Serum cystatin C levels in Healthy Nigerian neonates: Is there a need for normative values in Nigerian babies?

Cystatin C is an endogenous marker of renal function. Normal reference values have been documented in neonates outside Africa, but no study has been documented in African neonates. With reports that race may affect serum cystatin C values, this study was carried out to generate normal values in apparently healthy term neonates at birth and three days of life neonates in Nigeria. This was a hospital-based prospective study. A cohort of 120 apparently healthy term neonates were recruited at birth. Serum cystatin C was measured from the cord blood at birth and venous blood when they were three days old using enzyme-linked immunosorbent assay (ELISA) method. The mean serum cystatin C values for cord blood and 3rd day venous samples were 1.67 ± 0.52 mg/L and 1.62 ± 0.52 mg/L, respectively (P = 0.87). The cord blood and 3rd day serum cystatin C values for males were 1.67 ± 0.47 mg/L and 1.68 ± 0.51 mg/L, respectively (P = 0.77) and the values for females were 1.68 ± 0.56 mg/L and 1.58 ± 0.52 mg/L, respectively (P = 07.22). The serum cystatin C levels were similar among the different birth weight groups and gestational age (P >0.05). The cord blood and 3rd day serum cystatin C values were similar. Serum cystatin C values were independent of gender and birth weight of neonates. The values of serum cystatin C in Nigerian neonates were comparable to that reported for neonates in other regions of the world. It is recommended that ELISA technique may be reliably used to measure serum cystatin C levels in neonates.

The burden of Fallot's tetralogy among Nigerian children.

BACKGROUND: There are only very few reports on Fallot's tetralogy in Africa especially from sub-Saharan Africa. At best tetralogy of Fallot (TOF) is only mentioned as part of reports of surveys of other congenital heart diseases or as case reports in the region. There has been no report on cohorts of children with TOF in West Africa. This article describes the pattern and presentation of children diagnosed with TOF patients in a tertiary hospital in sub-Saharan Africa over a 9-year period. METHODS: Prospective and consecutive review of all subjects with diagnosis of TOF confirmed with echocardiography at the Lagos State University Teaching Hospital (LASUTH) between January 2007 and December 2015. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were presented as percentages or means and standard deviation. Means of normally distributed variables were compared using the Students' t-test and proportions using Chi-square test. Skewed distributions were analyzed using appropriate non-parametric tests. Level of significance set at P<0.05. RESULTS: The prevalence of TOF among children presenting at LASUTH at the study period was 4.9 per 1,000 while its prevalence among those with congenital heart disease was 16.9%. There was a male predominance with a mean age of 50.9±45.9 (months) and median age of 36 months. Most children presented within 1-5 years of age. The most common indication for evaluation was cyanosis. One hundred and nineteen out of 165 (72.1%) children were clinically cyanosed on presentation. CONCLUSIONS: TOF is prevalent among Nigerian children. Cyanosis was the commonest presenting feature and indication for evaluation. Most of the subjects presented late hence were diagnosed after 1 year of age. There is a need to increase awareness of TOF in Nigeria to encourage early diagnosis and hence better outcomes in these subjects.