during the period of study. Out of these; 479 (19.8) had non-communicable diseases consisting of 279 (58.2) males and 200 (41.8) females with a male: female ratio of 1.4:1. The top five non-communicable diseases were sickle cell disease (SCD) (17.1); malignancies (14.8); renal diseases (12.9); tetanus (10.2) and malnutrition (10.0). Conclusion: This study suggests a concomitant rise in NCD with four of them being among the top 10 disease burden when combined with communicable diseases. This poses a risk of a 'double burden' of disease which we cannot afford in our country which is fraught with poor government policies; poverty and poor funding of the health sector. Effective strategies are needed to control the risk factors for NCD

Priapism in Paediatric Patients with Sickle Cell Disease - A Report of Three Cases at University of Port Harcourt Teaching Hospital

Background: Priapism is an abnormal persistent erection of the penis which may be painful or not painful. Approximately two-thirds of all paediatric patients who have priapism also have sickle cell disease (SCD). The aim of this study is to review all the cases of priapism admitted into the paediatric emergency room of the University of Port Harcourt Teaching Hospital (UPTH) over a 5-year period and to determine the prevalence; presentation; precipitating factors and management of cases seen.Method: The admission register in the Children's emergency ward was reviewed from January 2001 to December 2005. All the cases of sickle cell disease were extracted. The folders of the patients with priapism were studied and data analysed.Results: Of the 185 SCD cases; three (1.6) had priapism. They were adolescents aged 17years; 11years and 10 years 9months respectively. Two patients had never attended a sickle cell clinic; never been on routine drugs nor received advice on oral liberal fluids intake. One patient had stuttering priapism; 24hours before the event. Two of them had glanulo-cavernous shunts; with early detumescence on Day 3 and 4 respectively; while the patient who was managed conservatively had detumescence after 12 days.Conclusion: Priapism is an uncommon presentation of SCD in our environment. With prolonged duration; priapism has severe sequelae of impotence and erectile dysfunction; thus; its presentation and management should be known by patients and parents or care givers. Surgical intervention is recommended as it is more effective and results in shorter hospital stay