RESUMO
INTRODUCTION AND IMPORTANCE: Prune belly syndrome (PBS), also known as Eagle-Barret syndrome, is a rare congenital disorder characterized by abdominal wall muscle underdevelopment, urinary system abnormalities, and cryptorchidism. This case report presents the clinical features, diagnosis, and management of PBS in a newborn. This is the first case report of prune belly syndrome in Somalia. The condition is estimated to occur in approximately 1 in 30,000 to 1 in 50,000 live births, making it a relatively uncommon presentation. Recognizing and managing this syndrome is crucial, as it can lead to significant morbidity and mortality if not addressed promptly. CASE PRESENTATION: A term baby delivered without complications developed respiratory distress, jaundice, and urinary retention shortly after birth. Physical examination revealed abdominal distension, fluid in the abdomen, and bilateral undescended testes. Laboratory tests showed elevated bilirubin levels and abnormal blood counts. Ultrasound findings demonstrated bilateral hydroureteronephrosis and underdeveloped abdominal wall muscles. The limited resources and infrastructure in the healthcare setting in Somalia posed challenges in providing comprehensive care for this neonate. CLINICAL DISCUSSION: PBS is a rare congenital syndrome with a higher prevalence in males. Its exact cause is not fully understood, but genetic factors may play a role. The management of PBS in resource-limited settings can be particularly challenging. The differential diagnosis included sepsis, neonatal jaundice, and posterior urethral valves. The key interventions included supportive care, such as maintaining fluid and electrolyte balance, treating infections, and addressing any urinary tract abnormalities. The limited access to specialized pediatric urology services and advanced diagnostic tools, such as magnetic resonance imaging (MRI), hindered the ability to fully characterize the extent of the urinary tract abnormalities and plan definitive surgical interventions. CONCLUSION: Despite the constraints of the resource-limited setting, the supportive care and management strategies implemented led to an improvement in the baby's condition. This case highlights the importance of recognizing and managing Prune Belly Syndrome, even in environments with limited healthcare resources. Continued efforts to improve diagnostic capabilities and access to specialized care are crucial for optimizing the outcomes of patients with this rare and complex congenital disorder.
RESUMO
BACKGROUND: Hypertension, a major global health concern, continues to affect millions of adults worldwide, leading to significant morbidity and mortality. The burden of hypertension is particularly pronounced in low- and middle-income countries, where limited healthcare resources and infrastructure pose unique challenges for effective prevention and management. Despite the pressing need for accurate data on hypertension prevalence and determinants, there is a dearth of research focusing on the Somali population. In this study, we aim to fill this critical knowledge gap by analyzing the latest available data from the Somalia Demographic Health Survey (SDHS) conducted in 2020. METHOD: The SDHS 2020 employed a three-stage stratified cluster sampling design to collect data from 48,796 individuals. Hypertension was measured through survey questions related to chronic diseases. Explanatory variables included age, sex, region, residence, tobacco use, wealth index, marital status, and body mass index (BMI). Statistical analysis involved univariate and multivariable logistic regression. RESULTS: The prevalence of hypertension in Somalia was found to be 2.11%, lower than previous studies in Hargeisa and the SLHDS 2020 report. Females had a higher prevalence than males, and urban areas exhibited higher rates compared to rural areas. Age, BMI, region, and wealth index were identified as significant factors associated with hypertension. DISCUSSION: The study's findings contribute to the understanding of hypertension in the Somali population and can inform public health interventions. The study benefits from its representative sample, multivariate analysis, and comparison with earlier studies. However, limitations include the cross-sectional design, limited information on lifestyle behaviors, and lack of data on treatment and control of hypertension. CONCLUSION: Hypertension is a public health concern in Somalia, and targeted interventions are needed to reduce its burden. Addressing factors such as age, gender, urban residence, BMI, and wealth index can contribute to hypertension management and control strategies. Future research should consider longitudinal studies and incorporate additional factors for a comprehensive assessment of hypertension etiology and management.