Respiratory syncytial virus--associated lower respiratory diseases in hospitalised pre-school children in Ibadan.

An analysis of the features of lower respiratory diseases (LRD) associated with Respiratory Syncytial Virus (RSV) in 21 children aged 1-23 months, indicated that the clinical features did not differ appreciably from those described for LRD due to other infective agents. It was however, remarkable that none of the children was grossly malnourished, neither was there any death. The final respiratory diagnoses were bronchiolitis alone (6 cases), bronchopneumonia (6 cases), empyema/pleural effusion (3 cases, including one with bronchopneumonia), lobar pneumonia (3 cases, including one with associated bronchopneumonia). Streptococcus pneumonia and Klebsiella pneumoniae respectively, were isolated from blood culture in the two cases with lobar pneumonia alone. One child had laryngotracheobronchitis (croup) alone and another, croup associated with bronchiolitis and bronchopneumonia. Radiologically, the single most common lesion was patchy consolidation (8 cases) followed by hyper-inflation (6 cases); in one case, there was no observable lesion on the chest radiograph. All the 6 children who had bronchiolitis alone were aged 12 months and below, and were well nourished; conversely, 8 of the 12 children with pneumonia alone or in addition to other lesions and both children with pleural effusion, were older than 12 months and underweight. Other viral agents were identified in 8 (38%) of the cases. Complications included heart failure in 4 cases and a combination of anaemia and heart failure in one child with empyema. In a child with symptom complex and radiological features suggestive of acute obstructive lower respiratory infection with immunofluorescence evidence of RSV infection, age and nutritional status are important factors in determining the need for antibiotic therapy pending the outcome of bacterial cultures.

Ultrasonic foetal head circumference as a means of assessing gestational age in Nigerians.

In a cross-sectional study, we have established the foetal head circumference in pregnant Nigerian women between the 16th to the 40th weeks of gestation. The relationship between the head circumference and gestational age is linear although there is some slight slowing of the growth rate after 32 weeks. A linear mathematical model was shown to describe the relationship between gestational age and head circumference and with the knowledge of one the other could be determined. The values obtained in this study compared favourably with similar studies amongst caucasians and the value of this data with reference to management of intrauterine growth retardation (IUGR) and foetal weight determinations was discussed.