Reductive effect of ursodeoxycholic acid on bilirubin levels in neonates on phototherapy.

BACKGROUND: Phototherapy is paramount in the management of high total serum bilirubin (TSB). Whether its effectiveness can be improved with ursodeoxycholic acid (UDCA) has not been evaluated among newborns of African descent. METHODS: A double-blind-controlled study was used to evaluate the effect of UDCA on the management of high TSB in neonates. Recruited neonates were categorized into the experimental group (given UDCA plus phototherapy) and the control group (phototherapy and plain syrup), and their TSB and conjugated bilirubin levels were measured. The data were analyzed using SPSS version 20. Statistical significance was set at a p-value of <0.05. RESULTS: The mean (SD) percentage reductions in TSB after 24 hrs were 40.73% (18.1) and 10.21% (7.1) in the experimental and control groups, respectively, and the difference was statistically significant (p=0.001). The mean (SD) durations on therapy were 3.0 days (0.58) in the experimental group and 5.5 days (1.35) in the control group (p=0.001). CONCLUSIONS: Phototherapy is still effective in the management of neonatal hyperbilirubinemia, but inclusion of UDCA accentuates the reductive effect of phototherapy on the TSB in neonates, reducing the duration of treatment and in-patient care.

Use of a Simple Anthropometric Measurement to Identify Low-Birth-Weight Infants in Enugu, Nigeria.

Background. This prospective study was conducted to identify a suitable alternative to birth weight and establish its cutoff point to facilitate the identification of low-birth-weight (LBW) infants in Enugu, Southeast Nigeria. Methods. The study involved newborn babies within the first 48 hours of life. Five anthropometric measurements (head, chest, mid-arm and calf circumferences, as well as abdominal girth) were taken using a tape measure while supine length was measured with an aluminum infantometer. Birth weight was also recorded. Linear regression analysis was done to identify the measurement with the highest coefficient of determination with birth weight while its cutoff point was defined using a receiver operating characteristic curve. Standard statistical tests were used to determine the statistical significance of the findings. Results. The LBW prevalence for the study population was 21.41%. Chest circumference had the highest R2 value of 0.83 for the general study population and 0.72 for the LBW infants. The identified cutoff point for chest circumference is ⩽30 cm. Conclusion. Chest circumference is the best alternative to birth weight in identifying LBW babies within the first 48 hours of life in this environment.

Socio-demographic determinants of malnutrition among primary school aged children in Enugu, Nigeria.

INTRODUCTION: Several factors including the parental literacy, illness, socioeconomic status, poor sanitation and hygienic practices affect the physical growth of children. The aim of this study was to determine the socio-demographic determinants of malnutrition among primary school aged children in Enugu, Nigeria. METHODS: A cross-sectional descriptive study involving primary school children in Enugu was carried out over a 3 month period. Subjects were selected using multistage sampling technique. Weight and height were measured using a digital scale and a wooden stadiometer, respectively. Body Mass Index (BMI), weight-for-age (WAZ), Height-for-age (HAZ) and BMI-for-age z scores were then derived using the new WHO reference standards. RESULTS: 348 children (40.4%) were recruited from 5 public schools while 512 (59.6%) were recruited from 9 private schools. The mean age of the study participants was 9.2 ± 1.8 years. 7 (0.8%) children were stunted, 26 (3.3%) wasted and 28 (3.3%) underweight. Of all the study participants, overweight and obesity were observed in 73 (8.5%) and 35 (4.1%) children, respectively. Children of lower socioeconomic class were more stunted, underweight and wasted, while overweight and obesity were more prevalent among children from the upper socioeconomic class. CONCLUSION: Factors such as age and sex, parental education and socioeconomic class had a significant impact on nutritional status. Overweight and obesity were more prevalent among the children from the upper socioeconomic class, attending private schools, while stunting and wasting were more in children of the lower class attending public schools.

Mothers' beliefs about infant teething in Enugu, South-east Nigeria: a cross sectional study.

BACKGROUND: Parents and Health Care Workers have traditionally attributed a variety of symptoms to teething in young children. Some of these symptoms may however connote underlying serious medical condition in a child. There is little evidence to support these beliefs despite their implications on management of a symptomatic teething child. This study therefore seeks determine the beliefs and problems mothers associate with teething in Enugu, South-east Nigeria. FINDINGS: A cross-sectional survey involving sixty mothers presenting at a Children's clinic in Enugu metropolis using questionnaire. More than 90% of the respondents thought that babies can experience medical problems as a result of teething. The commonest medical problems perceived to be associated with teething were fever (71.7%), loose stools (58.3%) and vomiting (35%). CONCLUSION: Mothers still associate a variety of symptoms of childhood illnesses to teething and this association is not evidence based and could lead to delayed interventions, increased morbidity and mortality of children. It is important therefore that mothers and health workers caring for young children are educated on the need to seek prompt medical attentions in a symptomatic child.