Clinical Utility of Procalcitonin and C-Reactive Protein in the Management of Neonatal Sepsis in a Resource-Limited Nigerian Hospital.

BACKGROUND: Neonatal sepsis is an invasive infection of the bloodstream in neonates and a leading cause of morbidity and mortality among them. AIM: To investigate the role of procalcitonin (PCT) and C-reactive protein (CRP) in the management of neonatal sepsis. MATERIALS AND METHODS: This was a prospective case-control study over one-year period using convenience sampling. Blood samples for PCT and CRP were taken from all neonates, while blood culture and white blood cell count samples were additionally taken from babies with neonatal sepsis. PCT and CRP were repeated at 24 and 48 hours. The continuous variables were found to have a nonparametric distribution. They were presented as median and interquartile range, and compared using Wilcoxon signed rank and Friedman test as appropriate. RESULTS: The blood culture analysis yielded a prevalence of 12.7% with Staphylococcus aureus being the commonest organism. Baseline concentrations of PCT (1.28 ng/ml) and CRP (17.31 mg/L) in neonates with sepsis were higher than that of controls (PCT-0.63 ng/ml, CRP-5.40 mg/L). PCT concentrations decreased after two days of antibiotic treatment, while CRP concentrations decreased after a day. The concentration of both decreased to normal levels after two days of treatment. CONCLUSION: This study showed that CRP was more reliable in monitoring antibiotic therapy, unlike other studies which suggested PCT. In cases where the management of neonatal sepsis may be limited by a low blood culture yield, therapeutic monitoring may be aided by CRP and/or PCT.

Relationship between Serum Uric Acid and Hypertension among Secondary School Adolescents in Ekiti State, Nigeria.

BACKGROUND: With the seemingly increasing trend of childhood hypertension, high serum uric acid (SUA) levels might be an indicator of essential hypertension among adolescents. OBJECTIVE: To determine the SUA levels of hypertensive students and randomly selected controls and find the association, if any, between SUA level and blood pressure (BP) among secondary school students in Ido-Osi Local Government Area (LGA). METHODOLOGY: The study was a nested case-control study conducted among selected secondary school students in IdoOsi LGA from June 2017 to March 2018. Of the 573 students screened for hypertension, SUA was assayed from 31 hypertensive students and an equal number of age- and sexmatched controls. Serum uric acid greater than 5.5 mg/ dL was taken as high. Statistical analysis included chi-square and Pearson correlation. RESULTS: There was a positive correlation between SUA level and both systolic BP (p < 0.013) and diastolic BP (p < 0.017). The mean (SD) serum uric acid level of the hypertensive students [5.39 (2.08) mg/ dL] was higher than that of the controls [4.24 (1.81) mg/ dL] (p = 0.023). Hypertensive students with hyperuricaemia had a higher mean (SD) systolic BP than those with low uric acid: 138.67 (14.81) versus 128.68 (10.04); p =0.037. CONCLUSION: The mean serum uric acid level of students with hypertension was higher than that of the non-hypertensive students and high SUA levels appear to more prominently affect systolic than diastolic blood pressures among the cohort of hypertensive students.

CONTEXTE: Compte tenu de la tendance apparemment croissante de l'hypertension chez les enfants, des taux élevés d'acide urique sérique (AUS) pourraient être un indicateur d'hypertension essentielle chez les adolescents. OBJECTIF: Déterminer les niveaux d'acide urique sérique des élèves hypertendus et des témoins choisis au hasard et trouver l'association, le cas échéant, entre le niveau d'acide urique sérique et la tension artérielle chez les élèves du secondaire dans la zone de gouvernement local (LGA) d'Ido-Osi. MÉTHODOLOGIE: L'étude était une étude cas-témoins imbriquée menée auprès d'élèves du secondaire sélectionnés dans la zone de gouvernement local d'Ido-Osi de juin 2017 à mars 2018. Sur les 573 élèves dépistés pour l'hypertension, le SUA a été dosé chez 31 élèves hypertendus et un nombre égal de témoins appariés selon l'âge et le sexe. Un taux d'acide urique sérique supérieur à 5,5 mg/ dL a été considéré comme élevé. L'analyse statistique a porté sur le chi-carré et la corrélation de Pearson. RÉSULTATS: Il y avait une corrélation positive entre le niveau de SUA et la tension systolique (p < 0,013) et la tension diastolique (p< 0,017). Le niveau moyen (SD) d'acide urique sérique des étudiants hypertendus [5,39 (2,08) mg/ dL] était plus élevé que celui des témoins [4,24 (1,81) mg/ dL] (p = 0,023). Les étudiants hypertendus présentant une hyperuricémie avaient une TA systolique moyenne (SD) plus élevée que ceux ayant un faible taux d'acide urique : 138,67 (14,81) contre 128,68 (10,04); p =0,037. CONCLUSION: Le taux moyen d'acide urique sérique des étudiants hypertendus était plus élevé que celui des étudiants non hypertendus et les taux élevés d'acide urique sérique semblent affecter davantage la pression artérielle systolique que la pression artérielle diastolique dans la cohorte d'étudiants hypertendus. Mots-clés: Adolescents, hypertension, relation, acide urique sérique.