Paediatric cochlear implantation in north-western Nigeria case report and review of our challenges.

OBJECTIVE: To report the commencement of cochlear implantation (CI) in children in Northern Nigeria and review the challenges encountered with a view to establishing CI programme. CASES: Two children with post-meningitic sensorineural hearing loss had standard pre-implantation assessment and cochlear implantation surgery in Nigeria in conjunction with surgeons from another developing country. Post-implantation meningitis was encountered and managed in one of the patients. Post-CI rehabilitation started in a foreign country and continued in our centre after training of our speech therapist. Both patients had improvement in their hearing. CONCLUSION: These showcase successful CI in patients from Sub-Saharan Africa, the challenges included need for development of surgical and post-CI rehabilitation personnel and affordability of the cost of the implant. The support of all the stakeholders needed for commencement of a CI programme was noted.

Pattern of perinatal mortality in babies delivered at the university of ilorin teaching hospital, ilorin, Nigeria.

BACKGROUND: Perinatal mortality remains a significant aspect of under-5 mortality, accounting for over 20% of under-five mortality in Nigeria. OBJECTIVE: To determine the pattern of perinatal mortality in the University of Ilorin Teaching Hospital, Ilorin. METHODS: This was a prospective study conducted at the University of Ilorin Teaching Hospital. Data on socio-biologic, antenatal and peripartum characteristics of 1969 gravid women was obtained over a 7-month period (April 2006-October 2006). Data on the 2042 babies delivered was also taken and these babies were followed up till discharge or death. RESULTS: There were 166 perinatal deaths (106 stillbirths and 60 perinatal deaths) out of the 2042 live and stillbirths during the study period (%). The perinatal mortality rate was 81 per 1000 live and stillbirths with a stillbirth rate of 52 per 1000 live and stillbirths and an early neonatal mortality rate of 31 per 1000 livebirths. Among the stillbirths, fresh stillbirths predominated over macerated stillbirths (1.4:1). Severe perinatal asphyxia was the most important cause of death in all birthweight categories except in extremely low birthweight babies were immaturity was more important. Prolonged labour was responsible for 42.6 % of those with severe perinatal asphyxia. CONCLUSIONS: There is an urgent need to improve the monitoring of women in labour to reduce the prevalence of prolonged obstructed labour and increase capacity to provide essential newborn care. There is also need to improve on capacity and facilities for the management of babies with severe perinatal asphyxia and prematurity.

Determinants of mortality of preterm babies in the university of Ilorin Teaching Hospital, Ilorin Nigeria.

AIMS AND OBJECTIVES: A prospective study to identify the determinants of mortality among 185 preterm babies at the University of Ilorin Teaching Hospital, Ilorin. SUBJECTS AND METHODS: Data on 185 preterm babies and their mothers were collected over a nine month period in a tertiary hospital to identify the determinants of mortality among these babies. RESULTS: Factors identified as significant determinants of mortality were severe perinatal asphyxia (p = 0.000; OR = 71.31; 95% CI = 17.63-308.24), apnoea (p = 0.000; OR = 178.20; 95% CI = 20.64-7709.02), necrotizing entero-colitis (p = 0.001) and resuscitation duration (p = 0.003; OR = 5.33; 95% CI = 1.62-19.02). CONCLUSION: The primary causes of death are severe perinatal asphyxia, respiratory distress syndrome and infection. In Nigeria, survival below 28 weeks gestation is less than 20%. The findings in this study highlight the need for prompt and effective resuscitation of these infants by a trained health worker with verifiable competence in newborn resuscitation. It also highlights the need for availability of functional facilities like ventilators and resources like surfactant.